Families including someone with mental illness can experience deep despair. They need support
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In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”
Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.
Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.
While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?
The role of caregivers
Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.
Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.
It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.
In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.
Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.
Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.
The family is a system
The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.
Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.
My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.
Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.
When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.
Shifting the focus
There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.
There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.
For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.
As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.
Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.
Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.
While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.
In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amanda Cole, Lead, Mental Health, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Constipation increases your risk of a heart attack, new study finds – and not just on the toilet
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If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and it’s believed he was straining very hard to poo, which then led to a fatal heart attack.
We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many.
But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack.
This includes a recent study led by Australian researchers involving data from thousands of people.
Elvis Presley was said to have died of a heart attack while straining on the toilet. But is that true? Kraft74/Shutterstock Are constipation and heart attacks linked?
Large population studies show constipation is linked to an increased risk of heart attacks.
For example, an Australian study involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age.
A Danish study of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes.
It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital.
These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated.
Researchers have studied thousands of people to see if there’s a link between constipation and heart attacks. fongbeerredhot/Shutterstock How about this new study?
The recent international study led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population.
The researchers analysed data from the UK Biobank, a database of health-related information from about half a million people in the United Kingdom.
The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation.
People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation.
The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension.
The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations.
A Japanese study looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day.
How might constipation cause a heart attack?
Chronic constipation can lead to straining when passing a stool. This can result in laboured breathing and can lead to a rise in blood pressure.
In one Japanese study including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people.
One theory is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels.
As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease doubles when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure).
The systolic blood pressure rise with straining in passing a stool has been reported to be as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks.
High blood pressure from straining on the toilet can last after pooing, especially in older people. Andrey_Popov/Shutterstock Some people with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing.
This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure.
Another intriguing avenue of research examines the imbalance in gut bacteria in people with constipation.
This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack.
This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease.
What can we do about this?
Constipation affects around 19% of the global population aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health.
Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What To Leave Off Your Table (To Stay Off This Surgeon’s)
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Why we eat too much (and how we can fix that)
This is Dr. Andrew Jenkinson. He’s a Consultant Surgeon specializing in the treatment of obesity, gallstones, hernias, heartburn and abdominal pain. He runs regular clinics in both London and Dubai. What he has to offer us today, though, is insight as to what’s on our table that puts us on his table, and how we can quite easily change that up.
So, why do we eat too much?
First things first: some metabolic calculations. No, we’re not going to require you to grab a calculator here… Your body does it for you!
Our body’s amazing homeostatic system (the system that does its best to keep us in the “Goldilocks Zone” of all our bodily systems; not too hot or too cold, not dehydrated or overhydrated, not hyperglycemic or hypoglycemic, blood pressure not too high or too low, etc, etc) keeps track of our metabolic input and output.
What this means: if we increase or decrease our caloric consumption, our body will do its best to increase or decrease our metabolism accordingly:
- If we don’t give it enough energy, it will try to conserve energy (first by slowing our activities; eventually by shutting down organs in a last-ditch attempt to save the rest of us)
- If we give it too much energy, it will try to burn it off, and what it can’t burn, it will store
In short: if we eat 10% or 20% more or less than usual, our body will try to use 10% to 20% more or less than usual, accordingly.
So… How does this get out of balance?
The problem is in how our system does that, and how we inadvertently trick it, to our detriment.
For a system to function, it needs at its most base level two things—a sensor and a switch:
- A sensor: to know what’s going on
- A switch: to change what it’s doing accordingly
Now, if we eat the way we’re evolved to—as hunter-gatherers, eating mostly fruit and vegetables, supplemented by animal products when we can get them—then our body knows exactly what it’s eating, and how to respond accordingly.
Furthermore, that kind of food takes some eating! Most fruit these days is mostly water and fiber; in those days it often had denser fiber (before agricultural science made things easier to eat), but either way, our body knows when we are eating fruit and how to handle that. Vegetables, similarly. Unprocessed animal products, again, the gut goes “we know what this is” and responds accordingly.
