How To Stay Alive (When You Really Don’t Want To)
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How To Stay Alive (When You Really Don’t Want To)
A subscriber recently requested:
❝Request: more people need to be aware of suicidal tendencies and what they can do to ward them off❞
…and we said we’d do that one of these Psychology Sundays, so here we are, doing it!
First of all, we’ll mention that we did previously do a main feature on managing depression (in oneself or a loved one); here it is:
The Mental Health First Aid That You’ll Hopefully Never Need
Now, not all depression leads to suicidality, and not all suicide is pre-empted by depression, but there’s a large enough crossover that it seems sensible to put that article here, for anyone who might find it of use, or even just of interest.
Now, onwards, to the specific, and very important, topic of suicide.
This should go without saying, but some of today’s content may be a little heavy.
We invite you to read it anyway if you’re able, because it’s important stuff that we all should know, and not talking about it is part of what allows it to kill people.
So, let’s take a deep breath, and read on…
The risk factors
Top risk factors for suicide include:
- Not talking about it
- Having access to a firearm
- Having a plan of specifically how to commit suicide
- A lack of social support
- Being male
- Being over 40
Now, some of these are interesting sociologically, but aren’t very useful practically; what a convenient world it’d be if we could all simply choose to be under 40, for instance.
Some serve as alarm bells, such as “having a plan of specifically how to commit suicide”.
If someone has a plan, that plan’s never going to disappear entirely, even if it’s set aside!
(this writer is deeply aware of the specifics of how she has wanted to end things before, and has used the advice she gives in this article herself numerous times. So far so good, still alive to write about it!)
Specific advices, therefore, include:
Talk about it / Listen
Depending on whether it’s you or someone else at risk:
- Talk about it, if it’s you
- Listen attentively, if it’s someone else
There are two main objections that you might have at this point, so let’s look at those:
“I have nobody to talk to”—it can certainly feel that way, sometimes, but you may be surprised who would listen if you gave them the chance. If you really can’t trust anyone around you, there are of course suicide hotlines (usually per area, so we’ll not try to list them here; a quick Internet search will get you what you need).
If you’re worried it’ll result in bad legal/social consequences, check their confidentiality policy first:
- Some hotlines can and will call the police, for instance.
- Others deliberately have a set-up whereby they couldn’t even trace the call if they wanted to.
- On the one hand, that means they can’t intervene
- On the other hand, that means they’re a resource for anyone who will only trust a listener who can’t intervene.
“But it is just a cry for help”—then that person deserves help. What some may call “attention-seeking” is, in effect, care-seeking. Listen, without judgement.
Remove access to firearms, if applicable and possible
Ideally, get rid of them (safely and responsibly, please).
If you can’t bring yourself to do that, make them as inconvenient to get at as possible. Stored securely at your local gun club is better than at home, for example.
If your/their plan isn’t firearm-related, but the thing in question can be similarly removed, remove it. You/they do not need that stockpile of pills, for instance.
And of course you/they could get more, but the point is to make it less frictionless. The more necessary stopping points between thinking “I should just kill myself” and being able to actually do it, the better.
Have/give social support
What do the following people have in common?
- A bullied teenager
- A divorced 40-something who just lost a job
- A lonely 70-something with no surviving family, and friends that are hard to visit
Often, at least, the answer is: the absence of a good social support network
So, it’s good to get one, and be part of some sort of community that’s meaningful to us. That could look different to a lot of people, for example:
- A church, or other religious community, if we be religious
- The LGBT+ community, or even just a part of it, if that fits for us
- Any mutual-support oriented, we-have-this-shared-experience community, could be anything from AA to the VA.
Some bonus ideas…
If you can’t live for love, living for spite might suffice. Outlive your enemies; don’t give them the satisfaction.
If you’re going to do it anyway, you might as well take the time to do some “bucket list” items first. After all, what do you have to lose? Feel free to add further bucket list items as they occur to you, of course. Because, why not? Before you know it, you’ve postponed your way into a rich and fulfilling life.
Finally, some gems from Matt Haig’s “The Comfort Book”:
- “The hardest question I have been asked is: “How do I stay alive for other people if I have no one?” The answer is that you stay alive for other versions of you. For the people you will meet, yes, but also the people you will be.”
- “Stay for the person you will become”
- “You are more than a bad day, or week, or month, or year, or even decade”
- “It is better to let people down than to blow yourself up”
- “Nothing is stronger than a small hope that doesn’t give up”
- “You are here. And that is enough.”
You can find Matt Haig’s excellent “The Comfort Book” on Amazon, as well as his more well-known book more specifically on the topic we’ve covered today, “Reasons To Stay Alive“.
