Finding Geriatric Doctors for Seniors

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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

❝[Can you write about] the availability of geriatric doctors Sometimes I feel my primary isn’t really up on my 70 year old health issues. I would love to find a doctor that understands my issues and is able to explain them to me. Ie; my worsening arthritis in regards to food I eat; in regards to meds vs homeopathic solutions.! Thanks!❞

That’s a great topic, worthy of a main feature! Because in many cases, it’s not just about specialization of skills, but also about empathy, and the gap between studying a condition and living with a condition.

About arthritis, we’re going to do a main feature specifically on that quite soon, but meanwhile, you might like our previous article:

Keep Inflammation At Bay (arthritis being an inflammatory condition)

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  • How can I stop using food to cope with negative emotions?

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    Have you ever noticed changes in your eating habits when you are sad, bored or anxious?

    Many people report eating either more, or less, as a way of helping them to cope when they experience difficult emotions.

    Although this is a very normal response, it can take the pleasure out of eating, and can become distressing and bring about other feelings of shame and self-criticism.

    Adding to the complexity of it all, we live in a world where diet culture is unavoidable, and our relationship to eating, food and body image can become complicated and confusing.

    Drazen Zigic/Shutterstock

    Emotional eating is common

    “Emotional eating” refers to the eating behaviours (typically eating more) that occur in response to difficult emotions.

    Research shows around 20% of people regularly engage in emotional eating, with a higher prevalence among adolescents and women. In a study of more than 1,500 adolescents, 34% engaged in emotional eating while sad and 40% did so while anxious.

    Foods consumed are often fast-foods and other energy-dense, nutrient-poor convenience foods.

    Stress, strong emotions and depression

    For some people, emotional eating was simply a habit formed earlier in life that has persisted over time.

    But other factors might also contribute to the likelihood of emotional eating. The physiological effects of stress and strong emotions, for example, can influence hormones such as cortisol, insulin and glucose, which can also increase appetite.

    Increased impulsivity (behaving before thinking things through), vulnerability to depression, a tendency to ruminate and difficulties regulating emotions also increase the likelihood of emotional eating.

    Man stands in kitchenette
    Depression increases the likelihood of emotional eating. TommyStockProject/Shutterstock

    So what do you do?

    First, know that fluctuations in eating are normal. However, if you find that the way you eat in response to difficult emotions is not working for you, there are a few things you can do.

    Starting with small things that are achievable but can have a huge impact, such as prioritising getting enough sleep and eating regularly.

    Then, you can start to think about how you handle your emotions and hunger cues.

    Expand your emotional awareness

    Often we label emotions as good or bad, and this can result in fear, avoidance, and unhelpful coping strategies such as emotional eating.

    But it’s also important to differentiate the exact emotion. This might be feeling isolated, powerless or victimised, rather than something as broad as sad.

    By noticing what the emotion is, we can bring curiosity to what it means, how we feel in our minds and bodies, and how we think and behave in response.

    Tap into your feelings of hunger and fullness

    Developing an intuitive way of eating is another helpful strategy to promote healthy eating behaviours.

    Intuitive eating means recognising, understanding and responding to internal signals of hunger and fullness. This might mean tuning in to and acknowledging physical hunger cues, responding by eating food that is nourishing and enjoyable, and identifying sensations of fullness.

    Intuitive eating encourages flexibility and thinking about the pleasure we get from food and eating. This style of eating also allows us to enjoy eating out with friends, and sample local delicacies when travelling.

    It can also reduce the psychological distress from feeling out of control with your eating habits and the associated negative body image.

    Friends eat dinner out
    Try to be flexible in thinking about the pleasure of food and eating with friends. La Famiglia/Shutterstock

    When is it time to seek help?

    For some people, the thoughts and behaviours relating to food, eating and body image can negatively impact their life.

    Having the support of friends and family, accessing online resources and, in some instances, seeing a trained professional, can be very helpful.

    There are many therapeutic interventions that work to improve aspects associated with emotional eating. These will depend on your situation, needs, stage of life and other factors, such as whether you are neurodivergent.

    The best approach is to engage with someone who can bring compassion and understanding to your personal situation, and work with you collaboratively. This work might include:

    • unpacking some of the patterns that could be underlying these emotions, thoughts and behaviours
    • helping you to discover your emotions
    • supporting you to process other experiences, such as trauma exposure
    • developing a more flexible and intuitive way of eating.

