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What are the most common symptoms of menopause? And which can hormone therapy treat?

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<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/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images 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-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

Body

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock 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-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

Body

Fun ways to boost memory in seniors

Memory issues can seriously deteriorate the quality of life for seniors. To reverse the typically progressive process of memory loss, many solutions have been put forward. These include creative leisure activities aimed to work on the senior’s brain while providing relaxation. To work on a senior’s memory, it’s optimal to have them work on a project, focusing and seeing the work being done. There are plenty of games and activities available to help memory. Paint by Numbers Paint by Numbers is a creative art form that involves painting a pre-drawn sketch on a linen canvas with reference numbers. It helps stimulate the intellect and senses. They’re available in colour books as well, you can find them at your local Kmart and select supermarkets. Diamond painting Diamond painting is a manual activity where the senior creates beautiful pictures using rhinestones to stick onto a self-adhesive canvas. It calls for concentration, reflection, memorisation, and patience from the practitioner, which is beneficial for working on memory. Scratch painting Scratch painting is a fun activity that involves scratching a picture with a coin or stylus, like a lottery scratch-off. It requires interest and concentration from the individual, who will enjoy the final picture and benefit their memory. Music therapy Music therapy is used to treat and alleviate disorders, such as relational, behavioural, and communication difficulties. It also has benefits for seniors with memory problems, as it allows them to mobilise concentration, emotions, and memory in a playful way. Image credit: Shutterstock

Mind

Aussie patient given new drug worth $5 million per dose

A potential cure for a rare genetic disease is being trialled, and it comes with a hefty price tag. Sydney’s Royal Prince Alfred Hospital is part of a groundbreaking new trial aimed at potentially curing haemophilia B – a hereditary bleeding disorder. Patients with haemophilia B have a mutation on the F9 gene, which causes excessive bleeding and damage to joins as they lack the protein that helps blood to clot. A mere 40 patients worldwide will be infused with the gene therapy, with each dose the equivalent of $5 million, or over $1,000 a drop. A safe virus carrying the F9 gene is infused into the body, sending it to the liver cells, where doctors hope the protein is made for the rest of the patient’s life. Professor John Rasko, Head of Cell and Molecular Therapies at RPA, said the process is a “thrilling moment in the history of gene therapy” "We are pushing the boundaries of medical technology hoping to bring cures to individuals," he said. "It's a massive international effort that takes time and money and ultimately the manufacturing alone costs millions and millions of dollars." Haemophilia B patients currently require three injections a week. This revolutionary treatment could mean just one infusion in a lifetime. The infusion on May 22 was the culmination of more than two decades of work. Image credit: Shutterstock

Caring

Ed Sheeran shoots for the stars with daughter’s name reveal

When Ed Sheeran and his wife Cherry Seaborn announced the birth of their second child in May 2022, they kept things simple. In a post to social media, Sheeran shared a picture of socks on a crochet blanket, with a caption reading “Want to let you all know we’ve had another beautiful baby girl. We are both so in love with her, and over the moon to be a family of 4”. The couple shared no ‘face reveal’ - opting to keep their children far removed from the public eye - and did not share their youngest daughter’s name with Sheeran’s 42.8m followers. But in a March interview with Rolling Stone, the 32-year-old singer-songwriter took everyone by surprise, opening up about his family life, and revealing the out-of-this-world moniker bestowed upon their youngest, Jupiter. “Me and Cherry were talking earlier about how it’s so lovely,” he told the publication, opening up about the little things in life that he and his family cherish the most. “We had an entire day. We did nothing but this. It’s so nice and wholesome having family on tour. “On the last tour, I’d party till 7 am, sleep till 4 pm, get up, and do the gig. But I was like, 26. It’s very different.” Jupiter’s birth, and establishing their new “lovely” life, were no easy feats for the couple. In February 2022 - a month that was already proving determined to knock Sheeran down - when Cherry was six months along in her pregnancy, she was diagnosed with a tumour. Surgery was required, but couldn’t be performed until she had given birth. As Sheeran wrote in a post outlining plans for his album Subtract, “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. My best friend Jamal, a brother to me, died suddenly, and I found myself standing in court defending my integrity and career as a songwriter. “I was spiralling through fear, depression and anxiety. I felt like I was drowning, head below the surface, looking up but not being able to break through for air.” “There’s nothing you can do about it,” he confessed to Rolling Stone. “You feel so powerless.” Over the course of his interview, Sheeran toyed with a chain bracelet - one gifted to him by his wife, with their daughters’ name engraved. “It felt symbolic,” he said of the swap to the silver from the rubber bands that had previously adorned his wrist, “to take off those bracelets and put on one for my family.” After the slew of tragedies to hit Sheeran in such a short span of time, it was Cherry who realised that he was in need of professional help, leading to the singer seeking out a therapist. “No one really talks about their feelings where I come from,” he said. “People think it’s weird getting a therapist in England … I think it’s very helpful to be able to speak with someone and just vent and not feel guilty about venting. Obviously, like, I’ve lived a very privileged life. So my friends would always look at me like, ‘Oh, it’s not that bad.’ ” “The help isn’t a button that is pressed, where you’re automatically okay,” he added. “It is something that will always be there and just has to be managed.” And as Sheeran himself <a href="https://www.oversixty.com.au/health/caring/writing-songs-is-my-therapy-ed-sheeran-reveals-further-heartbreak">wrote in his Subtract post</a>, “Writing songs is my therapy. It helps me make sense of my feelings … in just over a week I replaced a decade’s worth of work with my deepest darkest thoughts.” Images: Getty

Family & Pets

"Writing songs is my therapy": Ed Sheeran reveals further heartbreak

In the wake of the tragic news of the <a href="https://www.oversixty.com.au/news/news/tragedy-strikes-ed-sheeran-tour" target="_blank" rel="noopener">heartbreaking loss</a> suffered by his co-writer and touring partner, Ed Sheeran has taken to Instagram to share his struggle following a series of life-changing events – and how this has altered the course of his new album, Subtract. The singer shared how he “spiralled” into depression last year after his wife, Cherry, was diagnosed with a tumour during her second pregnancy, which couldn’t be treated until after she gave birth. The star explained that he was "trying to sculpt the perfect acoustic album" for almost a decade, when the series of events changed everything. “Writing songs is my therapy. It helps me make sense of my feelings. I wrote without thought of what the songs would be, I just wrote whatever tumbled out. “And in just over a week, I replaced a decade’s worth of work with my deepest darkest thoughts," he captioned. “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. “My best friend Jamal [Edwards], a brother to me, died suddenly and I found myself standing in court defending my integrity and career as a songwriter. I was spiralling through fear, depression and anxiety. “I felt like I was drowning, head below the surface, looking up but not being able to break through for air". <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ed Sheeran (@teddysphotos)</a> </div> </blockquote> The four-time Grammy award winner shared that this album was a "trapdoor" into his soul, and a way for him to make sense of everything he's been through. Sheeran announced the birth of his second daughter, Jupiter, in May of last year. Subtract will be released on the 5th of May 2023, through Asylum/Atlantic. Image: Getty

