The Mental Health First-Aid That You’ll Hopefully Never Need
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Take Your Mental Health As Seriously As General Health!
Sometimes, health and productivity means excelling—sometimes, it means avoiding illness and unproductivity. Both are essential, and today we’re going to tackle some ground-up stuff. If you don’t need it right now, great; we suggest to read it for when and if you do. But how likely is it that you will?
- One in four of us are affected by serious mental health issues in any given year.
- One in five of us have suicidal thoughts at some point in our lifetime.
- One in six of us are affected to at least some extent by the most commonly-reported mental health issues, anxiety and depression, in any given week.
…and that’s just what’s reported, of course. These stats are from a UK-based source but can be considered indicative generally. Jokes aside, the UK is not a special case and is not measurably worse for people’s mental health than, say, the US or Canada.
While this is not an inherently cheery topic, we think it’s an important one.
Depression, which we’re going to focus on today, is very very much a killer to both health and productivity, after all.
One of the most commonly-used measures of depression is known by the snappy name of “PHQ9”. It stands for “Patient Health Questionnaire Nine”, and you can take it anonymously online for free (without signing up for anything; it’s right there on the page already):
Take The PHQ9 Test Here! (under 2 minutes, immediate results)
There’s a chance you took that test and your score was, well, depressing. There’s also a chance you’re doing just peachy, or maybe somewhere in between. PHQ9 scores can fluctuate over time (because they focus on the past two weeks, and also rely on self-reports in the moment), so you might want to bookmark it to test again periodically. It can be interesting to track over time.
In the event that you’re struggling (or: in case one day you find yourself struggling, or want to be able to support a loved one who is struggling), some top tips that are useful:
Accept that it’s a medical condition like any other
Which means some important things:
- You/they are not lazy or otherwise being a bad person by being depressed
- You/they will probably get better at some point, especially if help is available
- You/they cannot, however, “just snap out of it”; illness doesn’t work that way
- Medication might help (it also might not)
Do what you can, how you can, when you can
Everyone knows the advice to exercise as a remedy for depression, and indeed, exercise helps many. Unfortunately, it’s not always that easy.
Did you ever see the 80s kids’ movie “The Neverending Story”? There’s a scene in which the young hero Atreyu must traverse the “Swamp of Sadness”, and while he has a magical talisman that protects him, his beloved horse Artax is not so lucky; he slows down, and eventually stops still, sinking slowly into the swamp. Atreyu pulls at him and begs him to keep going, but—despite being many times bigger and stronger than Atreyu, the horse just sinks into the swamp, literally drowning in despair.
See the scene: The Neverending Story movie clip – Artax and the Swamp of Sadness (1984)
Wow, they really don’t make kids’ movies like they used to, do they?
But, depression is very much like that, and advice “exercise to feel less depressed!” falls short of actually being helpful, when one is too depressed to do it.
If you’re in the position of supporting someone who’s depressed, the best tool in your toolbox will be not “here’s why you should do this” (they don’t care; not because they’re an uncaring person by nature, but because they are physiologically impeded from caring about themself at this time), but rather:
“please do this with me”
The reason this has a better chance of working is because the depressed person will in all likelihood be unable to care enough to raise and/or maintain an objection, and while they can’t remember why they should care about themself, they’re more likely to remember that they should care about you, and so will go with your want/need more easily than with their own. It’s not a magic bullet, but it’s worth a shot.
What if I’m the depressed person, though?
Honestly, the same, if there’s someone around you that you do care about; do what you can to look after you, for them, if that means you can find some extra motivation.
But I’m all alone… what now?
Firstly, you don’t have to be alone. There are free services that you can access, for example:
- US: https://nami.org/help
- Canada: https://www.wellnesstogether.ca/en-CA
- UK: https://www.samaritans.org/
…which varyingly offer advice, free phone services, webchats, and the like.
But also, there are ways you can look after yourself a little bit; do the things you’d advise someone else to do, even if you’re sure they won’t work:
- Take a little walk around the block
- Put the lights on when you’re not sleeping
- For that matter, get out of bed when you’re not sleeping. Literally lie on the floor if necessary, but change your location.