    One of the dangers that can occur in response to emotional eating is the temptation to diet, which can lead to disordered eating, and eating disorder behaviours. Indicators of a potential eating disorder can include:

    • recent rapid weight loss
    • preoccupation with weight and shape (which is usually in contrast to other people’s perceptions)
    • eating large amounts of food within a short space of time (two hours or less) and feeling a sense of loss of control
    • eating in secret
    • compensating for food eaten (with vomiting, exercise or laxatives).

    Evidence-based approaches can support people experiencing eating disorders. To find a health professional who is informed and specialises in this area, search the Butterfly Foundation’s expert database.


    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the Butterfly Foundation on 1800 ED HOPE (1800 33 4673).

    Inge Gnatt, PhD Candidate, Lecturer in Psychology, Swinburne University of Technology

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

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  • Where Nutrition Meets Habits!

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    Where Nutrition Meets Habits…

    This is Claudia Canu, MSc., INESEM. She’s on a mission to change the way we eat:

    Often, diet is a case of…

    • Healthy
    • Easy
    • Cheap

    (choose two)

    She wants to make it all three, and tasty too. She has her work cut out for her, but she’s already blazed quite a trail personally:

    Nine months before turning 40 years old, I set a challenge for myself: Arrive to the day I turn 40 as the best possible version of myself, physically, mentally and emotionally.❞

    ~ Claudia Canu

    In Her Own Words: My Journey To My Healthy 40s

    And it really was quite a journey:

    For those of us who’d like the short-cut rather than a nine-month quasi-spiritual journey… based on both her experience, and her academic and professional background in nutrition, her main priorities that she settled on were:

    • Making meals actually nutritionally balanced, which meant re-thinking what she thought a meal “should” be
    • Making nutritionally balanced meals that didn’t require a lot of skill and/or resources
    • That’s it!

    But, easier said than done… Where to begin?

    She shares an extensive list of recipes, from meals to snacks (I thought I was the only one who made coffee overnight oats!), but the most important thing from her is:

    Claudia’s 10 Guiding Principles:

    1. Buy only fresh ingredients that you are going to cook yourself. If you decide to buy pre-cooked ones, make sure they do not have added ingredients, especially sugar (in all its forms).
    2. Use easy and simple cooking methods.
    3. Change ingredients every time you prepare your meals.
    4. Prepare large quantities for three or four days.
    5. Store the food separately in tightly closed Tupperware.
    6. Organize yourself to always have ready-to-eat food in the fridge.
    7. When hungry, mix the ingredients in the ideal amounts to cover the needs of your body.
    8. Chew well and take the time to taste your food.
    9. Eat foods that you like and enjoy.
    10. Do not overeat but don’t undereat either.

    We have only two quibbles with this fine list, which are:

    About Ingredients!

    Depending on what’s available around you, frozen and/or tinned “one-ingredient” foods can be as nutritional as (if not more nutritional than) fresh ones. By “one-ingredient” foods here we mean that if you buy a frozen pack of chopped onions, the ingredients list will be: “chopped onions”. If you buy a tin of tomatoes, the ingredients will say “Tomatoes” or at most “Tomatoes, Tomato Juice”, for example.

    She does list the ingredients she keeps in; the idea that with these in the kitchen, you’ll never be in the position of “oh, we don’t have much in, I guess it’s a pizza delivery night” or “well there are some chicken nuggets at the back of the freezer”.

    Check Out And Plan: 10 Types Of Ingredients You Should Always Keep In Your Kitchen

    Here Today, Gone Tomorrow?

    Preparing large quantities for three or four days can result in food for one or two days if the food is unduly delicious

    But! Claudia has a remedy for that:

    Read: How To Eliminate Food Cravings And What To Do When They Win

    Anyway, there’s a wealth of resources in the above-linked pages, so do check them out!

    Perhaps the biggest take-away is to ask yourself:

    “What are my guiding principles when it comes to food?”

    If you don’t have a ready answer, maybe it’s time to tackle that—whether Claudia’s way or your own!

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  • Easing Election Stress & Anxiety

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    At the time of writing, the US is about to have a presidential election. Most of our readers are Americans, and in any case, what the US does tends to affect most of the world, so certainly many readers in other countries will be experiencing stress and anxiety about it too.

