Generation M – by Dr. Jessica Shepherd

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Menopause is something that very few people are adequately prepared for despite its predictability, and also something that very many people then neglect to take seriously enough.

Dr. Shepherd encourages a more proactive approach throughout all stages of menopause and beyond; she discusses “the preseason, the main event, and the after-party” (perimenopause, menopause, and postmenopause), which is important, because typically people take up an interest in perimenopause, are treating it like a marathon by menopause, and when it comes to postmenopause, it’s easy to think “well, that’s behind me now”, and it’s not, because untreated menopause will continue to have (mostly deleterious) cumulative effects until death.

As for HRT, there’s a chapter on that of course, going into quite some detail. There is also plenty of attention given to popular concerns such as managing weight changes and libido changes, as well as oft-neglected topics such as brain changes, as well as things considered more cosmetic but that can have a big impact on mental health, such as skin and hair.

The style throughout is pop-science; friendly without skimping on detail and including plenty of good science.

Bottom line: if you’d like a fairly comprehensive overview of the changes that occur from perimenopause all the way to menopause and well beyond, then this is a great book for that.

Click here to check out Generation M, and live well at every stage of life!

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  • What’s the difference between a psychopath and a sociopath? Less than you might think

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    Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as 7 signs your boss is a psychopath or How to avoid the sociopath next door.

    You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from The Silence of the Lambs.

    In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with something else entirely.

    So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.

    Benoit Daoust/Shutterstock

    What’s a psychopath?

    Psychopathy has been mentioned in the psychiatric literature since the 1800s. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) doesn’t list it as a recognised clinical disorder.

    Since the 1950s, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with antisocial personality disorder, which is what we have today.

    The Silence of the Lambs movie poster
    Was Hannibal Lecter from The Silence of the Lambs a psychopath, a sociopath or something else entirely? Ralf Liebhold/Shutterstock

    Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.

    To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.

    US psychiatrist Hervey Cleckley provided the first formal description of psychopathy traits in his 1941 book The Mask of Sanity. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.

    Canadian psychologist Professor Robert Hare refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.

    When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.

    Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.

    So how about a sociopath?

    The term sociopath first appeared in the 1930s, and was attributed to US psychologist George Partridge. He emphasised the societal consequences of behaviour that habitually violates the rights of others.

    Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some preferred the term sociopath because they said the public sometimes confused the word psychopath with psychosis.

    “Sociopathic personality disturbance” was the term used in the first edition of the DSM in 1952. This aligned with the prevailing views at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules.

    Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 definition of a psychopath.

    In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.

    Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.

    Born or made?

    Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.

    For example, people with psychopathic traits have certain brain differences especially in regions associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their nervous system, including a reduced heart rate.

    However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to run in families. These behaviours has been associated with physical abuse and parental conflict.

    What are the consequences?

    Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series Killing Evenot all people with psychopathy or sociopathy traits are serial killers or are physically violent.

    But psychopathy predicts a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.

    In the general population, psychopathy is associated with drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted failure to follow COVID restrictions.

    But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.

    In a nutshell

    Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.

    Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.

    Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.

    Bruce Watt, Associate Professor in Psychology, Bond University and Katarina Fritzon, Associate Professor of Psychology, Bond University

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

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  • The Case Against Sugar – by Gary Taubes

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    We generally already know that sugar is bad for the health. Most people don’t know how bad.

    Taubes makes, as the title goes, “the case against sugar”. Implicated in everything from metabolic syndrome to cancer to Alzheimer’s, sugar is ruinous to the health.

    It’s hard to review this book without making a comparison to William Duffy’s 1975 bestseller, “Sugar Blues“. Stylistically it’s very similar, and the general gist is certainly the same.

    However! Where this book beats Sugar Blues is in content; Duffy’s book often makes bold claims without scientific backing. Some of those claims didn’t stand the test of time and are now disproven. Instead, Taubes’ book leans on actual up-to-date science, and talks more about what we actually know, than what we imagine.

    If this book has a weak point, it’s when it veers away from its main topic and starts talking about, for example, saturated fat. In this side-topic, the book makes some good points, but is less well-considered, cherry-picks data, and lacks nuance.

    On its main topic, though, the investigation of sugar, it is rather more thorough.

    Bottom line: if you want a next-level motivation to reduce or eliminate dietary sugar, this book may certainly provide that.

    Click here to check out The Case Against Sugar and reduce a lot of your health risks!

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  • Beating Sleep Apnea

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    Healthier, Natural Sleep Without Obstruction!

    Obstructive Sleep Apnea, the sleep disorder in which one periodically stops breathing (and thus wakes up) repeatedly through the night, affects about 25% of men and 10% of women:

    Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

    Why the gender split?

    There are clues that suggest it is at least partially hormonal: once women have passed menopause, the gender split becomes equal.

    Are there other risk factors?

