From Strength to Strength – by Dr. Arthur Brooks
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.
For most professions, there are ways in which performance can be measured, and the average professional peak varies by profession, but averages are usually somewhere in the 30–45 range, with a pressure to peak between 25–35.
With a peak by age 45 or perhaps 50 at the latest (aside from some statistical outliers, of course), what then to expect at age 50+? Not long after that, there’s a reason for mandatory retirement ages in some professions.
Dr. Brooks examines the case for accepting that rather than fighting it, and/but making our weaknesses into our strengths as we go. If our fluid intelligence slows, our accumulated crystal intelligence (some might call it “wisdom“) can make up for it, for example.
But he also champions the idea of looking outside of ourselves; of the importance of growing and fostering connections; giving to those around us and receiving support in turn; not transactionally, but just as a matter of mutualism of the kind found in many other species besides our own. Indeed, Dr. Brooks gives the example of a grove of aspen trees (hence the cover art of this book) that do exactly that.
The style is very accessible in terms of language but with frequent scientific references, so very much a “best of both worlds” in terms of readability and information-density.
Bottom line: if ever you’ve wondered at what age you might outlive your usefulness, this book will do as the subtitle suggests, and help you carve out your new place.
Click here to check out From Strength To Strength, and find yours!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A 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.
Share This Post
-
It’s Not You, It’s Your Hormones – by Nicki Williams, DipION, mBANT, CNHC
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.
So, first a quick note: this book is very similar to the popular bestseller “The Galveston Diet”, not just in content, but all the way down to its formatting. Some Amazon reviewers have even gone so far as to suggest that “It’s Not You, It’s Your Hormones” (2017) brazenly plagiarized “The Galveston Diet” (2023). However, after carefully examining the publication dates, we feel quite confident that this book is not a copy of the one that came out six years after it. As such, we’ve opted for reviewing the original book.
Nicki Williams’ basic principle is that we can manage our hormonal fluctuations, by managing our diet. Specifically, in three main ways:
- Intermittent fasting
- Anti-inflammatory diet
- Eating more protein and healthy fats
Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.
Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.
The style is very accessible and clear, and Williams walks us through the changes we may want to make, to avoid the changes we don’t want.
In the category of criticism, there is some extra support that’s paywalled, in the sense that she wants the reader to buy her personally-branded online plan, and it can feel a bit like she’s holding back in order to upsell to that.
Bottom line: this book is aimed at peri-menopausal and post-menopausal women. It could also definitely help a lot of people with PCOS too, and, when it comes down to it, pretty much anyone with an endocrine system. It’s a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.
Click here to check out It’s Not You, It’s Your Hormones, and take control of yours!
Share This Post
-
Radical Longevity – by Dr. Ann Gittleman
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.
Dr. Gittleman takes a comprehensive approach, advising us about avoiding AGEs, freeing up fascia, stimulating cellular rejuvenation, the mind-gut connection, keeping the immune system healthy, and more.
The “plan” promised by the subtitle involves identifying the key factors of nutrition and lifestyle most impactful to you, and adjusting them accordingly, in a multistep, author-walks-the-reader-by-the-hand process.
There’s also, for those who prefer it, a large section (seven chapters) on a body part/system by body part/system approach, e.g. brain health, heart health, revitalizing skin, reversing hair loss, repairing bones, muscles, joints, etc.
The writing style is quite casual,butalso with a mind to education, with its call-out boxes, bullet-point summaries, and so forth. There is a “select references” section, but if one wants to find studies, it’s often necessary to go looking, as there aren’t inline citations.
Bottom line: we’d love to see better referencing, but otherwise this is a top-tier anti-aging book, and a lot more accessible than most, without skimping on depth and breadth.
Click here to check out Radical Longevity, and get rejuvenating radically!
Share This Post
Related Posts
-
How to Prepare for Your First Therapy Session
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.
Everyone (who ever has therapy, anyway) has a first therapy session. So, how to make best use of that, and get things going most effectively? Dr. Tori Olds has advice:
Things to prepare
Questions that you should consider, and prepare answers to beforehand, include:
- Why are you here? Not in any deep philosophical sense, but, what brought you to therapy?
- What would you like to focus on? Chances are, you are paying a hefty hourly rate—so having considered this will allow you to get your money’s worth.
- How will you know when you’ve met your goal? Note that this is really two questions in one, because first you need to identify your goal, and then you need to expand on it. If you woke up tomorrow and all your psychological problems were solved, how would you know? What would be different? What does it look like?
If you have a little time between now and your first session, journaling can help a lot.
Remember also that a first therapy session can also be like a mutual interview, to decide whether it’s a good match. Not every therapist is good at their job, and not every therapist will be good for you specifically. Sometimes, a therapist may be a mismatch through no fault of their own. Considering what those reasons might be can also be a good thing to think about in advance, to help find the best therapist for you in fewer tries!
For most on these ideas, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Which Tea Is Best, By Science?
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.
What kind of tea is best for the health?
It’s popular knowledge that tea is a healthful drink, and green tea tends to get the popular credit for “healthiest”.
