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:

…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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  • Why You Can’t Deep Squat (And the Benefits You’re Missing)

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    Matt Hsu fought his own battle with chronic pain from the age of 16 in his feet, knees, hips, back, shoulders, elbows, forearms, wrists, hands, and head. Seeking answers, he’s spent a career in corrective exercise, posture alignment, structural integration, orthopedic exercise, sports medicine, and has more certifications than we care to list. In short, he knows his stuff.

    Yes you can (with some work)

    The deep squat, also called Asian squat, Slav squat, sitting squat, resting squat, primal squat, and various other names, is an important way of sitting that has implications for a lot of aspects of health.

    Why it’s so important: it preserves the mobility of our hips, ankles, and everything in between, and maintaining especially the hip mobility makes a big difference not only to general health, but also to reducing the risk of injury. It also maintains lower body strength, making falls in older age less likely in the first place, and if falls do happen, makes injury less likely, and if injury does happen, makes the injury likely less severe.

    An important misconception: there is a popular, but unfounded, belief that the ability or inability to do this is decided by genes—or if not outright decided, that at the very least Asians and Slavs have a genetic advantage. However, this is simply not true. Westerners and others can learn to do it just fine, and on the flipside, Asians and Slavs who grew up in the West may often struggle with it. The truth is, the deciding factor is lifestyle: if your culture involves sitting this way more often, you’ll be able to do it more comfortably and easily than if you’re just now trying it for the first time.

    Factors that you can control: you can’t change where you grew up, but you can change how you sit down now. Achieving the squat requires repeated position practice, and the more frequently you do so (even if you just start with a few seconds and work your way up to longer periods), the better you’ll get at it. And, on the contrary, sitting in chairs weakens and shortens the muscles involved, so any time you spend sitting in chairs is working against you. There are many reasons it’s advisable to avoid sitting in chairs more than necessary, and this is one of them.

    10almonds tip: a limiting factor for many people initially is ankle flexibility, which may result in one’s center of gravity being a bit far back, leading to a tendency to have to change something to avoid toppling over backwards. Rather than holding onto something immobile (e.g. furniture) in front of where you are sitting, consider simply holding an object in front of you in your hands. A book is a fine example; holding that in front of you (feel free to read the book) will shift your center of gravity forwards a bit, and will thus allow you to sit there a little longer, thus improving your strength and flexibility while you do, until you can do it without holding something in front of you. If you try with a book and you’re still prone to toppling backwards, try with something heavier, but do use the minimum weight necessary, because ultimately the counterbalance is just a crutch to get you to where you need to be.

    For more visual advice on how to do it, enjoy:

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  • 4 Ways Vaccine Skeptics Mislead You on Measles and More

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    Measles is on the rise in the United States. In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the Centers for Disease Control and Prevention. Half of the people infected — mainly children — have been hospitalized.

    It’s going to get worse, largely because a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines. KFF Health News examined the rhetoric and explains why it’s misguided:

    The No-Big-Deal Trope

    A common distortion is that vaccines aren’t necessary because the diseases they prevent are not very dangerous, or too rare to be of concern. Cynics accuse public health officials and the media of fear-mongering about measles even as 19 states report cases.

    For example, an article posted on the website of the National Vaccine Information Center — a regular source of vaccine misinformation — argued that a resurgence in concern about the disease “is ‘sky is falling’ hype.” It went on to call measles, mumps, chicken pox, and influenza “politically incorrect to get.”

    Measles kills roughly 2 of every 1,000 children infected, according to the CDC. If that seems like a bearable risk, it’s worth pointing out that a far larger portion of children with measles will require hospitalization for pneumonia and other serious complications. For every 10 measles cases, one child with the disease develops an ear infection that can lead to permanent hearing loss. Another strange effect is that the measles virus can destroy a person’s existing immunity, meaning they’ll have a harder time recovering from influenza and other common ailments.

