‘It’s okay to poo at work’: new health campaign highlights a common source of anxiety
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For most people, the daily or near-daily ritual of having a bowel motion is not something we give a great deal of thought to. But for some people, the need to do a “number two” in a public toilet or at work can be beset with significant stress and anxiety.
In recognition of the discomfort people may feel around passing a bowel motion at work, the Queensland Department of Health recently launched a social media campaign with the message “It’s okay to poo at work”.
The campaign has gained significant traction on Instagram and Facebook. It has been praised by health and marketing experts for its humorous handling of a taboo topic.
A colourful Instagram post is accompanied by a caption warning of the health risks of “holding it in”, including haemorrhoids and other gastrointestinal problems. The caption also notes:
If you find it extremely difficult to poo around other people, you might have parcopresis.
What is parcopresis?
Parcopresis, sometimes called “shy bowel”, occurs when people experience a difficulty or inability to poo in public toilets due to fear of perceived scrutiny by others.
People with parcopresis may find it difficult to go to the toilet in public places such as shopping centres, restaurants, at work or at school, or even at home when friends or family are around.
They may fear being judged by others about unpleasant smells or sounds when they have a bowel motion, or how long they take to go, for example.
Living with a gastrointestinal condition (at least four in ten Australians do) may contribute to parcopresis due to anxiety about the need to use a toilet frequently, and perceived judgment from others when doing so. Other factors, such as past negative experiences or accessibility challenges, may also play a role.
For sufferers, anxiety can present in the form of a faster heart rate, rapid breathing, sweating, muscle tension, blushing, nausea, trembling, or a combination of these symptoms. They may experience ongoing worry about situations where they may need to use a public toilet.
Living with parcopresis can affect multiple domains of life and quality of life overall. For example, sufferers may have difficulties relating to employment, relationships and social life. They might avoid travelling or attending certain events because of their symptoms.
How common is parcopresis?
We don’t really know how common parcopresis is, partly due to the difficulty of evaluating this behaviour. It’s not necessarily easy or appropriate to follow people around to track whether they use or avoid public toilets (and their reasons if they do). Also, observing individual bathroom activities may alter the person’s behaviour.
I conducted a study to try to better understand how common parcopresis is. The study involved 714 university students. I asked participants to respond to a series of vignettes, or scenarios.
In each vignette participants were advised they were at a local shopping centre and they needed to have a bowel motion. In the vignettes, the bathrooms (which had been recently cleaned) had configurations of either two or three toilet stalls. Each vignette differed by the configuration of stalls available.
The rate of avoidance was just over 14% overall. But participants were more likely to avoid using the toilet when the other stalls were occupied.
Around 10% avoided going when all toilets were available. This rose to around 25% when only the middle of three toilets was available. Men were significantly less likely to avoid going than women across all vignettes.
For those who avoided the toilet, many either said they would go home to poo, use an available disabled toilet, or come back when the bathroom was empty.
Parcopresis at work
In occupational settings, the rates of anxiety about using shared bathrooms may well be higher for a few reasons.
For example, people may feel more self-conscious about their bodily functions being heard or noticed by colleagues, compared to strangers in a public toilet.
People may also experience guilt, shame and fear about being judged by colleagues or supervisors if they need to make extended or frequent visits to the bathroom. This may particularly apply to people with a gastrointestinal condition.
Reducing restroom anxiety
Using a public toilet can understandably cause some anxiety or be unpleasant. But for a small minority of people it can be a real problem, causing severe distress and affecting their ability to engage in activities of daily living.
If doing a poo in a toilet at work or another public setting causes you anxiety, be kind to yourself. A number of strategies might help:
- identify and challenge negative thoughts about using public toilets and remind yourself that using the bathroom is normal, and that most people are not paying attention to others in the toilets
- try to manage stress through relaxation techniques such as deep breathing and progressive muscle relaxation, which involves tensing and relaxing different muscles around the body
- engaging in gradual exposure can be helpful, which means visiting public toilets at different times and locations, so you can develop greater confidence in using them
- use grounding or distraction techniques while going to the toilet. These might include listening to music, watching something on your phone, or focusing on your breathing.