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The Stress-Proof Brain – by Dr. Melanie Greenberg
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The premise of the book is as stated in the subtitle: using mindfulness and neuroplasticity to manage our stress response.
As such, it’s divided into three parts:
- Understanding your stress (and different types of stressors)
- Calming your amygdalae (thus, dealing with your stress response while the stressor is stressing you)
- Moving forward with your prefrontal cortex (and thus, gradually improving automatic stress responses over time, as we learn new, better responses to do automatically)
The content ranges from the neurophysiological to “therapist’s couch” stuff; Dr. Greenberg having her PhD in psychology has prepared her to write both of those different-but-touching fields with equal competence. In-line citations are given throughout, for those who want to look up studies.
The style is direct and informative, with little to no attention given to making it an entertaining read. As a result, it’s information dense (which is good), and/but not necessarily a “couldn’t put it down” page-turner.
Bottom line: if you’d like to improve your ability to deal with stress, this book is as good as any.
Click here to check out The Stress-Proof Brain, and stress-proof yours!
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Eating on the Wild Side: – by Jo Robinson
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The author is an investigative journalist, and it shows here, as she leaves no stone unturned in her quest for the truth in the face of many food myths.
She covers a lot of “popular wisdom” things that are varyingly true or false, or sometimes even both—in the case of food lore that’s a good rule of thumb, but has notable exceptions (e.g. “more colorful and/or darker-colored fruits/vegetables contain more nutrients”, which is a very good rule of thumb until one meets a cauliflower, for example).
She also covers food preparation myths, and how, to give one example, in spite of the popularity of “less cooked is better”, in some cases certain cooking methods will indeed destroy nutrients; in others, certain cooking methods will improve nutritional availability. Either by destroying an adjacent antinutrient (e.g. phytates), or by breaking something down into a more manageable form that our body can absorb. Knowing which is which, is important.
The book is organized by kinds of food, and does exclusively cover plants, but there’s more than enough material for any omnivore to enjoy.
The style is… Journalistic, it would be fair to say. Which is not surprising, given the author. But it means that it is written in a fairly narrative way, to draw the reader in and make it an enjoyable read while still being informative in all parts (there is no padding). In terms of science, the in-the-prose science is as minimal as possible to still convey what needs to be conveyed, while 25 pages of bibliography stack up at the end to show that indeed, this journalist cites sources.
Bottom line: this is a really enjoyable book, packed with a wealth of knowledge, and is perfect to uplift your cooking by knowing your ingredients a little more intimately!
Click here to check out Eating On The Wild Side, and, enjoy!
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What happens to your vagina as you age?
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The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.
Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.
Here’s what happens to your vagina as you age, whether you notice or not.
Let’s clear up the terminology
We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.
What happens to the vagina as you age?
Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.
Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:
- less vaginal secretions, potentially leading to dryness
- less growth of vagina surface cells resulting in a thinned lining
- alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
- fewer blood vessels around the vagina, which may explain less blood flow after menopause
- a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.
What symptoms can I expect?
Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.
Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.
Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.
Not everyone has the same experience
Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.
In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.
If symptoms bother you
Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.
While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.
In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.
Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.
Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.
Are there other treatments?
New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.
For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.
Where to from here?
The normal ageing process, as well as menopause, both affect the vagina as we age.
Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.
While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.
Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.
Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Science of Stretch – by Dr. Leada Malek
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This book is part of a “Science of…” series, of which we’ve reviewed some others before (Yoga | HIIT | Pilates), and needless to say, we like them.
You may be wondering: is this just that thing where a brand releases the same content under multiple names to get more sales, and no, it’s not (long-time 10almonds readers will know: if it were, we’d say so!).
While flexibility and mobility are indeed key benefits in yoga and Pilates, they looked into the science of what was going on in yoga asanas and Pilates exercises, stretchy or otherwise, so the stretching element was not nearly so deep as in this book.
In this one, Dr. Malek takes us on a wonderful tour of (relevant) human anatomy and physiology, far deeper than most pop-science books go into when it comes to stretching, so that the reader can really understand every aspect of what’s going on in there.
This is important, because it means busting a lot of myths (instead of busting tendons and ligaments and things), understanding why certain things work and (critically!) why certain things don’t, how certain stretching practices will sabotage our progress, things like that.
It’s also beautifully clearly illustrated! The cover art is a fair representation of the illustrations inside.
Bottom line: if you want to get serious about stretching, this is a top-tier book and you won’t regret it.
Click here to check out Science of Stretching, and learn what you can do and how!
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How stigma perpetuates substance use
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In 2022, 54.6 million people 12 and older in the United States needed substance use disorder (SUD) treatment. Of those, only 24 percent received treatment, according to the most recent National Survey on Drug Use and Health.