    Measles vaccines have averted the deaths of about 94 million people, mainly children, over the past 50 years, according to an April analysis led by the World Health Organization. Together with immunizations against polio and other diseases, vaccines have saved an estimated 154 million lives globally.

    Some skeptics argue that vaccine-preventable diseases are no longer a threat because they’ve become relatively rare in the U.S. (True — due to vaccination.) This reasoning led Florida’s surgeon general, Joseph Ladapo, to tell parents that they could send their unvaccinated children to school amid a measles outbreak in February. “You look at the headlines and you’d think the sky was falling,” Ladapo said on a News Nation newscast. “There’s a lot of immunity.”

    As this lax attitude persuades parents to decline vaccination, the protective group immunity will drop, and outbreaks will grow larger and faster. A rapid measles outbreak hit an undervaccinated population in Samoa in 2019, killing 83 people within four months. A chronic lack of measles vaccination in the Democratic Republic of the Congo led to more than 5,600 people dying from the disease in massive outbreaks last year.

    The ‘You Never Know’ Trope

    Since the earliest days of vaccines, a contingent of the public has considered them bad because they’re unnatural, as compared with nature’s bounty of infections and plagues. “Bad” has been redefined over the decades. In the 1800s, vaccine skeptics claimed that smallpox vaccines caused people to sprout horns and behave like beasts. More recently, they blame vaccines for ailments ranging from attention-deficit/hyperactivity disorder to autism to immune system disruption. Studies don’t back the assertions. However, skeptics argue that their claims remain valid because vaccines haven’t been adequately tested.

    In fact, vaccines are among the most studied medical interventions. Over the past century, massive studies and clinical trials have tested vaccines during their development and after their widespread use. More than 12,000 people took part in clinical trials of the most recent vaccine approved to prevent measles, mumps, and rubella. Such large numbers allow researchers to detect rare risks, which are a major concern because vaccines are given to millions of healthy people.

    To assess long-term risks, researchers sift through reams of data for signals of harm. For example, a Danish group analyzed a database of more than 657,000 children and found that those who had been vaccinated against measles as babies were no more likely to later be diagnosed with autism than those who were not vaccinated. In another study, researchers analyzed records from 805,000 children born from 1990 through 2001 and found no evidence to back a concern that multiple vaccinations might impair children’s immune systems.

    Nonetheless, people who push vaccine misinformation, like candidate Robert F. Kennedy Jr., dismiss massive, scientifically vetted studies. For example, Kennedy argues that clinical trials of new vaccines are unreliable because vaccinated kids aren’t compared with a placebo group that gets saline solution or another substance with no effect. Instead, many modern trials compare updated vaccines with older ones. That’s because it’s unethical to endanger children by giving them a sham vaccine when the protective effect of immunization is known. In a 1950s clinical trial of polio vaccines, 16 children in the placebo group died of polio and 34 were paralyzed, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and author of a book on the first polio vaccine.

    The Too-Much-Too-Soon Trope

    Several bestselling vaccine books on Amazon promote the risky idea that parents should skip or delay their children’s vaccines. “All vaccines on the CDC’s schedule may not be right for all children at all times,” writes Paul Thomas in his bestselling book “The Vaccine-Friendly Plan.” He backs up this conviction by saying that children who have followed “my protocol are among the healthiest in the world.”

    Since the book was published, Thomas’ medical license was temporarily suspended in Oregon and Washington. The Oregon Medical Board documented how Thomas persuaded parents to skip vaccines recommended by the CDC, and reported that he “reduced to tears” a mother who disagreed.  Several children in his care came down with pertussis and rotavirus, diseases easily prevented by vaccines, wrote the board. Thomas recommended fish oil supplements and homeopathy to an unvaccinated child with a deep scalp laceration, rather than an emergency tetanus vaccine. The boy developed severe tetanus, landing in the hospital for nearly two months, where he required intubation, a tracheotomy, and a feeding tube to survive.