    We’re a health science publication, not a political outlet, so we’ll refrain from commenting on any candidates or campaign policies, and we’d also like to be clear we are not urging you to any particular action politically—our focus today is simply about mental health.

    First, CBT what can be CBT’d

    Cognitive Behavioral Therapy (CBT) is far from a panacea, but it’s often a very good starting point. And when it seems the stakes are high, it’s easy to fall into such cognitive distortions as “crystal ball” and “catastrophization”, that is to say, predicting the future and feeling the impact of that (probably undesired version of the) future, and also feeling like it will be the end of the world.

    Recognizing these processes and how they work, is the first step to managing our feelings about them.

    Learn more: The Art of Being Unflappable (Tricks For Daily Life)

    Next, DBT what can be DBT’d

    A lot of CBT hinges on the assumption that our assumptions are incorrect. For example, that our friend does not secretly despise us, that our spouse is not about to leave us, that the symptoms we are experiencing are not cancer, and in this case, that the election outcome will not go badly, and if it does, the consequences will be less severe than imagined.

    But… What if our concerns are, in fact, fully justified? Here’s where Dialectic Behavior Therapy (DBT) comes in, and with it, what therapists call “radical acceptance”.

    In other words, we accept up front the idea that maybe it’s going to be terrible and that will truly suck, and then either:

    • there’s nothing we can reasonably do about it now (so worrying just means you’ll suffer twice), or
    • there is something we can reasonably do about it now (so we can go do that thing)

    After doing the thing (if appropriate), defer processing the outcome of the election until after the election. There is no point in wasting energy to worry before then. In a broadly two-party system where things are usually close between those two largest parties, there’s something close to a 50% chance of an outcome that’s, at least, not the worst you feared.

    Learn more: CBT, DBT, & Radical Acceptance

    Lastly, empower yourself with Behavioral Activation (BA)

    Whatever the outcome of any given election, the world will keep turning, and the individual battles about any given law or policy or such will continue to go on. That’s not to say an election won’t change things—it will—but there will always still be stuff to do on a grassroots level to make the world a better place, no matter what politician has been elected.

    Being involved in doing things on a community level will not only help banish any feelings of despair (and if you got the election outcome you wanted, it’ll help you feel involved), but also, it can give you a sense of control, and can even form a part of the “ikigai” that is often talked about as one of the pillars of healthy longevity.

    Learn more: What’s Your Ikigai?

    And if you like videos, then enjoy this one (narrated by the ever soothing-voiced Alain de Botton):

    Watch now: How To Escape From A Despairing Mood (4:46) ← it also has a text version if you prefer that

    Take care!

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  • Diet Tips for Crohn’s Disease
  • Daily Activity Levels & The Measurable Difference They Make To Brain Health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Most studies into the difference that exercise makes to cognitive decline are retrospective, i.e. they look backwards in time, asking participants what their exercise habits were like in the past [so many] years, and tallying that against their cognitive health in the present.

    Some studies are interventional, and those are most often 3, 6, or 12 months, depending on funding. In those cases, they make a hypothesis (e.g. this intervention will boost this measure of brain health) and then test it.

    However, humans aren’t generally great at making short term decisions for long term gains. In other words: if it’s rainy out, or you’re a little pushed for time, you’re likely to take the car over walking regardless of what data point this adjusts in an overarching pattern that will affect your brain’s amyloid-β clean-up rates in 5–20 years time.

    Nine days

    The study we’re going to look at today was a 9-day observational study, using smartphone-based tracking with check-ins every 3½ hours, with participants reporting their physical activity as light, moderate, or intense (these terms were defined and exemplified, so that everyone involved was singing from the same songsheet in terms of what activities constitute what intensity).

    The sample size was reasonable (n=204) and was generally heterogenous sample (i.e. varied in terms of sex, racial background, and fitness level) of New Yorkers aged 40–65.

    So, the input variable was activity level, and the output variable was cognitive fitness.

    As to how they measured the output, two brain games assessed:

    1. cognitive processing speed, and
    2. working memory (a proxy for executive function).

