Do CBD Gummies Work?
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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:
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
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Body Language (In The Real World)
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Forget What You Think You Know About Body Language
…unless it’s about a specific person whose habits and mannerisms you know intimately, in which case, you probably have enough personal data stored up to actually recognize patterns à la “when my spouse does this, then…”, and probably do know what’s going on.
For everyone else… our body language can be as unique as our idiolect
What’s an idiolect? It’s any one given person’s way of speaking/writing, in their natural state (i.e. without having to adjust their style for some reason, for example in a public-facing role at work, where style often becomes much narrower and more consciously-chosen).
Extreme example first
To give an extreme example of how non-verbal communication can be very different than a person thinks, there’s an anecdote floating around the web of someone whose non-verbal autistic kid would, when he liked someone who was visiting the house, hide their shoes when they were about to leave, to cause them to stay longer. Then one day some relative visited and when she suggested that she “should be going sometime soon”, he hurried to bring her her shoes. She left, happy that the kid liked her (he did not).
The above misunderstanding happened because the visitor had the previous life experience of “a person who brings me things is being helpful, and if they do it of their own free will, it’s because they like me”.
In other words…
Generalizations are often sound… In general
…which does not help us when dealing with individuals, which as it turns out, everyone is.
Clenched fists = tense and angry… Except when it’s just what’s comfortable for someone, or they have circulation issues, or this, or that, or the other.
Pacing = agitated… Except when it’s just someone who finds the body in motion more comfortable
Relaxed arms and hands = at ease and unthreatening… Unless it’s a practitioner of various martial arts for whom that is their default ready-for-action state.
Folded arms = closed-off, cold, distant… Or it was just somewhere to put one’s hands.
Lack of eye contact = deceitful, hiding something… Unless it’s actually for any one of a wide number of reasons, which brings us to our next section:
A liar’s “tells”
Again, if you know someone intimately and know what signs are associated with deceit in them, then great, that’s a thing you know. But for people in general…
A lot of what is repeated about “how to know if someone is lying” has seeped into public consciousness from “what police use to justify their belief that someone is lying”.
This is why many of the traditional “this person is lying” signs are based around behaviors that show up when in fact “this person is afraid, under pressure, and talking to an authority figure who has the power to ruin their life”:
Research on Non-verbal Signs of Lies and Deceit: A Blind Alley
But what about eye-accessing cues? They have science to them, right?
For any unfamiliar: this is about the theory that when we are accessing different parts of our mind (such as memory or creativity, thus truthfulness or lying), our eyes move one way or another according to what faculty we’re accessing.
Does it work? No
But, if you carefully calibrate it for a specific person, such as by asking them questions along the lines of “describe your front door” or “describe your ideal holiday”, to see which ways they look for recall or creativity… Then also no:
The Eyes Don’t Have It: Lie Detection and Neuro-Linguistic Programming
How can we know what non-verbal communication means, then?
With strangers? We can’t, simply. It’s on us to be open-minded, with a healthy balance of optimism and wariness.
With people we know? We can build up a picture over time, learn the person’s patterns. Best of all, we can ask them. In the moment, and in general.
For more on optimizing interpersonal communication, check out:
Save Time With Better Communication
…and the flipside of that:
The Problem With Active Listening (And How To Do It Better)
Take care!
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Welcoming the Unwelcome – by Pema Chödrön
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There’s a lot in life that we don’t get to choose. Some things we have zero control over, like the weather. Others, we can only influence, like our health. Still yet others might give us an illusion of control, only to snatch it away, like a financial reversal or a bereavement.
How, then, to suffer those “slings and arrows of outrageous fortune” and come through the other side with an even mind and a whole heart?
Author Pema Chödrön has a guidebook for us.
Quick note: this book does not require the reader to have any particular religious faith to enjoy its benefits, but the author is a nun. As such, the way she describes things is generally within the frame of her religion. So that’s a thing to be aware of in case it might bother you. That said…
The largest part of her approach is one that psychology might describe as rational emotive behavioral therapy.
As such, we are encouraged to indeed “meet with triumph and disaster, and treat those two imposters just the same”, and more importantly, she lays out the tools for us to do so.
Does this mean not caring? No! Quite the opposite. It is expected, and even encouraged, that we might care very much. But: this book looks at how to care and remain compassionate, to others and to ourselves.
For Chödrön, welcoming the unwelcome is about de-toothing hardship by accepting it as a part of the complex tapestry of life, rather than something to be endured.
Bottom line: this book can greatly increase the reader’s ability to “go placidly amid the noise and haste” and bring peace to an often hectic world—starting with our own.
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A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
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A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies.
The lack of guidance could limit use of the drug, which is both novel — it targets hormone function to relieve symptoms instead of the brain’s serotonin system, as typical antidepressants do — and expensive, at $15,900 for the 14-day pill regimen.