But modern ultra-processed foods with trans-fatty acids, processed sugar and flour?
These foods zip calories straight into our bloodstream like greased lightning. We get them so quickly so easily and in such great caloric density, that our body doesn’t have the chance to count them on the way in!
What this means is: the body has no idea what it’s just consumed or how much or what to do with it, and doesn’t adjust our metabolism accordingly.
Bottom line:
Evolutionarily speaking, your body has no idea what ultra-processed food is. If you skip it and go for whole foods, you can, within the bounds of reason, eat what you like and your body will handle it by adjusting your metabolism accordingly.
Now, advising you “avoid ultra-processed foods and eat whole foods” was probably not a revelation in and of itself.
But: sometimes knowing a little more about the “why” makes the difference when it comes to motivation.
Want to know more about Dr. Jenkinson’s expert insights on this topic?
If you like, you can check out his website here—he has a book too
Why We Eat (Too Much) – Dr. Andrew Jenkinson on the Science of Appetite
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Less Common Oral Hygiene Options
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Less Common Alternatives For Oral Hygiene!
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
- The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
- The second part was: Flossing, Better (And Easier!)
- The third (and for now at least, final) part will look at some less common alternatives.
Tooth soap
The idea here is simplicity, and brushing with as few ingredients as possible. Soap cleans your teeth the same way it cleans your (sometimes compositionally quite similar—enamel and all) dishes, without damaging them.
We’d love to link to some science here, but alas, it appears to have not yet been done—at least, we couldn’t find any!
You can make your own tooth soap if you are feeling confident, or you might prefer to buy one ready-made (here’s an example product on Amazon, with various flavor options)
Oil pulling
We are getting gradually more scientific now; there is science for this one… But the (scientific) reviews are mixed:
Wooley et al., 2020, conducted a review of extant studies, and concluded:
❝The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene❞
The “Science-Based Medicine” project was less positive in its assessment, and declared that all and any studies that found oil pulling to be effective were a matter of researcher/publication bias. We would note that SBM is a private project and is not without its own biases, but for balance, here is what they had to offer:
A more rounded view seems to be that it is a good method for cleaning your teeth if you don’t have better options available (whereby, “better options” is “almost any other method”).
One final consideration, which the above seemed not to consider, is:
If you have sensitive teeth/gums, oil-pulling is the gentlest way of cleaning them, and getting them back into sufficient order that you can comfortably use other methods.
Want to try it? You can use any food-grade oil (coconut oil or olive oil are common choices).
Chewing stick
Not just any stick—a twig of the Salvadora persica tree. This time, there’s lots of science for it, and it’s uncontroversially effective:
❝A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties.
Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva.
Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush❞
Read in full: A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health
And about the efficacy vs using a toothbrush, here’s an example:
Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health
Want to try the miswak stick? Here’s an example product on Amazon.
Enjoy!
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Ice Baths: To Dip Or Not To Dip?
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Many Are Cold, But Few Are Frozen
We asked you for your (health-related) view of ice baths, and got the above-depicted, below-described, set of responses:
- About 31% said “ice baths are great for the health; we should take them”
- About 29% said “ice baths’ risks outweigh their few benefits”
- About 26% said “ice baths’ benefits outweigh their few risks”
- About 14% said “ice baths are dangerous and can kill you; best avoided”
So what does the science say?
Freezing water is very dangerous: True or False?
True! Water close to freezing point is indeed very dangerous, and can most certainly kill you.
Fun fact, though: many such people are still saveable with timely medical intervention, in part because the same hypothermia that is killing them also slows down the process* of death
Source (and science) for both parts of that:
Cold water immersion: sudden death and prolonged survival
*and biologically speaking, death is a process, not an event, by the way. But we don’t have room for that today!
(unless you die in some sudden violent way, such as a powerful explosion that destroys your brain instantly; then it’s an event)
Ice baths are thus also very dangerous: True or False?