If you feel parcopresis is having a significant impact on your life, talk to your GP or a psychologist who can help identify appropriate approaches to treatment. This might include cognitive behavioural therapy.
Simon Robert Knowles, Associate Professor and Clinical Psychologist, 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:
- September: Changes That Destabilize
- October: Looking for Focus
- November: New Habits
- December: Analyzing The First Results
- January: Traveling & Perfectionism
- February: Habits & Goals
- March: Connection, Cravings, & Organization
- April: Physical & Emotional Changes After 7 Months
- May: Reflections & Considerations
- June: Challenge Is Over
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:
- 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).
- Use easy and simple cooking methods.
- Change ingredients every time you prepare your meals.
- Prepare large quantities for three or four days.
- Store the food separately in tightly closed Tupperware.
- Organize yourself to always have ready-to-eat food in the fridge.
- When hungry, mix the ingredients in the ideal amounts to cover the needs of your body.
- Chew well and take the time to taste your food.
- Eat foods that you like and enjoy.
- 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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How Are You?
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Answering The Most Difficult Question: How Are You?
Today’s feature is aimed at helping mainly two kinds of people:
- “I have so many emotions that I don’t always know what to do with them”
- “What is an emotion, really? I think I felt one some time ago”
So, if either those describe you and/or a loved one, read on…
Alexithymia
Alexi who? Alexithymia is an umbrella term for various kinds of problems with feeling emotions.
That could be “problems feeling emotions” as in “I am unable to feel emotions” or “problems feeling emotions” as in “feeling these emotions is a problem for me”.
It is most commonly used to refer to “having difficulty identifying and expressing emotions”.
There are a lot of very poor quality pop-science articles out there about it, but here’s a decent one with good examples and minimal sensationalist pathologization:
Alexithymia Might Be the Reason It’s Hard to Label Your Emotions
A somatic start
Because a good level of self-awareness is critical for healthy emotional regulation, let’s start there. We’ll write this in the first person, but you can use it to help a loved one too, just switching to second person:
Simplest level first:
Are my most basic needs met right now? Is this room a good temperature? Am I comfortable dressed the way I am? Am I in good physical health? Am I well-rested? Have I been fed and watered recently? Does my body feel clean? Have I taken any meds I should be taking?
Note: If the answer is “no”, then maybe there’s something you can do to fix that first. If the answer is “no” and also you can’t fix the thing for some reason, then that’s unfortunate, but just recognize it anyway for now. It doesn’t mean the thing in question is necessarily responsible for how you feel, but it’s good to check off this list as a matter of good practice.
Bonus question: it’s cliché, but if applicable… What time of the month is it? Because while hormonal mood swings won’t create moods out of nothing, they sure aren’t irrelevant either and should be listened to too.
Bodyscanning next
What do you feel in each part of your body? Are you clenching your jaw? Are your shoulders tense? Do you have a knot in your stomach? What are your hands doing? How’s your posture? What’s your breathing like? How about your heart? What are your eyes doing?
Your observations at this point should be neutral, by the way. Not “my posture is terrible”, but “my posture is stooped”, etc. Much like in mindfulness meditation, this is a time for observing, not for judging.
Narrowing it down
Now, like a good scientist, you have assembled data. But what does the data mean for your emotions? You may have to conduct some experiments to find out.
Thought experiments: what calls to you? What do you feel like doing? Do you feel like curling up in a ball? Breaking something? Taking a bath? Crying?
Maybe what calls to you, or what you feel like doing, isn’t something that’s possible for you to do. This is often the case with anxiety, for example, and perhaps also guilt. But whatever calls to you, notice it, reflect on it, and if it’s something that your conscious mind considers reasonable and safe for you to do, you can even try doing it.
