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 Cleghornyou 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❞

~ Dr. Patricia Quinn

Source: Attention-deficit/hyperactivity disorder and its comorbidities in women and girls: An evolving picture

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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  • How to Vary Breakfast for Digestion?

    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

    ❝Would appreciate your thoughts on how best to promote good digestion. For years, my breakfast has consisted of flaxseeds, sunflower seeds, and almonds – all well ground up – eaten with a generous amount of kefir. This works a treat as far as my digestion is concerned. But I sometimes wonder whether it would be better for my health if I varied or supplemented this breakfast. How might I do this without jeopardising my good digestion?❞

    Sounds like you’re already doing great! Those ingredients are all very nutrient-dense, and grinding them up improves digestion greatly, to the point that you’re getting nutrients your body couldn’t get at otherwise. And the kefir, of course, is a top-tier probiotic.

    Also, you’re getting plenty of protein and healthy fats in with your carbs, which results in the smoothest blood sugar curve.

    As for variety…

    Variety is good in diet, but variety within a theme. Our gut microbiota change according to what we eat, so sudden changes in diet are often met with heavy resistance from our gut.

    • For example, people who take up a 100% plant-based diet overnight often spend the next day in the bathroom, and wonder what happened.
    • Conversely, a long-time vegan who (whether by accident or design) consumes meat or dairy will likely find themself quickly feeling very unwell, because their gut microbiota have no idea what to do with this.

    So, variety yes, but within a theme, and make any changes gradual for the easiest transition.

    All in all, the only obvious suggestion for improvement is to consider adding some berries. These can be fresh, dried, or frozen, and will confer many health benefits (most notably a lot of antioxidant activity).

    Enjoy!

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  • Getting Things Done – by David Allen

    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.

    Our “to-do” lists are usually hopelessly tangled:

    To do thing x needs thing y doing first but that can only be done with information that I must get by doing thing z”, and so on.

    Suddenly that two-minute task is looking like half an hour, which is making our overall to-do list look gargantuan. Tackling tiny parts of tasks seems useless; tackling large tasks seems overwhelming. What a headache!

    Getting Things Done (“GTD”, to its friends) shows us how to gather all our to-dos, and then use the quickest ways to break down a task (in reality, often a mini-project) into its constituent parts and which things can be done next, and what order to do them in (or defer, or delegate, or ditch).

    In a nutshell: The GTD system aims to make all your tasks comprehensible and manageable, for stress-free productivity. No need to strategize everything every time; you have a system now, and always know where to begin.

    And by popular accounts, it delivers—many put this book in the “life-changing” category.

    Check out today’s book on Amazon!

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  • Small Pleasures – by Ryan Riley

    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.

    When Hippocrates said “let food be thy medicine, and let medicine be thy food”, he may or may not have had this book in mind.

    In terms of healthiness, this one’s not the very most nutritionist-approved recipe book we’ve ever reviewed. It’s not bad, to be clear!

    But the physical health aspect is secondary to the mental health aspects, in this one, as you’ll see. And as we say, “mental health is also just health”.

    The book is divided into three sections:

    1. Comfort—for when you feel at your worst, for when eating is a chore, for when something familiar and reassuring will bring you solace. Here we find flavor and simplicity; pastas, eggs, stews, potato dishes, and the like.
    2. Restoration—for when your energy needs reawakening. Here we find flavors fresh and tangy, enlivening and bright. Things to make you feel alive.
    3. Pleasure—while there’s little in the way of health-food here, the author describes the dishes in this section as “a love letter to yourself; they tell you that you’re special as you ready yourself to return to the world”.

    And sometimes, just sometimes, we probably all need a little of that.

    Bottom line: if you’d like to bring a little more joie de vivre to your cuisine, this book can do that.

    Click here to check out Small Pleasures, and rekindle joy in your kitchen!

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  • Science of Pilates – by Tracy Ward

    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.

    We’ve reviewed other books in this series, “Science of Yoga” and “Science of HIIT” (they’re great too; check them out!). What does this one add to the mix?

    Pilates is a top-tier “combination exercise” insofar as it checks a lot of boxes, e.g:

    • Strength—especially core strength, but also limbs
    • Mobility—range of motion and resultant reduction in injury risk
    • Stability—impossible without the above two things, but Pilates trains this too
    • Fitness—many dynamic Pilates exercises can be performed as cardio and/or HIIT.

    The author, a physiotherapist, explains (as the title promises!) the science of Pilates, with:

    • the beautifully clear diagrams we’ve come to expect of this series,
    • equally clear explanations, with a great balance of simplicity of terms and depth where necessary, and
    • plenty of citations for the claims made, linking to lots of the best up-to-date science.

    Bottom line: if you are in a position to make a little time for Pilates (if you don’t already), then there is nobody who would not benefit from reading this book.

    Click here to check out Science of Pilates, and keep your body well!

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  • Hummus vs Guacamole – Which is Healthier?

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    Our Verdict

    When comparing hummus to guacamole, we picked the guacamole.

    Why?

    First up, let’s assume that the standards are comparable, for example that both have been made with simple whole foods. The hummus is mostly chickpeas with tahini and a little olive oil and some seasoning; the guacamole is mostly avocado with a little lime juice and some seasoning.

    In terms of macronutrients, hummus has slightly more protein and fiber, 2x the carbohydrates (but they are healthy carbs), and usually slightly less fat (but the fats are healthy in both cases).

    In terms of micronutrients, the hummus is rich in iron and B vitamins, and the guacamole is rich in potassium, magnesium, vitamins C, E, and K.