    What they found:

    1. participants active within the last 3½ hours had faster processing speed, equivalent to being four years younger
    2. response times in the working memory (for: executive function) task reflected similar processing speed improvements, for participants active in the last 3½ hours

    And, which is important to note,

    ❝This benefit was observed regardless of whether the activities they reported were higher intensity (e.g., running/jogging) or lower intensity (e.g., walking, chores).❞

    ~ Dr. Lizbeth Benson et al.

    Source: Cognitive Health Benefits of Everyday Physical Activity in a Diverse Sample of Middle-Aged Adults

    Practical take-away:

    Move more often! At least every couple of hours (when not sleeping)!

    The benefits will benefit you in the now, as well as down the line.

    See also:

    The Doctor Who Wants Us To Exercise Less, & Move More

    and, for that matter:

    Do You Love To Go To The Gym? No? Enjoy These “No-Exercise Exercises”!

    Take care!

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  • You’ve Got Questions? We’ve Got Answers!

    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.

    From Cucumbers To Kindles

    Q: Where do I get cucumber extract?

    A: You can buy it from BulkSupplements.com (who, despite their name, start at 100g packs)

    Alternatively: you want it as a topical ointment (for skin health) rather than as a dietary supplement (for bone and joint health), you can extract it yourself! No, it’s not “just juice cucumbers”, but it’s also not too tricky.

    Click Here For A Quick How-To Guide!

    Q: Tips for reading more and managing time for it?

    A: We talked about this a little bit in yesterday’s edition, so you may have seen that, but aside from that:

    • If you don’t already have one, consider getting a Kindle or similar e-reader. They’re very convenient, and also very light and ergonomicno more wrist strain as can occur with physical books. No more eye-strain, either!
    • Consider making reading a specific part of your daily routine. A chapter before bed can be a nice wind-down, for instance! What’s important is it’s a part of your day that’ll always, or at least almost always, allow you to do a little reading.
    • If you drive, walk, run, or similar each day, a lot of people find that’s a great time to listen to an audiobook. Please be safe, though!
    • If your lifestyle permits such, a “reading retreat” can be a wonderful vacation! Even if you only “retreat” to your bedroom, the point is that it’s a weekend (or more!) that you block off from all other commitments, and curl up with the book(s) of your choice.

    Q: Any study tips as we approach exam season? A lot of the productivity stuff is based on working life, but I can’t be the only student!

    A: We’ve got you covered:

    • Be passionate about your subject! We know of no greater study tip than that.
    • Find a willing person and lecture them on your subject. When one teaches, two learn!
    • Your mileage may vary depending on your subject, but, find a way of studying that’s fun to you!
    • If you can get past papers, get as many as you can, and use those as your “last minute” studying in the week before your exam(s). This will prime you for answering exam-style questions (and leverage state-dependent memory). As a bonus, it’ll also help ease any anxiety, because by the time of your exam it’ll be “same old, same old”!

    Q: Energy drinks for biohacking, yea or nay?

    A: This is definitely one of those “the dose makes the poison” things!

    But… The generally agreed safe dose of taurine is around 3g/day for most people; a standard Red Bull contains 1g.

    That math would be simple, but… if you eat meat (including poultry or fish), that can also contain 10–950mg per 100g. For example, tuna is at the high end of that scale, with a standard 12oz (340g) tin already containing up to 3.23g of taurine!

    And sweetened carbonated beverages in general have so many health issues that it’d take us a full article to cover them.

    Short version? Enjoy in moderation if you must, but there are definitely better ways of getting the benefits they may offer.

    Q: Best morning routine?

    A: The best morning routine is whatever makes you feel most ready to take on your day!

    This one’s going to vary a lot—one person’s morning run could be another person’s morning coffee and newspaper, for example.

    In a nutshell, though, ask yourself these questions:

    • How long does it take me to fully wake up in the morning, and what helps or hinders that?
    • When I get out of bed, what do I really need before I can take on my day?
    • If I could have the perfect morning, what would it look like?
    • What can evening me do, to look after morning me’s best interests? (Semi-prepare breakfast ready? Lay out clothes ready? Running shoes? To-Do list?)

    Q: I’m curious how much of these things you actually use yourselves, and are there any disagreements in the team? In a lot of places things can get pretty heated when it’s paleo vs vegan / health benefits of tea/coffee vs caffeine-abstainers / you need this much sleep vs rise and grinders, etc?