Your body is trying to help you here, by the way! It will try (and usually succeed) to give you a little dopamine spike when you anticipate doing the thing it wants you to do. Warning: it won’t always be right about what’s best for you, so do still make your own decisions about whether it is a good idea to safely do it.
Practical experiments: whether you have a theory or just a hypothesis (if you have neither make up a hypothesis; that is also what scientists do), you can also test it:
If in the previous step you identified something you’d like to do and are able to safely do it, now is the time to try it. If not…
- Find something that is likely to (safely) tip you into emotional expression, ideally, in a cathartic way. But, whatever you can get is good.
- Music is great for this. What songs (or even non-lyrical musical works) make you sad, happy, angry, energized? Try them.
- Literature and film can be good too, albeit they take more time. Grab that tear-jerker or angsty rage-fest, and see if it feels right.
- Other media, again, can be completely unrelated to the situation at hand, but if it evokes the same emotion, it’ll help you figure out “yes, this is it”.
- It could be a love letter or a tax letter, it could be an outrage-provoking news piece or some nostalgic thing you own.
Ride it out, wherever it takes you (safely)
Feelings feel better felt. It doesn’t always seem that way! But, really, they are.
Emotions, just like physical sensations, are messengers. And when a feeling/sensation is troublesome, one of the best ways to get past it is to first fully listen to it and respond accordingly.
- If your body tells you something, then it’s good to acknowledge that and give it some reassurance by taking some action to appease it.
- If your emotions are telling you something, then it’s good to acknowledge that and similarly take some action to appease it.
There is a reason people feel better after “having a good cry”, or “pounding it out” against a punchbag. Even stress can be dealt with by physically deliberately tensing up and then relaxing that tension, so the body thinks that you had a fight and won and can relax now.
And when someone is in a certain (not happy) mood and takes (sometimes baffling!) actions to stay in that mood rather than “snap out of it”, it’s probably because there’s more feeling to be done before the body feels heard. Hence the “ride it out if you safely can” idea.
How much feeling is too much?
While this is in large part a subjective matter, clinically speaking the key question is generally: is it adversely affecting daily life to the point of being a problem?
For example, if you have to spend half an hour every day actively managing a certain emotion, that’s probably indicative of something unusual, but “unusual” is not inherently pathological. If you’re managing it safely and in a way that doesn’t negatively affect the rest of your life, then that is generally considered fine, unless you feel otherwise about it.
If you do think “I would like to not think/feel this anymore”, then there are tools at your disposal too:
- How To Manage Chronic Stress
- How To Set Anxiety Aside
- How To Stop Revisiting Those Memories
- How To Stay Alive (When You Really Don’t Want To)
Take care!
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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Sleep Solution – by Dr. Chris Winter
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This book’s blurb contains a bold claim:
❝If you want to fix your sleep problems, Internet tips and tricks aren’t going to do it for you. You need to really understand what’s going on with your sleep—both what your problems are and how to solve them.❞
So, how well does it deliver, on the strength of being a whole book rather than an Internet article?
Well, for sure we wouldn’t have the room to include all the information that Dr. Winter does, in one of our main feature articles here (we’d need to spread it out over several weeks, at least).
He examines very thoroughly what is going on with sleep, sleep disturbance, and sleep deprivation. What’s going on with the different phases of sleep (far more than your phone’s sleep app will), and how imbalances in these can cause problems.
While the usual sleep hygiene tips do get a mention, he broadly assumes we know that part already. Instead, he focuses on aligning as many components as possible of our rich and interesting circadian rhythm. Yes, even if that means clawing our way out of insomnia and/or a bad sleep schedule (or lack of coherent sleep schedule) first. He gives plenty of practical advice on how to do that.
Bottom line: if you’d like to more deeply understand sleep, what is or isn’t wrong with yours, and how you can fix it, this book is a great resource.
Click here to check out The Sleep Solution, and enjoy the benefits of better rest!