False! Assuming that they are undertaken responsibly and you have no chronic diseases that make it more dangerous for you.
What does “undertaken responsibly” mean?
Firstly, the temperature should not be near freezing. It should be 10–15℃, which for Americans is 50–59℉.
You can get a bath thermometer to check this, by the way. Here’s an example product on Amazon.
Secondly, your ice bath should last no more than 10–15 minutes. This is not a place to go to sleep.
What chronic diseases would make it dangerous?
Do check with your doctor if you have any doubts, as no list we make can be exhaustive and we don’t know your personal medical history, but the main culprits are:
- Cardiovascular disease
- Hypertension
- Diabetes (any type)
The first two are for heart attack risk; the latter is because diabetes can affect core temperature regulation.
Ice baths are good for the heart: True or False?
True or False depending on how they’re done, and your health before starting.
For most people, undertaking ice baths responsibly, repeated ice bath use causes the cardiovascular system to adapt to better maintain homeostasis when subjected to thermal shock (i.e. sudden rapid changes in temperature).
For example: Respiratory and cardiovascular responses to cold stress following repeated cold water immersion
And because that was a small study, here’s a big research review with a lot of data; just scroll to where it has the heading“Specific thermoregulative adaptations to regular exposure to cold air and/or cold water exposure“ for many examples and much discussion:
Health effects of voluntary exposure to cold water: a continuing subject of debate
Ice baths are good against inflammation: True or False?
True! Here’s one example:
Uric acid and glutathione levels (important markers of chronic inflammation) are also significantly affected:
Uric acid and glutathione levels during short-term whole body cold exposure
Want to know more?
That’s all we have room for today, but check out our previous “Expert Insights” main feature looking at Wim Hof’s work in cryotherapy:
A Cold Shower A Day Keeps The Doctor Away?
Enjoy!
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I can’t afford olive oil. What else can I use?
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If you buy your olive oil in bulk, you’ve likely been in for a shock in recent weeks. Major supermarkets have been selling olive oil for up to A$65 for a four-litre tin, and up to $26 for a 750 millilitre bottle.
We’ve been hearing about the health benefits of olive oil for years. And many of us are adding it to salads, or baking and frying with it.
But during a cost-of-living crisis, these high prices can put olive oil out of reach.
Let’s take a look at why olive oil is in demand, why it’s so expensive right now, and what to do until prices come down.
Joyisjoyful/Shutterstock Remind me, why is olive oil so good for you?
Including olive oil in your diet can reduce your risk of developing type 2 diabetes and improve heart health through more favourable blood pressure, inflammation and cholesterol levels.
This is largely because olive oil is high in monounsaturated fatty acids and polyphenols (antioxidants).
Some researchers have suggested you can get these benefits from consuming up to 20 grams a day. That’s equivalent to about five teaspoons of olive oil.
Why is olive oil so expensive right now?
A European heatwave and drought have limited Spanish and Italian producers’ ability to supply olive oil to international markets, including Australia.
This has been coupled with an unusually cold and short growing season for Australian olive oil suppliers.
The lower-than-usual production and supply of olive oil, together with heightened demand from shoppers, means prices have gone up.
We’ve seen unfavourable growing conditions in Europe and Australia. KaMay/Shutterstock How can I make my olive oil go further?
Many households buy olive oil in large quantities because it is cheaper per litre. So, if you have some still in stock, you can make it go further by:
- storing it correctly – make sure the lid is on tightly and it’s kept in a cool, dark place, such as a pantry or cabinet. If stored this way, olive oil can typically last 12–18 months
- using a spray – sprays distribute oil more evenly than pourers, using less olive oil overall. You could buy a spray bottle to fill from a large tin, as needed
- straining or freezing it – if you have leftover olive oil after frying, strain it and reuse it for other fried dishes. You could also freeze this used oil in an airtight container, then thaw and fry with it later, without affecting the oil’s taste and other characteristics. But for dressings, only use fresh oil.
