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Shane Dixon's heartbreaking posts before cruise plunge

<p>Shane Dixon sadly <a href="https://www.oversixty.com.au/travel/travel-trouble/sad-reason-why-sydney-dad-went-overboard" target="_blank" rel="noopener">plunged to his death</a> on May 6 on board a P&O cruise ship, after racking up a $9000 casino debt that he couldn't afford to pay. </p> <p>His family said that the debt, on top of series of personal tragedies and setbacks, including health issues, family deaths, and the breakdown of his marriage which led to him being estranged from his three children, was the last straw for Shane. </p> <p>"[After he lost the money] his brain would have been going 100 miles an hour. He probably thought, 'F*** it, I can't afford it,'" his brother Scott Dixon told <em>Daily Mail Australia</em>. </p> <p>Shane was the eldest of five children to parents Susan and Wilbur, and grew up in Campbelltown, Sydney's western suburbs.</p> <p>His youngest brother, Dylan who was a twin, tragically died at just three months old in 1993, leaving a mark on the family. </p> <p>In 2009, Shane lost his father at the age of 54, and the loss had a huge effect on Shane who described him as the "strength of the family" and "life of all parties".</p> <p>Adding to the pain, Shane was also experiencing heart problems and his brother Scott was diagnosed with a terminal illness, which he is still fighting. </p> <p>On top of that Shane was also struggling with the breakdown of his marriage, and now old Facebook posts about his struggles have re-emerged. </p> <p>"F***ing sucks.. Now over 12 years [and I have] not seen or herd [sic] from my kids," he wrote in September.</p> <p>"Not knowing how they [are] doing or if they [are] going through hard times just sucks."</p> <p>On December 31, 2022 he wrote: "The only happy [thing about] New Years is that hopefully 1 year will be happy for me when I meet my kids again."</p> <p>"12 years to not see or hear from you.. Breaks me every year but I stay strong, hoping one new year my dreams will come true," he wrote with a picture of his three young children. </p> <p>Sadly, he never got to fix his broken relationship with his children.</p> <p>In another eerie post obtained by <a href="https://www.dailymail.co.uk/news/article-13424493/Shane-Dixon-P-O-cruise-debt-suicide-eerie-post.html" target="_blank" rel="noopener"><em>Daily Mail Australia</em></a>, last year the truck driver described how May was his "hardest month".  </p> <p>"My hardest month May is just around the corner," he wrote on April 2023. </p> <p>"[It's] not only my birthday, but my eldest girl turns 18 that I have not seen or heard from in over 12 years. My boy turns 15 and [it's] the same situation as my girl. [It's] my dad's birthday also who passed away in 2009 [at] only 54 years of age.</p> <p>"So yes, to me life is f***ed. [So] don't judge me or let's just swap shoes."</p> <p>His eldest daughter turned 19 this year, just three days after his death, and Shane would've been 46 in just one week. </p> <p>Several others have since spoken out on the enticing gambling tactics, and Shane's friend that he made on board the cruise even <a href="https://www.oversixty.com.au/travel/cruising/it-seems-crazy-shane-dixon-s-gambling-friend-breaks-his-silence" target="_blank" rel="noopener">recalled</a> how "full of energy and happy" Shane was just hours before his death. </p> <p>Earlier this week, a P&O spokeswoman told<em> Daily Mail Australia</em> that  it would be inappropriate to comment on Shane's death as the matter is under investigation from the coroner. </p> <p>In response to the other allegations and calls for a <a href="https://www.oversixty.com.au/travel/cruising/these-are-people-s-lives-calls-for-gambling-reform-after-fatal-cruise-ship-plunge" target="_blank" rel="noopener">gambling reform</a>, she said: "P&O Cruises Australia appreciates the feedback from guests."</p> <p>"We have Responsible Gaming Conduct Policies on all P&O ships and take those policies seriously."</p> <p>"We encourage any guest with concerns to get in contact with us so that we can investigate."</p> <p><em>Images: Facebook</em></p>

Cruising

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“Truly disgraceful”: Landlord cops backlash after posting photo of evicted tenant

<p>A landlord in Victoria has been slammed online after posting a photo of a former tenant who was evicted, and was forced to live in their car.</p> <p>The picture was originally posted to the private Landlords Victoria Facebook page, but was then leaked to X (formerly Twitter), and shows an old Nissan sedan with a tarp over the top, where a person was living after getting evicted from a rental.</p> <p>The landlord had described the tenant’s living situation as “karma” for the financial toll her eviction process had taken on him, claiming he dealt with years of legal battles.</p> <p>He claims he was left out of pocket to the tune of “thousands of dollars”.</p> <p>“Took me almost three years to get this person out of my rental,” he wrote in the post. “It seems she had trouble finding a new place to live."</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="qme"><a href="https://twitter.com/hashtag/ALAB?src=hash&amp;ref_src=twsrc%5Etfw">#ALAB</a> <a href="https://t.co/2WEn1hyBnf">pic.twitter.com/2WEn1hyBnf</a></p> <p>— Purplepingers (@purplepingers) <a href="https://twitter.com/purplepingers/status/1790345077816279280?ref_src=twsrc%5Etfw">May 14, 2024</a></p></blockquote> <p>“I am thousands of dollars out of pocket in legal fees and lost rent not to mention the stress and frustration with VCAT ... Looking at this karma must be real.”</p> <p>The landlord added that it “must be bloody freezing” and gloated that the woman was “not (in) an enviable position”.</p> <p>The landlord's post welcomed a wave of criticism, as many took aim at the landlord for broadcasting, and even taking pleasure in his former tenant's hardship. </p> <p>One social media comment accused the landlord of “publicly shaming and degrading her", while another said the post was “truly disgraceful”.</p> <p>While several people were disgusted by the landlord’s lack of empathy, others defended his rights as a property owner.</p> <p>“I wouldn’t want to see my tenant in that situation. But the fact is unless they pay the rent on time it won’t be me turning them out onto the street,” one person wrote. </p> <p><em>Image credits: X (Twitter)</em></p>

Money & Banking

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King Charles unveils first post-coronation portrait

