Miss Diagnosis: Anxiety, ADHD, & Women
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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
❝Why is ADHD so often misdiagnosed as anxiety in women?❞
A great question! A short and slightly flippant answer could be “it’s the medical misogyny”:
Women and Minorities Bear the Brunt of Medical Misdiagnosis
…and if you’d like to learn more in-depth about this, we recommend this excellent book:
Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn ← you can read our review here
However, in this case there is more going on too!
Part of this is because ADHD is, like many psychiatric issues, a collection of symptoms that may or may not all always be present. Since clinical definitions are decided by clinicians, rather than some special natural law of the universe, sometimes this results in “several small conditions in a trenchcoat”, and if one symptom is or isn’t present, it can make things look quite different:
What’s The Difference Between ADD and ADHD?
There are two things at hand here: as in the above example, there’s the presence or absence of hyperactivity, but also, that “attention deficit”?
It’s often not really a deficit of attention, so much as the attention is going somewhere else—an example of naming psychiatric disorders for how they affect other people, rather than the person in question.
Sidenote: personality disorders really get the worst of this!
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
etc
In the case of ADHD and anxiety and women, a lot of this comes down to how the redirection of focus is perceived:
❝For some time, it has been held that women with ADHD are more likely to internalize symptoms and become anxious and depressed and to suffer emotional dysregulation❞
This internalization of symptoms, vs the externalization more generally perceived in boys and men, is more likely to be seen as anxiety.
Double standards also abound for social reasons, e.g:
- He is someone who thinks ten steps ahead and covers all bases
- She is anxious and indecisive and unable to settle on one outcome
Here’s a very good overview of how this double-standard makes its way into diagnostic processes, along with other built-in biases:
Miss. Diagnosis: A Systematic Review of ADHD in Adult Women
Want to learn more?
We’ve reviewed quite a few books about ADHD, but if we had to pick one to spotlight, we’d recommend this one:
The Silent Struggle: Taking Charge of ADHD in Adults – by L. William Ross-Child, MLC
Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!
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Which Vitamin Brands Are Effective?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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
❝As far as specific brands of vitamin…some are good some not. I don’t like being told what buy but I guess I want to know which are effective. Could there be some brands recognized as good given to us?❞
The most reliable brands are generally those with the most transparency:
- They tell you what is in the supplement; not just the active ingredient(s), with doses, but also any buffers etc.
- They tell you, in the case of ingredients that can have various different sources, what the source is.
- They are, ideally, well-certified and independently tested.
Our previous sponsor Ora is a good example of a company that does this.
Additionally, in terms of bioavailability, generally speaking the order of preference goes liquid > capsule/softgel > tablet, so that’s something to look out for, too.
Note: “liquid” includes powders that are ingested when dissolved/suspended in water, and also includes tablets that become a liquid when dissolved/dispersed in water and ingested that way.
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Apple vs Apricot – Which is Healthier?
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Our Verdict
When comparing apple to apricot, we picked the apricot.
Why?
In terms of macros, there’s not too much between them; apples are higher in carbs and only a little higher in fiber, which disparity makes for a slightly higher glycemic index, but it’s not a big difference and they are both low GI foods.
Micronutrients, however, set these two fruits apart:
In the category of vitamins, apple is a tiny bit higher in choline, while apricots are higher in vitamins A, B1, B2, B3, B5, B6, B9, C, E, and K—in most cases, by quite large margins, too. All in all, a clear and easy win for apricots.
When it comes to minerals, apples are not higher in any minerals, while apricots are higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. There’s simply no contest here.
In short, if an apple a day keeps the doctor away, then an apricot will give the doctor a nice weekend break somewhere.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer
Take care!
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The Meds That Impair Decision-Making
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Impairment to cognitive function is often comorbid with Parkinson’s disease. That is to say: it’s not a symptom of Parkinson’s, but it often occurs in the same people. This may seem natural: after all, both are strongly associated with aging.
However, recent (last month, at time of writing) research has brought to light a very specific way in which medication for Parkinson’s may impair the ability to make sound decisions.
Obviously, this is a big deal, because it can affect healthcare decisions, financial decisions, and more—greatly impacting quality of life.
See also: Age-related differences in financial decision-making and social influence
(in which older people were found more likely to be influenced by the impulsive financial preferences of others than their younger counterparts, when other factors are controlled for)
As for how this pans out when it comes to Parkinson’s meds…
Pramipexole (PPX)
This drug can, due to an overlap in molecular shape, mimic dopamine in the brains of people who don’t have enough—such as those with Parkinson’s disease. This (as you might expect) helps alleviate Parkinson’s symptoms.
However, researchers found that mice treated with PPX and given a touch-screen based gambling game picked the high-risk, high reward option much more often. In the hopes of winning strawberry milkshake (the reward), they got themselves subjected to a lot of blindingly-bright flashing lights (the risk, to which untreated mice were much more averse, as this is very stressful for a mouse).
You may be wondering: did the mice have Parkinson’s?
The answer: kind of; they had been subjected to injections with 6-hydroxydopamine, which damages dopamine-producing neurons similarly to Parkinson’s.
This result was somewhat surprising, because one would expect that a mouse whose depleted dopamine was being mimicked by a stand-in (thus, doing much of the job of dopamine) would be less swayed by the allure of gambling (a high-dopamine activity), since gambling is typically most attractive to those who are desperate to find a crumb of dopamine somewhere.