    The vaccination schedule recommended by the CDC has been tailored to protect children at their most vulnerable points in life and minimize side effects. The combination measles, mumps, and rubella vaccine isn’t given for the first year of a baby’s life because antibodies temporarily passed on from their mother can interfere with the immune response. And because some babies don’t generate a strong response to that first dose, the CDC recommends a second one around the time a child enters kindergarten because measles and other viruses spread rapidly in group settings.

    Delaying MMR doses much longer may be unwise because data suggests that children vaccinated at 10 or older have a higher chance of adverse reactions, such as a seizure or fatigue.

    Around a dozen other vaccines have discrete timelines, with overlapping windows for the best response. Studies have shown that MMR vaccines may be given safely and effectively in combination with other vaccines.

    ’They Don’t Want You to Know’ Trope

    Kennedy compares the Florida surgeon general to Galileo in the introduction to Ladapo’s new book on transcending fear in public health. Just as the Roman Catholic inquisition punished the renowned astronomer for promoting theories about the universe, Kennedy suggests that scientific institutions oppress dissenting voices on vaccines for nefarious reasons.

    “The persecution of scientists and doctors who dare to challenge contemporary orthodoxies is not a new phenomenon,” Kennedy writes. His running mate, lawyer Nicole Shanahan, has campaigned on the idea that conversations about vaccine harms are censored and the CDC and other federal agencies hide data due to corporate influence.

    Claims like “they don’t want you to know” aren’t new among the anti-vaccine set, even though the movement has long had an outsize voice. The most listened-to podcast in the U.S., “The Joe Rogan Experience,” regularly features guests who cast doubt on scientific consensus. Last year on the show, Kennedy repeated the debunked claim that vaccines cause autism.

    Far from ignoring that concern, epidemiologists have taken it seriously. They have conducted more than a dozen studies searching for a link between vaccines and autism, and repeatedly found none. “We have conclusively disproven the theory that vaccines are connected to autism,” said Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in Australia. “So, the public health establishment tends to shut those conversations down quickly.”

    Federal agencies are transparent about seizures, arm pain, and other reactions that vaccines can cause. And the government has a program to compensate individuals whose injuries are scientifically determined to result from them. Around 1 to 3.5 out of every million doses of the measles, mumps, and rubella vaccine can cause a life-threatening allergic reaction; a person’s lifetime risk of death by lightning is estimated to be as much as four times as high.

    “The most convincing thing I can say is that my daughter has all her vaccines and that every pediatrician and public health person I know has vaccinated their kids,” Meyerowitz-Katz said. “No one would do that if they thought there were serious risks.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • 4 Critical Things Female Runners Should Know

    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.

    When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:

    Don’t let menopause run you down

    1. Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
    2. Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
    3. Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
    4. Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.

    For more on each of these (and some bonus comments about mobility training for runners), enjoy:

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  • 6 Kinds Of Drinks That Hasten Dementia

    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.

    Dr. William Li, most well-known for his diabetes expertise (remember that there are clear associations between diabetes and dementia), discusses drinks you might want to skip:

    Here’s to your good health

    The 6 kinds of drink are:

    • Alcohol which is bad for pretty much everything and this is no exception. Can cause a deficiency of thiamine, brain-shrinking, neuroinflammation, oxidative stress, and resultant neuron damage.
    • Soda / diet soda, the former of which is bad for the diabetes-dementia connection, and the latter of which is also usually (depends on the sweetener) harmful to the gut and thus the gut-brain connection.
    • Fruit juices, especially if processed, as the high sugar and zero or nearly-zero fiber can lead to insulin resistance, affecting the brain’s energy processing. In particular, fruit juice drinks sweetened with high-fructose corn syrup (HFCS) can accumulated as fat in the brain (due to how the body processes fructose in the absence of fiber to slow it down), impacting cognition.
    • Energy drinks, being basically the same as soda / diet soda, just now with added caffeine too.
    • [Caffeinated] late-night coffee, can (shocking nobody) disrupt sleep, and chronic sleep deprivation contributes to the build-up of harmful brain plaques.
    • Sports drinks, which (unless you’re super-sure about everything on the label; there are some good sports drinks out there) often contain HFCS in the US, along with various other additives that may not always be great for you. Also, the sodium content of electrolyte drinks are fine if you genuinely are actively sweating it out, but otherwise, can lead to high blood pressure, which is itself a dementia risk factor.