<p>King Charles has unveiled his first post-coronation portrait in a special ceremony at Buckingham Palace. </p> <p>The painting by Jonathan Yeo - known for portraits of celebrities including Nicole Kidman, Paris Hilton and Grayson Perry - was commissioned in 2020 to celebrate the then Prince of Wales’ 50 years as a member of charitable institution The Drapers’ Company. </p> <p>Yeo had four sittings with the King, with the first sitting when Charles was still Prince of Wales in June 2021 at his country home in Highgrove, and the last sitting in November 2023 at Clarence house. </p> <p>The portrait  – approximately 2.6 metres by 2 metres framed – depicts King Charles wearing the uniform of the Welsh Guard. </p> <p>“It was a privilege and pleasure to have been commissioned by The Drapers’ Company to paint this portrait of His Majesty The King, the first to be unveiled since his Coronation,” the artist said.</p> <p>“When I started this project, His Majesty The King was still His Royal Highness The Prince of Wales, and much like the butterfly I’ve painted hovering over his shoulder, this portrait has evolved as the subject’s role in our public life has transformed.</p> <p>“I do my best to capture the life experiences etched into any individual sitter’s face.</p> <p>“In this case, my aim was also to make reference to the traditions of Royal portraiture but in a way that reflects a 21st century monarchy and, above all else, to communicate the subject’s deep humanity,” said Mr Yeo.</p> <p>“I’m unimaginably grateful for the opportunity to capture such an extraordinary and unique person, especially at the historic moment of becoming King.”</p> <p>The King and Queen met The Master of The Drapers’ Company, Tom Harris and Past Master, William Charnley on Tuesday at Buckingham Palace. </p> <p>The portrait will go on public display for a month at the Philip Mould Gallery in London, from May 16 until June 14 and will be displayed at Drapers’ Hall from the end of August.</p> <p><em>Images: news.com.au</em></p> <p> </p>

Art

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"Best part of my life": Terri Irwin's moving Mother's Day post

<p>Terri Irwin has celebrated Mother's Day by reflecting on being a single parent to Bindi and Robert. </p> <p>Irwin called motherhood the “best part of my life,” writing that it had given her “purpose” after Steve's untimely death in 2006. </p> <p>The 59-year-old shared a series of photos with her two children, Bindi and Robert, who are now 25 and 20 years old.</p> <p>“Being a mum is the best part of my life,” she said on Instagram.</p> <p>“When Steve passed, it was not a burden being a single mum, it was actually my children that gave me purpose, courage, and happiness every day.”</p> <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-permalink="https://www.instagram.com/p/C65S8q7rqmr/?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/C65S8q7rqmr/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Terri Irwin (@terriirwincrikey)</a></p> </div> </blockquote> <p>“Bindi and Robert are the reason I can stand strong, meet every challenge, and embrace every adventure.</p> <p>“As a mother, I am truly blessed.”</p> <p>Bindi responded to the post, “I love these beautiful photos and memories. Thank you for ALWAYS being there for me and Robert. And now for Grace. It means more than I can possibly describe. I love you.”</p> <p>“Love you mum!” Robert wrote.</p> <p>Bindi also celebrated Mother's Day by posting her own tribute to her mum, posting a throwback picture and writing, "Happy Mother’s Day to this amazing woman. My mum. Her commitment to conservation and making the world a better place inspires me every day. I love you."</p> <p>The young wildlife warrior also shared a photo of her daughter Grace on the special day, paying tribute to the child who made her a mum. </p> <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-permalink="https://www.instagram.com/p/C64Mo3Hve1M/?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/C64Mo3Hve1M/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bindi Irwin (@bindisueirwin)</a></p> </div> </blockquote> <p>Bindi shared a series of photos with her daughter, writing, "Grace Warrior, when I look at you, I know the meaning of life."</p> <p>"Being your Mama is the best part of my existence."</p> <p class="css-1n6q21n-StyledParagraph e4e0a020" style="box-sizing: border-box; overflow-wrap: break-word; word-break: break-word; margin: 0px 0px 1.125rem; line-height: 25px;"><em>Image credits: Instagram </em></p>

Family & Pets

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"It loses its value": Calls for the Last Post to be canned from Anzac Day footy

<p>A radio host has called for the Last Post to be canned from the majority of Anzac Day football games, saying it has lost its meaning over the years, leaving people with "bugle fatigue". </p> <p>An Anzac Day AFL match has taken place every year at the MCG on Anzac Day since 1995, with Collingwood and Essendon going head to head year after year.</p> <p>It was the brainchild of then Essendon coach Kevin Sheedy who had also served in the Australian Army during his playing days for Richmond.</p> <p>The game started as a one off-match, which quickly snowballed into an entire round of games, while the NRL also joined in and created their own Anzac Day matches.</p> <p>Traditionally, each game starts with a ceremony of recognition of our veterans and a performance of the Last Post. before the game kicks off. </p> <p>The addition of the several extra games, all which begin with the Last Post, prompted radio host Greg 'Marto' Martin from Brisbane's <em>Triple M Breakfast with Marto, Margaux & Dan</em> to call for The Last Post to be scrapped from all matches, except the annual fixture between Essendon and Collingwood. </p> <p>"Football has now turned [The Last Post] into a gimmick," he said.</p> <p>"Back in 1995 when Kevin Sheedy, the coach of Essendon, he said, 'Let's have an Anzac Day clash at the MCG,' I reckon it's the most… spine tingling three minutes or so." </p> <p>"97,000 at the MCG… not one person yelling out while that's being played and, the honour that they give to all serving soldiers and returned soldiers is quite extraordinary."</p> <p>"But now what's happened, as football always does, and I'm not just talking AFL I'm talking rugby league as well, they've taken a wonderful thing and they've gone, 'Oh that's good —'"</p> <p>Margaux interrupted saying: "How can we capitalise!"</p> <p>Marto continued, "So what's going to happen this week in all eight games of the AFL and all eight games of the rugby league… every single one of them will play this [The Last Post] and you'll get ANZAC - you'll get bugle fatigue."</p> <p>"We have to stop it somewhere."</p> <p>Margaux said, "It gets saturated, so it loses its value. They all think they are doing the right thing, but all they are doing is turning it into a mockery."</p> <p>The AFL has confirmed that all nine matches across round seven will hold special Anzac observance ceremonies ahead of each game, with AFL General Manager Commercial Peta Webster saying, "Anzac Day is one of our country's most important national occasions so I'd encourage all fans attending matches throughout the round to arrive early to soak up the atmosphere and pre-match formalities that will no doubt be another moving tribute to the sacrifices of our past and present service men and women."</p> <p><em>Image credits: Getty Images </em></p>

Travel Trouble

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

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

Mind

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Princess Kate's post-surgery pic ignites even wilder conspiracy theories

<p>In a recent revelation that has the internet buzzing, Kensington Palace released a brand new photo of the Princess of Wales alongside her adorable brood, but it seems like the royal family might be playing with more than just thrones and crowns.</p> <p>The picture, meant to express gratitude to the public for their support during Catherine's recovery from abdominal surgery, quickly became a subject of speculation, leaving royal enthusiasts scratching their heads and raising eyebrows faster than you can say "corgi".</p> <p>The image, which features Catherine sitting and embracing her children – Prince Louis, Prince George and Princess Charlotte – in the scenic backdrop of Windsor, seems like a wholesome Mother's Day tribute at first glance. However, upon closer inspection, the cracks in this picture-perfect façade begin to show.</p> <p>Social media erupted with theories faster than a racehorse at Ascot. Some eagle-eyed observers speculated that the photo might have been the handiwork of artificial intelligence, citing suspiciously green grass and leaves in the dead of winter, a rarity even in England where the weather is as unpredictable as a teenage royal's romantic interests.</p> <p>"AI is that you?" asked one astute commentator on Instagram, voicing the suspicions of many.</p> <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/C4U_IqTNaqU/?utm_source=ig_embed&amp;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/C4U_IqTNaqU/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>"Ummmmm, this photo looks doctored…" wrote another astute reader. "Catherine’s right hand around Louis is entirely blurry but the left hand around Charlotte, at the same distance to the camera, is not, and either is Louis’ jumper around the hand blurry. Also Charlotte’s dress, which is clothing her torso behind her arm, impedes on the sleeve at the wrist… the cardigan sleeve shows the dress in front of it, when it should only be behind. And Louis’ middle finger must be awfully long to be entirely wrapped around the next finger without being able to see the finger nail… it’s also blurry. I’m a keen photographer, and those are not true elements of a photo as taken."</p> <p>But wait, there's more! The absence of Catherine's wedding ring did not escape the notice of keen observers, prompting questions about the state of her marriage. "WHERE'S YOUR RING??!" demanded one fan, while another pondered, "no ring, tree in full bloom in winter, jeans after major abdominal surgery, face shape completely different from car photo."</p> <p>And if that wasn't enough to fuel the royal gossip mill, Prince Louis's peculiar finger-crossing gesture sent conspiracy theorists into overdrive. Is he sending secret messages? Or is it just further evidence that we're all living in a simulation run by an eccentric royal fan with a knack for Photoshop?</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Additionally, a subtle misalignment in Princess Charlotte's hand compared to her jumper sleeve raised clear suspicions of digital manipulation. As the speculation grew louder, four of the world's largest photo agencies – The Associated Press, AFP, Getty Images and Reuters – issued a "mandatory kill notice", on the image, effectively retracting it from circulation.</span></p> <p>The reasons cited varied slightly among the agencies, with mentions of "editorial issues" and inconsistencies in the photograph's details. The decision to retract the photo wasn't taken lightly; it's a standard protocol for picture agencies to withdraw images that have been significantly altered.</p> <p>The reaction on social media was swift, with royal watchers and media personalities dissecting the image for clues. Chris Ship, ITV News's royal editor, shared close-up sections of the photo, highlighting apparent discrepancies in Charlotte's sleeve, Prince Louis's jumper, and the background behind him. His commentary underscored the seriousness of the situation, questioning Kensington Palace – the source of the photo – about the authenticity of the image.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I’ve never been much of a conspiracy theorist but if <a href="https://twitter.com/AP?ref_src=twsrc%5Etfw">@AP</a> <a href="https://twitter.com/AFP?ref_src=twsrc%5Etfw">@AFP</a> <a href="https://twitter.com/Reuters?ref_src=twsrc%5Etfw">@Reuters</a> &amp; other picture agencies are concerned enough to remove it and ask clients to delete it, there are serious questions for Kensington Palace - which was the source of the photo.<br />These appears to be the issues 👇 <a href="https://t.co/ifcSB9mUzu">https://t.co/ifcSB9mUzu</a> <a href="https://t.co/bH5gN9fJtJ">pic.twitter.com/bH5gN9fJtJ</a></p> <p>— Chris Ship (@chrisshipitv) <a href="https://twitter.com/chrisshipitv/status/1766947758529822803?ref_src=twsrc%5Etfw">March 10, 2024</a></p></blockquote> <p>Amidst the fervent speculation, Kensington Palace remained silent, neither confirming nor denying the allegations of photo manipulation. The lack of clarity has only fuelled the fire, leading to further conjecture about the intentions behind the controversial image.</p> <p>In a world where every pixel is scrutinised and every detail dissected, the royal family's attempt at a heartwarming family photo has turned into a comedic saga worthy of a Shakespearean farce.</p> <p>As the internet continues to buzz with speculation, one thing is for certain: when it comes to the royals, truth is often stranger than fiction. Or in this case, more digitally manipulated than reality TV.</p> <p><em>Image: Instagram</em></p>