Caring

Hugh Jackman reveals why he is now in therapy

Hugh Jackman has revealed he is undergoing therapy to help him come to terms with the trauma he experienced as a child. The Aussie actor opened up about his healing process in a new interview with Who magazine, telling the publication he recently began treatment. "I just started it recently. It's helped me a lot," he said. "We all need a village." "You need a friend you can unload everything – having someone really smart, who's a little a bit removed from your world can be really helpful." In his sessions, Jackman discussed his longstanding pain from being abandoned by his mother, Grace, and sisters Zoe and Sonya, who left Australia for the UK when he was just eight. Jackman remained in Sydney with his father, Christopher, and brothers Ian and Ralph. It wasn't until he was about 12 years old that he realised she was not coming home. However, therapy has allowed Jackman to accept the past and make peace with loved ones. "Understanding my past and how it's informing my thinking unconsciously – getting to really understand some of the patterns that I was unconsciously just repeating," he said. However, Jackman has been fortunate enough to reconnect with his mother over the years, previously telling The Sun: "As I grew older I gained an understanding of why Mum did leave … and we have definitely made our peace, which is important. I was always quite connected with my mum. I have a good relationship with her." Sadly, Jackman's father passed away in September last year, on Father's Day in Australia. Images: Instagram

Mind

"An arts engagement that’s changed their life": the magic of arts and health

In 2007, a life-changing encounter at South Australia’s Flinders Medical Centre became the catalyst and symbol for a national arts and health movement. A young woman, Becky Corlett, was being transported through the hospital where an artist-in-residence, Rebecca Cambrell, was painting a mural. Becky had suffered a stroke and cardiac failure. She had stopped eating and was non-responsive even to family. When Becky passed the mural, however, she made a noise of interest. Cambrell instinctively drew Becky closer and gave her a paint brush. To everyone’s surprise, Becky started adding dabs of paint to the canvas, and then she smiled. The wonder of this moment only dawned on Cambrell when she turned around. “Her parents were convinced that the moment she touched that paintbrush, something was triggered inside Becky that made her want to live”, remembers Cambrell. Becky’s story is just one of many collected in our new report <a href="https://apo.org.au/node/321047">Telling the Story of Arts in Health in South Australia</a>. <h2>What is ‘arts and health’?</h2> Arts and health is broadly defined as using arts practice to deliver health outcomes, be they specifically targeted interventions or general wellbeing benefits. Arts and health work comes in many forms. It can be <a href="https://statetheatrecompany.com.au/shows/euphoria/">play</a> about mental health issues in rural areas. It can be a <a href="https://www.visualisingmentalhealth.com/">university competition</a> to design solutions to community wellbeing challenges. It can be the <a href="https://celsus.net.au/a-hospital-within-a-park/">integration</a> of art throughout an entire hospital to create a calming environment. In an interview with us, design researcher Jane Andrew said the breadth of arts and health work means participant involvement can range “from passively viewing to making to being in the environment”. The benefits are diverse. A <a href="https://www.who.int/europe/publications/i/item/9789289054553">2019 World Health Organisation study</a> looking at over 900 peer-reviewed publications found arts and health can do everything from encouraging health-promoting behaviours to supporting end-of-life care. The diversity of the arts and health field is represented by the perspectives of our report’s 47 interviewees. We spoke to arts therapists, managers of hospital-based arts and health programs, government arts agency staff, CEOs of local health networks and former ministers. We asked them about their past experiences with arts and health, the present challenges and opportunities for the field, and how best to advance this work in the future. <h2>Art and health in Australia</h2> Although benefits of the arts to health have been recognised <a href="https://academic.oup.com/book/9415/chapter/156246455">for millennia</a>, the formal field of arts and health work <a href="https://www.tandfonline.com/doi/abs/10.1080/17533010903421484">first emerged</a> across South Australia and the rest of the nation through the community arts movement of the 1970s and the rise of health promotion in the 1980s. The establishment of the Flinders Medical Centre’s Arts in Health program in the late 1990s provided a major step for the field into health settings, and the program remains an <a href="https://anmj.org.au/the-art-of-healing-inside-flinders-medical-centres-pioneering-arts-in-health-program/">innovative leader today</a>. The former director of the program, Sally Francis, recalled how, “on a regular basis” the program would have “three, four, five stories of someone who has been critically ill and had an arts engagement that’s changed their life.” But Becky Corlett’s story had, as Francis describes it, a “huge and far-reaching effect” on arts and health in Australia. Days after Becky’s first painting experience, former South Australian Minister of Health and Assistant Arts Minister, John Hill, visited the hospital "I was just walking along, and I saw the painting going on and there was this little girl busily doing art. […] Her parents came up to me and had tears in their eyes. […] She was reconnected with life." Inspired by this encounter, Hill and Francis led a push to have arts and health formally recognised by the state and then federal government. The <a href="https://www.arts.qld.gov.au/images/documents/artsqld/Research/National-Arts-and-Health-Framework-May-2014.pdf">National Arts and Health Framework</a> was officially endorsed in 2014. This historic statement declared the Australian federal, state and territory governments’ recognition of and support for the field. The framework aimed to raise awareness of arts and health, and to encourage government departments and agencies across the country to integrate arts and health work into their services. However, it did not make any funding or legislative requests, meaning no permanent arts and health policy followed its endorsement. <h2>What next for arts and health?</h2> Next year marks ten years since the framework’s endorsement. While there is continuing good work in this space across the country, our interviewees believe arts and health remains underutilised. Community artist Lisa Philip-Harbutt told us there is a lack of “connection between all the various things that people are doing” – different arts and health projects often aren’t speaking to each other. To regain momentum for the field, interviewees recommend developing educational pathways for prospective arts and health workers, conducting a review and update of the National Arts and Health Framework to embed it in policy, and establishing research partnerships between universities and arts and health programs. The hope is that the next generation of leaders will be inspired by witnessing arts and health’s life-changing power. According to Deborah Mills, a key driver of the National Arts and Health Framework, "If you want passionate advocates, they have to have a visceral understanding of what creative activity does." Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/an-arts-engagement-thats-changed-their-life-the-magic-of-arts-and-health-196212" target="_blank" rel="noopener">The Conversation</a>.

