Breathe; Don’t Vent (At Least In The Moment)

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Zen And The Art Of Breaking Things

We’ve talked before about identifying emotions and the importance of being able to express them:

Answering The Most Difficult Question: How Are You?

However, there can be a difference between “expressing how we feel” and “being possessed by how we feel and bulldozing everything in our path”

…which is, of course, primarily a problem in the case of anger—and by extension, emotions that are often contemporaneous with anger, such as jealousy, shame, fear, etc.

How much feeling is too much?

While this is in large part a subjective matter, clinically speaking the key question is generally: is it adversely affecting daily life to the point of being a problem?

For example, if you have to spend half an hour every day actively managing a certain emotion, that’s probably indicative of something unusual, but “unusual” is not inherently bad. If you’re managing it safely and in a way that doesn’t negatively affect the rest of your life, then that is generally considered fine, unless you feel otherwise about it.

A good example of this is complicated grief and/or prolonged grief.

But what about when it comes to anger? How much is ok?

When it comes to those around you, any amount of anger can seem like too much. Anger often makes us short-tempered even with people who are not the object of our anger, and it rarely brings out the best in us.

We can express our feelings in non-aggressive ways, for example:

When You “Can’t Complain”

and

Seriously Useful Communication Skills!

Sometimes, there’s another way though…

Breathe; don’t vent

That’s a great headline, but we can’t take the credit for it, because it came from:

Breathe, don’t vent: turning down the heat is key to managing anger

…in which it was found that, by all available metrics, the popular wisdom of “getting it off your chest” doesn’t necessarily stand up to scrutiny, at least in the short term:

❝The work was inspired in part by the rising popularity of rage rooms that promote smashing things (such as glass, plates and electronics) to work through angry feelings.

I wanted to debunk the whole theory of expressing anger as a way of coping with it,” she said. “We wanted to show that reducing arousal, and actually the physiological aspect of it, is really important.❞

~ Dr. Brad Bushman

And indeed, he and his team did find that various arousal-increasing activities (such as hitting a punchbag, breaking things, doing vigorous exercise) did not help as much as arousal-decreasing activities, such as mindfulness-based relaxation techniques.

If you’d like to read the full paper, then so would we, but we couldn’t get full access to this one yet. However, the abstract includes representative statistics, so that’s worth a once-over:

A meta-analytic review of anger management activities that increase or decrease arousal: What fuels or douses rage?

Caveat!

Did you notice the small gap between their results and their conclusion?

In a lab or similar short-term observational setting, their recommendation is clearly correct.

However, if the source of your anger is something chronic and persistent, it could well be that calming down without addressing the actual cause is just “kicking the can down the road”, and will still have to actually be dealt with eventually.

So, while “here be science”, it’s not a mandate for necessarily suffering in silence. It’s more about being mindful about how we go about tackling our anger.

As for a primer on mindfulness, feel free to check out:

No-Frills, Evidence-Based Mindfulness

Take care!

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  • Wholesome Threesome Protein Soup

    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.

    This soup has two protein– and fiber-rich pseudo-grains, one real wholegrain, and nutrient-dense cashews for yet even more protein, and all of the above are full of many great vitamins and minerals. All in all, a well-balanced and highly-nutritious light meal!

    You will need

    • ⅓ cup quinoa
    • ⅓ cup green lentils
    • ⅓ cup wholegrain rice
    • 5 cups low-sodium vegetable stock (ideally you made this yourself from offcuts of vegetables, but failing that, low-sodium stock cubes can be bought in most large supermarkets)
    • ¼ cup cashews
    • 1 tbsp dried thyme
    • 1 tbsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt

    Optional topping:

    • ⅓ cup pine nuts
    • ⅓ cup finely chopped fresh mint leaves
    • 2 tbsp coconut oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Rinse the quinoa, lentils, and rice.

    2) Boil 4 cups of the stock and add the grains and seasonings (MSG/salt, pepper, thyme); simmer for about 25 minutes.

    3) Blend the cashews with the other cup of vegetable stock, until smooth. Add the cashew mixture to the soup, stirring it in, and allow to simmer for another 5 minutes.

    4) Heat the coconut oil in a skillet and add the pine nuts, stirring until they are golden brown.

    5) Serve the soup into bowls, adding the mint and pine nuts to each.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Loving Life at 50+ – by Maria Sabando

    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.

    What a pleasant mix of a book! Sabando writes about aging with a great blend of light-heartedness and seriousness, and gives extra attention to the important balancing act of:

    1. Indulging sufficiently to enjoy life
    2. Staying well enough to enjoy life

    …because one without the other will not generally result in an enjoyable life! An American proud of her Italian heritage, she blends (as many immigrant families do) cultures and perspectives, aiming where she can for “the best of both” in that regard, too.