Caring

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Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>.</p> <p><a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment.</p> <p>Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.</p> <h2>Walk, run, lift, or dance away depression</h2> <p>We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together.</p> <p>We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.</p> <p>Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.</p> <p>But of these exercises, people were most likely to stick with strength training and yoga.</p> <p><iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing.</p> <p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p> <h2>Join a program and go hard (with support)</h2> <p>Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.”</p> <p>But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.</p> <p>We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.</p> <h2>Yes, it’s hard to keep motivated</h2> <p>We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.</p> <p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.</p> <p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p> <p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p> <p>Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult.</p> <p>A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.</p> <p>Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it.</p> <p>So, when starting out, it seems wise to avoid going it alone. Instead:</p> <ul> <li> <p>join a fitness group or yoga studio</p> </li> <li> <p>get a trainer or an exercise physiologist</p> </li> <li> <p>ask a friend or family member to go for a walk with you.</p> </li> </ul> <p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p> <h2>Let’s make this official</h2> <p>Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.</p> <p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p> <p>In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression.</p> <p>Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.</p> <p><em>I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.</em></p>

Body

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Johnny Ruffo's partner shares heartbreaking post about grief

<p>Johnny Ruffo's girlfriend has shared her first Instagram post of 2024, sharing how she is getting through since the loss of her partner. </p> <p>Tahnee Sims took to social media to share a selection of photos from the highlights of January and February, with the snaps showing her smiling and having fun with friends. </p> <p>In amongst the pictures of the good days, the 30-year-old posted a devastating quote about grief from novelist Anne Lamott, as she continued to struggle with the loss of Johnny. </p> <p>“You will lose someone you can’t live without, and your heart will be badly broken, and the bad news is that you never get over the loss of your beloved,” read the quote Sims shared on Sunday.</p> <p>“But this is also the good news."</p> <p>“They live forever in your broken heart that doesn’t seal back up, and you come through."</p> <p>“It’s like a broken leg that never heals perfectly — that still hurts when the weather gets cold, but you learn to dance with the limp.”</p> <p>Friends and family flocked to the comments on the post to share their love and support for Tahnee. “So good to see you smiling again,” wrote Home and Away star Lynne McGranger, a close friend of Ruffo’s.</p> <p>“Loving seeing these happy moments. Am sure there are still lots of hard ones too, but focus on the positives and the future,” one follower said.</p> <p>“Stay strong, beautiful girl,” said a third. “He would want this.”</p> <p>Johnny Ruffo passed away on November 10th last year at the age of 35 after a long battle with brain cancer. </p> <p><em>Image credits: Instagram</em></p>

Family & Pets

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Jackie O opens up on loneliness post-divorce

<p>Jackie 'O' Henderson has opened up on being gripped with feelings of loneliness in the years following her divorce. </p> <p>Speaking with fans at Luke McLeod's book launch for <em>Everyday Enlightenment</em> on Thursday night, the 49-year-old admitted she is "desperate" to find love and companionship. </p> <p>After being single for over five years, Jackie said it feels like "something's missing" in her life. </p> <p>"I just really want to find someone. I can't find him and I'm sort of a bit lost at the moment," she said. </p> <p>When Luke asked why she was so desperate to get into a relationship, Jackie said she couldn't quite put her finger on it, but it felt like "a piece" of her was "missing".</p> <p>"I have a lot of love to give or I want that affection, that company. It just feels like there's something missing in my life," she added.</p> <p>Jackie went on to tell her fans that Luke had previously given a piece of advice that "changed my life". </p> <p>He said she was giving off too much "desperate energy", and if she really wanted to attract love in her life, then she needed to be grateful for what she already has.  </p> <p>"I said to him, 'How am I meant to change what I want and need? I feel like I need that in my life and I really want that. I can't just switch that off,'" she admitted.</p> <p>Jackie has been adopting Luke's technique, and makes time every day to express gratitude for what she already has, and not for what she's missing. </p> <p>'Now I'm at a place where I've almost gone the other way. I'm so happy being single and not looking for someone because I'm genuinely happy with my life,' she said.</p> <p>Jackie O separated from her husband Lee Henderson in 2018 after they married in 2003, with the pair now co-parenting their daughter Kitty. </p> <p><em>Image credits: Instagram</em></p>

Relationships

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Deborra-Lee Furness breaks silence on life post-divorce

<p dir="ltr">Deborra-Lee Furness has broken her silence on what life has looked like since her high profile split from Hugh Jackman. </p> <p dir="ltr">The Aussie actress has hit the press circuit promoting <em>Force of Nature: The Dry 2</em>, the sequel to the hit 2020 film, in which she’ll star alongside Eric Bana.</p> <p dir="ltr">Facing questions about her divorce, the 68-year-old finally broke her silence on how she has been dealing with life as a single woman. </p> <p dir="ltr">“It is kind of exciting,” she told <a href="https://www.adelaidenow.com.au/entertainment/celebrity-life/hook-ups-break-ups/deborralee-furness-on-life-without-hugh-jackman-frightening/news-story/dc4fa3f9e19c80ea9dada89a852e67c0"><em>The Advertiser</em>.</a></p> <p dir="ltr">“You know what, change, transition, evolution is a little frightening, and we are all a bit scared of it, but I think it is probably our greatest gift.”</p> <p dir="ltr">Deborra-Lee Furness and Hugh Jackman shocked the world in September last year when they announced they would be separating after 27 years of marriage. </p> <p dir="ltr">The couple released a joint statement at the time announcing they were going their separate ways and had decided to split to pursue “individual growth”.</p> <p dir="ltr">“We have been blessed to share almost three decades together as husband and wife in a wonderful, loving marriage,” they said.</p> <p dir="ltr">“Our journey now is shifting, and we have decided to separate to pursue our individual growth.”</p> <p dir="ltr">They added that their family is their highest priority and that they will undertake “this next chapter with gratitude, love and kindness”.</p> <p dir="ltr">The couple met in 1995 on the set of an Australian television show they both starred in, and married just one year later. </p> <p dir="ltr">Together they share two children, Oscar and Ava. </p> <p dir="ltr"><em>Image credits: Getty Images</em></p> <p><span id="docs-internal-guid-9556549a-7fff-b18e-2baf-242c622406aa"></span></p>

Relationships

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AusPost customer faces extra charge for using cash