Art

Sounds great: Scientists are manipulating dreams to prevent nightmares

It’s estimated that at any given time, around 4% of adults suffer <a href="https://cosmosmagazine.com/health/one-side-of-your-brain-might-be-giving-you-nightmares/" target="_blank" rel="noreferrer noopener">chronic nightmares</a> but researchers in Switzerland have a new approach which will be music to the ears of night-terror-sufferers. Basing their study on the relationship between the types of <a href="https://cosmosmagazine.com/science/biology/nightmares-and-night-terrors-in-kids-when-do-they-stop-being-normal/" target="_blank" rel="noreferrer noopener">emotions experienced in dreams</a> and our emotional well-being, researchers have investigated how to help people by manipulating emotions in their dreams. Traditional methods to help chronic nightmare patients involves ‘imagery rehearsal therapy’, during which they are coached to rehearse the dream scenario during the day and redirect it towards a more positive ending. A <a href="https://link.springer.com/article/10.1007/s11818-021-00320-w" target="_blank" rel="noreferrer noopener">2021 study</a> of 28 participants showed 3 in 5 patients benefitted from this approach, however, it doesn’t work for everyone. <div class="newsletter-box"> <div id="wpcf7-f6-p220659-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/health/sounds-great-preventing-nightmares/#wpcf7-f6-p220659-o1" method="post" novalidate="novalidate" data-status="init"> <input class="wpcf7-form-control wpcf7-text referer-page" name="referer-page" type="hidden" value="https://cosmosmagazine.com/health/" data-value="https://cosmosmagazine.com/health/" aria-invalid="false" /> </form> </div> </div> In a <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01477-4" target="_blank" rel="noreferrer noopener">study from Geneva University</a>, over a two-week period, researchers asked a group of 18 patients to create an association between the positively redirected version of their dream and a sound during an imagination exercise. The patients then wore wireless headbands during night which would play the specific sound during the REM (Rapid Eye Movement) stage of sleep – when <a href="https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515" target="_blank" rel="noreferrer noopener">nightmares typically occur</a>. When compared to 18 patients who undertook only the image rehearsal therapy, those who received the combined rehearsal and sound therapy had fewer nightmares. This trend continued even after three months post-intervention, with those receiving combination therapy also reporting experiencing more positive emotions such as ‘joy’ in their dreams. “We were positively surprised by how well the participants respected and tolerated the study procedures, for example performing imagery rehearsal therapy every day and wearing the sleep headband during the night,” says Lampros Perogamvros, senior author of the study and a psychiatrist at the Sleep Laboratory of the Geneva University Hospitals and the University of Geneva. “We observed a fast decrease of nightmares, together with dreams becoming emotionally more positive. For us, researchers and clinicians, these findings are very promising both for the study of emotional processing during sleep and for the development of new therapies.”  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=220659&title=Sounds+great%3A+Scientists+are+manipulating+dreams+to+prevent+nightmares" width="1" height="1" />  <div id="contributors"> <a href="https://cosmosmagazine.com/health/sounds-great-preventing-nightmares/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Clare Kenyon. Image: Getty Images </div>

Mind

New study to “give hope” to childhood trauma survivors with depression

A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression. Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions. The study, published in <a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma. While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent. The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma. Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma). But, they found that both groups experienced an improvement in symptoms at a similar rate. Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope. “Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said. “Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.” Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients. “This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said. “However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.” According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood. But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective. If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380. Image: Getty Images

Mind

The truth behind the healing power of music

If you’ve suffered anything from a bad day to a devastating loss, you probably know that one of the first and best places to turn to is music. According to recent studies, there’s a reason for that: it’s scientifically proven to be healing and cathartic. According to a study performed by the University of Missouri, people are actually able to lift themselves out of a low emotional state by playing contrastingly cheerful music if they consciously attempt to feel happier while doing so. Significantly, study participants who were instructed to attempt to raise their moods while listening to upbeat music were able to achieve this in the immediate short term period and even increased their overall happiness over the course of two weeks. On the other end of the spectrum, another study, conducted by the University of California and Berkely, found that even sad songs can help to heal a “broken” heart. According to the researchers, "Under certain circumstances, consumers in negative moods might choose aesthetic experiences consistent with their mood even when more pleasant alternatives are also available." So basically, music can be a self-indulgent means of experiencing and working through our emotions. So whether your choice of music is The Rolling Stones’ melancholy Out of Tears, Zeppelin’s heart breaking, Baby Come on Home, The Beatles’ optimistic Getting Better, or Clapton’s rebellious Cocaine, your impulse to turn to music in hard times is actually backed up by science. Image credits: Getty Images

Music

How to be more articulate: 8 must-follow secrets to improve your speech

<div class="slide-image" style="box-sizing: border-box; border: 0px; font-family: Raleway, sans-serif, Arial; font-size: 16px; font-style: normal; font-weight: 400; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; color: #444444; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> </div> <h2>Listen to yourself speak</h2> We know it’s terrifying, but nothing will squash those verbal ticks quite like listening to yourself speak. Record yourself in a natural conversation; for example, replay a conference call or have a friend interview you on tape. Listen for technical issues, such as filler words, up talk, monotone, and run-on sentences, as well as any habits that sound awkward or uncomfortable. Identifying the problem is the first step toward tackling it. <h2>Monitor your speed</h2> Not sure if you’re speaking too fast or too slow? Try this: copy and paste a 160-word passage into a word processor. Read the passage aloud (at your standard conversational speed) while recording yourself on a tape recorder. How long did it take you? It should be near the minute mark, says communications coach, Dr Carol A. Fleming. “Aim for about 155 to 175 words per minute for normal conversation,” she writes. If you’re reciting background information or summarising something, pick up the pace. If you’re explaining something more technical, slow it down. <div> </div> <h2>Eliminate filler words</h2> If you’re wondering how to be more articulate, it’s probably because you’ve caught yourself over-utilising words such as ‘um,’ ‘like,’ and ‘ahh,’ which can make you sound unsure and inarticulate. Replace these fillers with more eloquent transitions, suggests Forbes contributor Selena Rezvani. “One of the functions of ‘Um’ is to tell your audience that you’re not done talking yet and need to gather your thoughts,” she writes. ‘Let’s move on to…’, ‘Another important consideration is…’, and ‘Let’s transition to talking about…’ are great replacements. <h2>Focus on the final sound</h2> Avoid trailing off or mumbling by making a conscious effort to fully pronounce each syllable. Pay special attention to the Ts in contractions and the final words of sentences. <h2>Study other speakers</h2> Articulate speakers learn from other articulate speakers. Need inspiration? Find a radio show or podcast you enjoy, and analyse the host’s speech. He or she has likely squashed any verbal ticks, and can help you identify effective patterns of speech. <h2>Speak with confidence</h2> How to be more articulate? Speak with confidence. Even if you’re talking on the phone, the way you hold yourself impacts the way people perceive your ideas. Extend your vocal cords by keeping your chin parallel to the floor and sitting up straight, and avoid moving your hands too much (studies show keeping them folded on the table projects trustworthiness). <h2>Think before you speak</h2> Perhaps the most important trick for more articulate speech? Know what you’re talking about. Having a clear idea of what you want to say will allow you to organise your thoughts into a coherent structure. It’s that simple. <h2>Address your weaknesses</h2> Once you’ve identified your weaknesses, create a plan for addressing them. One strategy is to tackle a specific issue each day. For example, focus on eliminating filler words on Monday, and on completing your sentences on Tuesday. Repeat the process each week until speaking clearly becomes second nature. This article originally appeared on <a href="https://www.readersdigest.com.au/culture/how-to-be-more-articulate-8-must-follow-secrets-to-improve-your-speech" target="_blank" rel="noopener">Reader’s Digest</a>. Image: Shutterstock