Lawyers, advocates, and regulators are watching closely to see how insurance companies will shape policies for zuranolone because of how some handled its predecessor, an intravenous form of the same drug called brexanolone, which came on the market in 2019. Many insurers required patients to try other, cheaper medications first — known as the fail-first approach — before they could be approved for brexanolone, which was shown in early trials reviewed by the FDA to provide relief within days. Typical antidepressants take four to six weeks to take effect.
“We’ll have to see if insurers cover this drug and what fail-first requirements they put in” for zuranolone, said Meiram Bendat, a licensed psychotherapist and an attorney who represents patients.
Most health plans have yet to issue any guidelines for zuranolone, and maternal health advocates worry that the few that have are taking a restrictive approach. Some policies require that patients first try and fail a standard antidepressant before the insurer will pay for zuranolone.
In other cases, guidelines require psychiatrists to prescribe it, rather than obstetricians, potentially delaying treatment since OB-GYN practitioners are usually the first medical providers to see signs of postpartum depression.
Advocates are most worried about the lack of coverage guidance.
“If you don’t have a published policy, there is going to be more variation in decision-making that isn’t fair and is less efficient. Transparency is really important,” said Joy Burkhard, executive director of the nonprofit Policy Center for Maternal Mental Health, which commissioned the study.
With brexanolone, which was priced at $34,000 for the three-day infusion, California’s largest insurer, Kaiser Permanente, had such rigorous criteria for prescribing it that experts said the policy amounted to a blanket denial for all patients, according to an NPR investigation in 2021.
KP’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. Because the drug was approved only for up to six months postpartum, and trials of typical antidepressants take four to six weeks each, the clock would run out before a patient had time to try brexanolone.
An analysis by NPR of a dozen other health plans at the time showed Kaiser Permanente’s policy on brexanolone to be an outlier. Some did require that patients fail one or two other drugs first, but KP was the only one that recommended four.
Miriam McDonald, who developed severe postpartum depression and suicidal ideation after giving birth in late 2019, battled Kaiser Permanente for more than a year to find effective treatment. Her doctors put her on a merry-go-round of medications that didn’t work and often carried unbearable side effects, she said. Her doctors refused to prescribe brexanolone, the only FDA-approved medication specifically for postpartum depression at the time.
“No woman should suffer like I did after having a child,” McDonald said. “The policy was completely unfair. I was in purgatory.”
One month after NPR published its investigation, KP overhauled its criteria to recommend that women try just one medication before becoming eligible for brexanolone.
Then, in March 2023, after the federal Department of Labor launched an investigation into the insurer — citing NPR’s reporting — the insurer revised its brexanolone guidelines again, removing all fail-first recommendations, according to internal documents recently obtained by NPR. Patients need only decline a trial of another medication.
“Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” the insurer said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”
“Kaiser basically went from having the most restrictive policy to the most robust,” said Burkhard of the Policy Center for Maternal Mental Health. “It’s now a gold standard for the rest of the industry.”
McDonald is hopeful that her willingness to speak out and the subsequent regulatory actions and policy changes for brexanolone will lead Kaiser Permanente and other health plans to set patient-friendly policies for zuranolone.
“This will prevent other women from having to go through a year of depression to find something that works,” she said.
Clinicians were excited when the FDA approved zuranolone last August, believing the pill form, taken once a day at home over two weeks, will be more accessible to women compared with the three-day hospital stay for the IV infusion. Many perinatal psychiatrists told NPR it is imperative to treat postpartum depression as quickly as possible to avoid negative effects, including cognitive and social problems in the baby, anxiety or depression in the father or partner, or the death of the mother to suicide, which accounts for up to 20% of maternal deaths.
So far, only one of the country’s six largest private insurers, Centene, has set a policy for zuranolone. It is unclear what criteria KP will set for the new pill. California’s Medicaid program, known as Medi-Cal, has not yet established coverage criteria.
Insurers’ policies for zuranolone will be written at a time when the regulatory environment around mental health treatment is shifting. The U.S. Department of Labor is cracking down on violations of the Mental Health Parity and Addiction Equity Act of 2008, which requires insurers to cover psychiatric treatments the same as physical treatments.
Insurers must now comply with stricter reporting and auditing requirements intended to increase patient access to mental health care, which advocates hope will compel health plans to be more careful about the policies they write in the first place.
In California, insurers must also comply with an even broader state mental health parity law from 2021, which requires them to use clinically based, expert-recognized criteria and guidelines in making medical decisions. The law was designed to limit arbitrary or cost-driven denials for mental health treatments and has been hailed as a model for the rest of the country. Much-anticipated regulations for the law are expected to be released this spring and could offer further guidance for insurers in California setting policies for zuranolone.
In the meantime, Burkhard said, patients suffering from postpartum depression should not hold back from asking their doctors about zuranolone. Insurers can still grant access to the drug on a case-by-case basis before they formalize their coverage criteria.
“Providers shouldn’t be deterred from prescribing zuranolone,” Burkhard said.
This article is from a partnership that includes KQED, NPR and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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10 Lessons For A Healthy Mind & Body
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Sadia Badiei, food scientist of “Pick Up Limes” culinary fame, has advice in and out of the kitchen:
Pick up a zest for life
Here’s what she picked up, and we all can too:
- “I can’t do it… yet”: it’s never too late to adopt a growth mindset by adding “yet” to your self-doubt, focusing on progress and the possibility of improvement.
- The spotlight effect: people are generally too absorbed in their own lives to focus on you, so don’t worry too much about others’ perceptions.
- Nutrition by addition: focus on adding healthier foods to your diet rather than eliminating the less healthy ones to avoid restrictive mindsets. You can still eliminate the less healthy ones if you want to! It just shouldn’t be the primary focus. Focusing on a conceptually negative thing is rarely helpful.
- It’s ok to change: embrace change as a sign of growth and evolution, rather than seeing it as a failure or waste of time.
- The way you do one thing is the way you do everything: be mindful of how you approach small tasks, regular tasks, boring tasks, unwanted tasks—you can either create a habit of enthusiasm or a habit of suffering (it’s entirely your choice which)
- Setting goals for success: set goals based on actions you can control (inputs) rather than outcomes that are uncertain. Less “lose 10 lbs”, and more “eat fiber before starch”, for example.
- You probably can’t have it all at once: you can achieve all your dreams, but often not simultaneously; goals and desires unfold in stages over time.
- The five-year rule: before adopting a new lifestyle or habit, ask yourself if you can realistically sustain it for five years to ensure it’s not just a short-term fix. If you struggle with this prognostic, look backwards first instead. Which healthy habits have you maintained for decades, and which were you never able to make stick?
- Are you afraid or excited?: reframe fear as excitement, as both emotions share similar physical sensations and signify that you care about the outcome.
- The voice you hear most: speak kindly to yourself in self-talk to create a softer, more compassionate tone. Your subconscious is always listening, so reinforce healthy rather than unhealthy thought patterns.
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
80-Year-Olds Share Their Biggest Regrets
Take care!
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Procrastination, and how to pay off the to-do list debt
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Procrastination, and how pay off the to-do list debt
Sometimes we procrastinate because we feel overwhelmed by the mountain of things we are supposed to be doing. If you look at your to-do list and it shows 60 overdue items, it’s little wonder if you want to bury your head in the sand!
“What difference does it make if I do one of these things now; I will still have 59 which feels as bad as having 60”
So, treat it like you might a financial debt, and make a repayment plan. Now, instead of 60 overdue items today, you have 1/day for the next 60 days, or 2/day for the next 30 days, or 3/day for the next 20 days, etc. Obviously, you may need to work out whether some are greater temporal priorities and if so, bump those to the top of the list. But don’t sweat the minutiae; your list doesn’t have to be perfectly ordered, just broadly have more urgent things to the top and less urgent things to the bottom.
Note: this repayment plan means having set repayment dates.
Up front, sit down and assign each item a specific calendar date on which you will do that thing.
This is not a deadline! It is your schedule. You’ll not try to do it sooner, and you won’t postpone it for later. You will just do that item on that date.
A productivity app like ToDoist can help with this, but paper is fine too.
What’s important here, psychologically, is that each day you’re looking not at 60 things and doing the top item; you’re just looking at today’s item (only!) and doing it.
Debt Reduction/Cancellation
Much like you might manage a financial debt, you can also look to see if any of your debts could be reduced or cancelled.
We wrote previously about the “Getting Things Done” system. It’s a very good system if you want to do that; if not, no worries, but you might at least want to borrow this one idea….
Sort your items into:
Do / Defer / Delegate / Ditch
- Do: if it can be done in under 2 minutes, do it now.
- Defer: defer the item to a specific calendar date (per the repayment plan idea we just talked about)
- Delegate: could this item be done by someone else? Get it off your plate if you reasonably can.
- Ditch: sometimes, it’s ok to realize “you know what, this isn’t that important to me anymore” and scratch it from the list.
As a last resort, consider declaring bankruptcy
Towards the end of the dot-com boom, there was a fellow who unintentionally got his 5 minutes of viral fame for “declaring email bankruptcy”.
Basically, he publicly declared that his email backlog had got so far out of hand that he would now not reply to emails from before the declaration.
He pledged to keep on top of new emails only from that point onwards; a fresh start.
We can’t comment on whether he then did, but if you need a fresh start, that can be one way to get it!