<p dir="ltr">As conversations continue about moving to a cashless society, an Australia Post customer was outraged after being slapped with a charge for using cash. </p> <p dir="ltr">Brisbane resident Gerrie Hoogland shared her outrage after hearing about the supposed cash charge through a friend, who claims they were charged $2.20 for wanting to use cash to pay a bill. </p> <p dir="ltr">Hoogland recounted the story on X, formerly known as Twitter, to share the story, while asking if anyone else had encountered anything similar. </p> <p dir="ltr">She wrote, “A friend of my husband’s went to pay a bill at the Post Office last week. He gave them $82.00 in cash and they said they would have to charge him $2.20 for using cash.”</p> <p dir="ltr">“He refused to pay it after telling them cash is legal tender, and then he left without paying the bill at all. Is anyone else hearing more of this?”</p> <p dir="ltr">A number of Aussies took to the comments to call out Australia Post for being “shady”, with some calling the fee a “scam” and a “disgrace”. </p> <p dir="ltr">However the outrage towards Australia Post may be misplaced. </p> <p dir="ltr"><em><a href="https://au.finance.yahoo.com/news/australia-post-customer-charged-220-for-using-cash---but-is-the-outrage-warranted-025519571.html">Yahoo Finance</a></em> has contacted the national postal service and understands the fee is set by individual billers, rather than Australia Post themselves.</p> <p dir="ltr">The fee relates to bills paid in person at an Australia Post outlet via Post Billpay and can apply to both cash and card transactions, and whether or not the fee is passed onto the customer will depend on the individual biller. </p> <p dir="ltr">In recent years, a number of billers charge an additional payment fee for bills paid in person, with some notable examples include telcos Telstra, Optus and Vodafone.</p> <p dir="ltr"><em>Image credits: Shutterstock</em><span id="docs-internal-guid-934db778-7fff-f88e-e460-f8550a0ce109"></span></p>

Money & Banking

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Tourist fined after posting this one photo on social media

<p>A man has been fined after flouting the rules to get the perfect photo with a quokka at Rottnest Island. </p> <p>The tourist was visiting the popular nature reserve, off the coast of Western Australia, when he was tracked down by authorities after posting a photo of him holding the marsupial on Instagram, despite signs saying not to touch the vulnerable animals. </p> <p>"Feeding and touching quokkas is not permitted for the safety of visitors and the welfare of the animals," A Rottnest Island Authority spokesperson told <em>Perth Now</em>. </p> <p>The unnamed tourist copped a $200 fine and an infringement was issued over the weekend, but the spokesperson said he was not evicted from the island.</p> <p>The Rottnest Island website also clearly states the rules against touching the furry animals.</p> <p>"It’s important, for their safety and yours, that you don’t touch the quokkas," the website read. </p> <p>Tourists are also warned that touching the marsupials can make them sick, spread disease and cause mothers to abandon their young if they carry an unfamiliar scent. </p> <p>Samuel Cornell, a research fellow from UNSW, told <em>Yahoo News Australia </em>that these rules exist for a reason. </p> <p>"The rules are there usually to protect people's own safety, first and foremost. And then secondly, of course, we enact rules to protect the environment," Cornell said. </p> <p>"They are still wild animals, but because they're plastered all over social media and people are used to seeing pretty pictures with them, I think people then have this interpretation of them that they're just some fluffy, safe creature that you can just go up to and pick up."</p> <p>Cornell added that tourists flouting the rules is not just an issue in Rottnest Island, but "a problem across Australia," including popular tourists destinations like K'gari (formerly Fraser Island), Babinda boulders, and Wedding Cake Rock in Sydney. </p> <p>"Some people do just ignore rules or signs because they think they know better or they really want a photo in a certain place," he explained. </p> <p>"But there are a subset of people that will claim 'oh, I didn't actually see the sign or I wasn't really aware'".</p> <p><em>Images: PerthNow/ Getty</em></p>

Travel Trouble

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Elderly woman reduced to tears by irate postie

<p>Australia Post is investigating an incident of extreme road rage, after a postie reduced an elderly woman to tears. </p> <p>The postman was driving a three-wheeled electric delivery vehicle on the Gold Coast on Monday morning, when an elderly woman almost struck him on a roundabout. </p> <p>The mailman then instructed the woman to pull over, and began berating her until she burst into tears.</p> <p>The altercation was filmed by a passerby, who attempted to intervene to assist the older woman, an 80-year-old named Kay.  </p> <p>“You’re supposed to give way at the roundabout,” the man is heard yelling in footage of the incident aired by <em>Nine News</em>. </p> <p><iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/video.php?height=314&href=https%3A%2F%2Fwww.facebook.com%2F9NewsGoldCoast%2Fvideos%2F1680294369165021%2F&show_text=false&width=560&t=0" width="560" height="314" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></p> <p>“You’re supposed to stop at the roundabout."</p> <p>“Why were you not seeing me?”</p> <p>Bystander Melissa Burrows ran to the aid of Kay, who was visibly upset by the altercation, with Burrows asking the postie to tone down his tirade. </p> <p>“She’s an older lady,” Ms Burrows is heard telling the postie. “She’s scared. Please stop.”</p> <p>“I didn’t see you,” Kay told the postie.</p> <p>Ms Burrows then threatens to call the police on the postie, who responds with a “go away”.</p> <p>“Leave her alone and let her go,” she said.</p> <p>“Can you just slow down next time, please?” the postie asks the elderly woman.</p> <p>“I’m so sorry I didn’t see you,” Kay reaffirms.</p> <p>Speaking to Melissa after the postie drove away, Kay said, “I didn’t even touch him, but I didn’t see him either. I can’t believe how he’s reacted.”</p> <p>Ms Burrows later told the broadcaster the incident was “absolutely horrifying” and a “tirade of incredible abuse”.</p> <p>Australia Post told <a href="https://www.news.com.au/technology/motoring/on-the-road/tirade-of-incredible-abuse-furious-postie-unleashes-on-elderly-gold-coast-driver/news-story/2c9985732e80970951aa73a6f03e1988" target="_blank" rel="noopener"><em>news.com.au</em></a> an investigation will be conducted reviewing video captured before and after the incident. </p> <p>“Australia Post’s Electric Delivery Vehicles (eDVs) are equipped with on-board telematics which capture video footage and data designed to help keep our people safe on the roads,” a spokesperson said.</p> <p><em>Image credits: Nine News</em></p>