    Better options include:

    • decaffeinated coffee (or coffee enjoyed in the early afternoon)
    • green tea
    • turmeric-based drinks

    Dr. Li mentions turmeric milk drinks, but unfermented dairy is generally inflammatory, so better to make it kefir (fermented milk drink) or plant-based. Or just have a turmeric tea; that works too.

    Dr. Li also mentions berry smoothies, which are not nearly as bad as fruit juice, but still not as good as eating whole berries.

    For more on all of this, enjoy:

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    Reduce Your Alzheimer’s Risk

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  • A Urologist Explains Edging: What, Why, & Is It Safe?

    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.

    “Edging” is the practice of intentionally delaying orgasm, which can be enjoyed by anyone, with a partner or alone.

    On the edge

    Question: why?

    Answer: the more tension is built up, the stronger the orgasm can be at the end of it. And, even before then, pleasure along the way is pleasure along the way, which is generally considered a good thing—especially for any (usually but not always women, for hormonal and social reasons) who find it difficult to orgasm. It’s also a great way to experiment and learn more about one’s own body and/or that of one’s partner(s), personal responses, and so forth. Also, for any (usually but not always men, for hormonal reasons) who find they usually orgasm sooner than they’d like, it’s a great way to change that, if changing that is what’s wanted.

    Bonus answer: for some (usually but not always men, for hormonal reasons) who find they have an uncomfortable slump in mood after orgasm, that can simply be skipped entirely, postponed for another time, etc, with pleasure being derived from the sexual activity rather than orgasm. That way, there’s a lasting dopamine high, with no prolactin crash afterwards ← this is very much tied to male hormones, by the way. If you have female hormones, there’s usually no prolactin crash either way, and instead, the post-orgasm spike in oxytocin is stronger, and a wave of serotonin makes the later decline of dopamine much more gentle.

    Question: can it cause any problems?

    Answer: yep! Or rather, subjectively, it may be considered so—this is obviously a personal matter and your mileage may vary. The main problem it may cause is that if practised habitually, it may result in greater difficulty achieving orgasm, simply because the body has got used to “ok, when we do this (sex/masturbation), we are in no particular rush to do that (orgasm)”. So whether not this would be a worry for you is down to any given individual. Lastly, if your intent was a long edging session with an orgasm at the end and then something happened to interrupt that, then your orgasm may be unintentionally postponed to another time, which again, may be more or less of an issue depending on your feelings about that.

    For more on these things including advice on how to try it, enjoy:

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  • The End of Old Age – by Dr. Marc Agronin

    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.

    First, what this book is not: a book about ending aging. For that, you would want to check out “Ending Aging”, by Dr. Aubrey de Grey.

    What this book actually is: a book about the purpose of aging. As in: “aging: to what end?”, and then the book answers that question.

    Rather than viewing aging as solely a source of decline, this book (while not shying away from that) resolutely examines the benefits of old age—from clinically defining wisdom, to exploring the many neurological trade-offs (e.g., “we lose this thing but we get this other thing in the process”), and the assorted ways in which changes in our brain change our role in society, without relegating us to uselessness—far from it!

    The style of the book is deep and meaningful prose throughout. Notwithstanding the author’s academic credentials and professional background in geriatric psychiatry, there’s no hard science here, just comprehensible explanations of psychiatry built into discussions that are often quite philosophical in nature (indeed, the author additionally has a degree in psychology and philosophy, and it shows).

    Bottom line: if you’d like your own aging to be something you understand better and can actively work with rather than just having it happen to you, then this is an excellent book for you.

    Click here to check out The End Of Old Age, and live it!

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