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Pine Nuts vs Peanuts – Which is Healthier?
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Our Verdict
When comparing pine nuts to peanuts, we picked the pine nuts.
Why?
An argument could be made for either, honestly, as it depends on what we prioritize the most. These are both very high-calorie foods, and/but are far from empty calories, as they both contain main nutrients. Obviously, if you are allergic to nuts, this one is just not a comparison for you, sorry.
Looking at the macros first, peanuts are higher in protein, carbs, and fiber, while pine nuts are higher in fats—though the fats are healthy, being mostly polyunsaturated, with about a third of the total fats monounsaturated, and a low amount of saturated fat (peanuts have nearly 2x the saturated fat). On balance, we’ll call the macros category a moderate win for peanuts, though.
In terms of vitamins, peanuts have more of vitamins B1, B3, B5, B6, and B9, while pine nuts have more of vitamins A, B2, C, E, K, and choline. All in all, a marginal win for pine nuts.
In the category of minerals, peanuts have more calcium and selenium, while pine nuts have more copper, iron, magnesium, manganese, phosphorus, and zinc. An easy win for pine nuts, even before we take into account that peanuts have nearly 10x as much sodium. And yes, we are talking about the raw nuts, not nuts that have been roasted and salted.
Adding up the categories gives a win for pine nuts—but if you have certain particular priorities, you might still prefer peanuts for the areas in which peanuts are stronger.
Of course, the best solution is to enjoy both!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Take care!
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14 Powerful Strategies To Prevent Dementia
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Dementia risk starts climbing very steeply after the age of 65, but it’s not entirely predetermined. Dr. Brad Stanfield, a primary care physician, has insights:
The strategies
We’ll not keep them a mystery; they are:
- Cognitive stimulation: which means genuinely challenging mental activities using a variety of mental faculties. This will usually mean that anything that is just “same old, same old” all the time will stop giving benefits after a short while once it becomes rote, and you’ll need something harder and/or different.
- Hearing health: being unable to participate in conversations increases dementia risk; hearing aids can help.
- Eyesight health: similar to the above; regular eye tests are good, and the use of glasses where appropriate.
- Depression management: midlife depression is linked to later life dementia, likely in large part due to social isolation and a lack of stimulation, but either way, treating depression earlier reduces later dementia risk.
- Exercising regularly: what’s good for the heart is good for the brain; the brain is a hungry organ and the blood is what feeds it (and removes things that shouldn’t be there)
- Head injury avoidance: even mild head injuries can cause problems down the road. Protecting one’s head in sports, and even while casually cycling, is important.
- Smoking cessation: just don’t smoke; if you smoke, make it a top priority to quit unless you are given direct strong medical advice to the contrary (there are cases, few and far between, whereby quitting smoking genuinely needs to be deferred until after something else is dealt with first, but they are a lot rarer than a lot of people who are simply afraid of quitting would like to believe)
- Cholesterol management: again, healthy blood means a healthy brain, and that goes for triglycerides too.
- Weight management: obesity, especially waist to hip ratio (indicating visceral abdominal fat specifically) is associated with many woes, including dementia.
- Diabetes management: once again, healthy blood means a healthy brain, and that goes for blood sugar management too.
- Blood pressure management: guess what, healthy blood still means a healthy brain, and that goes for blood pressure too.
- Alcohol reduction/cessation: alcohol is bad for pretty much everything, and for most people who drink, quitting is probably the top thing to do after quitting smoking.
- Social engagement: while we all may have our different preferences on a scale of introversion to extroversion, we are fundamentally a social species and thrive best with social contact, even if it’s just a few people.
- Air pollution reduction: avoiding pollutants, and filtering the air we breathe where pollutants are otherwise unavoidable, makes a measurable difference to brain health outcomes.
For more information on all of these (except the last two, which really he only mentions in passing), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Reduce Your Alzheimer’s Risk ← our own main feature on the topic
Take care!
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