    There are few risk other factors; some we can’t control, and some we can:

    • Being older is riskier than being younger
    • Being overweight is riskier than not being overweight
    • Smoking is (what a shock) riskier than not smoking
    • Chronic respiratory diseases increase risk, for example:
      • Asthma
      • COPD
      • Long COVID*—probably. The science is young for this one so far, so we can’t say for sure until more research has been done.
    • Some hormonal conditions increase risk, for example:

    *However, patients already undergoing Continuous Positive Airway Pressure (CPAP) treatment for obstructive sleep apnea may have an advantage when fighting a COVID infection:

    Prolonged Effects of the COVID-19 Pandemic on Sleep Medicine Services—Longitudinal Data from the Swedish Sleep Apnea Registry

    What can we do about it?

    Avoiding the above risk factors, where possible, is great!

    If you are already suffering from obstructive sleep apnea, then you probably already know about the possibility of a CPAP device; it’s a mask that one wears to sleep, and it does what its name says (i.e. it applies continuous positive airway pressure), which keeps the airway open.

    We haven’t tested these, but other people have, so here are some that the Sleep Foundation found to be worthy of note:

    Sleep Foundation | Best CPAP Machines of 2024

    What can we do about it that’s not CPAP?

    Wearing a mask to sleep is not everyone’s preferred way to do things. There are also a plethora of surgeries available, but we’ll not review those, as those are best discussed with your doctor if necessary.

    However, some lifestyle changes can help, including:

    • Lose weight, if overweight. In particular, having a collar size under 16” for women or under 17” for men, is sufficient to significantly reduce the risk of obstructive sleep apnea.
    • Stop smoking, if you smoke. This one, we hope, is self-explanatory.
    • Stop drinking alcohol, or at least reduce intake, if you drink. People who consume alcohol tend to have more frequent, and longer, incidents of obstructive sleep apnea. See also: How To Reduce Or Quit Drinking
    • Avoid sedatives and muscle relaxants, if it is safe for you to do so. Obviously, if you need them to treat some other condition you have, talk this through with your doctor. But basically, they can contribute to the “airway collapses on itself” by reducing the muscular tension that keeps your airway the shape it’s supposed to be.
    • Sleep on your side, not your back. This is just plain physics, and a matter of wear the obstruction falls.
    • Breathe through your nose, not through your mouth. Initially tricky to do while sleeping, but the more you practice it while awake, the more it becomes possible while asleep.
    • Consider a nasal decongestant before sleep, if congestion is a problem for you, as that can help too.

    For more of the science of these, see:

    Cultivating Lifestyle Transformations in Obstructive Sleep Apnea

    There are more medical options available not discussed here, too:

    American Sleep Apnea Association | Sleep Apnea Treatment Options

    Take care!

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  • What is PMDD?

    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.

    Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.

    Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.

    Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.

    What are the symptoms of PMDD?

    People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.

    Mood symptoms may include:

    • Irritability
    • Anxiety and panic attacks
    • Extreme or sudden mood shifts
    • Difficulty concentrating
    • Depression and suicidal ideation

    Physical symptoms may include:

    • Fatigue
    • Insomnia
    • Headaches
    • Changes in appetite
    • Body aches
    • Bloating
    • Abdominal cramps
    • Breast swelling or tenderness

    What is the difference between PMS and PMDD?

    Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.

    In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.

    What is the history of PMDD?

    PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.

    References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.

    Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.

    What causes PMDD?

    Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.

    People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.

    How is PMDD diagnosed?

    Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.

    Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.

    How is PMDD treated?

    There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:

    • Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
    • Hormonal birth control to prevent ovulation-related hormonal changes. 
    • Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.

    Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:

    • Limiting caffeine intake
    • Eating meals regularly to balance blood sugar
    • Exercising regularly
    • Practicing stress management using breathing exercises and meditation
    • Having regular therapy sessions and attending peer support groups

    For more information, talk to your health care provider.

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • The Food For Life Cookbook – by Dr. Tim Spector

    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.

    We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.

    The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.

    The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.

    Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.

    Click here to check out the Food For Life Cookbook, and get cooking for life!

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  • Ultra-Processed People – by Dr. Chris van Tulleken

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    It probably won’t come as a great surprise to any of our readers that ultra-processed food is—to make a sweeping generalization—not fabulous for the health. So, what does this book offer beyond that?

    Perhaps this book’s greatest strength is in showing not just what ultra-processed foods are, but why they are. In principle, food being highly processed should be neither good nor bad by default. Much like GMOs, if a food is modified to be more nutritious, that should be good, right?

    Only, that’s mostly not what happens. What happens instead is that food is modified (be it genetically or by ultra-processing) to be cheaper to produce, and thus maximise the profit margin.

    The addition of a compound that increases shelf-life but harms the health, increases sales and is a net positive for the manufacturer, for instance. Dr. van Tulleken offers us many, many, examples and explanations of such cost-cutting strategies at our expense.

    In terms of qualifications, the author has an MD from Oxford, and also a PhD, but the latter is in molecular virology; not so relevant here. Yet, we are not expected to take an “argument from authority”, and instead, Dr. van Tulleken takes great pains to go through a lot of studies with us—the good, the bad, and the misleading.

    If the book has a downside, then this reviewer would say it’s in the format; it’s less a reference book, and more a 384-page polemic. But, that’s a subjective criticism, and for those who like that sort of thing, that is the sort of thing that they like.

    Click here to check out Ultra-Processed People, and understand better what you are putting in your body!

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