War in Ukraine affected wellbeing worldwide, but people’s speed of recovery depended on their personality
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The war in Ukraine has had impacts around the world. Supply chains have been disrupted, the cost of living has soared and we’ve seen the fastest-growing refugee crisis since World War II. All of these are in addition to the devastating humanitarian and economic impacts within Ukraine.
Our international team was conducting a global study on wellbeing in the lead up to and after the Russian invasion. This provided a unique opportunity to examine the psychological impact of the outbreak of war.
As we explain in a new study published in Nature Communications, we learned the toll on people’s wellbeing was evident across nations, not just in Ukraine. These effects appear to have been temporary – at least for the average person.
But people with certain psychological vulnerabilities struggled to recover from the shock of the war.
Tracking wellbeing during the outbreak of war
People who took part in our study completed a rigorous “experience-sampling” protocol. Specifically, we asked them to report their momentary wellbeing four times per day for a whole month.
Data collection began in October 2021 and continued throughout 2022. So we had been tracking wellbeing around the world during the weeks surrounding the outbreak of war in February 2022.
We also collected measures of personality, along with various sociodemographic variables (including age, gender, political views). This enabled us to assess whether different people responded differently to the crisis. We could also compare these effects across countries.
Our analyses focused primarily on 1,341 participants living in 17 European countries, excluding Ukraine itself (44,894 experience-sampling reports in total). We also expanded these analyses to capture the experiences of 1,735 people living in 43 countries around the world (54,851 experience-sampling reports) – including in Australia.
A global dip in wellbeing
On February 24 2022, the day Russia invaded Ukraine, there was a sharp decline in wellbeing around the world. There was no decline in the month leading up to the outbreak of war, suggesting the change in wellbeing was not already occurring for some other reason.
However, there was a gradual increase in wellbeing during the month after the Russian invasion, suggestive of a “return to baseline” effect. Such effects are commonly reported in psychological research: situations and events that impact our wellbeing often (though not always) do so temporarily.
Unsurprisingly, people in Europe experienced a sharper dip in wellbeing compared to people living elsewhere around the world. Presumably the war was much more salient for those closest to the conflict, compared to those living on an entirely different continent.
Interestingly, day-to-day fluctuations in wellbeing mirrored the salience of the war on social media as events unfolded. Specifically, wellbeing was lower on days when there were more tweets mentioning Ukraine on Twitter/X.
Our results indicate that, on average, it took around two months for people to return to their baseline levels of wellbeing after the invasion.
Different people, different recoveries
There are strong links between our wellbeing and our individual personalities.
However, the dip in wellbeing following the Russian invasion was fairly uniform across individuals. None of the individual factors assessed in our study, including personality and sociodemographic factors, predicted people’s response to the outbreak of war.
On the other hand, personality did play a role in how quickly people recovered. Individual differences in people’s recovery were linked to a personality trait called “stability”. Stability is a broad dimension of personality that combines low neuroticism with high agreeableness and conscientiousness (three traits from the Big Five personality framework).
Stability is so named because it reflects the stability of one’s overall psychological functioning. This can be illustrated by breaking stability down into its three components:
- low neuroticism describes emotional stability. People low in this trait experience less intense negative emotions such as anxiety, fear or anger, in response to negative events
- high agreeableness describes social stability. People high in this trait are generally more cooperative, kind, and motivated to maintain social harmony
- high conscientiousness describes motivational stability. People high in this trait show more effective patterns of goal-directed self-regulation.
So, our data show that people with less stable personalities fared worse in terms of recovering from the impact the war in Ukraine had on wellbeing.
In a supplementary analysis, we found the effect of stability was driven specifically by neuroticism and agreeableness. The fact that people higher in neuroticism recovered more slowly accords with a wealth of research linking this trait with coping difficulties and poor mental health.
These effects of personality on recovery were stronger than those of sociodemographic factors, such as age, gender or political views, which were not statistically significant.
Overall, our findings suggest that people with certain psychological vulnerabilities will often struggle to recover from the shock of global events such as the outbreak of war in Ukraine.
Luke Smillie, Professor in Personality Psychology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hypertension: Factors Far More Relevant Than Salt
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Hypertension: Factors Far More Relevant Than Salt
Firstly, what is high blood pressure vs normal, and what do those blood pressure readings mean?
