Miss Diagnosis: Anxiety, ADHD, & Women
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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
❝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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Are plant-based burgers really bad for your heart? Here’s what’s behind the scary headlines
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We’re hearing a lot about ultra-processed foods and the health effects of eating too many. And we know plant-based foods are popular for health or other reasons.
So it’s not surprising new research out this week including the health effects of ultra-processed, plant-based foods is going to attract global attention.
And the headlines can be scary if that research and the publicity surrounding it suggests eating these foods increases your risk of heart disease, stroke or dying early.
Here’s how some media outlets interpreted the research. The Daily Mail ran with:
Vegan fake meats are linked to increase in heart deaths, study suggests: Experts say plant-based diets can boost health – but NOT if they are ultra-processed
The New York Post’s headline was:
Vegan fake meats linked to heart disease, early death: study
But when we look at the study itself, it seems the media coverage has focused on a tiny aspect of the research, and is misleading.
So does eating supermarket plant-based burgers and other plant-based, ultra-processed foods really put you at greater risk of heart disease, stroke and premature death?
Here’s what prompted the research and what the study actually found.
Nina Firsova/Shutterstock Remind me, what are ultra-processed foods?
Ultra-processed foods undergo processing and reformulation with additives to enhance flavour, shelf-life and appeal. These include everything from packet macaroni cheese and pork sausages, to supermarket pastries and plant-based mince.
There is now strong and extensive evidence showing ultra-processed foods are linked with an increased risk of many physical and mental chronic health conditions.
Although researchers question which foods should be counted as ultra-processed, or if all of them are linked to poorer health, the consensus is that, generally, we should be eating less of them.
We also know plant-based diets are popular. These are linked with a reduced risk of chronic health conditions such as heart disease and stroke, cancer and diabetes. And supermarkets are stocking more plant-based, ultra-processed food options.
How about the new study?
The study looked for any health differences between eating plant-based, ultra-processed foods compared to eating non-plant based, ultra-processed foods. The researchers focused on the risk of cardiovascular disease (such as heart disease and stroke) and deaths from it.
Plant-based, ultra-processed foods in this study included mass-produced packaged bread, pastries, buns, cakes, biscuits, cereals and meat alternatives (fake meats). Ultra-processed foods that were not plant-based included milk-based drinks and desserts, sausages, nuggets and other reconstituted meat products.
The researchers used data from the UK Biobank. This is a large biomedical database that contains de-identified genetic, lifestyle (diet and exercise) and health information and biological samples from half a million UK participants. This databank allows researchers to determine links between this data and a wide range of diseases, including heart disease and stroke.
They used data from nearly 127,000 people who provided details of their diet between 2009 and 2012. The researchers linked this to their hospital records and death records. On average, the researchers followed each participant’s diet and health for nine years.
Plant-based, ultra-processed foods included in this study included packaged supermarket bread. doublelee/Shutterstock What did the study find?
With every 10% increase of total energy from plant-sourced, ultra-processed foods there was an associated 5% increased risk of cardiovascular disease (such as heart disease or stroke) and a 12% higher risk of dying from cardiovascular disease.
But for every 10% increase in plant-sourced, non-ultra-processed foods consumed there was an associated 7% lower risk of cardiovascular disease and a 13% lower risk of dying from cardiovascular disease.
The researchers found no evidence for an association between all plant-sourced foods (whether or not they were ultra-processed) and either an increased or decreased risk of cardiovascular disease or dying from it.
This was an observational study, where people recalled their diet using questionnaires. When coupled with other data, this can only tell us if someone’s diet is associated with a particular risk of a health outcome. So we cannot say that, in this case, the ultra-processed foods caused the heart disease and deaths from it.
Why has media coverage focused on fake meats?
Much of the media coverage has focused on the apparent health risks associated with eating fake meats, such as sausages, burgers, nuggets and even steaks.
These are considered ultra-processed foods. They are made by deconstructing whole plant foods such as pea, soy, wheat protein, nuts and mushrooms, and extracting the protein. They are then reformulated with additives to make the products look, taste and feel like traditional red and white meats.
However this was only one type of plant-based, ultra-processed food analysed in this study. This only accounted for an average 0.2% of the dietary energy intake of all the participants.
Compare this to bread, pastries, buns, cakes and biscuits, which are other types of plant-based, ultra-processed foods. These accounted for 20.7% of total energy intake in the study.