In closing…
Procrastination is not usually a matter of laziness, it’s usually a matter of overwhelm. Hopefully the above approach will help reframe things, and make things more manageable.
Sometimes procrastination is a matter of perfectionism, and not starting on tasks because we worry we won’t do them well enough, and so we get stuck in a pseudo-preparation rut. If that’s the case, our previous main feature on perfectionism may help:
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Needle Pain Is a Big Problem for Kids. One California Doctor Has a Plan.
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Almost all new parents go through it: the distress of hearing their child scream at the doctor’s office. They endure the emotional torture of having to hold their child down as the clinician sticks them with one vaccine after another.
“The first shots he got, I probably cried more than he did,” said Remy Anthes, who was pushing her 6-month-old son, Dorian, back and forth in his stroller in Oakland, California.
“The look in her eyes, it’s hard to take,” said Jill Lovitt, recalling how her infant daughter Jenna reacted to some recent vaccines. “Like, ‘What are you letting them do to me? Why?’”
Some children remember the needle pain and quickly start to internalize the fear. That’s the fear Julia Cramer witnessed when her 3-year-old daughter, Maya, had to get blood drawn for an allergy test at age 2.
“After that, she had a fear of blue gloves,” Cramer said. “I went to the grocery store and she saw someone wearing blue gloves, stocking the vegetables, and she started freaking out and crying.”
Pain management research suggests that needle pokes may be children’s biggest source of pain in the health care system. The problem isn’t confined to childhood vaccinations either. Studies looking at sources of pediatric pain have included children who are being treated for serious illness, have undergone heart surgeries or bone marrow transplants, or have landed in the emergency room.
“This is so bad that many children and many parents decide not to continue the treatment,” said Stefan Friedrichsdorf, a specialist at the University of California-San Francisco’s Stad Center for Pediatric Pain, speaking at the End Well conference in Los Angeles in November.
The distress of needle pain can follow children as they grow and interfere with important preventive care. It is estimated that a quarter of all adults have a fear of needles that began in childhood. Sixteen percent of adults refuse flu vaccinations because of a fear of needles.
Friedrichsdorf said it doesn’t have to be this bad. “This is not rocket science,” he said.
He outlined simple steps that clinicians and parents can follow:
- Apply an over-the-counter lidocaine, which is a numbing cream, 30 minutes before a shot.
- Breastfeed babies, or give them a pacifier dipped in sugar water, to comfort them while they’re getting a shot.
- Use distractions like teddy bears, pinwheels, or bubbles to divert attention away from the needle.
- Don’t pin kids down on an exam table. Parents should hold children in their laps instead.
At Children’s Minnesota, Friedrichsdorf practiced the “Children’s Comfort Promise.” Now he and other health care providers are rolling out these new protocols for children at UCSF Benioff Children’s Hospitals in San Francisco and Oakland. He’s calling it the “Ouchless Jab Challenge.”
If a child at UCSF needs to get poked for a blood draw, a vaccine, or an IV treatment, Friedrichsdorf promises, the clinicians will do everything possible to follow these pain management steps.
“Every child, every time,” he said.
It seems unlikely that the ouchless effort will make a dent in vaccine hesitancy and refusal driven by the anti-vaccine movement, since the beliefs that drive it are often rooted in conspiracies and deeply held. But that isn’t necessarily Friedrichsdorf’s goal. He hopes that making routine health care less painful can help sway parents who may be hesitant to get their children vaccinated because of how hard it is to see them in pain. In turn, children who grow into adults without a fear of needles might be more likely to get preventive care, including their yearly flu shot.
In general, the onus will likely be on parents to take a leading role in demanding these measures at medical centers, Friedrichsdorf said, because the tolerance and acceptance of children’s pain is so entrenched among clinicians.
Diane Meier, a palliative care specialist at Mount Sinai, agrees. She said this tolerance is a major problem, stemming from how doctors are usually trained.
“We are taught to see pain as an unfortunate, but inevitable side effect of good treatment,” Meier said. “We learn to repress that feeling of distress at the pain we are causing because otherwise we can’t do our jobs.”
During her medical training, Meier had to hold children down for procedures, which she described as torture for them and for her. It drove her out of pediatrics. She went into geriatrics instead and later helped lead the modern movement to promote palliative care in medicine, which became an accredited specialty in the United States only in 2006.
Meier said she thinks the campaign to reduce needle pain and anxiety should be applied to everyone, not just to children.
“People with dementia have no idea why human beings are approaching them to stick needles in them,” she said. And the experience can be painful and distressing.
Friedrichsdorf’s techniques would likely work with dementia patients, too, she said. Numbing cream, distraction, something sweet in the mouth, and perhaps music from the patient’s youth that they remember and can sing along to.
“It’s worthy of study and it’s worthy of serious attention,” Meier said.
This article is from a partnership that includes KQED, NPR, and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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