They did find out why this happened, by the way, the PPX hyperactivated the external globus pallidus (also called GPe, and notwithstanding the name, this is located deep inside the brain). Chemically inhibiting this area of the brain reduced the risk-taking activity of the mice.
This has important implications for Parkinson’s patients, because:
- on an individual level, it means this is a side effect of PPX to be aware of
- on a research-and-development level, it means drugs need to be developed that specifically target the GPe, to avoid/mitigate this side effect.
You can read the study in full here:
Don’t want to get Parkinson’s in the first place?
While nothing is a magic bullet, there are things that can greatly increase or decrease Parkinson’s risk. Here’s a big one, as found recently (last week, at the time of writing):
Air Pollution and Parkinson’s Disease in a Population-Based Study
Also: knowing about its onset sooner rather than later is scary, but beneficial. So, with that in mind…
Recognize The Early Symptoms Of Parkinson’s Disease
Finally, because Parkinson’s disease is theorized to be caused by a dysfunction of alpha-synuclein clearance (much like the dysfunction of beta-amyloid clearance, in the case of Alzheimer’s disease), this means that having a healthy glymphatic system (glial cells doing the same clean-up job as the lymphatic system, but in the brain) is critical:
How To Clean Your Brain (Glymphatic Health Primer)
Take care!
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Shoulders Range – by Elia Bartolini
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Shoulder flexibility and mobility can be a big deal, especially when it starts to decline—more so than other kinds of flexibility. Most seniors can get through the day without doing the splits against a wall, for example, but shoulder tightness can be more of a problem if you can’t easily get into or out of your clothes.
If you think it couldn’t happen to you: the great Jane Fonda has a now-famous photoset of her looking glamorous in a dress at a red carpet event, and then looking frazzled making breakfast in the same dress in her kitchen the next morning, because, as she wrote, “I couldn’t get my dress unzipped so I slept in it”.
Now, “to avoid ending up like Jane Fonda” is not a series of words that usually precedes advice, but in this case: this book delves into the science of one of the most quirky joints of the human body, and how to leverage this to maximize shoulder mobility, while maintaining adequate strength (because flexibility without strength is just asking for a dislocation) without doing anything that would actually bulk up our shoulders, because it’s just about progressing through passive, active, and tensed stretching, static, dynamic, and loaded stretching, as well as PNF stretching and antagonist stretching.
If that seems like a lot of stretching, don’t worry; the author presents a series of workouts that will take us through these stretches in a very small amount of time each day.
The style is instructional like a textbook, with clear diagrams where appropriate, and lots of callout boxes, bullet points, emboldening for key points, etc. It all makes for every easy learning.
Bottom line: if you’d like to improve and maintain your shoulder mobility, this is an excellent book for that.
Click here to check out Shoulders Range, and perfect your shoulders and upper body flexibility!
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Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health
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Many people are drinking less sugary soft drink than in the past. This is a great win for public health, given the recognised risks of diets high in sugar-sweetened drinks.
But over time, intake of diet soft drinks has grown. In fact, it’s so high that these products are now regularly detected in wastewater.
So what does the research say about how your health is affected in the long term if you drink them often?
Breakingpic/Pexels What makes diet soft drinks sweet?
The World Health Organization (WHO) advises people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.”
But most regular soft drinks contain a lot of sugar. A regular 335 millilitre can of original Coca-Cola contains at least seven teaspoons of added sugar.
Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources.
Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness.
Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight.
But while surveys of Australian adults and adolescents show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly.
Diet soft drinks contain artificial or natural sweeteners. Vintage Tone/Shutterstock What does the research say about aspartame?
The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the US and Australia. However, some researchers have raised concern about the long-term risks of consumption.
People who drink diet soft drinks regularly and often are more likely to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks.
The link was found even after accounting for other dietary and lifestyle factors (such as physical activity).
In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “possibly carcinogenic to humans” (carcinogenic means cancer-causing).
Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally.
Will diet soft drinks help manage weight?
Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management.
In 2022, the WHO conducted a systematic review (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management.
Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners.
But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity.
In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO advising artificial sweeteners should not be used to manage weight.
Studies in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven.
You can’t go wrong with water. hurricanehank/Shutterstock What about inflammation and dental issues?
There is some early evidence artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed.
High amounts of diet soft drinks have also been linked with liver disease, which is based on inflammation.
The consumption of diet soft drinks is also associated with dental erosion.
Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion.
Moderation is key
As with many aspects of nutrition, moderation is key with diet soft drinks.
Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term.
Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Outlive – by Dr. Peter Attia
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We know, we know; this diet, that exercise, don’t smoke or drink, get decent sleep”—a lot of books don’t go beyond this level of advice!
What Dr. Attia offers is a multi-vector approach that covers the above and a lot more.
Themes of the book include:
- The above-mentioned things, of course
- Rethinking medicine for the age of chronic disease
- The pros and cons of…
- caloric restriction
- dietary restriction
- intermittent fasting
- Pre-emptive interventions for…
- specific common cause-of-death conditions
- specific common age-related degenerative conditions
- The oft-forgotten extra pillar of longevity: mental health
The last one in the list there is covered mostly in the last chapter of the book, but it’s there as a matter of importance, not as an afterthought. As Dr. Attia puts it, not only are you less likely to take care of your physical health if you are (for example) depressed, but also… “Longevity is meaningless if your life sucks!”
So, it’s important to do things that promote and maintain good physical and mental health.
Bottom line: if you’re interested in happy, healthy, longevity, this is a book for you.
Click here to check out Dr. Attia’s “Outlive” on Amazon today!
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