    A: We are indeed genuinely enthusiastic about health and productivity, and that definitely includes our own! We may or may not all do everything, but between us, we probably have it all covered. As for disagreements, we’ve not done a survey, but if you take an evidence-based approach, any conflict will tend to be minimized. Plus, sometimes you can have the best of both!

    • You could have a vegan paleo diet (you’d better love coconut if you do, though!
    • There is decaffeinated coffee and tea (your taste may vary)
    • You can get plenty of sleep and rise early (so long as an “early to bed, early to rise” schedule suits you!)

    Interesting note: humans are social creatures on an evolutionary level. Evolution has resulted in half of us being “night owls” and the other half “morning larks”, the better to keep each other safe while sleeping. Alas, modern life doesn’t always allow us to have the sleep schedule that’d suit each of us best individually!

    Have a question you’d like answered? Reply to this email, or use the feedback widget at the bottom! We always love to hear from you

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  • Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression

    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.

    Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”.

    Some stress in daily life is unavoidable. But remaining stressed is unhealthy. Chronic stress increases chronic health conditions, including heart disease and stroke and diabetes. It can also lead to burnout or depression.

    Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle.

    What does the stress cycle look like?

    Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by self-help experts but it does have a scientific basis.

    The stress cycle is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation.

    The stress cycle has three stages:

    • stage 1 is perceiving the threat
    • stage 2 is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol
    • stage 3 is relief, including physiological and psychological relief. This completes the stress cycle.

    Different people will respond to stress differently based on their life experiences and genetics.

    Unfortunately, many people experience multiple and ongoing stressors out of their control, including the cost-of-living crisis, extreme weather events and domestic violence.

    Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. Chronic stress and high cortisol can increase inflammation, which damages our brain and other organs.

    When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are unhelpful strategies that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an increased stress response.

    Stress and the brain

    In the brain, chronic high cortisol can shrink the hippocampus. This can impair a person’s memory and their capacity to think and concentrate.

    Chronic high cortisol also reduces activity in the prefrontal cortex but increases activity in the amygdala.

    The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is goal-directed and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed.

    There are five types of activities that can help our brains complete the stress cycle. https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&start=0 It can help to understand how the brain encounters stress.

    1. Exercise – its own complete stress cycle

    When we exercise we get a short-term spike in cortisol, followed by a healthy reduction in cortisol and adrenaline.

    Exercise also increases endorphins and serotonin, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have anti-inflammatory effects.

    When you exercise, there is more blood flow to the brain and higher activity in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to relieve feelings of stress.

    Exercise can also increase the volume of the hippocampus. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety.

    2. Cognitive activities – reduce negative thinking

    Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was stronger in people with more negative thinking.

    Higher amygdala activity and less rational thinking when you are stressed can lead to distorted thinking such as focusing on negatives and rigid “black-and-white” thinking.

    Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called cognitive behaviour therapy.

    At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle.

    Young person draws in notebook
    Journalling could help process stressful events and complete the stress cycle. Shutterstock/Fellers Photography

    3. Getting creative – a pathway out of ‘flight or fight’

    Creative activities can be art, craft, gardening, cooking or other activities such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work.

    Such pursuits increase prefrontal cortex activity and promote flow and focus.

    Flow is a state of full engagement in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses.

    4. Getting social and releasing feel-good hormones

    Talking with someone else, physical affection with a person or pet and laughing can all increase oxytocin. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe.

    Laughing is also a social activity that activates parts of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases endorphins and serotonin and improves our mood.

    5. Self-soothing

    Breathing exercises and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the vagus nerves, and reduce cortisol.

    A good cry can help too by releasing stress energy and increasing oxytocin and endorphins.

    Emotional tears also remove cortisol and the hormone prolactin from the body. Our prior research showed cortisol and prolactin were associated with depression, anxiety and hostility.

    man jogs outside
    Getting moving can help with stress and its effects on the brain. Shutterstock/Jaromir Chalabala

    Action beats distraction

    Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle.

    Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing.

    Importantly, chronic stress and burnout can also indicate the need for change, such as in our workplaces. However, not all stressful circumstances can be easily changed. Remember help is always available.

    If you have concerns about your stress or health, please talk to a doctor.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.

    Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong and Susan J. Thomas, Associate professor in Mental Health and Behavioural Science, University of Wollongong

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

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