Rather than take up undue space here, we’ll just quickly link to…
Blood Pressure Readings Explained (With A Colorful Chart)
More details of specifics, at:
Hypotension | Normal | Elevated | Stage 1 | Stage 2 | Danger zone
Keeping Blood Pressure Down
As with most health-related things (and in fact, much of life in general), prevention is better than cure.
People usually know “limit salt” and “manage stress”, but there’s a lot more to it!
Salt isn’t as big a factor as you probably think
That doesn’t mean go crazy on the salt, as it can cause a lot of other problems, including organ failure. But it does mean that you can’t skip the salt and assume your blood pressure will take care of itself.
This paper, for example, considers “high” sodium consumption to be more than 5g per day, and urinary excretion under 3g per day is considered to represent a low sodium dietary intake:
Sodium Intake and Hypertension
Meanwhile, health organizations often recommend to keep sodium intake to under 2g or under 1.5g
Top tip: if you replace your table salt with “reduced sodium” salt, this is usually sodium chloride (regular table salt) cut with potassium chloride, which is almost as “salty” tastewise, but obviously contains less sodium. Not only that, but potassium actually helps the body eliminate sodium, too.
The rest of what you eat is important too
The Mediterranean Diet is as great for this as it is for most health conditions.
If you sometimes see the DASH diet mentioned, that stands for “Dietary Approaches to Stop Hypertension”, and is basically the Mediterranean Diet with a few tweaks.
What are the tweaks?
- Beans went down a bit in priority
- Red meat got removed entirely instead of “limit to a tiny amount”
- Olive oil was deprioritized, and/but vegetable oil is at the bottom of the list (i.e., use sparingly)
You can check out the details here, with an overview and examples:
DASH Eating Plan—Description, Charts, and Recipes
Don’t drink or smoke
And no, a glass of red a day will not help your heart. Alcohol does make us feel relaxed, but that is because of what it does to our brain, not what it does to our heart.
In reality, even a single drink will increase blood pressure. Yes, really:
And smoking? It’s so bad that even second-hand smoke increases blood pressure:
Get those Zs in
Sleep is a commonly underestimated/forgotten part of health, precisely because in a way, we’re not there for it when it happens. We sleep through it! But it is important, including to protect against hypertension:
Short- and long-term health consequences of sleep disruption
Move your body!
Moving your body often is far more important for your heart than running marathons or bench-pressing your spouse.
Those 150 minutes “moderate exercise” (e.g. walking) per week are important, and can be for example:
- 22 minutes per day, 7 days per week
- 25 minutes per day, 6 days per week
- 30 minutes per day, 5 days per week
- 75 minutes per day, 2 days per week
If you’d like to know more about the science and evidence for this, as well as practical suggestions, you can download the complete second edition of the Physical Activity Guidelines for Americans here (it’s free, and no sign-up required!)
If you prefer a bite-size summary, then here’s their own:
Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans
PS: Want a blood pressure monitor? We don’t sell them (or anything else), but for your convenience, here’s a good one you might want to consider.
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Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
The first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Ruminating vs Processing
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When it comes to traumatic experiences, there are two common pieces of advice for being able to move forwards functionally:
- Process whatever thoughts and feelings you need to process
- Do not ruminate
The latter can seem, at first glance, a lot like the former. So, how to tell them apart, and how to do one without the other?
Getting tense
One major difference between the two is the tense in which our mental activity takes place:
- processing starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if possible why, and then asks the question “ok, what now?” and begins work on laying out a path for the future.
- rumination starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if why, oh why oh why, “I was such an idiot, if only I had…” and gets trapped in a fairly tight (and destructive*) cycle of blame and shame/anger, never straying far from the events in question.
*this may be directly self-destructive, but it can also sometimes be only indirectly self-destructive, for example if the blame and anger is consciously placed with someone else.
This idea fits in, by the way, with Dr. Elisabeth Kübler-Ross’s “five stages of grief” model; rumination here represents the stages “bargaining”, “despair”, and “anger”, while emotional processing here represents the stage “acceptance”. Thus, it may be that rumination does have a place in the overall process—just don’t get stuck there!
For more on healthily processing grief specifically:
What Grief Does To The Body (And How To Manage It)
Grief, by the way, can be about more than the loss of a loved one; a very similar process can play out with many other kinds of unwanted life changes too.
