Does This New Machine Cure Depression?
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Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).
TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:
The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.
Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:
Antidepressants: Personalization Is Key!
Transcranial stimulation… At home?
Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).
First, what it’s not: electroconvulsive therapy (ECT). Rather, it uses a very low current.
What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.
In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).
See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies
And as for the study, here it is:
…which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…
Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:
Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode
This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.
And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.
Want something else against depression meanwhile?
Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:
The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like
Take care!
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Is thirst a good predictor of dehydration?
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Water is essential for daily functioning and health, and we can only survive a few days without it. Yet we constantly lose water through sweat, urination and even evaporation when we breathe.
This is why we have evolved a way to regulate and maintain water in our bodies. Like other animals, our survival relies on a strong biological drive that tells us to find and drink water to balance fluid loss.
This is thirst – a sensation of dryness in the mouth signalling we need to have a drink. This basic physiological mechanism is controlled mainly by part of the brain’s “control centre”, called the hypothalamus. The hypothalamus receives signals from various regions of the body and in return, releases hormones that act as a messenger to signal the thirst sensation.
KieferPix/Shutterstock What is dehydration?
Staying hydrated (having enough water in our bodies) is important for several reasons, including:
- regulating body temperature through sweat and respiration
- lubricating joints and eyes
- preventing infections
- digesting and absorbing nutrients
- flushing out waste (via the kidneys)
- preventing constipation
- brain function (including memory and concentration)
- mood and energy levels
- physical performance and recovery from exercise
- skin health.
Dehydration occurs when our body doesn’t have enough water. Even slight drops in fluid levels have noticeable consequences, such as headaches, feeling dizzy, lethargy and struggling to concentrate.
Chronic dehydration can pose more serious health risks, including urinary tract infections, constipation and kidney stones.
What does the evidence say?
Despite thirst being one of the most basic biological drivers for good hydration, science suggests our feelings of thirst and subsequent fluid intake don’t always correlate with hydration levels.
For example, a recent study explored the impact of thirst on fluid intake and hydration status. Participants attended a lab in the morning and then later in the afternoon to provide markers of hydration status (such as urine, blood samples and body weight). The relationship between levels of thirst in the morning and afternoon hydration status was negligible.
Further, thirst may be driven by environmental factors, such as access to water. For example, one study looked at whether ample access to water in a lab influenced how much people drank and how hydrated they were. The link between how thirsty they felt and how hydrated they were was weak, suggesting the availability of water influenced their fluid intake more than thirst.
Exercise can also change our thirst mechanism, though studies are limited at this stage.
Being thirsty doesn’t necessarily mean we’re dehydrated. puhhha/Shutterstock Interestingly, research shows women experience thirst more strongly than men, regardless of hydration status. To understand gender differences in thirst, researchers infused men and women with fluids and then measured their thirst and how hydrated they were. They found women generally reported thirst at a lower level of fluid loss. Women have also been found to respond more to feeling thirsty by drinking more water.
Other ways to tell if you need to drink some water
While acknowledging some people will need to drink more or less, for many people, eight cups (or two litres) a day is a good amount of water to aim for.
But beyond thirst, there are many other ways to tell whether you might need to drink more water.
1. urine colour: pale yellow urine typically indicates good hydration, while darker, concentrated urine suggests dehydration
2. frequency of going to the toilet: urinating regularly (around four to six times a day) indicates good hydration. Infrequent urination can signal dehydration
3. skin turgor test: gently pinching the skin (for example, on the back of the hand) and observing how quickly the skin returns to its normal position can help assess hydration. Slow return may indicate dehydration
If skin stays elevated after pinching it may be a sign of dehydration. SusaZoom/Shutterstock 4. mouth and lips: a dry mouth or cracked lips can be early signs of dehydration
5. headaches and fatigue: frequent headaches, dizziness, or unexplained fatigue can be signs of inadequate hydration
6. sweating: in physically active people, monitoring how much they sweat during activity can help estimate fluid loss and hydration needs. Higher levels of sweat may predispose a person to dehydration if they are unable to replace the fluid lost through water intake
These indicators, used together, provide a more comprehensive picture of hydration without solely depending on the sensation of thirst.