SUD is a treatable, chronic medical condition that causes people to have difficulty controlling their use of legal or illegal substances, such as alcohol, tobacco, prescription opioids, heroin, methamphetamine, or cocaine. Using these substances may impact people’s health and ability to function in their daily life.
While help is available for people with SUD, the stigma they face—negative attitudes, stereotypes, and discrimination—often leads to shame, worsens their condition, and keeps them from seeking help.
Read on to find out more about how stigma perpetuates substance use.
Stigma can keep people from seeking treatment
Suzan M. Walters, assistant professor at New York University’s Grossman School of Medicine, has seen this firsthand in her research on stigma and health disparities.
She explains that people with SUD may be treated differently at a hospital or another health care setting because of their drug use, appearance (including track marks on their arms), or housing situation, which may discourage them from seeking care.
“And this is not just one case; this is a trend that I’m seeing with people who use drugs,” Walters tells PGN. “Someone said, ‘If I overdose, I’m not even going to the [emergency room] to get help because of this, because of the way I’m treated. Because I know I’m going to be treated differently.’”
People experience stigma not only because of their addiction, but also because of other aspects of their identities, Walters says, including “immigration or race and ethnicity. Hispanic folks, brown folks, Black folks [are] being treated differently and experiencing different outcomes.”
And despite the effective harm reduction tools and treatment options available for SUD, research has shown that stigma creates barriers to access.
Syringe services programs, for example, provide infectious disease testing, Narcan, and fentanyl test strips. These programs have been proven to save lives and reduce the spread of HIV and hepatitis C. SSPs don’t increase crime, but they’re often mistakenly “viewed by communities as potential settings of drug-related crime;” this myth persists despite decades of research proving that SSPs make communities safer.
To improve this bias, Walters says it’s helpful for people to take a step back and recognize how we use substances, like alcohol, in our own lives, while also humanizing those with addiction. She says, “There’s a lack of understanding that these are human beings and people … [who] are living lives, and many times very functional lives.”
Misconceptions lead to stigma
SUD results from changes in the brain that make it difficult for a person to stop using a substance. But research has shown that a big misconception that leads to stigma is that addiction is a choice and reflects a person’s willpower.
Michelle Maloney, executive clinical director of mental health and addiction recovery services for Rogers Behavioral Health, tells PGN that statements such as “you should be able to stop” can keep a patient from seeking treatment. This belief goes back to the 1980s and the War on Drugs, she adds.
“We think about public service announcements that occurred during that time: ‘Just say no to drugs,’” Maloney says. “People who have struggled, whether that be with nicotine, alcohol, or opioids, [know] it’s not as easy as just saying no.”
Stigma can worsen addiction
Stigma can also lead people with SUD to feel guilt and shame and blame themselves for their medical condition. These feelings, according to the National Institute on Drug Abuse, may “reinforce drug-seeking behavior.”
In a 2020 article, Dr. Nora D. Volkow, the director of NIDA, said that “when internalized, stigma and the painful isolation it produces encourage further drug taking, directly exacerbating the disease.”
Overall, research agrees that stigma harms people experiencing addiction and can make the condition worse. Experts also agree that debunking myths about the condition and using non-stigmatizing language (like saying someone is a person with a substance use disorder, not an addict) can go a long way toward reducing stigma.
Resources to mitigate stigma:
- CDC: Stigma Reduction
- National Harm Reduction Coalition: Respect To Connect: Undoing Stigma
- NIDA:
- Shatterproof: Addiction language guide (Disclosure: The Public Good Projects, PGN’s parent company, is a Shatterproof partner)
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Policosanol: A Rival To Statins, Without The Side Effects?
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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:
2001: it works!
After a lot of research in the 1990s, it came out of the gate strong in 2001, with:
❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞
This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.
Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women
Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:
2006–2010: we do not trust the Cubans!
After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):
Heart Beat: Policosanol: A sweet nothing for high cholesterol
And furthermore, US-based labs were unable to replicate the results:
Policosanols as Nutraceuticals: Fact or Fiction
The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.
Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.
Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.
2012: never mind, it does work after all!
An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:
❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞
Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.
Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol
2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba
A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:
- Consumption of Cuban Policosanol Improves Blood Pressure and Lipid Profile via Enhancement of HDL Functionality in Healthy Women Subjects: Randomized, Double-Blinded, and Placebo-Controlled Study
- Long-Term Consumption of Cuban Policosanol Lowers Central and Brachial Blood Pressure and Improves Lipid Profile With Enhancement of Lipoprotein Properties in Healthy Korean Participants
Mystery resolved!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.
Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎
Enjoy!
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