This image was at the top of the media release. Screenshot/Imperial It’s hard to say why the media focused on fake meat. But there is one clue in the media release issued to promote the research.
Although the media release did not mention the words “fake meat”, an image of plant-based burgers, sausages and meat balls or rissoles featured prominently.
The introduction of the study itself also mentions plant-sourced, ultra-processed foods, such as sausages, nuggets and burgers.
So it’s no wonder people can be confused.
Does this mean fake meats are fine?
Not necessarily. This study analysed the total intake of plant-based, ultra-processed foods, which included fake meats, albeit a very small proportion of people’s diets.
From this study alone we cannot tell if there would be a different outcome if someone ate large amounts of fake meats.
In fact, a recent review of fake meats found there was not enough evidence to determine their impact on health.
We also need more recent data to reflect current eating patterns of fake meats. This study used dietary data collected from 2009 to 2012, and fake meats have become more popular since.
What if I really like fake meat?
We have known for a while that ultra-processed foods can harm our health. This study tells us that regardless if an ultra-processed food is plant-based or not, it may still be harmful.
We know fake meat can contain large amounts of saturated fats (from coconut or palm oil), salt and sugar.
So like other ultra-processed foods, they should be eaten infrequently. The Australian Dietary Guidelines currently recommends people should only consume foods like this sometimes and in small amounts.
Are some fake meats healthier than others?
Check the labels and nutrition information panels. Look for those lowest in fat and salt. Burgers and sausages that are a “pressed cake” of minced ingredients such as nuts, beans and vegetables will be preferable to reformulated products that look identical to meat.
You can also eat whole plant-based protein foods such as legumes. These include beans, lentils, chickpeas and soy beans. As well as being high in protein and fibre, they also provide essential nutrients such as iron and zinc. Using spices and mushrooms alongside these in your recipes can replicate some of the umami taste associated with meat.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Heal Your Stressed Brain
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Rochelle Walsh, therapist, explains the problem and how to fix it:
Not all brain damage is from the outside
Long-term stress and burnout cause brain damage; it’s not just a mindset issue—it impacts the brain physiologically. To compound matters, it also increases the risk of neurodegenerative diseases. While the brain can indeed grow new neurons and regenerate itself, chronic stress damages specific regions, and inhibits that.
There are some effects of chronic stress that can seem positive—the amygdalae and hypothalamus are seen to grow larger and stronger, for instance—but this is, unfortunately, “all the better to stress you with”. In compensation for this, chronic stress deprioritizes the pre-frontal cortex and hippocampi, so there goes your reasoning and memory.
This often results in people not managing chronic stress well. Just like a weak heart and lungs might impede the exercise that could make them stronger, the stressed brain is not good at permitting you to do the things that would heal it—preferring to keep you on edge all day, worrying and twitchy, mind racing and body tense. It also tends to lead to autoimmune diseases, due to the increased inflammation (because the body’s threat-detection system as at “jumping at own shadow” levels so it’s deploying every defense it has, including completely inappropriate ones).
Notwithstanding the “Heal Your Stressed Brain” thumbnail, she doesn’t actually go into this in detail and bids us sign up for her masterclass. We at 10almonds however like to deliver, so you can find useful advice and free resources in our links-drop at the bottom of this article.
Meanwhile, if you’d like to hear more about the neurological woes described above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Meditation That You’ll Actually Enjoy
- How To Manage/Reduce Chronic Stress
- Lower Your Cortisol! (Here’s Why & How)
- How Healthy People Regulate Their Emotions
- Sleep: Yes, You Really Do Still Need It!
- Give Your Adrenal Glands A Chance
- The Stress Prescription (Against Aging!)
Take care!
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Avoiding Razor Burn, Ingrown Hairs & Other Shaving Irritation
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How Does The Video Help?
Dr. Simi Adedeji’s incredibly friendly persona makes this video (below) on avoiding skin irritation, ingrown hairs, and razor burn after shaving a pleasure to watch.
To keep things simple, she breaks down her guide into 10 simple tips.
What Are The 10 Simple Tips?
Tip 1: Prioritize Hydration. Shaving dry hair can lead to increased skin irritation, so Dr. Simi recommends moistening the hair by showering or using a warm, wet towel for 2-4 minutes before getting the razor out.
Tip 2: Avoid Dry Shaving. Dry shaving not only removes hair but can also remove the protective upper layer of skin, which contributes to razor burn. To prevent this, simply use some shaving gel or cream.
Tip 3: Keep Blades New and Sharp. This one’s simple: dull blades can cause skin irritation, whilst a sharp blade ensures a smoother and more comfortable shaving experience.
Tip 4: Avoid Shaving the Same Area Repeatedly. Multiple passes over the same area can remove skin layers, leading to cuts and irritation. Aim to shave each area only once for safer results.
Tip 5: Consider Hair Growth Direction. Shaving in the direction of hair growth results in less irritation, although it may not provide the closest shave.
Tip 6: Apply Gentle Pressure While Shaving. Excessive pressure can lead to cuts and nicks. Use a gentle touch to reduce these risks.
Tip 7: Incorporate Exfoliation into Your Routine. Exfoliating helps release trapped hairs and reduces the risk of ingrown hairs. For those with sensitive skin, it’s recommended to exfoliate either two days before or after shaving.
Tip 8: Avoid Excessive Skin Stretching. Over-stretching the skin during shaving can cause hairs to become ingrown.
Tip 9: Moisturize After Shaving. Shaving can compromise the skin barrier, leading to dryness. Using a moisturizer can be a simple fix.
Tip 10: Regularly Rinse Your Blade. Make sure that, during the shaving process, you are rinsing your blade frequently to remove hair and skin debris. This keeps it sharp during your shave.
If this summary doesn’t do it for you, then you can watch the full video here:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Unprocessed – by Kimberly Wilson
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.
First, what this is not: hundreds of pages to say “eat less processed food”. That is, of course, also advisable (and indeed, is advised in the book too), but there’s a lot more going on here too.
Though not a doctor, the author is a psychologist who brings a lot of data to the table, especially when it comes to the neurophysiology at hand, what forgotten micronutrients many people are lacking, and what trends in society worsen these deficiencies in the population at large.
If you only care about the broadest of take-away advice, it is: eat a diet that’s mostly minimally processed plants and some oily fish, watch out for certain deficiencies in particular, and increase dietary intake of them where necessary (with taking supplements as a respectable next-best remedy).
On which note, a point of criticism is that there’s some incorrect information about veganism and brain health; she mentions that DHA is only found in fish (in fact, fish get it from algae, which has it, and is the basis of many vegan omega-3 supplements), and the B12 is found only in animals (also found in yeast, which is not an animal, as well as various bacteria in soil, and farm animals get their B12 from supplements these days anyway, so it is arguable that we could keep things simpler by just cutting out the middlecow).
However, the strength of this book really is in the delivery of understanding about why certain things matter. If you’re told “such-and-such is good for the brain”, you’ll up your intake for 1–60 days, depending on whether you bought a supermarket item or ordered a batch of supplements. And then you’ll forget, until 6–12 months later, and you’ll do it again. On the other hand, if you understand how something is good or bad for the brain, what it does (for good or ill) on a cellular level, the chemistry and neurophysiology at hand, you’ll make new habits for life.
The style is middle-range pop-science; by this we mean there are tables of data and some long words that are difficult to pronounce, but also it’s not just hard science throughout—there’s (as one might expect from an author who is a psychologist) a lot about the psychology and sociology of why many people make poor dietary decisions, and the things governments often do (or omit doing) that affect this adversely—and how we can avoid those traps as individuals (unless we be incarcerated or such).
As an aside, the author is British, so governmental examples are mostly UK-based, but it doesn’t take a lot to mentally measure that against what the governments of, for example, the US or Canada do the same or differently.
Bottom line: there’s a lot of great information about brain health here; the strongest parts are whether the author stays within her field (psychology encompasses such diverse topics as neurophysiology and aspects of sociology, but not microbiology, for example). If you want to learn about the physiology of brain health and enjoy quite a sociopolitical ride along the way, this one’s a good one for that.
Click here to check out Unprocessed, and make the best choices for you!
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Red Cabbage vs Brussels Sprouts – Which is Healthier?
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Our Verdict
When comparing red cabbage to Brussels sprouts, we picked the sprouts.
Why?
First let’s note that we have an interesting comparison today, because these two plants are the exact same species (and indeed, also the exact same species as broccoli, cauliflower. and kale)—just a different cultivar. All of these plants and more are simply cultivars of Brassica oleracea.
Them being the same species notwithstanding, there are nutritional differences:
In terms of macros, the sprouts have more than 2x the protein, slightly more carbs, and nearly 2x the fiber. An easy win for sprouts here.
Looking at vitamins next, red cabbage has more vitamin A (whence the color), while Brussels sprouts have more of vitamins B1, B2, B3, B5, B6, B7, B9, C, E, K, and choline. Another easy win for sprouts.
In the category of minerals, red cabbage has a tiny bit more calcium, while Brussels sprouts have more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc—while being literally just a few mg/100g behind red cabbage on calcium anyway. So, once again, sprouts are sweeping the victory.
Both vegetables are a rich source of assorted polyphenols; for most polyphenols, Brussels sprouts scores higher—an exception being that red cabbage is very slightly higher in quercetin. So, we’ll call this category a win for Brussels sprouts, too.
In short: enjoy both; diversity is great and so is pretty much any iteration of Brassica oleracea. Standing next to Brussels sprouts made red cabbage look bad, but we assure you that cabbage in general is a nutritional powerhouse, and in this case it was hot the heels of sprouts in most of those micronutrients. If you’re going to pick one though, the Brussels sprouts are indeed the more nutritionally dense.
Want to learn more?
You might like to read:
Sprout Your Seeds, Grains, Beans, Etc ← sprout your Brassica oleracea, too!
Take care!
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10almonds Subcribers Take The Wheel!
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❓ Q&A With 10almonds Subscribers!
Q: What kind of salt is best for neti pots?
A: Non-iodised salt is usually recommended, but really, any human-safe salt is fine. By this we mean for example:
- Sodium chloride (like most kitchen salts),
- Potassium chloride (as found in “reduced sodium” kitchen salts), or
- Magnesium sulfate (also known as epsom salts).
Q: You talked about spearmint as reducing testosterone levels, what about ginseng for increasing them?
A: Hormones are complicated and often it’s not a simple matter of higher or lower levels! It can also be a matter of…
- how your body converts one thing into another
- how your body responds (or not) to something according to how the relevant hormone’s receptors are doing
- …and whether there’s anything else blocking those receptors.
All this to say: spearmint categorically is an anti-androgen, but the mechanism of action remains uncertain.
Panax ginseng, meanwhile, is one of the most well-established mysteries in herbal medicine.
Paradoxically, it seems to improve both male and female hormonal regulation, despite being more commonly associated with the former.
- It doesn’t necessarily increase or decrease testosterone or estrogen levels (but it can, even if indirectly)
- It does improve sexual function
- …and alleviates symptoms associated with conditions as varied as:
- Late-onset hypogonadism (common for men during the andropause)
- Benign prostate hyperplasia (again common for men during the andropause)
- …and also counteracts unwanted side-effects of finasteride. Finasteride is often taken by men as a hair loss remedy or, less often but critically, in the case of an enlarged prostate.
But it also…
- Alleviates symptoms of PCOS (polycystic ovary syndrome, which effects around 20% of women)
- May even be an effective treatment for PCOS (rat model only so far)
- It also may improve female reproductive fertility more generally (the studies are down to fruit flies now though)
Bottom line: Panax ginseng is popularly taken to improve natural hormone function, a task at which it appears to excel.
Scientists are still working out exactly how it does the many things it appears to do.
Progress has been made, and it clearly is science rather than witchcraft, but there are still far more unanswered questions than resolved ones!
Q: I like that the quizzes (I’ve done two so far) give immediate results , with no “give us your email to get your results”. Thanks!
A: You’re welcome! That’s one of the factors that influences what things we include here! Our mission statement is “to make health and productivity crazy simple”, and the unwritten part of that is making sure to save your time and energy wherever we reasonably can!
Q: Do you know if adrafanil is as good as modafinil? It seems to be a lot cheaper for the same result?
A: Adrafinil is the pro-drug of modafinil. What this means is that if you take it, your own liver will use it to make modafinil inside you. So the end result is chemically the same drug.
As to whether it’s as good, it depends what you need. It’s worth noting that anything that taxes liver function can be harmful if you take too much, and/or your liver is already strained for some reason.
If in doubt, consult a doctor! And if it’s something that’s accessible to you, a recent lipids test (a kind of blood test that checks your liver health) is always a good thing to have.
Q: Would love to see your take on polyphasic sleep!
A: Watch this space
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