The Mental Health First-Aid That You’ll Hopefully Never Need
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Take Your Mental Health As Seriously As General Health!
Sometimes, health and productivity means excelling—sometimes, it means avoiding illness and unproductivity. Both are essential, and today we’re going to tackle some ground-up stuff. If you don’t need it right now, great; we suggest to read it for when and if you do. But how likely is it that you will?
- One in four of us are affected by serious mental health issues in any given year.
- One in five of us have suicidal thoughts at some point in our lifetime.
- One in six of us are affected to at least some extent by the most commonly-reported mental health issues, anxiety and depression, in any given week.
…and that’s just what’s reported, of course. These stats are from a UK-based source but can be considered indicative generally. Jokes aside, the UK is not a special case and is not measurably worse for people’s mental health than, say, the US or Canada.
While this is not an inherently cheery topic, we think it’s an important one.
Depression, which we’re going to focus on today, is very very much a killer to both health and productivity, after all.
One of the most commonly-used measures of depression is known by the snappy name of “PHQ9”. It stands for “Patient Health Questionnaire Nine”, and you can take it anonymously online for free (without signing up for anything; it’s right there on the page already):
Take The PHQ9 Test Here! (under 2 minutes, immediate results)
There’s a chance you took that test and your score was, well, depressing. There’s also a chance you’re doing just peachy, or maybe somewhere in between. PHQ9 scores can fluctuate over time (because they focus on the past two weeks, and also rely on self-reports in the moment), so you might want to bookmark it to test again periodically. It can be interesting to track over time.
In the event that you’re struggling (or: in case one day you find yourself struggling, or want to be able to support a loved one who is struggling), some top tips that are useful:
Accept that it’s a medical condition like any other
Which means some important things:
- You/they are not lazy or otherwise being a bad person by being depressed
- You/they will probably get better at some point, especially if help is available
- You/they cannot, however, “just snap out of it”; illness doesn’t work that way
- Medication might help (it also might not)
Do what you can, how you can, when you can
Everyone knows the advice to exercise as a remedy for depression, and indeed, exercise helps many. Unfortunately, it’s not always that easy.
Did you ever see the 80s kids’ movie “The Neverending Story”? There’s a scene in which the young hero Atreyu must traverse the “Swamp of Sadness”, and while he has a magical talisman that protects him, his beloved horse Artax is not so lucky; he slows down, and eventually stops still, sinking slowly into the swamp. Atreyu pulls at him and begs him to keep going, but—despite being many times bigger and stronger than Atreyu, the horse just sinks into the swamp, literally drowning in despair.
See the scene: The Neverending Story movie clip – Artax and the Swamp of Sadness (1984)
Wow, they really don’t make kids’ movies like they used to, do they?
But, depression is very much like that, and advice “exercise to feel less depressed!” falls short of actually being helpful, when one is too depressed to do it.
If you’re in the position of supporting someone who’s depressed, the best tool in your toolbox will be not “here’s why you should do this” (they don’t care; not because they’re an uncaring person by nature, but because they are physiologically impeded from caring about themself at this time), but rather:
“please do this with me”
The reason this has a better chance of working is because the depressed person will in all likelihood be unable to care enough to raise and/or maintain an objection, and while they can’t remember why they should care about themself, they’re more likely to remember that they should care about you, and so will go with your want/need more easily than with their own. It’s not a magic bullet, but it’s worth a shot.
What if I’m the depressed person, though?
Honestly, the same, if there’s someone around you that you do care about; do what you can to look after you, for them, if that means you can find some extra motivation.
But I’m all alone… what now?
Firstly, you don’t have to be alone. There are free services that you can access, for example:
- US: https://nami.org/help
- Canada: https://www.wellnesstogether.ca/en-CA
- UK: https://www.samaritans.org/
…which varyingly offer advice, free phone services, webchats, and the like.
But also, there are ways you can look after yourself a little bit; do the things you’d advise someone else to do, even if you’re sure they won’t work:
- Take a little walk around the block
- Put the lights on when you’re not sleeping
- For that matter, get out of bed when you’re not sleeping. Literally lie on the floor if necessary, but change your location.
