Antidepressants: Personalization Is Key!

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Antidepressants: Personalization Is Key!

Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:

  • Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
  • Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
  • Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
  • Four respondents said “They are no better than placebo, and are more likely to harm”
  • Two respondents said “They merely mask the problem, and thus don’t really help”

So what does the science say?

❝They are no better than placebo, and are more likely to harm? True or False?❞

True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:

Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.

Otherwise it is like getting a flu shot and being surprised when you still catch a cold!

❝They merely mask the problem, and thus don’t really help: True or False?❞

False, categorically.

The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).

❝They may help some people, but the side-effects are alarming: True or False?❞

True or False depending on more factors than we can cover here.

Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.

One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.

❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞

True! Contingently.

That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.

*common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.

For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.

Want to know more about the different kinds?

Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:

Mind | Comparing Antidepressants

Want a drug-free approach?

You might like our previous main feature:

The Mental Health First-Aid That You’ll Hopefully Never Need

Take care!

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  • Willpower: A Muscle To Flex, Or Spoons To Conserve?

    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.

    Willpower: A Muscle To Flex, Or Spoons To Conserve?

    We have previously written about motivation; this one’s not about that.

    Rather, it’s about willpower itself, and especially, the maintenance of such. Which prompts the question…

    Is willpower something that can be built up through practice, or something that is a finite resource that can be expended?

    That depends on you—and your experiences.

    • Some people believe willpower is a metaphorical “muscle” that must be exercised to be built up
    • Some people believe willpower is a matter of metaphorical “spoons” that can be used up

    A quick note on spoon theory: this traces its roots to Christine Miserandino’s 2003 essay about chronic illness and the management of limited energy. She details how she explained this to a friend in a practical fashion, she gave her a bunch of spoons from her kitchen, as an arbitrary unit of energy currency. These spoons would then need to be used to “pay” for tasks done; soon her friend realised that if she wanted to make it through the day, she was going to have to give more forethought to how she would “spend” her spoons, or she’d run out and be helpless (and perhaps hungry and far from home) before the day’s end. So, the kind of forethought and planning that a lot of people with chronic illnesses have to give to every day’s activities.

    You can read it here: But You Don’t Look Sick? The Spoon Theory

    So, why do some people believe one way, and some believe the other? It comes down to our experiences of our own willpower being built or expended. Researchers (Dr. Vanda Siber et al.) studied this, and concluded:

    ❝The studies support the idea that what people believe about willpower depends, at least in part, on recent experiences with tasks as being energizing or draining.❞

    Source: Autonomous Goal Striving Promotes a Nonlimited Theory About Willpower

    In other words, there’s a difference between going out running each morning while healthy, and doing so with (for example) lupus.

    On a practical level, this translates to practicable advice:

    • If something requires willpower but is energizing, this is the muscle kind! Build it.
    • If something requires willpower and is draining, this is the spoons kind! Conserve it.

    Read the above two bullet-points as many times as necessary to cement them into your hippocampus, because they are the most important message of today’s newsletter.

    Do you tend towards the “nonlimited” belief, despite getting tired? If so, here’s why…

    There is something that can continue to empower us even when we get physically fatigued, and that’s the extent to which we truly get a choice about what we’re doing. In other words, that “Autonomous” at the front of the title of the previous study, isn’t just word salad.

    • If we perceive ourselves as choosing to do what we are doing, with free will and autonomy (i.e., no externally created punitive consequences), we will feel much more empowered, and that goes for our willpower too.
    • If we perceive ourselves as doing what we have to (or suffer the consequences), we’ll probably do it, but we’ll find it draining, and that goes for our willpower too.

    Until such a time as age-related physical and mental decline truly take us, we as humans tend to gradually accumulate autonomy in our lives. We start as literal babies, then are children with all important decisions made for us, then adolescents building our own identity and ways of doing things, then young adults launching ourselves into the world of adulthood (with mixed results), to a usually more settled middle-age that still has a lot of external stressors and responsibilities, to old age, where we’ve often most things in order, and just ourselves and perhaps our partner to consider.

    Consequently…

    Age differences in implicit theories about willpower: why older people endorse a nonlimited theory

    …which explains why the 30-year-old middle-manager might break down and burn out and stop going to work, while an octogenarian is busy training for a marathon daily before getting back to their daily book-writing session, without fail.

    One final thing…

    If you need a willpower boost, have a snack*. If you need to willpower boost to avoid snacking, then plan for this in advance by finding a way to keep your blood sugars stable. Because…

    The physiology of willpower: linking blood glucose to self-control

    *Something that will keep your blood sugars stable, not spike them. Nuts are a great example, unless you’re allergic to such, because they have a nice balance of carbohydrates, protein, and healthy fats.

    Want more on that? Read: 10 Ways To Balance Blood Sugars

    Share This Post

  • Stop Self-Sabotage – by Dr. Judy Ho

    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 books of this genre identify one particular kind of self-sabotage, for example, they might pick one out of:

    • Bad habits
    • Limiting self-beliefs
    • Poor goal-setting
    • Procrastination

    …etc, slap a quick fix on whatever they chose to focus on, and call it a day. Not so with Dr. Ho!

    Here we have a much more comprehensive approach to tackling the problem of unintentional self-sabotage. With a multi-vector method, of which all angles can be improved simultaneously, it becomes much less like “whack-a-mole”… And much more like everything actually getting into order and staying that way.