What are the results?
Another way to tell them apart is to look at the results of each. If you come out of a long rumination session feeling worse than when you started, it’s highly unlikely that you just stopped too soon and were on the verge of some great breakthrough. It’s possible! But not likely.
- Processing may be uncomfortable at first, and if it’s something you’ve ignored for a long time, that could be very uncomfortable at first, but there should quite soon be some “light at the end of the tunnel”. Perhaps not even because a solution seems near, but because your mind and body recognize “aha, we are doing something about it now, and thus may find a better way forward”.
- Rumination tends to intensify and prolong uncomfortable emotions, increases stress and anxiety, and likely disrupts sleep. At best, it may serve as a tipping point to seek therapy or even just recognize “I should figure out a way to deal with this, because this isn’t doing me any good”. At worst, it may serve as a tipping point to depression, and/or substance abuse, and/or suicidality.
See also: How To Stay Alive (When You Really Don’t Want To) ← which also has a link back to our article on managing depression, by the way!
Did you choose it, really?
A third way to tell them apart is the level of conscious decision that went into doing it.
- Processing is almost always something that one decides “ok, let’s figure this out”, and sits down to figure it out.
- Rumination tends to be about as voluntary as social media doomscrolling. Technically we may have decided to begin it (we also might not have made any conscious decision, and just acted on impulse), but let’s face it, our hands weren’t at the wheel for long, at all.
A good way to make sure that it is a conscious process, is to schedule time for it in advance, and then do it only during that time. If thoughts about it come up at other times, tell yourself “no, leave that for later”, and then deal with it when (and only when) the planned timeslot arrives.
It’s up to you and your schedule what time you pick, but if you’re unsure, consider an hour in the early evening. That means that the business of the day is behind you, but it’s also not right before bed, so you should have some decompression time as a buffer. So for example, perhaps after dinner you might set a timer* for an hour, and sit down to journal, brainstorm, or just plain think, about the matter that needs processing.
*electronic timers can be quite jarring, and may distract you while waiting for the beeps. So, consider investing in a relaxing sand timer like this one instead.
Is there any way to make rumination less bad?
As we mentioned up top, there’s a case to be made for “rumination is an early part of the process that gets us where we need to go, and may not be skippable, or may not be advisable to skip”.
So, if you are going to ruminate, then firstly, we recommend again bordering it timewise (with a timer as above) and having a plan to pull yourself out when you’re done rather than getting stuck there (such as: The Off-Button For Your Brain: How To Stop Negative Thought Spirals).
And secondly, you might want to consider the following technique, which allows one to let one’s brain know that the thing we’re thinking about / imagining is now to be filed away safely; not lost or erased, but sent to the same place that nightmares go after we wake up:
A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing (EMDR)
What if I actually do want to forget?
That’s not usually recommendable; consider talking it through with a therapist first. However, for your interest, there is a way:
The Dark Side Of Memory (And How To Forget)
Take care!
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Sesame Chocolate Fudge
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If you’d like a sweet treat without skyrocketing your blood sugars with, well, rocket fuel… Today’s recipe can help you enjoy a taste of decadence that’s not bad for your blood sugars, and good for your heart and brain.
You will need
- ½ cup sesame seeds
- ¼ cup cocoa powder
- 3 tbsp maple syrup
- 1 tbsp coconut oil (plus a little extra for the pan)
Method
(we suggest you read everything at least once before doing anything)
1) Lightly toast the sesame seeds in a pan until golden brown. Remove from the heat and allow to cool.
2) Put them in a food processor, and blend on full speed until they start to form a dough-like mixture. This may take a few minutes, so be patient. We recommend doing it in 30-second sessions with a 30-second rest between them, to avoiding overheating the motor.
3) Add the rest of the ingredients and blend to combine thoroughly—this should go easily now and only take 10 seconds or so, but judge it by eye.
4) Grease an 8″ square baking tin with a little coconut oil, and add the mixture, patting it down to fill the tin, making sure it is well-compressed.
5) Allow to chill in the fridge for 6 hours, until firm.
6) Turn the fudge out onto a chopping board, and cut into the size squares you want. Serve, or store in the fridge until ready to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tasty Polyphenols For Your Heart & Brain
- Cacao vs Carob – Which is Healthier?