- Change your bedding, or at least your clothes
- If changing the bedding is too much, change just the pillowcase
- If changing your clothes is too much, change just one item of clothing
- Drink some water; it won’t magically cure you, but you’ll be in slightly better order
- On the topic of water, splash some on your face, if showering/bathing is too much right now
- Do something creative (that’s not self-harm). You may scoff at the notion of “art therapy” helping, but this is a way to get at least some of the lights on in areas of your brain that are a little dark right now. Worst case scenario is it’ll be a distraction from your problems, so give it a try.
- Find a connection to community—whatever that means to you—even if you don’t feel you can join it right now. Discover that there are people out there who would welcome you if you were able to go join them. Maybe one day you will!
- Hiding from the world? That’s probably not healthy, but while you’re hiding, take the time to read those books (write those books, if you’re so inclined), learn that new language, take up chess, take up baking, whatever. If you can find something that means anything to you, go with that for now, ride that wave. Motivation’s hard to come by during depression and you might let many things slide; you might as well get something out of this period if you can.
If you’re not depressed right now but you know you’re predisposed to such / can slip that way?
Write yourself instructions now. Copy the above list if you like.
Most of all: have a “things to do when I don’t feel like doing anything” list.
If you only take one piece of advice from today’s newsletter, let that one be it!
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Managing [E-word] Dysfunction Reactions
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!
As for questions we’re answering today…
Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?
When it comes to that particular issue, one or more of these three factors are often involved:
- Hormones
- Circulation
- Psychology
The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.
To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:
Hormones
Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.
This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.
Circulation
Look after your heart health; eat for your heart health, and exercise regularly!
Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.
Psychology
[E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!
Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).
So, to recap, we recommend:
- Have your hormones checked
- Look after your circulation
- Make the decision to have fun!
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Castor Oil: All-Purpose Life-Changer, Or Snake Oil?
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As “trending” health products go, castor oil is enjoying a lot of popularity presently, lauded as a life-changing miracle-worker, and social media is abuzz with advice to put it everywhere from your eyes to your vagina.
But:
- what things does science actually say it’s good for,
- what things lack evidence, and
- what things go into the category of “wow definitely do not do that”?
We don’t have the space to go into all of its proposed uses (there are simply far too many), but we’ll examine some common ones:
To heal/improve the skin barrier
Like most oils, it’s functional as a moisturizer. In particular, its high (90%!) ricinoleic fatty acid content does indeed make it good at that, and furthermore, has properties that can help reduce skin inflammation and promote wound healing:
Bioactive polymeric formulations for wound healing ← there isn’t a conveniently quotable summary we can just grab here, but you can see the data and results, from which we can conclude:
- formulations with ricinoleic acid (such as with castor oil) performed very well for topical anti-inflammatory purposes
- they avoided the unwanted side effects associated with some other contenders
- they consistently beat other preparations in the category of wound-healing
To support hair growth and scalp health
There is no evidence that it helps. We’d love to provide a citation for this, but it’s simply not there. There’s also no evidence that it doesn’t help. For whatever reason, despite its popularity, peer-reviewed science has simply not been done for this, or if it has, it wasn’t anywhere publicly accessible.
It’s possible that if a person is suffering hair loss specifically as a result of prostaglandin D2 levels, that ricinoleic acid will inhibit the PGD2, reversing the hair loss, but even this is hypothetical so far, as the science is currently only at the step before that:
However, due to some interesting chemistry, the combination of castor oil and warm water can result in acute (and irreversible) hair felting, in other words, the strands of hair suddenly glue together to become one mass which then has to be cut off:
“Castor Oil” – The Culprit of Acute Hair Felting
👆 this is a case study, which is generally considered a low standard of evidence (compared to high-quality Randomized Controlled Trials as the highest standard of evidence), but let’s just say, this writer (hi, it’s me) isn’t risking her butt-length hair on the off-chance, and doesn’t advise you to, either. There are other hair-oils out there; argan oil is great, coconut oil is totally fine too.
As a laxative
This time, there’s a lot of evidence, and it’s even approved for this purpose by the FDA, but it can be a bit too good, insofar as taking too much can result in diarrhea and uncomfortable cramping (the cramps are a feature not a bug; the mechanism of action is stimulatory, i.e. it gets the intestines squeezing, but again, it can result in doing that too much for comfort):
Castor Oil: FDA-Approved Indications
To soothe dry eyes
While putting oil in your eyes may seem dubious, this is another one where it actually works:
❝Castor oil is deemed safe and tolerable, with strong anti-microbial, anti-inflammatory, anti-nociceptive, analgesic, antioxidant, wound healing and vasoconstrictive properties.
These can supplement deficient physiological tear film lipids, enabling enhanced lipid spreading characteristics and reducing aqueous tear evaporation.
Studies reveal that castor oil applied topically to the ocular surface has a prolonged residence time, facilitating increased tear film lipid layer thickness, stability, improved ocular surface staining and symptoms.❞
Source: Therapeutic potential of castor oil in managing blepharitis, meibomian gland dysfunction and dry eye
Against candidiasis (thrush)
We couldn’t find science for (or against) castor oil’s use against vaginal candidiasis, but here’s a study that investigated its use against oral candidiasis:
…in which castor oil was the only preparation that didn’t work against the yeast.
Summary
We left a lot unsaid today (so many proposed uses, it feels like a shame to skip them), but in few words: it’s good for skin (including wound healing) and eyes; but we’d give it a miss for hair, candidiasis, and digestive disorders.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Take care!
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Fully Present – by Dr. Susan Smalley and Diana Winston
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“The Science and the Art of…” tends to be a bit of a fuzzy obfuscation, but in this case, it’s accurate, especially in this presentation. The authors are, indeed, a scientist and an artist—and both practitioners, meeting in the middle.
As such, we get the clinical insights of a researcher and professor of psychiatry, and the grounded-yet-spiritual insights of an erstwhile Buddhist nun.
While the book is pop psychology in essence, the format is much more that of a textbook than a self-help book. Will it be useful for helping yourself anyway, though? Yes, absolutely, if you apply the information contained within.
Don’t be fooled into thinking that a textbook format makes it dry, though—the writing is very compelling, and you’ll find yourself turning pages eagerly. There’s no time like the present, after all!
Bottom line: if you find the scientific evidence-base for the usefulness of mindfulness appealing, but find a lot of guides a little fluffy, this one is perfectly balanced—and very well written, too.
Click here to check out Fully Present, bring yourself into the moment, always!
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Related Posts
Cooling Bulgarian Tarator
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The “Bulgarian” qualifier is important here because the name “tarator” is used to refer to several different dishes from nearby-ish countries, and they aren’t the same. Today’s dish (a very healthy and deliciously cooling cucumber soup) isn’t well-known outside of Bulgaria, but it should be, and with your help we can share it around the world. It’s super-easy and takes only about 10 minutes to prepare:
You will need
- 1 large cucumber, cut into small (¼” x ¼”) cubes or small (1″ x ⅛”) batons (the size is important; any smaller and we lose texture; any larger and we lose the balance of the soup, and also make it very different to eat with a spoon)
- 2 cups plain unsweetened yogurt (your preference what kind; live-cultured of some kind is best, and yes, vegan is fine too)
- 1½ cup water, chilled but not icy (fridge-temperature is great)
- ½ cup chopped walnuts (substitutions are not advised; omit if allergic)
- ½ bulb garlic, minced
- 3 tbsp fresh dill, chopped
- 2 tbsp extra virgin olive oil
- 1 tsp black pepper, coarse ground
- ½ tsp MSG* or 1 tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Mix the cucumber, garlic, 2 tbsp of the dill, oil, MSG-or-salt and pepper in a big bowl
2) Add the yogurt and mix it in too
3) Add the cold water slowly and stir thoroughly; it may take a minute to achieve smooth consistency of the liquid—it should be creamy but thin, and definitely shouldn’t stand up by itself
4) Top with the chopped nuts, and the other tbsp of dill as a garnish
5) Serve immediately, or chill in the fridge until ready to serve. It’s perfect as a breakfast or a light lunch, by the way.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- How To Really Look After Your Joints ← this is about how cucumber has phytochemicals that outperform glucosamine and chondroitin by 200%, at 1/135th of the dose
- Making Friends With Your Gut (You Can Thank Us Later)
- Is Dairy Scary? ← short answer in terms of human health is “not if it’s fermented”
- Why You Should Diversify Your Nuts!
- The Many Health Benefits Of Garlic
- Is “Extra Virgin” Worth It?
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk? ← *for those who are worried about the health aspects of MSG; it is healthier and safer than table salt
Take care!
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How do I handle it if my parent is refusing aged care? 4 things to consider
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It’s a shock when we realise our parents aren’t managing well at home.
Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.
You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?
Here are four things to consider.
1. Start with more help at home
Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.
Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.
Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.
Call My Aged Care to discuss your options.
Is Mum or Dad OK at home?
Nadino/Shutterstock2. Be prepared for multiple conversations
Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.
Ideally, the older person feels supported rather than attacked during these conversations.
Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.
Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.
3. Understand the options when help at home isn’t enough
If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be considering a nursing home (also known as residential aged care in Australia).
Every person has a legal right to choose where we live (unless they have lost capacity to make that decision).
This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.
It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).
Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?
Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.
Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.
Research suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.
Mum and Dad should be involved in the decision-making process about where they live, and when they might move.
Some families start looking “just in case” as it often takes some time to find the right nursing home and there can be a wait.
After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.
We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.
For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.
Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.
You might need to have multiple conversations about aged care.
CGN089/Shutterstock4. Understand the options if a parent has lost capacity to make decisions
If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.
If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.
Mum or Dad may have appointed an enduring guardian to make decisions about their health and lifestyle decisions when they are not able to.
An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.
If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can appoint that person a private guardian (usually a family member, close friend or unpaid carer).
If no such person is available to act as private guardian, a public official may be appointed as public guardian.
Deal with your own feelings
Families often feel guilt and grief during the decision-making and transition process.
Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.
Lee-Fay Low, Professor in Ageing and Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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To Nap Or Not To Nap; That Is The Question
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Is it good to nap in the afternoon, or better to get the famous 7 to 9 hours at night and leave it at that? I’m worried that daytime napping to make up for a shorter night’s sleep will just perpetuate and worsen it in the long run, is there a categorical answer here?❞
Short version: generally considered best is indeed the 7–9 hours at night (yes, including at older ages):
Why You Probably Need More Sleep
…and sleep efficiency does matter too:
Why 7 Hours Sleep Is Not Enough
…which in turn, is influenced by factors other than just length and depth:
The 6 Dimensions Of Sleep (And Why They Matter)
However! Knowing what is best in theory does not help at all if it’s unattainable in practice. So, if you’re not getting a good night’s sleep (and we’ll assume you’re already practising good sleep hygiene; fresh bedding, lights-off by a certain time, no alcohol or caffeine before bed, that kind of thing), then a first port-of-call may be sleep remedies:
Safe Effective Sleep Aids For Seniors
If even those don’t work, then napping is now likely your best back-up option. But, napping done incorrectly can indeed cause as many problems as it solves. There’s a difference between:
- “I napped and now I have energy again” and you continue with your day
- “Darkness took me, and I strayed out of thought and time. Stars wheeled overhead, and every day was as long as the life age of the earth—but it was not the end.” and now you’re not sure whether it’s day or night, whose house you’re in, or whether you’ve been drugged.
These two very common napping experiences are influenced by factors that we can control:
How To Nap Like A Pro (No More “Sleep Hangovers”!)
If you still prefer to not risk napping but do need at least some kind of refreshment that’s actually a refreshment and not just taking stimulants, then you might consider this practice (from yoga nidra) that gives some of the same benefits of sleep, without actually sleeping:
Non-Sleep Deep Rest: A Neurobiologist’s Insights
Take care!
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