    The main approach here is CBT, but far beyond what most pop-psychology CBT books go for, with more techniques and resources.

    On which note…

    There are many great exercises that Dr. Ho recommends we do while reading… So you might want to get a nice notebook alongside this book if you don’t already have one! And what is more inspiring of optimism than a new notebook?

    Bottom line: this is a great, well-organized guide to pruning the “why am I still doing this to myself?” aspects out of your life for a much more intentional, purposeful, effective way of living.

    Click here to check it out on Amazon today, and stop sabotaging yourself!

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  • Cucumber Canapés-Crudités

    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 time to party with these delicious snacks, which are great as an hors d’œuvre, amuse-bouche, or part of a buffet. And like all our offerings, they’re very healthy too—in this case, especially for the gut and heart!

    You will need

    • 1 cucumber, sliced
    • 1 cup pitted Kalamata olives (or other black olives)
    • 1 cup sun-dried tomatoes
    • 2 oz feta cheese (or vegan equivalent, or pine nuts)
    • 2 tbsp extra virgin olive oil
    • 1 tbsp fresh basil, chopped
    • 2 tsp black pepper, coarse ground

    Method

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

    1) Make the first topping by combining the olives, half the olive oil, and half the black pepper, into a food processor and blending until it is a coarse pâté.

    2) Make the second topping by doing the same with the tomatoes, basil, feta cheese (or substitution), and the other half of the olive oil and black pepper, again until it is a coarse pâté.

    3) Assemble the canapés-crudités by topping the cucumber slices alternately with the two toppings, and serve:

    Enjoy!

    Want to learn more?

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

    Take care!

    Share This Post

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  • Do CBD Gummies Work?

    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

    ❝I take CBD gummies. I don’t know if they are worth buying. Can you find a study on the effectiveness of gummies❞

    If you take them, and you’re not sure whether they’re worth it, then it sounds like you’re not getting any observable benefit from them?

    If so, that would seem to answer your question, since presumably the reason that you are taking them is for relaxation and/or pain relief, so if you’re not getting the results you want, then no, they are not worth it.

    However! CBD gummies are an incredibly diverse and not-well-studied product, so far, given the relative novelty of their legality. By diverse we mean, they’re not well-standardized.

    In other words: the CBD gummies you get could be completely unlike CBD gummies from a different source.

    CBD itself (i.e. in forms other than just gummies, and mostly as oil) has been studied somewhat better, and we did a main feature on it here:

    CBD Oil’s Many Benefits

    And while we’re at it:

    Cannabis Myths vs Reality ← This one is about cannabis products in general, and includes discussion of THC content and effects, which might not be so relevant to you, but may to some readers.

    Companies selling CBD and CBD gummies may make bold claims that are not yet backed by science, so if you are buying them for those reasons, you might want to be aware:

    Selling cannabidiol products in Canada: a framing analysis of advertising claims by online retailers

    One thing that we would add is that even though CBD is generally recognized as safe, it is possible to overdose on CBD gummies, so do watch your limits:

    A Case of Toxicity from Cannabidiol Gummy Ingestion

    Take care!

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  • What causes food cravings? And what can we do about them?

    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.

    Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?

    High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.

    Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.

    Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.

    Fascinadora/Shutterstock

    What causes cravings?

    A food craving is an intense desire or urge to eat something, often focused on a particular food.

    We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.

    Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.

    Three people holding a cone of french fries.
    Our brains learn to crave foods based on what we’ve enjoyed before. fon thachakul/Shutterstock

    The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.

    What else influences our choices?

    While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
    Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.

    But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.

    Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.

    Looking for something salty or sweet

    So what if a cue prompts us to look for a certain food, but it’s not available?

    Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.

    But our new research has confirmed something you probably knew: it’s more specific than that.

    If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.

    Food cues and mindless eating

    Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.

    Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.

    This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.

    Is there anything I can do to resist cravings?

    We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.

    • Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
    • Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
    • At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
    • Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
    • Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.

    Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University

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

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  • Exhausted To Energized – by Dr. Libby Weaver

    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.

    There are very many possible causes of low energy; some are obvious; some are not.

    Dr. Weaver goes through a comprehensive list that goes beyond the common, to encompass also the “not rare” options—how to test for them where appropriate, and how to improve/fix them where appropriate.

    Thus, she talks us through the marvels of mitochondria (including how to keep them happy and healthy and how to promote the generation of new ones), antioxidant defense mechanisms, coenzyme Q10 and friends, B vitamins of various kinds, macronutrients, the autonomic nervous system, sleep and its many factors, blood oxygenation, digestive issues, what’s going on in the spleen, the gallbladder, the liver, the kidneys, the adrenal glands, our thyroid goings-on in all its multifarious wonders, minerals like iodine, iron, magnesium, zinc, our epigenetic factors, and even psychological considerations ranging from stress to grief. In short—and we have shortened the list to pick out particularly salient pointsquite a comprehensive rundown of the human body to make your human body less run-down.

    The style is on the very readable pop-science, and/but she does bring her professional knowledge to bear on topic (her doctorate is a PhD in biochemistry, and it shows; a lot of explanations come from that angle).

    Bottom line: if you are often exhausted and would rather be energized, this this book almost certainly address at least a couple of things you probably haven’t considered—and even just one would make it worthwhile.

    Click here to check out Exhausted To Energized, go from exhausted to energized!

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