Caring

Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

Physiotherapists are increasingly offering needling therapies in addition to their standard care. Many Australian <a href="https://australian.physio/research/prf/translation/five-facts-about-acupuncture-and-dry-needling-musculoskeletal-pain" target="_blank" rel="noopener">physiotherapists</a> in private practice now offer dry needling or Western medical acupuncture as part of a treatment approach. Is it just a fad or does science support it? <h2>Needling, three ways</h2> Physiotherapists can be trained to use dry needling, Western acupuncture and/or traditional acupuncture. <a href="https://pubmed.ncbi.nlm.nih.gov/23801002/" target="_blank" rel="noopener">Dry needling</a> involves penetrating the skin with needles to altered or dysfunctional tissue in order to improve or restore function. This often involves needling muscle trigger points to activate a reflexive relaxation of the muscle. <a href="https://pubmed.ncbi.nlm.nih.gov/28739020/" target="_blank" rel="noopener">Western acupuncture</a> uses traditional needling <a href="https://www.sciencedirect.com/science/article/pii/S2005290110600143" target="_blank" rel="noopener">meridians</a> (the ancient idea of energy channels through the body) and trigger points. But these ideas are applied to Western understandings of anatomy. In Western acupuncture, points are stimulated to create local tissue changes, as well as spinal and brain effects. The goals is to trigger pain-relieving chemicals, muscle activation or relaxation. Even though traditional acupuncture points are used with this style of needling, Western acupuncture is not viewed as traditional Chinese medicine. <a href="https://healthtimes.com.au/hub/pain-management/44/research/kk1/acupuncture-for-pain-management/1581/" target="_blank" rel="noopener">Traditional acupuncture</a> uses meridian lines or other points based on traditional Chinese medicine assessment methods and approaches. All physiotherapists trained in either acupuncture or dry needling meet safety standards which are viewed as within scope by the <a href="https://www.ahpra.gov.au/" target="_blank" rel="noopener">Australian Health Practitioners Regulatory Agency</a> and the <a href="https://www.physiotherapyboard.gov.au/" target="_blank" rel="noopener">Physiotherapy Registration Board</a>. These standards cover the level of training required, registration to practice and safety standards that include needle safety and hygiene to protect the public. Minor reported <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015026/#:%7E:text=Examples%20of%20minor%20adverse%20reactions,pain%20during%20or%20after%20treatment." target="_blank" rel="noopener">side effects</a> related to acupuncture including pain and bleeding or bruising from needle insertion are fairly common. But major adverse events – pneumothorax (collapsed lung), excessive bleeding, prolonged aggravation – are rare. <h2>What’s needling good for?</h2> Research into the effectiveness of acupuncture and dry needling is variable. Some studies show comparable results between dry needling and acupuncture, while others show more favourable results for one or the other depending on the condition being treated. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedling" target="_blank" rel="noopener">review</a> that assessed the effects of acupuncture and dry needling for the treatment of low-back pain found they may be useful add-on therapies but could not make firm conclusions due to a lack of quality trials. Another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600071/#CIT0034" target="_blank" rel="noopener">review</a> reported the growing popularity of dry needling world wide and across disciplines and points out that many questions still remain regarding the use of needling. For <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full?highlightAbstract=acupuncture%7Cmigraine%7Cmigrain%7Cacupunctur" target="_blank" rel="noopener">migraine</a> and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007587.pub2/full?highlightAbstract=acupuncture%7Cheadach%7Ctension%7Cacupunctur%7Cheadache%7Ctype" target="_blank" rel="noopener">tension</a> headaches, experts say acupuncture seems to reduce the frequency and intensity of attacks – though more research is needed to compare it to other treatments. Acupuncture and dry needling may reduce pain and improve function for people with <a href="https://pubmed.ncbi.nlm.nih.gov/17224820/" target="_blank" rel="noopener">neck pain</a>. A systematic review found significant differences between acupuncture and “sham acupuncture” (which is performed away from acupuncture points) when used to treat <a href="https://pubmed.ncbi.nlm.nih.gov/22965186/" target="_blank" rel="noopener">certain types of chronic pain</a>. However, some research only shows <a href="https://pubmed.ncbi.nlm.nih.gov/33066556/" target="_blank" rel="noopener">small and temporary</a> relief for neck pain with dry needling. Results from randomised control trials support the use of needling for <a href="https://pubmed.ncbi.nlm.nih.gov/27062955" target="_blank" rel="noopener">shoulder pain</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/32301166/" target="_blank" rel="noopener">tennis elbow</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32186030/" target="_blank" rel="noopener">osteo arthritic knee pain</a>. But a recent systemic review of research reported only weak evidence to support needling to treat <a href="https://pubmed.ncbi.nlm.nih.gov/33760098/" target="_blank" rel="noopener">plantarfasciitis and chronic ankle instability</a>. <h2>Not just for sporting injuries</h2> Similarly, small randomised control trials have shown acupuncture and dry needling might reduce <a href="https://pubmed.ncbi.nlm.nih.gov/17095133/" target="_blank" rel="noopener">problematic jaw pain</a> (<a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd#:%7E:text=Temporomandibular%20disorders%20(TMD)%20are%20disorders,may%20result%20in%20temporomandibular%20disorder." target="_blank" rel="noopener">temporo mandibular disorder</a>) and improve mouth opening. Systematic reviews have reported needling and acupuncture were safe and effective recommendations for the treatment of broad conditions of <a href="https://www.healthline.com/health/tendinopathy" target="_blank" rel="noopener">tendinopathy</a> (the breakdown of collagen in tendons) and <a href="https://pubmed.ncbi.nlm.nih.gov/30787631/#:%7E:text=At%20follow%2Dup%20in%20the,for%20the%20management%20of%20FM." target="_blank" rel="noopener">fibromyalgia</a> (chronic pain in the muscles and bones). For women’s health, acupuncture has been shown to be effective for reducing pain with <a href="https://pubmed.ncbi.nlm.nih.gov/29879061/" target="_blank" rel="noopener">periods</a>, compared to no treatment or non-steroidal pain relief medications – but the research had design limitations. Though <a href="https://www.cochrane.org/CD002962/PREG_acupuncture-or-acupressure-induction-labour#:%7E:text=Acupuncture%20involves%20the%20insertion%20of,with%20onset%20of%20labour%20contractions." target="_blank" rel="noopener">widely used</a> in pregnancy, research into the use of acupuncture to <a href="https://pubmed.ncbi.nlm.nih.gov/32032444/" target="_blank" rel="noopener">induce labour</a> reports it may increase satisfaction with pain management and reduce pain intensity. But it may have little to no effect on the rates of caesarean or assisted vaginal birth. In summary, it appears needling techniques – whether dry needling or acupuncture – generally show positive effects over no treatment or “sham” treatments, but more research and high quality trials are needed. <h2>Just one part of a treatment program</h2> Needling <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedlin" target="_blank" rel="noopener">may be useful</a> as part of multimodal care – that is, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780149/" target="_blank" rel="noopener">more than one treatment</a> is used in conjunction to treat a problem. Physiotherapists may combine needling therapies with exercise prescription, hands-on care including massage, mobilisations and manipulations, and taping techniques. They may also employ therapies that apply external energy such as ultrasound, laser, transcutaneous (under the skin) electrical nerve stimulation and biofeedback. Finally, while the various needling techniques all use a filiform needle (with a solid filament as opposed to a hollow bore needle), the styles with each can be quite different. Ask what style of needling is being employed to treat you, and if you have a history of finding one style works better for you, discuss this with your practitioner. This article originally appeared on <a href="https://theconversation.com/physio-dry-needling-and-acupuncture-whats-the-difference-and-what-does-the-evidence-say-181939" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