I’ve run out of olive oil. What else can I use?
Here are some healthy and cheaper alternatives to olive oil:
- canola oil is a good alternative for frying. It’s relatively low in saturated fat so is generally considered healthy. Like olive oil, it is high in healthy monounsaturated fats. Cost? Up to $6 for a 750mL bottle (home brand is about half the price)
- sunflower oil is a great alternative to use on salads or for frying. It has a mild flavour that does not overwhelm other ingredients. Some studies suggest using sunflower oil may help reduce your risk of heart disease by lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Cost? Up to $6.50 for a 750mL bottle (again, home brand is about half the price)
- sesame oil has a nutty flavour. It’s good for Asian dressings, and frying. Light sesame oil is typically used as a neutral cooking oil, while the toasted type is used to flavour sauces. Sesame oil is high in antioxidants and has some anti-inflammatory properties. Sesame oil is generally sold in smaller bottles than canola or sunflower oil. Cost? Up to $5 for a 150mL bottle.
There are plenty of alternative oils you can use in salads or for frying. narai chal/Shutterstock How can I use less oil, generally?
Using less oil in your cooking could keep your meals healthy. Here are some alternatives and cooking techniques:
- use alternatives for baking – unless you are making an olive oil cake, if your recipe calls for a large quantity of oil, try using an alternative such as apple sauce, Greek yoghurt or mashed banana
- use non-stick cookware – using high-quality, non-stick pots and pans reduces the need for oil when cooking, or means you don’t need oil at all
- steam instead – steam vegetables, fish and poultry to retain nutrients and moisture without adding oil
- bake or roast – potatoes, vegetables or chicken can be baked or roasted rather than fried. You can still achieve crispy textures without needing excessive oil
- grill – the natural fats in meat and vegetables can help keep ingredients moist, without using oil
- use stock – instead of sautéing vegetables in oil, try using vegetable broth or stock to add flavour
- try vinegar or citrus – use vinegar or citrus juice (such as lemon or lime) to add flavour to salads, marinades and sauces without relying on oil
- use natural moisture – use the natural moisture in ingredients such as tomatoes, onions and mushrooms to cook dishes without adding extra oil. They release moisture as they cook, helping to prevent sticking.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Walnuts vs Pecans – Which is Healthier?
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Our Verdict
When comparing walnuts to pecans, we picked the walnuts.
Why?
It was very close, though, and an argument could be made for pecans! Walnuts are nevertheless always a very good bet, and so far in our This-or-That comparisons, the only nut to beat them so far as been almonds, and that was very close too.
In terms of macros, walnuts have a lot more protein, while pecans have a little more fiber (for approximately the same carbs). Both are equally fatty (near enough; technically pecans have a little more) but where the walnuts stand out in the fat category is that while pecans have mostly healthy monounsaturated fats, walnuts have mostly healthy polyunsaturated fats, including including a good balance of omega-3 and omega-6 fatty acids. So, while we do love the extra fiber from pecans, we’re calling it for walnuts in the macros category, on account of the extra protein and the best lipids profile (not that pecans’ lipids profile is bad by any stretch; just, walnuts have it better).
In the vitamins category, walnuts have more of vitamins B2, B6, B9, and C, while pecans offer more of vitamins A, B1, B3, B5, E, K, and choline. The margins aren’t huge and walnuts are also excellent for all the vitamins that pecans narrowly beat them on, but still, the vitamins category is a win for pecans.
When it comes to minerals, walnuts take back the crown; walnuts offer more calcium, copper, iron, magnesium, phosphorus, potassium, and selenium, while pecans have a little more manganese and zinc. Once again, the margins aren’t huge and pecans are also excellent for all the minerals that walnuts narrowly beat them on, but still, the minerals category is a win for walnuts.
In short: enjoy both of these nuts for their healthy fats, vitamins, minerals, protein, and fiber, but if you’re going to pick one, walnuts come out on top.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Take care!
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