    Nor is this just a philosophical book—there’s yoga to be learned here, chapter by chapter, and recipes peppered throughout. The recipes, by the way, are simple and… Honestly, not as healthy as the recipes we share here at 10almonds, but they are good and when it comes to those indulgences we mentioned, her philosophy is that strategic mindful indulgence keeps mindless binge-eating at bay. Which is generally speaking not a bad approach, and is one we’ve written about before as well.

    When it comes to health advice, the author is no doctor or scientist, but her husband (a doctor) had input throughout, keeping things on track and medically sound.

    The style is very casual, like talking to a friend, which makes for a very easy and enjoyable read. Absolutely a book that one could read casually in the garden, put down when interrupted, pick up again, and continue happily where one left off.

    Bottom line: whatever your age (no matter whether your 50th birthday is in your shrinkingly near future or your increasingly distant past), there’s wisdom to be gained here—it’s not a manual (unless you want to treat it as one), it’s more… Thought-provoking, from cover to cover. Highly recommendable.

    Click here to check out Loving Life at 50+, and love life at 50+!

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  • What Your Mucus Says About Your Health

    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 not a sexy topic (unless perhaps you have a fetish), but it is a useful topic to know about.

    So, let’s get down to business with this much-maligned bodily fluid:

    What is mucus? And why?

    Sometimes, it can seem that mucus only exists to be an inconvenience, and to convey disease.

    And… Actually, that’s mostly true.

    While some kinds of mucus have other jobs beyond the scope of today’s article (did you know semen is mostly mucus? If not, now you do), the primary job of most of our mucus is to stop things (especially pathogens) going where they shouldn’t.

    So, in essence, it really does exist to be an inconvenience—to pathogens. And to convey those pathogens to where they can be disposed of safely, either outside of the body, or to be an easy meal (what with being stuck in mucus, and thus at least moderately immobilized) for our various active immune cells. To make matters worse for the pathogens, there are (usually) enzymes in our mucus that have antimicrobial properties, too.

    Some of mucus’s protective role can be in other ways too, such as by lining our stomach. You know, the stomach that contains the acid that can dissolve meat, despite us also being made of meat.

    The slimiest rainbow

    Ok, maybe not the slimiest rainbow—there’s probably a YouTube slime channel producing more colors. But, our noses are capable of dispensing astonishing quantities of mucus sometimes, and the color can vary widely, so here’s what we can know from that:

    Clear

    This is as it should be, in good health. If you’re getting lots of it but it’s clear, then it’s usually allergies, but watch out in case it changes color, heralding an infection. This “clear is how it looks when in ideal health”, by the way, is why when someone is sobbing in abject grief, any mucus that shows up to add to that picture will generally be clear.

    White

    As above, but now inflamed. Inflammation is usually something we don’t want, but in the case of a threat from a pathogen, we actually do want acute inflammation like this—the body is assembling its armies, of which, the most visible (when they appear in mass) are white blood cells. Because of their abundant presence at this stage, the mucus will also become thicker.

    Yellow

    As above, but the battle is now truly underway, and the yellow color comes from dead white blood cells. This does not, however, mean the battle is necessarily going badly—the body treats its white blood cells as very disposable fighters, and their deaths in large numbers are expected and normal when doing battle.

    Green

    As above, but neutrophils (a specific kind of white blood cell) have joined the party. They release an enzyme that colors the mucus green—and kills a lot of pathogens. Popular lore says that green mucus means a bacterial infection, but it’s not always so; these can be deployed against viruses too, depending on various factors beyond the scope of this article (but generally pertaining to severity). In any case, this too does not mean the battle is necessarily going badly, but it does express that your body is taking it very seriously—and you should, too.

    Red

    Nothing to do with infections, usually—it’s just a little blood (the red kind, this time). Usually it got into the mucus because the mucus membrane got damaged, usually due to some kind of physical trauma (e.g. very vigorous nose-blowing, poking things up the nose, etc) or sometimes if the air is very dry (then the mucus itself can dry out, and become stabby inside the nose; when more mucus is produced, it gets infused with blood from the injury).

    Pink

    As above, but combined with the “white” stage of infection response.

    Orange

    As above, but combined with the “yellow” stage of infection response.

    Brown

    As above, but the blood has oxidized—or, as a completely alterative possibility, it could mean you have been breathing a lot of pollutants. Smoke of various kinds (from fires, from smoking, etc) can cause this.

    Black

    There are various possible explanations here and all of them are bad. Get thee to a doctor. Superficial examples include:

    • Fungal infection (you thought toxic black mold was bad when it was on the wall of the house, wait until it’s on the walls of your respiratory system)
    • Blood, in abundance, oxidized (which begs the question of what caused that, but certainly: something wrong is not right)
    • Pollutants again, but this time at absurd levels of exposure

    That last one might sound very transient and self-correcting, but it’s not, and it comes with many increased short- and long-term health risks.