- Change your bedding, or at least your clothes
- If changing the bedding is too much, change just the pillowcase
- If changing your clothes is too much, change just one item of clothing
- Drink some water; it won’t magically cure you, but you’ll be in slightly better order
- On the topic of water, splash some on your face, if showering/bathing is too much right now
- Do something creative (that’s not self-harm). You may scoff at the notion of “art therapy” helping, but this is a way to get at least some of the lights on in areas of your brain that are a little dark right now. Worst case scenario is it’ll be a distraction from your problems, so give it a try.
- Find a connection to community—whatever that means to you—even if you don’t feel you can join it right now. Discover that there are people out there who would welcome you if you were able to go join them. Maybe one day you will!
- Hiding from the world? That’s probably not healthy, but while you’re hiding, take the time to read those books (write those books, if you’re so inclined), learn that new language, take up chess, take up baking, whatever. If you can find something that means anything to you, go with that for now, ride that wave. Motivation’s hard to come by during depression and you might let many things slide; you might as well get something out of this period if you can.
If you’re not depressed right now but you know you’re predisposed to such / can slip that way?
Write yourself instructions now. Copy the above list if you like.
Most of all: have a “things to do when I don’t feel like doing anything” list.
If you only take one piece of advice from today’s newsletter, let that one be it!
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A Cold Shower A Day Keeps The Doctor Away?
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A Cold Shower A Day Keeps The Doctor Away?
This is Dutch extreme athlete Wim Hof, also known as “The Iceman”! He’s broken many world records mostly relating to the enduring the cold, for example:
- climbing Mount Kilimanjaro in shorts
- running a half-marathon above the Arctic Circle barefoot
- standing in a container completely covered with ice cubes for more than 112 minutes
You might not want to do yoga in your pyjamas on an iceberg, but you might like…
- better circulatory health
- reduced risk of stroke
- a boosted immune system
- healthier skin
- more energy and alertness
…and things like that. Wim Hof’s method is not just about extreme athletic achievements; most of what he does, the stuff that can benefit the rest of us, is much more prosaic.
The Wim Hof Method
For Wim Hof, three things are key:
- Breathing (See: Wim Hof Method Breathing Exercises)
- Commitment (See: How to Increase Willpower)
- Cold therapy (See: Benefits of Cold Therapy)
Today, we’re going to be focusing on the last one there.
What are the benefits of Cold Therapy?
Once upon a time, we didn’t have central heating, electric blankets, thermal underwear, and hot showers. In fact, once upon a time, we didn’t have houses or clothes. We used to be a lot more used to the elements! And while it’s all well and good to enjoy modern comforts, it has left our bodies lacking practice.
Practice at what? Most notably: vasodilation and vasoconstriction, in response to temperature changes. Either:
- vasodilation, because part of our body needs more blood to keep it warm and nourished, or
- vasoconstriction, because part of our body needs less blood running through it to get cooled down.
Switching between the two gives the blood vessels practice at doing it, and improves vascular muscle tone. If your body doesn’t get that practice, your blood vessels will be sluggish at making the change. This can cause circulation problems, which in turn have a big impact in many other areas of health, including:
- cardiovascular disease
- stroke risk
- mood instability
- nerve damage in extremities
On the flipside, if the blood vessels do get regular practice at dilating and constricting, you might enjoy lower risk of those things, and instead:
- improved immune response
- healthier skin
- better quality sleep
- more energy and alertness
- improved sexual performance/responsiveness
So, how to get that, without getting extreme?
As today’s title suggests, “a cold shower a day” is a great practice.
You don’t have to jump straight in, especially if you think your circulation and vascular responses might be a bit sluggish in the first instance. In fact, Wim Hof recommends:
- Week 1: Thirty seconds of cold water at the end of a warm shower each morning
- Week 2: One minute of cold water at the end of a warm shower each morning
- Week 3: A minute and a half of cold water at the end of a warm shower each morning
- Week 4: Two minutes of cold water at the end of a warm shower each morning
How cold is cold?