Of course, if you do feel thirsty, it’s still a good idea to drink some water.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Kiara Too, PhD candidate, School of Human Movement and Nutrition Sciences, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Science-Backed Anti-Inflammatory Diet for Beginners – by Dr. Yasmine Elamir & Dr. William Grist
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We have written about how to eat to beat inflammation, but what we didn’t do is include 75 recipes and a plan for building up one’s culinary repertoire around those core dishes!
That’s what this book does. It covers briefly the science of inflammation and anti-inflammatory diet, discusses experimental elimination diets (e.g. you eliminate likely culprits of triggering your inflammation, then reintroduce them one by one to see which it was), and ingredients likely to increase or decrease inflammation.
The 75 recipes are good, and/but a caveat is “yes, one of the recipes is ketchup and another is sour cream” so it’s not exactly 75 mains.
However! Where this book excels is in producing anti-inflammatory versions of commonly inflammatory dishes. That ketchup? Not sugary. The sour cream? Vegan. And so forth. We also see crispy roast potatoes, an array of desserts, and sections for popular holiday dishes too, so you will not need to be suddenly inflamed into the next dimension when it comes to festive eating.
The recipes are what the title claims them to be, “science-backed anti-inflammatory”, and that is clearly the main criterion for their inclusion. They are not by default vegan, vegetarian, dairy-free, nut-free, gluten-free, etc. For this reason, all recipes are marked with such tags as “V, VG, DF, GF, EF, NF” etc as applicable.
Bottom line: we’d consider this book more of a jumping-off point than a complete repertoire, but it’s a very good jumping-off point, and will definitely get you “up and running” (there’s a 21-day meal plan, for example).
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Spreading Mental Health Awareness
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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
Request: more people need to be aware of suicidal tendencies and what they can do to ward them off
That’s certainly a very important topic! We’ll cover that properly in one of our Psychology Sunday editions. In the meantime, we’ll mention a previous special that we did, that was mostly about handling depression (in oneself or a loved one), and obviously there’s a degree of crossover:
The Mental Health First-Aid That You’ll Hopefully Never Need
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Drug Metabolism (When You’re Not Average!)
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When Your Medications Run Out… Of You
Everybody knows that alcohol can affect medications’ effects, but what of smoking, and what of obesity? And how does the alcohol thing work anyway?
It’s all about the enzymes
Medicines that are processed by the liver (which is: most medicines) are metabolized there by specialist enzymes, and the things we do can increase or decrease the quantity of those enzymes—and/or how active they are.
Dr. Kata Wolff Pederson and her team of researchers at Aarhus University in Denmark examined the livers of recently deceased donors in ways that can’t (ethically) be done with live patients, and were able to find the associations between various lifestyle factors and different levels of enzymes responsible for drug metabolism.
And it’s not always how you might think!
Some key things they found:
- Smokers have twice as high levels of enzyme CYP1A2 than non-smokers, which results in the faster metabolism of a lot of drugs.
- Drinkers have 30% higher levels of enzyme CYP2E1, which also results in a faster metabolism of a lot of drugs.
- Patients with obesity have 50% lower levels of enzyme CYP3A4, resulting in slower metabolism of many drugs
This gets particularly relevant when we take into account the next fact:
- Of the individuals in the study, 40% died from poisoning from a mixture of drugs (usually: prescription and otherwise)
Read in full: Sex- and Lifestyle-Related Factors are Associated with Altered Hepatic CYP Protein Levels
Read a pop-sci article about it: Your lifestyle can determine how well your medicine will work
How much does the metabolism speed matter?
It can matter a lot! If you’re taking drugs and carefully abiding by the dosage instructions, those instructions were assuming they know your speed of metabolism, and this is based on an average.
- If your metabolism is faster, you can get too much of a drug too quickly, and it can harm you
- If your metabolism is faster, it also means that while yes it’ll start working sooner, it’ll also stop working sooner
- If it’s a painkiller, that’s inconvenient. If it’s a drug that keeps you alive, then well, that’s especially unfortunate.