What happens when a petting zoo visits an aged care home

In June 2022, residents, families and team members at Arcare North Lakes had an a-moo-sing time with the beloved animals from mobile petting zoo, Amazing Animals. Residents had the opportunity to feed and pat the farm animals which included ducks, chickens, rabbits, guinea pigs, goats, sheep and baby animals such as piglets, a one-month-old calf and a three-week-old goat. While holding onto the baby goat, resident Joyce Crawford said, “I love you! I would take you home in a flash; I just need a bag big enough to steal him,” Joyce’s husband John, who is also a resident at Arcare North Lakes and is visually impaired, spent quality time with the animals as the Lifestyle team made sure to bring them close to him. He fed and cuddled them and enjoyed the sensory experience. “I had a great time with the animals and I’m glad we could spend time with them today,” John said. The residents enjoyed their visit so much that they have already booked them in for another visit. “Animal therapy is a wonderful way to support aged care residents as it promotes confidence, supports sensory and tactile stimulation and enables them to relive memories as many of the residents grew up on farms. One question was asked time and time again "can we keep them!" it was such a special moment for them to enjoy.” - Lifestyle Coordinator Maree said. “There were smiles, laughs and enthusiasm as resident’s shared stories and fond memories of their own experiences working on their farms,” lifestyle Coordinator Maree said. Check out the adorable gallery below.