Is that accurate? It depends on what you’re looking for…
Black
Its strong flavor packs in lots of polyphenols, often more than other kinds of tea. This brings some great benefits:
As well as effects beyond the obvious:
…and its cardioprotective benefits aren’t just about lowering blood pressure; it improves triglyceride levels as well as improving the LDL to HDL ratio:
The effect of black tea on risk factors of cardiovascular disease in a normal population
Finally (we could say more, but we only have so much room), black tea usually has the highest caffeine content, compared to other teas.
That’s good or bad depending on your own physiology and preferences, of course.
White
White tea hasn’t been processed as much as other kinds, so this one keeps more of its antioxidants, but that doesn’t mean it comes out on top; in this study of 30 teas, the white tea options ranked in the mid-to-low 20s:
White tea is also unusual in its relatively high fluoride content, which is consider a good thing:
White tea: A contributor to oral health
In case you were wondering about the safety of that…
Water Fluoridation: Is It Safe, And How Much Is Too Much?
Green
Green tea ranks almost as high as black tea, on average, for polyphenols.
Its antioxidant powers have given it a considerable anti-cancer potential, too:
- Green tea consumption and breast cancer risk or recurrence: a meta-analysis
- Green tea consumption and prostate cancer risk: a prospective study
…and many others, but you get the idea. Notably:
Green Tea Catechins: Nature’s Way of Preventing and Treating Cancer
…or to expand on that:
About green tea’s much higher levels of catechins, they also have a neuroprotective effect:
Green tea of course is also a great source of l-theanine, which we could write a whole main feature about, and we did:
Red
Also called “rooibos” or (literally translated from Afrikaans to English) “redbush”, it’s quite special in that despite being a “true tea” botanically and containing many of the same phytochemicals as the other teas, it has no caffeine.
There’s not nearly as much research for this as green tea, but here’s one that stood out:
However, in the search for the perfect cup of tea (in terms of phytochemical content), another set of researchers found:
❝The optimal cup was identified as sample steeped for 10 min or longer. The rooibos consumers did not consume it sufficiently, nor steeped it long enough. ❞
Read in full: Rooibos herbal tea: an optimal cup and its consumers
Bottom line
Black, white, green, and red teas all have their benefits, and ultimately the best one for you will probably be the one you enjoy drinking, and thus drink more of.
If trying to choose though, we offer the following summary:
- 🖤 Black tea: best for total beneficial phytochemicals
- 🤍 White tea:best for your oral health
- 💚 Green tea: best for your brain
- ❤️ Red tea: best if you want naturally caffeine-free
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Who you are and where you live shouldn’t determine your ability to survive cancer
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.
In Canada, nearly everyone has a cancer story to share. It affects one in every two people, and despite improvements in cancer survivorship, one out of every four people affected by cancer still will die from it.
As a scientist dedicated to cancer care, I work directly with patients to reimagine a system that was never designed for them in the first place – a system in which your quality of care depends on social drivers like your appearance, your bank statements and your postal code.
We know that poverty, poor nutrition, housing instability and limited access to education and employment can contribute to both the development and progression of cancer. Quality nutrition and regular exercise reduce cancer risk but are contingent on affordable food options and the ability to stay active in safe, walkable neighbourhoods. Environmental hazards like air pollution and toxic waste elevate the risk of specific cancers, but are contingent on the built environment, laws safeguarding workers and the availability of affordable housing.
On a health-system level, we face implicit biases among care providers, a lack of health workforce competence in addressing the social determinants of health, and services that do not cater to the needs of marginalized individuals.
Indigenous peoples, racialized communities, those with low income and gender diverse individuals face the most discrimination in health care, resulting in inadequate experiences, missed diagnosis and avoidance of care. One patient living in subsidized housing told me, “You get treated like a piece of garbage – you come out and feel twice as bad.”
As Canadians, we benefit from a taxpayer funded health-care system that encompasses cancer care services. The average Canadian enjoys a life expectancy of more than 80 years and Canada boasts high cancer survival rates. While we have made incredible strides in cancer care, we must work together to ensure these benefits are equally shared amongst all people in Canada. We need to redesign systems of care so that they are:
- Anti-oppressive. We must begin by understanding and responding to historical and systemic racism that shapes cancer risk, access to care and quality of life for individuals facing marginalizing conditions. Without tackling the root causes, we will never be able to fully close the cancer care gap. This commitment involves undoing intergenerational trauma and harm through public policies that elevate the living and working conditions of all people.
- Patient-centric. We need to prioritize patient needs, preferences and values in all aspects of their health-care experience. This means tailoring treatments and services to individual patient needs. In policymaking, it involves creating policies that are informed by and responsive to the real-life experiences of patients. In research, it involves engaging patients in the research process and ensuring studies are relevant to and respectful of their unique perspectives and needs. This holistic approach ensures that patients’ perspectives are central to all aspects of health care.
- Socially just. We must strive for a society in which everyone has equal access to resources, opportunities and rights, and systemic inequalities and injustices are actively challenged and addressed. When redesigning the cancer care system, this involves proactive practices that create opportunities for all people, particularly those experiencing the most marginalization, to become involved in systemic health-care decision-making. A system that is responsive to the needs of the most marginalized will ultimately work better for all people.
Who you are, how you look, where you live and how much money you make should never be the difference between life and death. Let us commit to a future in which all people have the resources and support to prevent and treat cancer so that no one is left behind.
This article is republished from HealthyDebate under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: