Managing Jealousy

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Jealousy is often thought of as a young people’s affliction, but it can affect us at any age—whether we are the one being jealous, or perhaps a partner.

And, the “green-eyed monster” can really ruin a lot of things; relationships, friendships, general happiness, physical health even (per stress and anxiety and bad sleep), and more.

The thing is, jealousy looks like one thing, but is actually mostly another.

Jealousy is a Scooby-Doo villain

That is to say: we can unmask it and see what much less threatening thing is underneath. Which is usually nothing more nor less than: insecurities

  • Insecurity about losing one’s partner
  • Insecurity about not being good enough
  • Insecurity about looking bad socially

…etc. The latter, by the way, is usually the case when one’s partner is socially considered to be giving cause for jealousy, but the primary concern is not actually relational loss or any kind of infidelity, but rather, looking like one cannot keep one’s partner’s full attention romantically/sexually. This drives a lot of people to act on jealousy for the sake of appearances, in situations where they might otherwise, if they didn’t feel like they’d be adversely judged for it, be considerably more chill.

Thus, while monogamy certainly has its fine merits, there can also be a kind of “toxic monogamy” at hand, where a relationship becomes unhealthy because one partner is just trying to live up to social expectations of keeping the other partner in check.

This, by the way, is something that people in polyamorous and/or open relationships typically handle quite neatly, even if a lot of the following still applies. But today, we’re making the statistically safe assumption of a monogamous relationship, and talking about that!

How to deal with the social aspect

If you sit down with your partner and work out in advance the acceptable parameters of your relationship, you’ll be ahead of most people already. For example…

  • What counts as cheating? Is it all and any sex acts with all and any people? If not, where’s the line?
  • What about kissing? What about touching other body parts? If there are boundaries that are important to you, talk about them. Nothing is “too obvious” because it’s astonishing how many times it will happen that later someone says (in good faith or not), “but I thought…”
  • What about being seen in various states of undress? Or seeing other people in various states of undress?
  • Is meaningless flirting between friends ok, and if so, how do we draw the line with regard to what is meaningless? And how are we defining flirting, for that matter? Talk about it and ensure you are both on the same page.
  • If a third party is possibly making moves on one of us under the guise of “just being friendly”, where and how do we draw the line between friendliness and romantic/sexual advances? What’s the difference between a lunch date with a friend and a romantic meal out for two, and how can we define the difference in a way that doesn’t rely on subjective “well I didn’t think it was romantic”?

If all this seems like a lot of work, please bear in mind, it’s a lot more fun to cover this cheerfully as a fun couple exercise in advance, than it is to argue about it after the fact!

See also: Boundary-Setting Beyond “No”

How to deal with the more intrinsic insecurities

For example, when jealousy is a sign of a partner fearing not being good enough, not measuring up, or perhaps even losing their partner.

The key here might not shock you: communication

Specifically, reassurance. But critically, the correct reassurance!

A partner who is jealous will often seek the wrong reassurance, for example wanting to read their partner’s messages on their phone, or things like that. And while a natural desire when experiencing jealousy, it’s not actually helpful. Because while incriminating messages could confirm infidelity, it’s impossible to prove a negative, and if nothing incriminating is found, the jealous partner can just go on fearing the worst regardless. After all, their partner could have a burner phone somewhere, or a hidden app for cheating, or something else like that. So, no reassurance can ever be given/gained by such requests (which can also become unpleasantly controlling, which hopefully nobody wants).

A quick note on “if you have nothing to fear, you have nothing to hide”: rhetorically that works, but practically it doesn’t.

Writer’s example: when my late partner and I formalized our relationship, we discussed boundaries, and I expressed “so far as I am concerned, I have no secrets from you, except secrets that are not mine to share. For example, if someone has confided in me and asked that I not share it, I won’t. Aside from that, you have access-all-areas in my life; me being yours has its privileges” and this policy itself would already pre-empt any desire to read my messages. Now indeed, I had nothing to hide. I am by character devoted to a fault. But my friends may well sometimes have things they don’t want me to share, which made that a necessary boundary to highlight (which my partner, an absolute angel by the way and not overly prone to jealousy in any case, understood completely).

So, it is best if the partner of a jealous person can explain the above principles as necessary, and offer the correct reassurance instead. Which could be any number of things, but for example:

  • I am yours, and nobody else has a chance
  • I fully intend to stay with you for life
  • You are the best partner I have ever had
  • Being with you makes my life so much better

…etc. Note that none of these are “you don’t have to worry about so-and-so”, or “I am not cheating on you”, etc, because it’s about yours and your partner’s relationship. If they ask for reassurances with regard to other people or activities, by all means state them as appropriate, but try to keep the focus on you two.

And if your partner (or you, if it’s you who’s jealous) can express the insecurity in the format…

“I’m afraid of _____ because _____”

…then the “because” will allow for much more specific reassurance. We all have insecurities, we all have reasons we might fear not being good enough for our partner, or losing their affection, and the best thing we can do is choose to trust our partners at least enough to discuss those fears openly with each other.

See also: Save Time With Better Communication ← this can avoid a lot of time-consuming arguments

What about if the insecurity is based in something demonstrably correct?

By this we mean, something like a prior history of cheating, or other reasons for trust issues. In such a case, the jealous partner may well have a reason for their jealousy that isn’t based on a personal insecurity.

In our previous article about boundaries, we talked about relationships (romantic or otherwise) having a “price of entry”. In this case, you each have a “price of entry”:

  • The “price of entry” to being with the person who has previously cheated (or similar), is being able to accept that.
  • And for the person who cheated (or similar), very likely their partner will have the “price of entry” of “don’t do that again, and also meanwhile accept in good grace that I might be jittery about it”.

And, if the betrayal of trust was something that happened between the current partners in the current relationship, most likely that was also traumatic for the person whose trust was betrayed. Many people in that situation find that trust can indeed be rebuilt, but slowly, and the pain itself may also need treatment (such as therapy and/or couples therapy specifically).

See also: Relationships: When To Stick It Out & When To Call It Quits ← this covers both sides

And finally, to finish on a happy note:

Only One Kind Of Relationship Promotes Longevity This Much!

Take care!

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  • Why Everyone You Don’t Like Is A Narcissist

    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 written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:

    “You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”

    “You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”

    See also: Miss Diagnosis: Anxiety, ADHD, & Women

    Antisocial Diagnoses

    These days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.

    And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:

    • perhaps for coming across as overly sensationalized, and thus lacking credibility
    • perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.

    You may be wondering: what do “psychopathy” and “sociopathy” mean?

    And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.

    Stigma vs pathology

    Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.

    If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.

    Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.

    A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:

    The Mental Health First-Aid You’ll Hopefully Never Need

    The disorder is not the problem

    Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:

    • After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
    • The disorder is not the problem; the way they treat (or have treated) you is the problem.

    For example, let’s take a key thing generally attributed to narcissists: a lack of empathy

    Now, empathy can be divided into:

    • affective empathy: the ability to feel what other people are feeling
    • cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)

    A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.

    Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.

    As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.

    Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.

    Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.

    So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?

    Take the bull by the horns

    Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.

    So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.

    And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.

    • So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
    • But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”

    Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).

    That’s just one example, but the same methodology can be applied to most things.

    For tricks pertaining to how to communicate such things without causing undue resistance, see:

    Seriously Useful Communication Skills

    Take care!

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  • The Art of Being Unflappable (Tricks For Daily Life)

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    The Art of Being Unflappable

    From Stoicism to CBT, thinkers through the ages have sought the unflappable life.

    Today, in true 10almonds fashion, we’re going to distil it down to some concentrated essentials that we can all apply in our daily lives:

    Most Common/Impactful Cognitive Distortions To Catch (And Thus Avoid)

    These are like the rhetorical fallacies with which you might be familiar (ad hominem, no true Scotsman, begging the question, tu quoque, straw man, etc), but are about what goes on between your own ears, pertaining to your own life.

    If we learn about them and how to recognize them, however, we can catch them before they sabotage us, and remain “unflappable” in situations that could otherwise turn disastrous.

    Let’s take a look at a few:

    Catastrophizing / Crystal Ball

    • Distortion: not just blowing something out of proportion, but taking an idea and running with it to its worst possible conclusion. For example, we cook one meal that’s a “miss” and conclude we are a terrible cook, and in fact for this reason a terrible housewife/mother/friend/etc, and for this reason everyone will probably abandon us and would be right to do so
    • Reality: by tomorrow, you’ll probably be the only one who even remembers it happened

    Mind Reading

    • Distortion: attributing motivations that may or may not be there, and making assumptions about other people’s thoughts/feelings. An example is the joke about two partners’ diary entries; one is long and full of feelings about how the other is surely dissatisfied in their marriage, has been acting “off” with them all day, is closed and distant, probably wants to divorce, may be having an affair and is wondering which way to jump, and/or is just wondering how to break the news—the other partner’s diary entry is short, and reads “motorcycle won’t start; can’t figure out why”
    • Reality: sometimes, asking open questions is better than guessing, and much better than assuming!

    All-or-Nothing Thinking / Disqualifying the Positive / Magnifying the Negative

    • Distortion: having a negative bias that not only finds a cloud in every silver lining, but stretches it out so that it’s all that we can see. In a relationship, this might mean that one argument makes us feel like our relationship is nothing but strife. In life in general, it may lead us to feel like we are “naturally unlucky”.
    • Reality: those negative things wouldn’t even register as negative to us if there weren’t a commensurate positive we’ve experienced to hold them in contrast against. So, find and remember that positive too.

    For brevity, we put a spotlight on (and in some cases, clumped together) the ones we think have the most bang-for-buck to know about, but there are many more.

    So for the curious, here’s some further reading:

    Psychology Today: 50 Common Cognitive Distortions

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  • How to Stop Negative Thinking – by Daniel Paul

    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.

    Just think positive thoughts” is all well and good, but it doesn’t get much mileage in the real world, does it?

    What Daniel Paul offers is a lot better than that. Taking a CBT approach, he recommends tips and tricks, gives explanations and exercises, and in short, puts tools in the reader’s toolbox.

    But it doesn’t stop at just stopping negative thinking. Rather, it takes a holistic approach to also improve your general life…

    • Bookending your day with a good start and finish
    • Scheduling a time for any negative thinking that does need to occur (again with the useful realism!)
    • Inviting the reader to take on small challenges, of the kind that’ll have knock-on effects that add and multiply and compound as we go

    The format is very easy-reading, and we love that there are clear section headings and chapter summaries, too.

    Bottom line: definitely a book with the potential to improve your life from day one, and that’ll keep you coming back to it as a cheatsheet and references source.

    Get your copy of “How to Stop Negative Thinking” from Amazon today!

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Related Posts

  • Can We Side-Step Age-Related Alienation?
  • With all this bird flu around, how safe are eggs, chicken or milk?

    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.

    Enzo Palombo, Swinburne University of Technology

    Recent outbreaks of bird flu – in US dairy herds, poultry farms in Australia and elsewhere, and isolated cases in humans – have raised the issue of food safety.

    So can the virus transfer from infected farm animals to contaminate milk, meat or eggs? How likely is this?

    And what do we need to think about to minimise our risk when shopping for or preparing food?

    AS Foodstudio/Shutterstock

    How safe is milk?

    Bird flu (or avian influenza) is a bird disease caused by specific types of influenza virus. But the virus can also infect cows. In the US, for instance, to date more than 80 dairy herds in at least nine states have been infected with the H5N1 version of the virus.

    Investigations are under way to confirm how this happened. But we do know infected birds can shed the virus in their saliva, nasal secretions and faeces. So bird flu can potentially contaminate animal-derived food products during processing and manufacturing.

    Indeed, fragments of bird flu genetic material (RNA) were found in cow’s milk from the dairy herds associated with infected US farmers.

    However, the spread of bird flu among cattle, and possibly to humans, is likely to have been caused through contact with contaminated milking equipment, not the milk itself.

    The test used to detect the virus in milk – which uses similar PCR technology to lab-based COVID tests – is also highly sensitive. This means it can detect very low levels of the bird flu RNA. But the test does not distinguish between live or inactivated virus, just that the RNA is present. So from this test alone, we cannot tell if the virus found in milk is infectious (and capable of infecting humans).

    Rows of milk bottles in supermarket fridge
    It’s best to stick with pasteurised milk. Amnixia/Shutterstock

    Does that mean milk is safe to drink and won’t transmit bird flu? Yes and no.

    In Australia, where bird flu has not been reported in dairy cattle, the answer is yes. It is safe to drink milk and milk products made from Australian milk.

    In the US, the answer depends on whether the milk is pasteurised. We know pasteurisation is a common and reliable method of destroying concerning microbes, including influenza virus. Like most viruses, influenza virus (including bird flu virus) is inactivated by heat.

    Although there is little direct research on whether pasteurisation inactivates H5N1 in milk, we can extrapolate from what we know about heat inactivation of H5N1 in chicken and eggs.

    So we can be confident there is no risk of bird flu transmission via pasteurised milk or milk products.

    However, it’s another matter for unpasteurised or “raw” US milk or milk products. A recent study showed mice fed raw milk contaminated with bird flu developed signs of illness. So to be on the safe side, it would be advisable to avoid raw milk products.

    How about chicken?

    Bird flu has caused sporadic outbreaks in wild birds and domestic poultry worldwide, including in Australia. In recent weeks, there have been three reported outbreaks in Victorian poultry farms (two with H7N3 bird flu, one with H7N9). There has been one reported outbreak in Western Australia (H9N2).

    The strains of bird flu identified in the Victorian and Western Australia outbreaks can cause human infection, although these are rare and typically result from close contact with infected live birds or contaminated environments.

    Therefore, the chance of bird flu transmission in chicken meat is remote.

    Nonetheless, it is timely to remind people to handle chicken meat with caution as many dangerous pathogens, such as Salmonella and Campylobacter, can be found on chicken carcasses.

    Always handle chicken meat carefully when shopping, transporting it home and storing it in the kitchen. For instance, make sure no meat juices cross-contaminate other items, consider using a cool bag when transporting meat, and refrigerate or freeze the meat within two hours.

    Avoid washing your chicken before cooking to prevent the spread of disease-causing microbes around the kitchen.

    Finally, cook chicken thoroughly as viruses (including bird flu) cannot survive cooking temperatures.

    Are eggs safe?

    The recent Australian outbreaks have occurred in egg-laying or mixed poultry flocks, so concerns have been raised about bird flu transmission via contaminated chicken eggs.

    Can flu viruses contaminate chicken eggs and potentially spread bird flu? It appears so. A report from 2007 said it was feasible for influenza viruses to enter through the eggshell. This is because influenza virus particles are smaller (100 nanometres) than the pores in eggshells (at least 200 nm).

    So viruses could enter eggs and be protected from cleaning procedures designed to remove microbes from the egg surface.

    Therefore, like the advice about milk and meat, cooking eggs is best.

    The US Food and Drug Administration recommends cooking poultry, eggs and other animal products to the proper temperature and preventing cross-contamination between raw and cooked food.

    In a nutshell

    If you consume pasteurised milk products and thoroughly cook your chicken and eggs, there is nothing to worry about as bird flu is inactivated by heat.

    The real fear is that the virus will evolve into highly pathogenic versions that can be transmitted from human to human.

    That scenario is much more frightening than any potential spread though food.

    Enzo Palombo, Professor of Microbiology, Swinburne University of Technology

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

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  • What you need to know about endometriosis

    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.

    Endometriosis affects one in 10 people with a uterus who are of reproductive age. This condition occurs when tissue similar to the endometrium—the inner lining of the uterus—grows on organs outside of the uterus, causing severe pain that impacts patients’ quality of life.

    Read on to learn more about endometriosis: What it is, how it’s diagnosed and treated, where patients can find support, and more.

    What is endometriosis, and what areas of the body can it affect?

    The endometrium is the tissue that lines the inside of the uterus and sheds during each menstrual cycle. Endometriosis occurs when endometrial-like tissue grows outside of the uterus.

    This tissue can typically grow in the pelvic region and may affect the outside of the uterus, fallopian tubes, ovaries, vagina, bladder, intestines, and rectum. It has also been observed outside of the pelvis on the lungs, spleen, liver, and brain.

    What are the symptoms?

    Symptoms may include pelvic pain and cramping before or during menstrual periods, heavy menstrual bleeding, bleeding or spotting between periods, pain with bowel movements or urination, pain during or after sex or orgasm, fatigue, nausea, bloating, and infertility.

    The pain associated with this condition has been linked to depression, anxiety, and eating disorders. A meta-analysis published in 2019 found that more than two-thirds of patients with endometriosis report psychological stress due to their symptoms.

    Who is at risk?

    Endometriosis most commonly occurs in people with a uterus between the ages of 25 and 40, but it can also affect pre-pubescent and post-menopausal people. In rare cases, it has been documented in cisgender men.

    Scientists still don’t know what causes the endometrial-like tissue to grow, but research shows that people with a family history of endometriosis are at a higher risk of developing the condition. Other risk factors include early menstruation, short menstrual cycles, high estrogen, low body mass, and starting menopause at an older age.

    There is no known way to prevent endometriosis.

    How does endometriosis affect fertility?

    Up to 50 percent of people with endometriosis may struggle to get pregnant. Adhesions and scarring on the fallopian tubes and ovaries as well as changes in hormones and egg quality can contribute to infertility.

    Additionally, when patients with this condition are able to conceive, they may face an increased risk of pregnancy complications and adverse pregnancy outcomes.

    Treating endometriosis, taking fertility medications, and using assistive reproductive technology like in vitro fertilization can improve fertility outcomes.

    How is endometriosis diagnosed, and what challenges do patients face when seeking a diagnosis?

    A doctor may perform a pelvic exam and request an ultrasound or MRI. These exams and tests help identify cysts or other unusual tissue that may indicate endometriosis.

    Endometriosis can only be confirmed through a surgical laparoscopy (although less-invasive diagnostic tests are currently in development). During the procedure, a surgeon makes a small cut in the patient’s abdomen and inserts a thin scope to check for endometrial-like tissue outside of the uterus. The surgeon may take a biopsy, or a small sample, and send it to a lab.

    It takes an average of 10 years for patients to be properly diagnosed with endometriosis. A 2023 U.K. study found that stigma around menstrual health, the normalization of menstrual pain, and a lack of medical training about the condition contribute to delayed diagnoses. Patients also report that health care providers dismiss their pain and attribute their symptoms to psychological factors.

    Additionally, endometriosis has typically been studied among white, cisgender populations. Data on the prevalence of endometriosis among people of color and transgender people is limited, so patients in those communities face additional barriers to care.

    What treatment options are available?

    Treatment for endometriosis depends on its severity. Management options include:

    • Over-the-counter pain medication to alleviate pelvic pain
    • Hormonal birth control to facilitate lighter, less painful periods
    • Hormonal medications such as gonadotropin-releasing hormone (GnRH) or danazol, which stop the production of hormones that cause menstruation
    • Progestin therapy, which may stop the growth of endometriosis tissue
    • Aromatase inhibitors, which reduce estrogen

    In some cases, a doctor may perform a laparoscopic surgery to remove endometrial-like tissue.

    Depending on the severity of the patient’s symptoms and scar tissue, some doctors may also recommend a hysterectomy, or the removal of the uterus, to alleviate symptoms. Doctors may also recommend removing the patient’s ovaries, inducing early menopause to potentially improve pain.

    Where can people living with endometriosis find support?

    Given the documented mental health impacts of endometriosis, patients with this condition may benefit from therapy, as well as support from others living with the same symptoms. Some peer support organizations include:

    For more information, talk to your health care provider.

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

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  • Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

    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.

    An article published this week in the prestigious journal Nature Medicine documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.

    The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.

    Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.

    The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop Creuztfeldt-Jakob disease (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.

    What’s CJD got to do with Alzehimer’s?

    CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.

    Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised public health concerns over the eating of beef products in the United Kingdom in the 1980s.

    Human growth hormone used to come from donated organs

    Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.

    But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around 16,000 donated glands.

    An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.

    hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.

    Scientist in a lab
    Human growth hormone is now produced in a lab.
    National Cancer Institute/Unsplash

    What are the latest findings about Alzheimer’s disease?

    The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.

    The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.

    They considered other explanations for the findings but concluded donated hGH was the likely cause.

    Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.

    Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is increasing evidence these proteins spread in the brain in a similar way to prion diseases. So the mode of transmission the authors propose is certainly plausible.

    However, given the amyloid protein deposits in the brain at least 20 years before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.

    When was this process used in Australia?

    In Australia, donated pituitary material was used from 1967 to 1985 to treat people with short stature and infertility.

    More than 2,000 people received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.

    The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are considered to be incredibly small.

    Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for around 5% of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.

    Older man places his hands on his head
    Early onset Alzheimer’s means it occurs before age 65.
    perfectlab/Shutterstock

    The risk is very low – and you can’t ‘catch’ it like a virus

    The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.

    Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.

    The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.The Conversation

    Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University

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

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