    So far, it’s pretty much tied. What else is there to consider?

    We picked the guacamole because some of its nutrients (especially the potassium, magnesium, and vitamin K) are more common deficiencies in most people’s diets than iron and B vitamins. So, on average, it’s probably the one with the nutrients that you need more of at any given time.

    So, it was very very close, and it came down to the above as the deciding factor.

    However!

    • If you like one and not the other? Eat that one; it’s good.
    • If you like both but feel like eating one of them in particular? Eat that one; your body is probably needing those nutrients more right now.
    • If you are catering for a group of people? Serve both!
    • If you are catering for just yourself and would enjoy both? Serve both! There’s nobody to stop you!

    Want to read more?

    You might like: Avocado Oil vs Olive Oil – Which is Healthier?

    Enjoy!

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  • How many vegetables influence brain waves and control brain states?

    Is it OK if my child eats lots of fruit but no vegetables?

    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.

    Does it seem like most vegetables you serve your children end up left on the plate, or worse, strewn across the floor? But mention dessert, and your fruit skewers are polished off in an instant.

    Or maybe the carrot and cucumber sticks keep coming home in your child’s lunchbox untouched, yet the orange slices are nowhere to be seen.

    If you’re facing these struggles with your child, you’re not alone. Many children prefer fruit to vegetables.

    So if your child eats lots of fruit but minimal or no vegetables, is that OK? And how can you get them to eat more veggies?

    Children have an innate preference for fruit

    The Australian Dietary Guidelines’ recommended daily intakes for vegetables and fruit depend on a child’s age.

    A chart showing the serving amounts of fruit and veg for ages 4-18.
    Fruit and vegetable serving sizes by age. The Conversation.
    National Health and Medical Research Council, CC BY-SA

    Consumption among Australian children falls well below recommendations. Around 62.6% of children aged over two meet the recommended daily fruit intake, but only 9% meet the recommended vegetable intake.

    This is not surprising given children have a natural preference for fruit. At least in part, this is due to its sweetness and texture, whether crispy, crunchy or juicy. The texture of fruit has been linked to a positive sensory experience among children.

    Vegetables, on the other hand, are more of an acquired taste, and certain types, such as cruciferous vegetables, can be perceived by children as bitter.

    The reason children often prefer fruit over vegetables could also be related to the parents’ preferences. Some research has even suggested we develop food preferences before birth based on what our mother consumes during pregnancy.

    Balance is key

    So, a preference for fruit is common. But is it OK if your child eats lots of fruit but little to no vegetables? This is a question we, as dietitians, get asked regularly.

    You might be thinking, at least my child is eating fruit. They could be eating no veggies and no fruit. This is true. But while it’s great your child loves fruit, vegetables are just as important as part of a balanced eating pattern.

    Vegetables provide us with energy, essential vitamins and minerals, as well as water and fibre, which help keep our bowels regular. They also support a strong immune system.

    If your child is only eating fruit, they are missing some essential nutrients. But the same is true if they are eating only veggies.

    Fruit likewise provides the body with a variety of essential vitamins and minerals, as well as phytochemicals, which can help reduce inflammation.

    Evidence shows healthy consumption of fruit and vegetables protects against chronic diseases including high blood pressure, heart disease and stroke.

    Consumed together, fruit and vegetables in a variety of colours provide different nutrients we need, some of which we can’t get from other foods. We should encourage kids to eat a “rainbow” of fruit and vegetables each day to support their growth and development.

    What if my child eats too much fruit?

    If your child is eating slightly more fruit than what’s recommended each day, it’s not usually a problem.

    Fruit contains natural sugar which is good for you. But too much of a good thing, even if it’s natural, can create problems. Fruit also contains virtually no fat and very little to no protein, both essential for a growing child.

    When overindulging in fruit starts to displace other food groups such as vegetables, dairy products and meat, that’s when things can get tricky.

    6 tips to get your kids to love vegetables

    1. Get them involved

    Take your child with you when you go shopping. Let them choose new vegetables. See if you can find vegetables even you haven’t tried, so you’re both having a new experience. Then ask them to help you with preparing or cooking the vegetables using a recipe you have chosen together. This will expose your child to veggies in a positive way and encourage them to eat more.

    2. Sensory learning

    Try to expose your child to vegetables rather than hiding them. Kids are more likely to eat veggies when they see, smell and feel them. This is called sensory learning.

    3. Have fun with food

    Use colourful vegetables of different sizes and textures. Make them fun by creating scenes or faces on your child’s plate. Add edible flowers or mint for decoration. You can even serve this with a side of veggie-based dip such as hummus or guacamole for some bonus healthy fats.

    4. Teach them to grow their own

    Teach your child how to grow their own vegetables. Evidence shows kids are more inclined to try the food they have helped and watched grow. You don’t need to have a big backyard to do this. A windowsill with a pot plant is a perfect start.

    5. Lead by example

    Your child learns from you, and your eating habits will influence theirs. Ensure they see you eating and enjoying veggies, whether in meals or as snacks.

    6. Practise persistence

    If your child refuses a particular vegetable once, don’t give up. It can take many attempts to encourage children to try a new food.The Conversation

    Yasmine Probst, Associate Professor, School of Medical, Indigenous and Health Sciences, University of Wollongong; Olivia Wills, Accredited Practising Dietitian, PhD candidate, University of Wollongong, and Shoroog Allogmanny, Accredited Practising Dietitian, PhD candidate, University of Wollongong

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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