- Can Saturated Fats Be Healthy?
Take care!
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Building Psychological Resilience (Without Undue Hardship)
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What’s The Worst That Could Happen?
When we talk about the five lifestyle factors that make the biggest difference to health, stress management would be a worthy addition as number six. We haven’t focused explicitly on that for a while, so let’s get ready to start the New Year on a good footing…
You’re not going to have a stress-free 2024
What a tender world that would be! Hopefully your stressors will be small and manageable, but rest assured, things will stress you.
And that’s key: “rest assured”. Know it now, prepare for it, and build resilience.
Sounds grim, doesn’t it? It doesn’t have to be, though.
When the forecast weather is cold and wet, you’re not afraid of it when you have a warm dry house. When the heating bill comes for that warm dry house, you’re not afraid of it when you have money to pay it. If you didn’t have the money and the warm dry house, the cold wet weather could be devastating to you.
The lesson here is: we can generally handle what we’re prepared for.
Negative visualization and the PNS
This is the opposite of what a lot of “think and grow rich”-style gurus would advise. And indeed, it’s not helpful to slide into anxious worrying.
If you do find yourself spiralling, here’s a tool for getting out of that spiral:
RAIN: an intervention for dealing with difficult emotions
For now, however, we’re going to practice Radical Acceptance.
First, some biology: you may be aware that your Central Nervous System (CNS) branches into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS).
The PNS is the part that cues our body to relax, and suppresses our fight/flight response. We’re going to activate it.
Activating the PNS is easy for most people in comfortable circumstances (e.g., you are not currently exposed to stressful stimuli). It may well be activated already, and if it’s not, a few deep breaths is usually all it takes.
If you’d like a quick and easy Mindfulness-Based Stress Reduction (MBSR) technique, here you go:
No-Frills, Evidence-Based Mindfulness
Activating the PNS is hard for most people in difficult circumstances (e.g., you either are currently exposed to stressful stimuli, or you are in one of the emotional spirals we discussed earlier).
However, we can trick our bodies and brains by—when we are safe and unstressed—practicing imagining those stressful stimuli. Taking a moment to not just imagine it experientially, but immersively. This, in CBT and DBT, is the modern equivalent to the old samurai who simply accepted, before battle, that they were already dead—and thus went into battle with zero fear of death.
A less drastic example is the zen master who had a favorite teacup, and feared it would get broken. So he would tell himself “the cup is already broken”. One day, it actually broke, and he simply smiled ruefully and said “Of course”.
How this ties together: practice the mindfulness-based stress reduction we linked above, while imagining the things that do/would stress you the most.
Since it’s just imagination, this is a little easier than when the thing is actually happening. Practicing this way means that when and if the thing actually happens (an unfortunate diagnosis, a financial reversal, whatever it may be), our CNS is already well-trained to respond to stress with a dose of PNS-induced calm.
You can also leverage hormesis, a beneficial aspect of (in this case, optional and chosen by you) acute stress:
Dr. Elissa Epel | The Stress Prescription
Psychological resilience training
This (learned!) ability to respond to stress in an adaptive fashion (without maladaptive coping strategies such as unhelpful behavioral reactivity and/or substance use) is a key part of what in psychology is called resilience:
And yes, the CBT/DBT/MBSR methods we’ve been giving you are the evidence-based gold standard.
Only the best for 10almonds subscribers! 😎
❝That was helpful, but not cheery; can we finish the year on a cheerier note?❞
We can indeed:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Take care!
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Food for Life – by Dr. Tim Spector
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This book is, as the author puts it, “an eater’s guide to food and nutrition”. Rather than telling us what to eat or not eat, he provides an overview of what the latest science has to say about various foods, and leaves us to make our own informed decisions.
He also stands firmly by the “personalized nutrition” idea that he introduced in his previous book which we reviewed the other day, and gives advice on what tests we might like to perform.
The writing style is accessible, without shying away from reference to hard science. Dr. Spector provides lots of information about key chemicals, genes, gut bacteria, and more—as well as simply providing a very enjoyable read along the way.
Bottom line: if you’d like a much better idea of what food is (and isn’t) doing what, this book is an invaluable resource.
Click here to check out Food for Life, and make the best decisions for you!
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