Retirement Life

CBT is wrong in how it understands mental illness

Cognitive behavioural therapy (CBT) is one of the most popular forms of talking therapy. It is the treatment of choice for depression and anxiety and is a staple of public healthcare systems, such as the NHS and the Australian Medicare system. CBT’s understanding of mental illness and therapeutic techniques is already part of the mainstream – accusations of “catastrophising” and pleas to “reality check” beliefs <a href="https://www.rallyware.com/cognitive_distortions">can be found everywhere</a>. As a <a href="https://www.washingtonpost.com/archive/lifestyle/wellness/2002/09/03/a-change-of-mind/19573ec9-9b36-4d11-874f-eb6dbc5d9164/">Washington Post article</a> put it: “For better or worse, cognitive therapy is fast becoming what people mean when they say they are ‘getting therapy’.” One of the reasons for CBT’s runaway success is the reams of <a href="https://www.cambridge.org/core/journals/psychological-medicine/article/evidence-for-cognitive-behavioural-therapy-in-any-condition-population-or-context-a-metareview-of-systematic-reviews-and-panoramic-metaanalysis/3BE55E078F21F06CFF90FFAD1ACEA5E0">evidence that support its effectiveness</a> at treating a host of mental health disorders. Although there is evidence for CBT’s effectiveness, the evidence for its theory, particularly its understanding of mental illness, is far more mixed. To put it another way, we know that CBT works, but we are not sure how or why it works. CBT’s <a href="https://beckinstitute.org/about/intro-to-cbt/">cognitive model of mental illness</a>, originally <a href="https://www.upenn.edu/pennpress/book/14502.html">developed by Aaron Beck in the 1960s</a>, hypothesised that disorders such as depression were characterised by certain patterns of thought that give rise to the negative emotions and behaviour typical of mental illness. These patterns of thought are referred to as “cognitive distortions” or “negative automatic thoughts”. But what exactly is wrong with these thoughts? What makes them “distorted”? Generally, vague answers are offered in response. For example, the American Psychological Association describes these thoughts as being <a href="https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral">“faulty” or “unhelpful”</a>. Looking at <a href="https://www.verywellmind.com/ten-cognitive-distortions-identified-in-cbt-22412">lists of distortions</a>, offers clues. Most distortions focus on faulty reasoning, where someone “jumps to conclusions”, makes a poor inference (“overgeneralising”), is biased in how they perceive a situation (“black or white thinking”), or, more straightforwardly, when they believe something false or inaccurate. CBT then goes on to suggest that if this faulty reasoning was resolved, the “unhelpful” negative emotions and behaviour will change. <h2>Three reasons to doubt the model</h2> There are three reasons to doubt the cognitive model and the association of mental illnesses with errors in reasoning. First, the sort of issues CBT draws attention to – bias, false beliefs, poor inferences – are all relatively common, even in mentally healthy people. As a great deal of psychological research <a href="https://www.cambridge.org/core/books/judgment-under-uncertainty/6F9E814794E08EC43D426E480A4B412C">has shown</a>, we are all prone to poor reasoning. And even with mental disorders that seem to involve obvious faulty thinking, such as schizophrenia or psychosis, it is very difficult to nail down the difference between a <a href="https://mitpress.universitypressscholarship.com/view/10.7551/mitpress/9780262035484.001.0001/upso-9780262035484-chapter-013">delusion and a strange belief</a>. For example, what distinguishes delusions from the sorts of beliefs associated with conspiracy theories or belief in the supernatural? “Faulty” thinking does not obviously correlate with mental illness. Second, although CBT researchers have studies showing that mental disorder has something to do with cognitive distortions, there is a problem with the tests or measures used in this research. Many of these tests ask questions that have nothing to do with poor reasoning. They often ask people to answer questions that are simply about how they feel (“I’m so disappointed in myself”, <a href="https://psycnet.apa.org/record/1981-20180-001">Automatic Thoughts Questionnaire</a>), need a great deal more information, maybe about population-level data to answer (“I do few things as well as others”, <a href="https://books.google.at/books/about/Inventory_of_Cognitive_Distortions.html?id=aSlJNwAACAAJ&redir_esc=y">Inventory of Cognitive Distortions</a>), or seem to be about moral or practical issues rather than poor reasoning (“Taking even a small risk is foolish because the loss is likely to be a disaster”, “To be a good, moral, worthwhile, person, I must help everyone who needs it”, <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft00091-000">Dysfunctional Attitude Scale</a>). Finally, there is research suggesting that it is mental health rather than mental illness that is related to poor reasoning. The “depressive realism hypothesis”, shows that depressed people more accurately: <a href="https://psycnet.apa.org/record/1981-02686-001">predict how much control they have over outcomes</a>, <a href="https://psycnet.apa.org/record/1980-01102-001">evaluate their performance</a> and <a href="https://psycnet.apa.org/record/1984-23229-001">recall feedback</a>. Mentally healthy people, on the other hand, succumb to an “illusion of control” and tend to recall their own performance and feedback in an excessively rosy light. Although most of this research has been on depression, there are studies suggesting that schizophrenia may be associated with <a href="https://pubmed.ncbi.nlm.nih.gov/17978328/">better theoretical reasoning</a> and autism is sometimes characterised by enhanced logical and theoretical reasoning. <h2>Not backed by research</h2> Not only is there contrary evidence showing problems with reasoning are widespread as well as potentially associated with mental health rather than mental disorder. But the evidence in favour of CBT’s take on mental illness is tainted because the tests used in these studies do not even track problems with reasoning. CBT provides a compelling story about mental illness – mental illness is associated with “faulty” reasoning, and in resolving this, negative behaviour and emotions are addressed. Unfortunately, research doesn’t quite back up this story. We might wonder whether it matters. After all, CBT seems to work, so why should we care how it works or whether it is wrong in its story about mental illness? It matters ethically. It is one thing to point out that certain patterns of thinking are “unhelpful” or bring about negative emotions and behaviour, quite another to suggest that someone is irrational or reasoning poorly when the evidence for this is shaky. It is what the philosopher Miranda Fricker terms “<a href="https://oxford.universitypressscholarship.com/view/10.1093/acprof:oso/9780198237907.001.0001/acprof-9780198237907">epistemic injustice</a>”, where a member of a disenfranchised group (that is, the mentally ill), is told their claims are plagued by errors or cannot be taken at face value. Even worse, with CBT they are told this when they come seeking help. Troubling, at best, unethical at worst. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/cbt-is-wrong-in-how-it-understands-mental-illness-175943" target="_blank" rel="noopener">The Conversation</a>.

Mind

What is art therapy and how can it help you

According to studies done in collaboration with Scalabrini, here are the benefits of art therapy for seniors: Improved Memory Going to museums, painting, sculpting, and many other types of art therapy are hugely helpful, and can actually help people with memory loss. In fact, the Alzheimer’s Disease Center in the United States believes that art therapy gets through to people with Alzheimer’s by exploiting parts of the brain with the least impairment. This can have a profound impact on their ability to access their memories. Reduced Pain Art therapy is naturally relaxing and can help reduce stiffness and inflammation. Seniors are using their arms and fingers for art, and while this is light physical activity, it’s consistent, and can help promote better dexterity and blood flow. By using small, purposeful movements, they benefit from increased coordination and can more easily ignore their pain since they’re focused on their art. Reduced Stress Art therapy can reduce stress for people of all ages, but it’s particularly helpful for seniors and people with the early stages of memory loss. We have around 60,000 thoughts a day and many of these can be negative for people dealing with aging, so art therapy is particularly helpful. That’s because when seniors are engaged with an art therapy activity, they’re often ‘in the zone’ and can enjoy an almost meditative experience. Reduced Depression Seniors struggling with health implications, memory loss, or mobility problems will commonly experience depression. When they create art, the symptoms of depression are often reduced due to mood and cognitive stimulation. Even seniors who have problems communicating verbally can still express their thoughts and feelings through their art. Increased Communication and Socialisation By getting involved in art projects, seniors can find it easier to connect with others, reducing the feelings of isolation and loneliness that are common in the twilight years. Many people who have dementia / Alzheimer’s can find it difficult to express themselves and communicate with others, and art therapy can help them do this by providing a visual means of communication. Relief from Chronic Conditions Growing older can be very difficult for some people, particularly people living with Parkinson’s, Alzheimer’s, multiple sclerosis, arthritis, dementia, or are currently recovering from a stroke. Dealing with these conditions and the limited mobility that can occur can sometimes be overwhelming. But art activities and crafts projects can provide some relief for these conditions. This can range from painting to pottery, games to puzzles. Coloring projects, scrapbooking, and other activiites give seniors something to look forward to, while taking their minds off their condition. Improved Brain Function As we age, so do our brains. This can make it difficult to carry out some tasks- particularly when living with dementia / Alzheimer’s. Art therapy for adults can help boost these cognitive functions, improving senior’s abilities to use logic and reasoning, problem solve, focus on tasks for a sustained period of time, and improve working memory. Art therapy can make a massive difference when it comes to both the mental and physical health of seniors. To learn more about why we love art therapy, get in touch today. Image: Getty

Art

Daunted by therapy? Virtual reality could be the answer

If opening up to a therapist seems like a near-impossible task, new research shows that you’re not the only one - and proposes a new option that could soon be available. A study from Edith Cowan University, published in <a rel="noopener" href="https://www.frontiersin.org/articles/10.3389/frvir.2021.750729/full" target="_blank">Frontiers in Virtual Reality</a>, found that 30 percent of people surveyed would rather talk about negative experiences with a virtual reality (VR) avatar than a real-life person. Researchers created a ‘realistic motion avatar’ that appeared similar to its real-life counterpart, then compared the social interactions between people talking to the avatar versus a real person. Participants then rated their experience on factors such as enjoyment, comfort, awkwardness, perceived understanding, and how much they think they disclosed about themselves. Dr Shane Rogers, a psychology and communication researcher involved in the study, said participants found VR and face-to-face interactions to be quite similar in all but one way. “Overall, people rated VR social interaction as similar to face-to-face interaction, with the exception of closeness, where people tended to feel a little closer with each other when face-to-face,” Dr Rogers <a rel="noopener" href="https://www.scimex.org/newsfeed/virtual-reality-could-help-make-therapy-easier" target="_blank">said</a>. “This technology has the potential for broad application across a number of areas such as casual conversation, business, tourism, education and therapy,” he said. “The study found that 30 percent of people preferred disclosing negative experiences via VR. This means that therapy might be opened up to new people who don’t feel comfortable with traditional face-to-face interactions.” <img style="width: 500px; height:281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7846832/vr1.jpg" alt="" data-udi="umb://media/b6881ee566e74d5ba66c6e6a0c91129a" /> Virtual reality has been used in video games for several years now, but new research shows it can also be used in mental health settings. Image: Getty Images Though VR has been around for several years, the new research is among several new studies and initiatives applying the technology to treat mental health conditions. In the United States, veterans with Post-Traumatic Stress Disorder (PTSD) are being treated with the assistance of VR, which can transport them back to traumatic experiences - even if they struggle to remember the event or other details. The tech has also been used in “empathy training”, where clinicians wear VR headsets to better understand what patients in their care are experiencing, particularly for veterans with dementia or older LGBTQ veterans. “Now what you hear and what you see in front of your eyes is the same thing as a patient who’s experiencing dementia or an LGBTQ vertan who’s ageing,” Anne Lord Bailey, a pharmacist and director of clinical tech innovation involved in the scheme, told <a rel="noopener" href="https://fedtechmagazine.com/article/2021/12/how-va-using-vr-veterans-therapy-perfcon" target="_blank">FedTech</a>. “All of a sudden, people start talking to you and what you hear is muddled, or your vision doesn’t see what you should be seeing. It looks distorted, or I can’t hear things because they’re not clear, even though I can tell that people are talking to me. Or, I get disoriented: I try to turn to the right, and things are shifty or crooked.” Meanwhile, the UK NHS launched a treatment plan last year using VR to treat patients with trypanophobia, or a phobia of needles, ahead of their Covid vaccinations. Patients are treated by being exposed to scenarios such as a medical waiting room or blood draw, to help therapists treat patients’ fears in a controlled environment. “VR is very effective at bridging the gap between real-life exposure and what the patient feels able to do at the time they enter treatment,” Vanessa Dodds, a cognitive behavioural therapist involved in the UK program, told <a rel="noopener" href="https://www.medicaldevice-network.com/news/needle-phobia-vr/" target="_blank">Medical Device Network</a>. Dr Rogers echoed this sentiment, adding that improvements in the technology will improve its affordability and accessibility as a treatment option - with applications beyond therapy as well. “It might also enable therapists to conduct therapy more effectively at a distance, as a person can be in the therapist room (in virtual reality) while seated in their own home,” he said. “More powerful computers are becoming more affordable, VR headsets are continuing to develop, and more user-friendly VR interaction software platforms are becoming more available and being updated.” Following the work by Dr Rogers and his colleagues, future steps will involve more investigation of how different aspects of the avatar affect user experience, as well as how VR can be used in therapeutic settings. Image: Getty Images

Mind

Explainer: what is music therapy?

Defining music therapy is challenging because the practice is so diverse; but the <a href="http://www.austmta.org.au/">Australian Music Therapy Association</a> (AMTA) uses the following definition: "Music therapy is a research-based practice and profession in which music is used to actively support people as they strive to improve their health, functioning and wellbeing." Music therapy is the intentional use of music by a university-trained professional who is registered with the AMTA. Registered music therapists draw on an extensive body of research and are bound by a code of ethics that informs their practice. They incorporate a range of music-making methods within a therapeutic relationship and are employed in a variety of sectors including health, community, aged care, disability, early childhood, and private practice. Music therapy is different from music education and entertainment as it focuses on health, functioning and wellbeing, and music therapists work with people of any age and ability, culture or background. <h2>History</h2> The use of music in healing has had a long history, but music therapy as a profession began to develop formally in USA in the 1950s to help war veterans suffering from physical and emotional problems. The demand for a university curriculum grew as hospital musicians needed training. The <a href="http://www.musictherapy.org/">American Association for Music Therapy</a> was established in 1971 and the Australian Association soon after in 1975 by music therapy pioneers <a href="http://www.austmta.org.au/about-us/honoured-members">Dr Ruth Bright</a> and <a href="http://www.conservatorium.unimelb.edu.au/staff/denisegrocke">Emeritus Professor Denise Grocke</a>. As anyone who sings or plays a musical instrument will tell you, making music, especially with others, is great for the mind, body and soul. The benefits flow whether you are an accomplished musician or an enthusiastic amateur. Music therapists draw on the benefits of music to help people of all ages and abilities attain and maintain good health and wellbeing. They work in a range of places including hospitals, nursing homes, schools and the community, delivering tailor-made programs to meet specific needs. <h2>Endorphin, dopamine and oxytocin triggers</h2> The techniques used by music therapists can include writing songs for or with clients, free or structured movement to music activities, singing and vocal activities, improvisation, playing traditional instruments or digital music equipment, listening to recorded music and engaging socially in a group setting. The ability of music to change our mood seems to be related to the production of different chemicals in the brain. Endorphins triggered by music listening and music-making provide a kind of natural pain relief, where dopamine leads to feelings of buoyancy, optimism, energy and power. This may explain the kinds of “flow” and “peak” experiences often described as being evoked by both music-listening and more active musical participation. Impacts are even more potent for group music-making, because shared, positive experiences also release oxytocin, a brain tool for building trust. In this way, musical relationships develop encouraging non-verbal and emotional expression and building self-esteem, motivation and confidence. <h2>Music therapy in neurorehabilitation</h2> Music is processed widely across the brain in connection to memories, emotions and communication. Developments in brain-scanning technology show that making music increases brain activity, creating new pathways across both hemispheres of the brain. This makes music therapy especially beneficial in <a href="http://en.wikipedia.org/wiki/Neurorehabilitation">neurorehabilitation</a> where the organising function of rhythm in music can be used to rehabilitate movement and speech following a brain injury or stroke. <h2>Music therapy and dementia</h2> There is a strong connection between music and memory as can be attested by the flood of emotion stimulated by hearing significant songs, or the annoying advertising jingles that get stuck in your brain. Music therapists use this feature of music to help people with memory difficulties access important pieces of information in specifically composed songs. Memory for music is closely linked to emotions and both are processed deeply within the brain. Memory for song lyrics often remains long after other memory and verbal ability have deteriorated for people with dementia. Music therapy often awakens something within people in late-stage dementia and can stimulate windows of lucidity, providing family members with glimpses of the person they love. <h2>Music therapy in children’s hospitals</h2> Music therapy is frequently used in children’s hospitals for pain and anxiety management during procedures and to engage children in a normalising activity that is unrelated to them being unwell. This provides an opportunity for choice and control in an environment where they have little control over everything else. In special education, music therapists work with children with intellectual and/or physical disabilities to help them meet developmental and educational goals. This may include using music to increase opportunities for cognitive and sensory stimulation and to help develop motor skills, orientation and mobility. Music therapy provides an outlet for a child’s emotional expression, increased awareness of the immediate environment and other people, and enhances self-confidence through active music making. It can also help improve a child’s social skills and communication. <h2>Teenagers and music</h2> Young people spend a significant amount of time engaging with music and vulnerable teenagers spend even more so. Music therapists in adolescent mental health use this strong connection that teens have with music as a resource in grappling with their emerging mental health problems. The Australian Research Council has recently funded a research project headed by <a href="http://www.conservatorium.unimelb.edu.au/staff/katrinaskewesmcferran">Assoc. Prof Katrina McFerran</a> to investigate the music uses of young people with and without mental ill-health with a view to early identification and early intervention in adolescence. Image credits: Getty Images This article first appeared in <a rel="noopener" href="https://theconversation.com/explainer-what-is-music-therapy-20154" target="_blank">The Conversation</a>.

Music

5 signs you might benefit from therapy

The decision to seek out professional help for mental health is often a very daunting one, and many tend to put it off for a long time. Despite the feeling that we may not be having a hard enough time to seek out therapy, or fears associated with talking to another person about our concerns, studies have found that even <a rel="noopener" href="https://thepsychologist.bps.org.uk/volume-32/november-2019/it-forced-me-think-different-ways-about-single-session-therapy" target="_blank">a single session</a> of Cognitive Behavioural Therapy (CBT) can help. If you’ve been considering seeing a therapist, here are five <a rel="noopener" href="https://www.psychologytoday.com/au/blog/in-practice/202111/20-signs-youd-benefit-seeing-therapist" target="_blank">signs</a> that can help you decide. 1. You think about it a lot If you have considered seeing a therapist multiple times but have hesitated, it may be a sign that you want to go but that something is holding you back. As nerve-wracking as it may be, giving therapy a try will help you end the debate once and for all. 2. Basic tasks are difficult Those struggling with depression or burnout can find it difficult to keep up with tasks like showering, shopping for clothes, deciding what to wear each day, or filling out forms. If this is you, therapy can provide a way to make these tasks less of a struggle. 3. You struggle to make or keep friends Whether you find it easy to make friends but hard to keep them, or you struggle with both making and maintaining friendships, therapy can help. For instance, some people with insecure attachment styles - which develop when we’re young - <a rel="noopener" href="https://www.psychologytoday.com/au/basics/attachment" target="_blank">therapy</a> can act as a way to learn relational skills that can be applied in friendships and relationships. 4. You’re looking for support Whether you’re unsure how to make a big decision or are struggling to cope with a stressful event in your life, therapy can help. Though a therapist won’t give their opinions on what you should do, they can help you figure out what you want to do and lay out all of the pros and cons clearly. Therapy can also help you figure out how to navigate the stressful events that come up and develop coping skills to use in the future. 5. You’re curious Therapy isn’t just for the people who need it. If you’re interested in gaining strategies to use in different areas of your life or you want to get a different perspective on yourself, therapy can be worth trying. Despite common perceptions about therapy, it doesn’t need to be a long-term commitment or take up a large chunk of time. Since everyone is different, our experiences with therapy will also differ and can involve attending for a long period of time or just a few sessions. No matter what is driving you to consider going to a therapist, it doesn’t hurt to take the plunge and try it out. Image: Getty Images

Mind

Orchestra brings joy to people with dementia

An orchestra in Manchester is offering free music therapy workshops to people with dementia based in an unusual location - a monastery. Manchester Camerata have delivered a program called Music in Mind since 2012, with its nine musicians and two music therapists delivering weekly music therapy sessions to 20 local aged care homes. <img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845044/music-dementia1.jpg" alt="" data-udi="umb://media/5dad496ff0bc4f3da69545d44a34b053" /> Manchester Camerata have been providing music therapy to those with dementia for the last nine years. Image: Manchester Camerata After COVID-19 saw the team pivot to an online offering, they returned to in-person sessions inside the 149-year-old Gorton Monastery as the UK eased health restrictions. During the weekly sessions, the musicians share their knowledge, techniques, and resources with those caring for people with dementia so they can continue to use music therapeutically at home. “Our new music cafe offers such a fantastic and vital opportunity for all at-home carers to make new friends and learn new life-enhancing skills,” Lizzie Hoskin, Head of Camerata in the Community, <a rel="noopener" href="https://www.itv.com/news/granada/2021-09-15/manchester-camerata-runs-weekly-music-sessions-for-people-with-dementia" target="_blank">said</a>. “We are very proud to be able to make this service possible, especially for those who’ve been isolating because of the pandemic and have spent so much time apart with little or no support.” David Tollington, a french horn player in the orchestra, <a rel="noopener" href="https://www.bbc.com/news/av/uk-england-manchester-58595926" target="_blank">said</a> the sessions show “the power of music” for those with dementia. He said some people taking part don’t “remember what they have had for breakfast but they remember the entire lyrics to a song”. When it comes to music and memory, it can have a range of <a rel="noopener" href="https://practicalneurology.com/articles/2017-june/music-and-dementia-an-overview" target="_blank">positive effects</a> on those diagnosed with dementia. <a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/24009169/" target="_blank">Some studies</a> have shown that listening to music or singing in music therapy sessions can improve an individual’s general cognition, and their ability to pay attention. Singing has also been shown to evoke remote memories, resulting in people being better able to recall short stories as well as the names of children and friends. Image: Manchester Camerata

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