The benefits of cold exposure begin at around 16ºC / 60ºF, so in most places, water from the cold water mains is sufficiently cold.
As your body becomes more used to making the quick-change on a vascular level, the cold water will seem less shocking to your system. In other words, on day 30 it won’t hit you like it did on day one.
At that point, you can either continue with your two-minutes daily cold shower, and reap the benefits, or if you’re curious to push it further, that’s where ice baths come in!
Can anyone do it, or are any conditions contraindicated?
As ever, we’re a health and productivity newsletter, not doctors, let alone your doctors. Nothing here is medical advice. However, Wim Hof himself says:
❝Listen to your body, and never force the practices. We advise against doing Wim Hof Method if you are dealing with any of the following:
- Epilepsy
- High blood pressure
- Coronary heart disease
- A history of serious healthy issues like heart failure or stroke
- Pregnancy*
- Childhood*❞
*There is simply not enough science regarding the effects of cold exposure on people who are pregnant, or children. Obviously, we don’t expect this to be remedied anytime soon, because the study insitutions’ ethics boards would (rightly!) hold up the study.
As for the other conditions, and just generally if unsure, consult a doctor.
As you can see, this does mean that a limitation of Cold Therapy is that it appears to be far better as a preventative, since it helps guard against the very conditions that could otherwise become contraindications.
We haven’t peppered today’s main feature with study papers, partly because Wim Hof’s own website has kindly collated a collection of them (with links and summaries!) onto one page:
Further reading: The Science Behind The Wim Hof Method
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Reclaiming Body Trust – by Hilary Kinavey & Dana Sturtevant
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Authored by a therapist and a dietician, this book draws from both of their extensive professional clinical experiences, to explore how we can (often early in our lives) be led into disordered thinking when it comes to food and our bodies, and how we can “take back that which has been stolen from us”.
More prosaically: the presented goal here is for us to each figure out where we are with our own body, and how we might build our relationship with same going forwards, in the way that will work the best for us.
The style is relaxed and conversational, while taking care to cover topics that are often tricky with no less seriousness. Chapter headings such as “Your coping is rooted in wisdom”, “What does grief have to do with it?” and “Allowing for pleasure and satisfaction” give an idea of the flavors at hand here.
Bottom line: if you think your relationship with food and your body could be better, not only are you probably right, but also, this book can help.
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When Did You Last Have a Cognitive Health Check-Up?
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When Did You Last Have a Cognitive Health Check-Up?
Regular health check-ups are an important part of a good health regime, especially as we get older. But after you’ve been prodded, probed, sampled and so forth… When did you last have a cognitive health check-up?
Keeping on top of things
In our recent Monday Research Review main feature about citicoline, we noted that it has beneficial effects for a lot of measures of cognitive health.
And that brought us to realize: just how on top of this are we?
Your writer here today could tell you what her sleep was like on any night in the past year, what her heart rate was like, her weight, and all that. Moods too! There’s an app for that. But cognitive health? My last IQ test was in 2001, and I forget when my last memory test was.
It’s important to know how we’re doing, or else how to we know if there has been some decline? We’ve talked previously about the benefits of brain-training of various kinds to improve cognition, so in some parts we’ll draw on the same resources today, but this time the focus is on getting quick measurements that we can retest regularly (mark the calendar!)
Some quick-fire tests
These tests are all free, quick, and accessible. Some of them will try to upsell you on other (i.e. paid) services; we leave that to your own discretion, but the things we’ll be using today are free.
Test your verbal memory
This one’s a random word list generator. It defaults to 12 words, but you can change that if you like. Memorize the words, and then test yourself by seeing how many you can write down from memory. If it gets too easy, crank up the numbers.
Test your visual memory
This one’s a series of images; the test is to click to say whether you’ve seen this exact image previously in the series or not.
Test your IQ
This one’s intended to be general purpose intelligence; in reality, IQ tests have their flaws too, but it’s not a bad metric to keep track of. Just don’t get too hung up on the outcome, and remember, your only competition is yourself!
Test your attention / focus
This writer opened this and this three other attention tests (to get you the best one) before getting distracted, noting the irony, and finally taking the test. Hopefully you can do better!
Test your creativity
This one’s a random object generator. Give yourself a set period of time (per your preference, but make a note of the time you allow yourself, so that you can use the same time period when you retest yourself at a later date) in which to list as many different possible uses for the item.
Test your musical sense
This one’s a pitch recognition test. So, with the caveat that it is partially testing your hearing as well as your cognition, it’s a good one to take and regularly retest in any case.
How often should you retest?
There’s not really any “should” here, but to offer some advice:
- If you take them too often, you might find you get bored of doing so and stop, essentially burning out.
- If you don’t take them regularly, you may forget, lose this list of tests, etc.
- Likely a good “sweet spot” is quarterly or six-monthly, but there’s nothing wrong with testing annually either.
It’s all about the big picture, after all.
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Can We Drink To Good Health?
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Can we drink to good health?
We asked you for your thoughts on alcohol and heart health, and we got quite an even spread of results!
If perchance that’s too tiny to read, the figures were:
- 32% voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!”
- 32% voted for: “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️”
- 36% voted for: “Alcohol is bad for pretty much everything, including heart health ✋”
One subscriber who voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!” added the following thoughts:
❝While it isn’t necessary to consume alcohol, moderate amounts can be beneficial and contribute to well-being through social activity, celebrations, etc.❞
That’s an interesting point, and definitely many people do see alcohol that way! Of course, that does not mean that one will find no social activities, celebrations, etc, in parts of the world where alcohol consumption is uncommon. Indeed, in India, wedding parties where no alcohol is consumed can go on for days!
But, “we live in a society” and all that, and while we’re a health newsletter not a social issues newsletter, it’d be remiss of us to not acknowledge the importance of socialization for good mental health—and thus the rest of our health too.
So, if indeed all our friends and family drink alcohol, it can certainly make abstaining more of a challenge.
On that note, let’s take a moment to consider “The French Paradox” (an observation of a low prevalence of ischemic heart disease despite high intakes of saturated fat, a phenomenon accredited to the consumption of red wine).
As it happens, a comprehensive review in “Circulation”, a cardiovascular health journal, has suggested the French Paradox may not be so paradoxical after all.
Research suggests it has more to do with other lifestyle factors (and historic under-reporting of cardiovascular disease by French doctors), which would explain why Japan has lower rates of heart disease, despite drinking little wine, and more beer and spirits.
So, our subscriber’s note may not be completely without reason! It’s just about the party, not the alcohol.
One subscriber who voted for “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️” wrote:
❝Keeping in mind, moderate means one glass of wine for women a day and two for men. Hard alcohol doesn’t have the same heart benefits as wine❞
That is indeed the guideline according to some health bodies!
In other places with different guiding advisory bodies, that’s been dropped down to one a day for everyone (the science may be universal, but how government institutions interpret that is not).
About that wine… Specifically, red wine, for its resveratrol content:
While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, you might even need more.
To this end, many people prefer resveratrol supplementation. ← link is to an example product, but there are plenty more so feel free to shop around
A subscriber who voted for “Alcohol is bad for pretty much everything, including heart health ✋” says:
❝New guidelines suggest 1 to 2 drinks a week are okay but the less the better.❞
If you haven’t heard these new guidelines, we’ll mention again: every government has its own official bodies and guidelines so perhaps your local guidelines differ, but for example here’s what that World Health Organization has to say (as of January this year):
WHO: No level of alcohol consumption is safe for our health
So, whom to believe? The governments who hopefully consider the welfare of their citizenry more important than the tax dollars from alcohol sales, or the World Health Organization?
It’s a tough one, but we’ll always err on the side of the science.
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Is chocolate milk a good recovery drink after a workout? A dietitian reviews the evidence
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Whether you enjoy chocolate milk regularly, as a weekend treat, or as an occasional dose of childhood nostalgia, it probably wouldn’t be the first option you think of for post-workout recovery.