    Want to know more?

    Knowledge is power, so read up, and stay well:

    Take care!

    Share This Post

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  • Heart Smarter for Women – by Dr. Jennifer Mieres

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    Dr. Mieres takes us through understanding our own heart disease risks as individuals rather than as averages. As the title suggests, she does assume a female readership, so if you are a man and have no female loved ones, this might not be the book for you. But aside from that, she walks us through examining risk in the context of age, other health conditions, lifestyle factors, and so forth—including not turning a blind eye to factors that might intersect, such as for example if a physical condition reduces how much we can exercise, or if there’s some reason we can’t follow the usual gold standard of heart-healthy diet.

    On which note, she does offer dietary advice, including information around recipes, meal-planning, and what things to always have in stock, as well as what things matter the most when it comes to what and how we eat.

    It’s not all lifestyle medicine though; Dr. Mieres gives due attention to many of the medications available for heart health issues—and the pros and cons of these.

    The style of the book is very simple and readable pop-science, without undue jargon, and with a generous glossary. As with many books of this genre, it does rely on (presumably apocryphal) anecdotes, though an interesting choice for this book is that it keeps a standing cast of four recurring characters, each to represent a set of circumstances and illustrate how certain things can go differently for different people, with different things then being needed and/or possible. Hopefully, any given reader will find themself represented at least moderately well somewhere in or between these four characters.

    Bottom line: this is a very informative and accessible book, that demystifies a lot of common confusions around heart health.

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  • Increase in online ADHD diagnoses for kids poses ethical questions

    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.

    In 2020, in the midst of a pandemic, clinical protocols were altered for Ontario health clinics, allowing them to perform more types of care virtually. This included ADHD assessments and ADHD prescriptions for children – services that previously had been restricted to in-person appointments. But while other restrictions on virtual care are back, clinics are still allowed to virtually assess children for ADHD.

    This shift has allowed for more and quicker diagnoses – though not covered by provincial insurance (OHIP) – via a host of newly emerging private, for-profit clinics. However, it also has raised significant ethical questions.

    It solves an equity issue in terms of rural access to timely assessments, but does it also create new equity issues as a privatized service?

    Is it even feasible to diagnose a child for a condition like ADHD without meeting that child in person?

    And as rates of ADHD diagnosis continue to rise, should health regulators re-examine the virtual care approach?

    Ontario: More prescriptions, less regulation

    There are numerous for-profit clinics offering virtual diagnoses and prescriptions for childhood ADHD in Ontario. These include KixCare, which does not offer the option of an in-person assessment. Another clinic, Springboard, makes virtual appointments available within days, charging around $2,600 for assessments, which take three to four hours. The clinic offers coaching and therapy at an additional cost, also not covered by OHIP. Families can choose to continue to visit the clinic virtually during a trial stage with medications, prescribed by a doctor in the clinic who then sends prescribing information back to the child’s primary care provider.

    For-profit clinics like these are departing from Canada’s traditional single-payer health care model. By charging patients out-of-pocket fees for services, the clinics are able to generate more revenue because they are working outside of the billing standards for OHIP, standards that set limits on the maximum amount doctors can earn for providing specific services. Instead many services are provided by non-physician providers, who are not limited by OHIP in the same way.

    Need for safeguards

    ADHD prescriptions rose during the pandemic in Ontario, with women, people of higher income and those aged 20 to 24 receiving the most new diagnoses, according to research published in January 2024 by a team including researchers from the Centre for Addictions and Mental Health and Holland Bloorview Children’s Hospital. There may be numerous reasons for this increase but could the move to virtual care have been a factor?

    Ontario psychiatrist Javeed Sukhera, who treats both children and adults in Canada and the U.S., says virtual assessments can work for youth with ADHD, who may receive treatment quicker if they live in remote areas. However, he is concerned that as health care becomes more privatized, it will lead to exploitation and over-diagnosis of certain conditions.

    “There have been a lot of profiteers who have tried to capitalize on people’s needs and I think this is very dangerous,” he said. “In some settings, profiteering companies have set up systems to offer ADHD assessments that are almost always substandard. This is different from not-for-profit setups that adhere to quality standards and regulatory mechanisms.”

    Sukhera’s concerns recall the case of Cerebral Inc., a New York state-based virtual care company founded in 2020 that marketed on social media platforms including Instagram and TikTok. Cerebral offered online prescriptions for ADHD drugs among other services and boasted more than 200,000 patients. But as Dani Blum reported in the New York Times, Cerebral was accused in 2023 of pressuring doctors on staff to prescribe stimulants and faced an investigation by state prosecutors into whether it violated the U.S. Controlled Substances Act.

    “At the start of the pandemic, regulators relaxed rules around medical prescription of controlled substances,” wrote Blum. “Those changes opened the door for companies to prescribe and market drugs without the protocols that can accompany an in-person visit.”

    Access increased – but is it equitable?

    Virtual care has been a necessity in rural areas in Ontario since well before the pandemic, although ADHD assessments for children were restricted to in-person appointments prior to 2020.

    But ADHD assessment clinics that charge families out-of-pocket for services are only accessible to people with higher incomes. Rural families, many of whom are low income, are unable to afford thousands for private assessments, let alone the other services upsold by providers. If the private clinic/virtual care trend continues to grow unchecked, it may also attract doctors away from the public model of care since they can bill more for services. This could further aggravate the gap in care that lower income people already experience.

    This could further aggravate the gap in care that lower income people already experience.

    Sukhera says some risks could be addressed by instituting OHIP coverage for services at private clinics (similar to private surgical facilities that offer mixed private/public coverage), but also with safeguards to ensure that profits are reinvested back into the health-care system.

    “This would be especially useful for folks who do not have the income, the means to pay out of pocket,” he said.

    Concerns of misdiagnosis and over-prescription

    Some for-profit companies also benefit financially from diagnosing and issuing prescriptions, as has been suggested in the Cerebral case. If it is cheaper for a clinic to do shorter, virtual appointments and they are also motivated to diagnose and prescribe more, then controls need to be put in place to prevent misdiagnosis.

    The problem of misdiagnosis may also be related to the nature of ADHD assessments themselves. University of Strathclyde professor Matthew Smith, author of Hyperactive: The Controversial History of ADHD, notes that since the publication of Diagnostic and Statistical Manual of Mental Disorders in 1980, assessment has typically involved a few hours of parents and patients providing their subjective perspectives on how they experience time, tasks and the world around them.

    “It’s often a box-ticking exercise, rather than really learning about the context in which these behaviours exist,” Smith said. “The tendency has been to use a list of yes/no questions which – if enough are answered in the affirmative – lead to a diagnosis. When this is done online or via Zoom, there is even less opportunity to understand the context surrounding behaviour.”

    Smith cited a 2023 BBC investigation in which reporter Rory Carson booked an in-person ADHD assessment at a clinic and was found not to have the condition, then had a private online assessment – from a provider on her couch in a tracksuit – and was diagnosed with ADHD after just 45 minutes, for a fee of £685.

    What do patients want?

    If Canadian regulators can effectively tackle the issue of privatization and the risk of misdiagnosis, there is still another hurdle: not every youth is willing to take part in virtual care.

    Jennifer Reesman, a therapist and Training Director for Neuropsychology at the Chesapeake Center for ADHD, Learning & Behavioural Health in Maryland, echoed Sukhera’s concerns about substandard care, cautioning that virtual care is not suitable for some of her young clients who had poor experiences with online education and resist online health care. It can be an emotional issue for pediatric patients who are managing their feelings about the pandemic experience.

    “We need to respect what their needs are, not just the needs of the provider,” says Reesman.

    In 2020, Ontario opted for virtual care based on the capacity of our health system in a pandemic. Today, with a shortage of doctors, we are still in a crisis of capacity. The success of virtual care may rest on how engaged regulators are with equity issues, such as waitlists and access to care for rural dwellers, and how they resolve ethical problems around standards of care.

    Children and youth are a distinct category, which is why we had restrictions on virtual ADHD diagnosis prior to the pandemic. A question remains, then: If we could snap our fingers and have the capacity to provide in-person ADHD care for all children, would we? If the answer to that question is yes, then how can we begin to build our capacity?

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

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  • Staying Alive – by Dr. Jenny Goodman

    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.

    A lot of “healthy long life” books are science-heavy to the point of being quite challenging to read—they become excellent reference sources, but not exactly “curl up in the armchair” books.

    Dr. Goodman writes in a much more reader-friendly fashion, casual yet clear.

    She kicks off with season-specific advice. What does that mean? Basically, our bodies need different things at different times of year, and we face different challenges to good health. We may ignore such at our peril!

    After a chapter for each of the four seasons (assuming a temperate Northern Hemisphere climate), she goes on to cover the seasons of our life. Once again, our bodies need different things at different times in our life, and we again face different challenges to good health!

    There’s plenty of “advice for all seasons”, too. Nutritional dos and don’t, and perennial health hazards to avoid.

    As a caveat, she does also hold some unscientific views that may be skipped over. These range from “plant-based diets aren’t sustainable” to “this detox will get rid of heavy metals”. However, the value contained in the rest of the book is more than sufficient to persuade us to overlook those personal quirks.

    In particular, she offers very good advice on overcoming cravings (and distinguishing them from genuine nutritional cravings), and taking care of our “trillions of tiny companions” (beneficial gut microbiota) without nurturing Candida and other less helpful gut flora and fauna.

    In short, a fine lot of information in a very readable format.

    Order your copy of “Staying Alive” from Amazon today!

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