Travel Trouble

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Robert Irwin's girlfriend sparks engagement rumours with sweet birthday post

<p>Robert Irwin's girlfriend, Rorie Buckey has shared a sweet birthday tribute for the Wildlife Warrior's 20th birthday, and the post has added fuel to the engagement rumours. </p> <p>"Happy birthday to the most radiant, beautiful human being. You are my everything," she captioned the photo of Robert on her Instagram stories. </p> <p>She then shared an Instagram post dedicated to her beau with the caption: "Happy 20th birthday to my partner in crime and best friend. I love you." </p> <p>"Awww Rorie ❤️ thank you, I can’t wait to enter my 20th year with you!" Robert replied in the comments. </p> <p>The pair are currently in a long-distance relationship with Rorie based in Perth and Robert in Queensland. </p> <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/reel/C0RrFb5vgaB/?utm_source=ig_embed&amp;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/reel/C0RrFb5vgaB/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Rors 🦋💌🌼🌷 (@roriebuckey)</a></p> </div> </blockquote> <p>But that doesn't stop their love from blooming, with Rorie already winning the hearts of the young conservationist's family after showing her willingness to go out into nature. </p> <p>Robert is reportedly planning to propose in the coming months, when Rorie visits him in Africa while he films <em>I'm A Celebrity</em>.</p> <p>"Everyone is convinced he is aiming to pop the question when they're in Africa," an insider told <em>New Idea magazine</em>.</p> <p>"Robert is crazy about her and is planning something unforgettable when he formally proposes. They both know it is part of their plans so he's been dreaming up special ways to make it a surprise."</p> <p>The source added that the young lovebirds are taking their relationship "very serious," and have been planning their future together. </p> <p>Robert and Rorie first made their <a href="https://www.oversixty.com.au/lifestyle/beauty-style/robert-irwin-makes-red-carpet-debut-with-girlfriend" target="_blank" rel="noopener">red carpet debut</a> as a couple in July, after months of rumours that the pair were dating. </p> <p><em>Images: Instagram</em></p>

Relationships

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"I was so scared": Chezzi Denyer's shocking mental health revelation

<p>Chezzi Denyer has opened up about the moment she decided to seek professional help for a debilitating mental health condition. </p> <p>Grant Denyer's wife shared an emotional post on Instagram, marking the 10 year anniversary of the day she made a major change after struggling with post-natal depression and PTSD. </p> <p>In a lengthy caption, she wrote, “Ten years ago, today, I made a very scary step and began professional treatment for Post Traumatic Stress Disorder, and Postnatal Anxiety."</p> <p>“At the time I was unable to articulate what I was feeling, or understand why. For some time I had exhausted myself trying to conceal it.”</p> <p>She said that she felt "scared" to admit she was struggling, out of fear she would be called "crazy". </p> <p>“Scared to sleep most nights because of the night terrors,” she wrote.</p> <p>“The repeated visions of the very things that had scarred me, waking me shaking. I would die graphically in my dreams. Scared to care for my young daughter Sailor at times."</p> <p>“I had never experienced anxiety up to this point so I didn’t know what it was ... but my fear over her becoming unwell or injured left me paralysed at times.”</p> <p>Denyer said that as a seasoned “mask wearer”, she had laughed it off and became used to concealing her mental health battle.</p> <p>“Most people who knew me well had no idea of my personal battle,” she wrote.</p> <p>“While seeking help took me a number of attempts, as many dismissed me at first - my mask was strong - It has become the single most profound thing I have ever done in my life.</p> <p>“My entire world began to change on that day, ten years ago.”</p> <p>After seeking professional help, Chezzi learned the details of her own psychology, and began to forgive herself. </p> <p>“I learnt that I was not the sum of my affliction/ condition, and that there was a path out and to a much better place should I want that, and I did so very very much."</p> <p>“I worked through the pain, and the fear and while sometimes it felt too hard ... I continued to face it."</p> <p>“And today while I quietly smile about how far I’ve come, I wanted to share this quite personal post with you because I know that it will resonate with many people still trying to conceal and wear their masks.”</p> <p>Chezzi’s followers were stunned by the raw honesty of the post, with many thanking her for helping them to feel less alone.</p> <p>“Thank you for sharing so vulnerably,” one follower wrote.</p> <p>“I just know being open about your experience will help others feel less alone and will hopefully help someone to take that first step to ask for help. Thank you. Just thank you.”</p> <p><em>Image credits: Instagram</em></p>

Caring

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"It feels liberating": Nat Bass' surprising update on her love life post-divorce

<p>After months of trying to keep her divorce private, Natalie Bassingthwaighte has spoken out about her marriage breakdown, and finding love with a woman. </p> <p>Earlier this year, the Australian singer parted ways with her second husband, and longtime Rogue Traders bandmate, Cameron McGlinchey, although the pair never addressed the split personally. </p> <p>Now, three months on, Nat Bass has bared all in a candid interview with <em>Stellar</em> magazine, sharing why she chose to stay silent on her divorce, and how "overwhelming" it was when the press finally found out. </p> <p>“[I got a] phone call; I’d been waiting for it to happen, but [was] trying to protect our inner sanctum for so long, trying to navigate grief and really sit in it and feel it all. It hurts, trying to navigate what the next bits look like, especially as a couple who have two children, who work together,” she said. </p> <p>“So having public interest, I won’t lie, was terrifying from the get-go. Since it first happened, I was waiting for someone to say something. And it just felt like I wasn’t ready."</p> <p>Despite going their separate ways after 12 years of marriage, Nat says she doesn't look at her divorce as a failure, given all the love she still has for her ex-husband.</p> <p>“We had a very successful marriage. It was very beautiful. We’ve done amazing things together, achieved a lot and have two incredible children. We admire and respect each other, and there’s love there. It’s just different,” she said. </p> <p>After her divorce, Nat is moving on and finding love in unexpected places: with a woman. </p> <p>Bassingthwaighte said her “beautiful” new relationship “with a woman who makes my heart smile and makes me happy” has been difficult to navigate in the public eye, as she has yet to publicly identify her new partner. </p> <p>Struggling with revealing her same-sex relationship to the world, Nat called her ex-husband for advice. </p> <p>“I rang Cam and I was hysterical. And he said, ‘It’s OK. This is your truth and you now have to sit in it and stand in it and own it.’ So to have that support from him has been nothing short of beautiful, and I’m very grateful for it,” she says.</p> <p>“Now I can speak from my own mouth, on my own truth, and that feels rewarding. I’m OK. Everything is OK, and everyone is OK. We’re in a good space. It feels liberating."</p> <p><em>Image credits: Instagram / Stellar </em></p>

Relationships

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The rise and fall of antibiotics. What would a post-antibiotic world look like?

<p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p> </p> <p>These days, we don’t think much about being able to access a course of antibiotics to head off an infection. But that wasn’t always the case – antibiotics have been available for less than a century.</p> <p>Before that, patients would die of relatively trivial infections that became more serious. Some serious infections, such as those involving the heart valves, were <a href="https://pubmed.ncbi.nlm.nih.gov/20173297/">inevitably</a> fatal.</p> <p>Other serious infections, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070694/">tuberculosis</a>, weren’t always fatal. Up to a <a href="https://www.biorxiv.org/content/10.1101/729426v1.full.pdf">half</a> of people died within a year with the most severe forms, but some people recovered without treatment and the remainder had ongoing chronic infection that slowly ate away at the body over many years.</p> <p>Once we had antibiotics, the outcomes for these infections were much better.</p> <h2>Life (and death) before antibiotics</h2> <p>You’ve probably heard of Alexander Fleming’s accidental <a href="https://www.acs.org/education/whatischemistry/landmarks/flemingpenicillin.html">discovery of penicillin</a>, when fungal spores landed on a plate with bacteria left over a long weekend in 1928.</p> <p>But the <a href="https://www.ox.ac.uk/news/science-blog/penicillin-oxford-story">first patient</a> to receive penicillin was an instructive example of the impact of treatment. In 1941, Constable Albert Alexander had an infected scratch on his face that had become infected.</p> <p>He was hospitalised but despite various treatments, the infection progressed to involve his head. This required removing one of his eyes.</p> <p>Howard Florey, the Australian pharmacologist then working in Oxford, was concerned penicillin could be toxic in humans. Therefore, he felt it was only ethical to give this new drug to a patient in a desperate condition.</p> <p>Constable Alexander was given the available dose of penicillin. Within the first day, his condition had started to improve.</p> <p>But back then, penicillin was difficult to produce. One way of extending the limited supply was to “recycle” penicillin that was excreted in the patient’s urine. Despite this, supplies ran out by the fifth day of Alexander’s treatment.</p> <p>Without further treatment, the infection again took hold. Constable Alexander eventually died a month later.</p> <p>We now face a world where we are potentially running out of antibiotics – not because of difficulties manufacturing them, but because they’re losing their effectiveness.</p> <h2>What do we use antibiotics for?</h2> <p>We currently use antibiotics in humans and animals for a variety of reasons. Antibiotics reduce the duration of illness and the chance of death from infection. They also prevent infections in people who are at high risk, such as patients undergoing surgery and those with weakened immune systems.</p> <p>But antibiotics aren’t always used appropriately. <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/fulltext">Studies</a> consistently show a dose or two will adequately prevent infections after surgery, but antibiotics are <a href="https://irp.cdn-website.com/d820f98f/files/uploaded/surgical-prophylaxis-prescribing-in-australian-hospitals-results-of-the-2020-surgical-national-antimicrobial-prescribing-survey.pdf">often</a> continued for several days unnecessarily. And sometimes we use the wrong type of antibiotic.</p> <p><a href="https://irp.cdn-website.com/d820f98f/files/uploaded/antimicrobial-prescribing-practice-in-australian-hospitals-results-of-the-2020-hospital-national-antimicrobial-prescribing-survey.pdf">Surveys</a> have found 22% of antimicrobial use in hospitals is inappropriate.</p> <p>In some situations, this is understandable. Infections in different body sites are usually due to different types of bacteria. When the diagnosis isn’t certain, we often <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/resp.13334">err</a> on the side of caution by giving broad spectrum antibiotics to make sure we have active treatments for all possible infections, until further information becomes available.</p> <p>In other situations, there is a degree of inertia. If the patient is improving, doctors tend to simply continue the same treatment, rather than change to more appropriate choice.</p> <p>In general practice, the issue of diagnostic uncertainty and therapeutic inertia are often magnified. Patients who recover after starting antibiotics don’t usually require tests or come back for review, so there is no easy way of knowing if the antibiotic was actually required.</p> <p>Antibiotic prescribing can be more complex again if <a href="https://www.mja.com.au/journal/2014/201/2/antibiotic-prescribing-practice-residential-aged-care-facilities-health-care">patients</a> are expecting “a pill for every ill”. While doctors are generally good at educating patients when antibiotics are not likely to work (for example, for viral infections), without confirmatory tests there can always be a lingering doubt in the minds of both doctors and patients. Or sometimes the patient goes elsewhere to find a prescription.</p> <p>For other infections, resistance can develop if treatments aren’t given for long enough. This is particularly the <a href="https://pubmed.ncbi.nlm.nih.gov/11971765/">case</a> for tuberculosis, caused by a slow growing bacterium that requires a particularly long course of antibiotics to cure.</p> <p>As in humans, antibiotics are also used to prevent and treat infections in animals. However, a proportion of antibiotics are used for growth promotion. In Australia, an <a href="https://www.mja.com.au/journal/2019/211/4/antibiotic-use-animals-and-humans-australia">estimated</a> 60% of antibiotics were used in animals between 2005-2010, despite growth-promotion being phased out.</p> <h2>Why is overuse a problem?</h2> <p>Bacteria become resistant to the effect of antibiotics through natural selection – those that survive exposure to antibiotics are the strains that have a mechanism to evade their effects.</p> <p>For example, antibiotics are sometimes given to <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30279-2/fulltext">prevent</a> recurrent urinary tract infections, but a consequence, any infection that does <a href="https://academic.oup.com/cid/article/73/3/e782/6141409">develop</a> tends to be with resistant bacteria.</p> <p>When resistance to the commonly used first-line antibiotics occurs, we often need to reach deeper into the bag to find other effective treatments.</p> <p>Some of these last-line antibiotics are those that had been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202707/">superseded</a> because they had serious side effects or couldn’t be given conveniently as tablets.</p> <p>New drugs for some bacteria have been developed, but many are much more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955006/">expensive</a> than older ones.</p> <h2>Treating antibiotics as a valuable resource</h2> <p>The concept of antibiotics as a valuable resource has led to the <a href="https://pubmed.ncbi.nlm.nih.gov/8856755/">concept</a> of “antimicrobial stewardship”, with programs to promote the responsible use of antibiotics. It’s a similar concept to environmental stewardship to prevent climate change and environmental degradation.</p> <p>Antibiotics are a rare class of medication where treatment of one patient can potentially affect the outcome of other patients, through the transmission of antibiotic resistant bacteria. Therefore, like efforts to combat climate change, antibiotic stewardship relies on changing individual actions to benefit the broader community.</p> <p>Like climate change, antibiotic resistance is a complex problem when seen in a broader context. Studies have linked resistance to the values and priorities <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30186-4/fulltext">of governments</a> such as corruption and infrastructure, including the availability of electricity and public services. This highlights that there are broader “causes of the causes”, such as public spending on sanitation and health care.</p> <p>Other <a href="https://academic.oup.com/jac/article/74/9/2803/5512029?login=true">studies</a> have suggested individuals need to be considered within the broader social and institutional influences on prescribing behaviour. Like all human behaviour, antibiotic prescribing is complicated, and factors like what doctors feel is “normal” prescribing, whether junior staff feel they can challenge senior doctors, and even their <a href="https://www.nytimes.com/2016/10/07/upshot/your-surgeon-is-probably-a-republican-your-psychiatrist-probably-a-democrat.html">political views</a> may be important.</p> <p>There are also issues with the <a href="https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/value-assessment-of-antimicrobials-and-the-implications-for-development-access-and-funding-of-effective-treatments-australian-stakeholder-perspective/D45758CFB95520DA4FF06E46135E0628">economic model</a> for developing new antibiotics. When a new antibiotic is first approved for use, the first reaction for prescribers is not to use it, whether to ensure it retains its effectiveness or because it is often very expensive.</p> <p>However, this doesn’t really <a href="https://academic.oup.com/cid/article/50/8/1081/449089?login=true">encourage</a> the development of new antibiotics, particularly when pharma research and development budgets can easily be diverted to developing drugs for conditions patients take for years, rather than a few days.</p> <h2>The slow moving pandemic of resistance</h2> <blockquote> <p>If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine – <a href="https://amr-review.org/">David Cameron</a>, former UK Prime Minister</p> </blockquote> <p>Antibiotic resistance is already a problem. Almost all infectious diseases physicians have had the dreaded call about patients with infections that were essentially untreatable, or where they had to scramble to find supplies of long-forgotten last-line antibiotics.</p> <p>There are already hospitals in some parts of the world that have had to carefully <a href="https://www.reactgroup.org/news-and-views/news-and-opinions/year-2022/the-impact-of-antibiotic-resistance-on-cancer-treatment-especially-in-low-and-middle-income-countries-and-the-way-forward/">consider</a> whether it’s still viable to treat cancers, because of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276316/">high risk</a> of infections with antibiotic-resistant bacteria.</p> <p>A global <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext">study</a> estimated that in 2019, almost 5 million deaths occurred with an infection involving antibiotic-resistant bacteria. Some 1.3 million would not have occurred if the bacteria were not resistant.</p> <p>The UK’s 2014 <a href="https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf">O'Neill report</a> predicted deaths from antimicrobial resistance could rise to 10 million deaths each year, and cost 2-3.5% of global GDP, by 2050 based on trends at that time.</p> <h2>What can we do about it?</h2> <p>There is a lot we can do to prevent antibiotic resistance. We can:</p> <ul> <li> <p><a href="https://www.marketingmag.com.au/news/film-picking-gonorrhoea-wins-tropfest-prize/">raise</a> <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7258-3">awareness</a> that many infections will get better by themselves, and don’t necessarily need antibiotics</p> </li> <li> <p>use the antibiotics we have more appropriately and for as short a time as possible, supported by co-ordinated clinical and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437704/">public policy</a>, and <a href="https://www.amr.gov.au/">national</a> <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00796-4/fulltext">oversight</a></p> </li> <li> <p><a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/about-aura-surveillance-system">monitor</a> for infections due to resistant bacterial to inform control policies</p> </li> <li> <p>reduce the inappropriate use of antibiotics in animals, such as <a href="https://nam.edu/antibiotic-resistance-in-humans-and-animals/">growth promotion</a></p> </li> <li> <p><a href="https://pubmed.ncbi.nlm.nih.gov/11971765/">reduce</a> cross-transmission of resistant organisms in hospitals and in the community</p> </li> <li> <p>prevent infections by other means, such as clean water, <a href="https://apps.who.int/iris/bitstream/handle/10665/204948/WHO_FWC_WSH_14.7_eng.pdf">sanitation</a>, hygiene and <a href="https://www.who.int/teams/immunization-vaccines-and-biologicals/product-and-delivery-research/anti-microbial-resistance">vaccines</a></p> </li> <li> <p>continue developing new antibiotics and alternatives to antibiotics and ensure the right <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(23)00124-2/fulltext#:%7E:text=We%20consider%20four%20incentive%20options,exclusivity%20extensions%2C%20and%20milestone%20payments.">incentives</a> are in place to encourage a continuous pipeline of new drugs.</p> </li> </ul> <p><a href="https://theconversation.com/profiles/allen-cheng-94997"><em>Allen Cheng</em></a><em>, Professor in Infectious Diseases Epidemiology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-rise-and-fall-of-antibiotics-what-would-a-post-antibiotic-world-look-like-213450">original article</a>.</em></p>

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