Unless you’re on TikTok, perhaps. According to many people on the social media platform, chocolate milk is not only delicious, but it offers benefits comparable to sports drinks after a workout.
So is there any evidence to support this? Let’s take a look.
Rehydrating after a workout is important
Water accounts for somewhere between 50% and 60% of our body weight. Water has many important functions in the body, including helping to keep our body at the right temperature through sweating.
We lose water naturally from our bodies when we sweat, as well as through our breathing and when we go to the toilet. So it’s important to stay hydrated to replenish the water we lose.
When we don’t, we become dehydrated, which can put a strain on our bodies. Signs and symptoms of dehydration can range from thirst and dizziness to low blood pressure and confusion.
Athletes, because of their higher levels of exertion, lose more water through sweating and from respiration (when their breathing rate gets faster). If they’re training or competing in hot or humid environments they will sweat even more.
Dehydration impacts athletes’ performance and like for all of us, can affect their health.
So finding ways to ensure athletes rehydrate quickly during and after they train or compete is important. Fortunately, sports scientists and dietitians have done research looking at the composition of different fluids to understand which ones rehydrate athletes most effectively.
The beverage hydration index
The best hydrating drinks are those the body retains the most of once they’ve been consumed. By doing studies where they give people different drinks in standardised conditions, scientists have been able to determine how various options stack up.
To this end, they’ve developed something called the beverage hydration index, which measures to what degree different fluids hydrate a person compared to still water.
According to this index beverages with similar fluid retention to still water include sparkling water, sports drinks, cola, diet cola, tea, coffee, and beer below 4% alcohol. That said, alcohol is probably best avoided when recovering from exercise.
Beverages with superior fluid retention to still water include milk (both full-fat and skim), soy milk, orange juice and oral rehydration solutions.
This body of research indicates that when it comes to rehydration after exercise, unflavoured milk (full fat, skim or soy) is better than sports drinks.
But what about chocolate milk?
A small study looked at the effects of chocolate milk compared to plain milk on rehydration and exercise performance in futsal players (futsal is similar to soccer but played on a court indoors). The researchers found no difference in rehydration between the two. There’s no other published research to my knowledge looking at how chocolate milk compares to regular milk for rehydration during or after exercise.
But rehydration isn’t the only thing athletes look for in sports drinks. In the same study, drinking chocolate milk after play (referred to as the recovery period) increased the time it took for the futsal players to become exhausted in further exercise (a shuttle run test) four hours later.
This was also shown in a review of several clinical trials. The analysis found that, compared to different placebos (such as water) or other drinks containing fat, protein and carbohydrates, chocolate milk lengthened the time to exhaustion during exercise.
What’s in chocolate milk?
Milk contains protein, carbohydrates and electrolytes, each of which can affect hydration, performance, or both.
Protein is important for building muscle, which is beneficial for performance. The electrolytes in milk (including sodium and potassium) help to replace electrolytes lost through sweating, so can also be good for performance, and aid hydration.
Compared to regular milk, chocolate milk contains added sugar. This provides extra carbohydrates, which are likewise beneficial for performance. Carbohydrates provide an immediate source of energy for athletes’ working muscles, where they’re stored as glycogen. This might contribute to the edge chocolate milk appears to have over plain milk in terms of athletic endurance.
Coffee-flavoured milk has an additional advantage. It contains caffeine, which can improve athletic performance by reducing the perceived effort that goes into exercise.
One study showed that a frappe-type drink prepared with filtered coffee, skim milk and sugar led to better muscle glycogen levels after exercise compared to plain milk with an equivalent amount of sugar added.
So what’s the verdict?
Evidence shows chocolate milk can rehydrate better than water or sports drinks after exercise. But there isn’t evidence to suggest it can rehydrate better than plain milk. Chocolate milk does appear to improve athletic endurance compared to plain milk though.
Ultimately, the best drink for athletes to consume to rehydrate is the one they’re most likely to drink.
While many TikTok trends are not based on evidence, it seems chocolate milk could actually be a good option for recovery from exercise. And it will be cheaper than specialised sports nutrition products. You can buy different brands from the supermarket or make your own at home with a drinking chocolate powder.
This doesn’t mean everyone should look to chocolate milk when they’re feeling thirsty. Chocolate milk does have more calories than plain milk and many other drinks because of the added sugar. For most of us, chocolate milk may be best enjoyed as an occasional treat.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The “Love Drug”
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Get PEA-Brained!
Today we’ll be looking at phenylethylamine, or PEA, to its friends.
Not to be mistaken for the related amino acid phenylalanine! Both ultimately have effects on the dopaminergic system, but the process and benefits are mostly quite different.
We thought we’d do this one in the week of Valentine’s Day, because of its popular association with love:
❝Phenylethylamine (PEA), an amphetamine-like substance that has been alluringly labeled the “chemical of love,” makes the best case for the love-chocolate connection since it has been shown that people in love may actually have higher levels of PEA in their brain, as surmised from the fact that their urine is richer in a metabolite of this compound. In other words, people thrashing around in the throes of love pee differently from others.❞
Source: Office for Science and Society | The Chemical of Love
What is it?
It’s an amino acid. Because we are mammals, we can synthesize it inside our bodies, so it’s not considered an “essential amino acid”, i.e. one that we need to get from our diet. It is found in some foods, though, including:
- Other animals, especially other mammals
- Various beans, legumes, nuts, seeds. In particular almonds, soybeans, lentils, and chickpeas score highly
- Fermented foods
- Chocolate (popular lore holds this to be a good source of PEA; science finds it to be a fair option, but not in the same ballpark as the other items)
Fun fact: the reason Marvel’s Venom has a penchant for eating humans and chocolate is (according to the comics) because phenylethylamine is an essential amino acid for it.
What does it do for us?
It’s a Central Nervous System (CNS) stimulant, and also helps us synthesize critical neurotransmitters such as dopamine, norepinephrine (adrenaline) and serotonin:
It works similarly, but not identically, to amphetamines:
Is it safe?
We normally do this after the benefits, but “it works similarly to amphetamines” may raise an eyebrow or two, so let’s do it here:
- It is recommended to take no more than 500mg/day, with 100mg–500mg being typical doses
- It is not recommended to take it at all if you have, or have a predisposition to, any kind of psychotic disorder (especially schizophrenia, or bipolar disorder wherein you sometimes experience mania)
- This isn’t a risk for most people, but if you fall into the above category, the elevated dopamine levels could nudge you into a psychotic/manic episode that you probably don’t want.
See for example: Does phenylethylamine cause schizophrenia?
There are other contraindications too, so speak with your doctor/pharmacist before trying it.
On the other hand, if you are considering ADHD medication, then phenylethylamine could be a safer thing to try first, to see if it helps, before going to the heavy guns of actual amphetamines (as are commonly prescribed for ADHD). Same goes for depression and antidepressants.
What can I expect from PEA?
More dopamine, norepinephrine, and serotonin. Mostly the former two. Which means, you can expect stimulation.
For focus and attention, it’s so effective that it has been suggested (as we mentioned above) as a safer alternative to ADHD meds:
β-phenylethylamine, a small molecule with a large impact
…and may give similar benefits to people without ADHD, namely improved focus, attention, and mental stamina:
It also improves mood:
❝Phenylethylamine (PEA), an endogenous neuroamine, increases attention and activity in animals and has been shown to relieve depression in 60% of depressed patients. It has been proposed that PEA deficit may be the cause of a common form of depressive illness.
Effective dosage did not change with time. There were no apparent side effects. PEA produces sustained relief of depression in a significant number of patients, including some unresponsive to the standard treatments. PEA improves mood as rapidly as amphetamine but does not produce tolerance.❞
Source: Sustained antidepressant effect of PEA replacement
Where can I get it?
We don’t sell it, but here is an example product on Amazon for your convenience
Enjoy!
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