- If your metabolism is slower, it can mean your body is still processing the previous dose(s) when you take the next one, and you can overdose (and potentially die)
We touched on this previously when we talked about obesity in health care settings, and how people can end up getting worse care:
As for alcohol and drugs? Obviously we do not recommend, but here’s some of the science of it with many examples:
Why it’s a bad idea to mix alcohol with some medications
Take care!
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An Addiction Expert’s Insights On Festive Drinking
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This is Dr. Christopher Kahler. He’s Professor of Behavioral and Social Sciences, Director of Alcohol and Addiction Studies, Professor of Psychiatry and Human Behavior, all at Brown University.
What does he want us to know?
It’s the trickiest time of the year
Per stats, alcohol sales peak in December, with the heaviest drinking being from mid-December (getting an early start on the Christmas cheer) to New Year’s Eve. As for why, there’s a collection of reasons, as he notes:
❝The main challenge is there’s an extra layer of stress, with a lot of obligations and expectations from friends and family. We’re around people who maybe we’re not usually around, and in larger groups. It’s also a time of heightened emotion and, for some people, loneliness.
On top of that, alcohol use is built into a lot of our winter holiday traditions. It’s often marketed as part of the “good life.” We’re expected to have alcohol when we celebrate.❞
As for how much alcohol is safe to drink… According to the World Health Organization, the only safe amount of alcohol is zero:
Dr. Kahler acknowledges, however, that many people will wish to imbibe anyway, and indeed, he himself does drink a little, but endeavours to do so mindfully, and as such, he recommends that we…
HALT!
Dr. Kahler counsels us against making decisions (including the decision to drink alcohol), on occasions when we are one or more of the following:
- Hungry
- Angry
- Lonely
- Tired
He also notes that around this time of year, often our normal schedules and habits are disrupted, which introduces more microdecisions to our daily lives, which in turn means more “decision fatigue”, and the greater chance of making bad decisions.
We share some practical tips on how to reduce the chances of thusly erring, here:
Set your intentions now
He bids us figure out what our goal is, and really think it through, including not just “how many drinks to have” if we’re drinking, but also such things as “what feelings are likely to come up”. Because, if we’ve historically used alcohol as a maladaptive coping mechanism, we’re going to need a different, better, healthier coping mechanism (we talked more about that in our above-linked article about reducing or quitting alcohol, too, with some examples).
He also suggests that we memorize our social responses—exactly what we’re going to say if offered a drink, for example:
❝It’s important to know what you’re going to say about your alcohol use. If someone asks if they can get you a drink, good responses could be: “A glass of water would be great” or “Do you have any non-alcoholic cider?” You don’t have to explain yourself. Just ask for what you want, because saying no to someone can be difficult.❞
See also:
December’s Traps To Plan Around
Mix it up and slow it down
No, that doesn’t mean mix yourself a sloe gin cocktail. But rather, it’s about alternating alcoholic and non-alcoholic drinks, to give your body half a chance to process the alcohol, and also to rehydrate a little along the way.
We talk about this and other damage-limitation methods, here:
How To Reduce The Harm Of Festive Drinking (Without Abstaining)
Take care!
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Anti-Cholesterol Cardamom & Pistachio Porridge
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This tasty breakfast’s beta-glucan content binds to cholesterol and carries it out of the body; there are lots of other nutritional benefits too!
You will need
- 1 cup coconut milk
- ⅓ cup oats
- 4 tbsp crushed pistachios
- 6 cardamom pods, crushed
- 1 tsp rose water or 4 drops edible rose essential oil
- Optional sweetener: drizzle of honey or maple syrup
- Optional garnishes: rose petals, chopped nuts, dried fruit
Method
(we suggest you read everything at least once before doing anything)
1) Heat the coconut milk, adding the oats and crushed cardamom pods. Simmer for 5–10 minutes depending on how cooked you want the oats to be.
2) Stir in the crushed pistachio nuts, as well as the rose water.
3) Serve in a bowl, adding any optional toppings:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The Best Kind Of Fiber For Overall Health? ← it’s beta-glucan, which is fund abundantly in oats
- Pistachios vs Pecans – Which is Healthier? ← have a guess
- Can Saturated Fats Be Healthy? ← coconut can!
Take care!
Don’t Forget…
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