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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  • Total Recovery – by Dr. Gary Kaplan

    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, know: Dr. Kaplan is an osteopath, and as such, will be mostly approaching things from that angle. That said, he is also board certified in other things too, including family medicine, so he’s by no means a “one-trick pony”, nor are there “when your only tool is a hammer, everything starts to look like a nail” problems to be found here. Instead, the scope of the book is quite broad.

    Dr. Kaplan talks us through the diagnostic process that a doctor goes through when presented with a patient, what questions need to be asked and answered—and by this we mean the deeper technical questions, e.g. “what do these symptoms have in common”, and “what mechanism was at work when the pain become chronic”, not the very basic questions asked in the initial debriefing with the patient.

    He also asks such questions (and questions like these get chapters devoted to them) as “what if physical traumas build up”, and “what if physical and emotional pain influence each other”, and then examines how to interrupt the vicious cycles that lead to deterioration of one’s condition.

    The style of the book is very pop-science and often narrative in its presentation, giving lots of anecdotes to illustrate the principles. It’s a “sit down and read it cover-to-cover” book—or a chapter a day, whatever your preferred pace; the point is, it’s not a “dip directly to the part that answers your immediate question” book; it’s not a textbook or manual.

    Bottom line: a lot of this work is about prompting the reader to ask the right questions to get to where we need to be, but there are many illustrative possible conclusions and practical advices to be found and given too, making this a useful read if you and/or a loved one suffers from chronic pain.

    Click here to check out Total Recovery, and solve your own mysteries!

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  • Black Bean & Butternut Balti

    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.

    Protein, fiber, and pungent polyphenols abound in this tasty dish that’s good for your gut, heart, brain, and more:

    You will need

    • 2 cans (each 14 oz or thereabouts) black beans, drained and rinsed (or: 2 cups black beans, cooked, drained, and rinsed)
    • 1 butternut squash, peeled and cut into ½” cubes
    • 1 cauliflower, cut into florets
    • 1 red onion, finely chopped
    • 1 can (14 oz or thereabouts) chopped tomatoes
    • 1 cup coconut milk
    • ½ bulb garlic, crushed
    • 1″ piece of fresh ginger, peeled and finely chopped
    • 1 fresh red chili (or multiply per your preference and the strength of your chilis), finely chopped
    • 1 tbsp black pepper, coarse ground
    • 1 tbsp garam masala
    • 2 tsp cumin seeds
    • 2 tsp ground coriander
    • 1 tsp ground turmeric
    • 1 tsp ground paprika
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Juice of ½ lemon
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 400℉ / 200℃.

    2) Toss the squash and cauliflower in a little olive oil, to coat evenly. No need to worry about seasoning, because these are going into the curry later and will get plenty there.

    3) Roast them on a baking tray lined with baking paper for about 25 minutes.

    You can enjoy a 10-minute break for the first 10 minutes of that, before continuing, such that the timing will be perfect:

    4) Heat a little oil in a sauté pan (or anything that’s suitable for both frying and adding volume; we’re going to be using the space later; everything is going in here!) and fry the onion on medium for about 5 minutes, stirring well.

    5) Add the spices/seasonings, including the garlic, ginger, and chili, and stir well to combine.

    6) Add the tomatoes, beans, and coconut milk, and simmer for 10 minutes. You can add a little water at any time if it seems to need it.

    7) Stir in the roasted vegetables (they should be finished now), and heat through. Add the lemon juice and stir.

    8) Serve as-is, or with your preferred carbohydrate (we recommend our Tasty Versatile Rice recipe), or if you have time, keep it warm for a while until you’re ready to use it (the flavors will benefit from this time, if available).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • In Vermont, Where Almost Everyone Has Insurance, Many Can’t Find or Afford Care

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    RICHMOND, Vt. — On a warm autumn morning, Roger Brown walked through a grove of towering trees whose sap fuels his maple syrup business. He was checking for damage after recent flooding. But these days, his workers’ health worries him more than his trees’.

    The cost of Slopeside Syrup’s employee health insurance premiums spiked 24% this year. Next year it will rise 14%.

    The jumps mean less money to pay workers, and expensive insurance coverage that doesn’t ensure employees can get care, Brown said. “Vermont is seen as the most progressive state, so how is health care here so screwed up?”

    Vermont consistently ranks among the healthiest states, and its unemployment and uninsured rates are among the lowest. Yet Vermonters pay the highest prices nationwide for individual health coverage, and state reports show its providers and insurers are in financial trouble. Nine of the state’s 14 hospitals are losing money, and the state’s largest insurer is struggling to remain solvent. Long waits for care have become increasingly common, according to state reports and interviews with residents and industry officials.

    Rising health costs are a problem across the country, but Vermont’s situation surprises health experts because virtually all its residents have insurance and the state regulates care and coverage prices.

    For more than 15 years, federal and state policymakers have focused on increasing the number of people insured, which they expected would shore up hospital finances and make care more available and affordable.

    “Vermont’s struggles are a wake-up call that insurance is only one piece of the puzzle to ensuring access to care,” said Keith Mueller, a rural health expert at the University of Iowa.

    Regulators and consultants say the state’s small, aging population of about 650,000 makes spreading insurance risk difficult. That demographic challenge is compounded by geography, as many Vermonters live in rural areas, where it’s difficult to attract more health workers to address shortages.

    At least part of the cost spike can be attributed to patients crossing state lines for quicker care in New York and Massachusetts. Those visits can be more expensive for both insurers and patients because of long ambulance rides and charges from out-of-network providers.

    Patients who stay, like Lynne Drevik, face long waits. Drevik said her doctor told her in April that she needed knee replacement surgeries — but the earliest appointment would be in January for one knee and the following April for the other.

    Drevik, 59, said it hurts to climb the stairs in the 19th-century farmhouse in Montgomery Center she and her husband operate as an inn and a spa. “My life is on hold here, and it’s hard to make any plans,” she said. “It’s terrible.”

    Health experts say some of the state’s health system troubles are self-inflicted.

    Unlike most states, Vermont regulates hospital and insurance prices through an independent agency, the Green Mountain Care Board. Until recently, the board typically approved whatever price changes companies wanted, said Julie Wasserman, a health consultant in Vermont.

    The board allowed one health system — the University of Vermont Health Network — to control about two-thirds of the state’s hospital market and allowed its main facility, the University of Vermont Medical Center in Burlington, to raise its prices until it ranked among the nation’s most expensive, she said, citing data the board presented in September.

    Hospital officials contend their prices are no higher than industry averages.

    But for 2025, the board required the University of Vermont Medical Center to cut the prices it bills private insurers by 1%.

    The nonprofit system says it is navigating its own challenges. Top officials say a severe lack of housing makes it hard to recruit workers, while too few mental health providers, nursing homes, and long-term care services often create delays in discharging patients, adding to costs.

    Two-thirds of the system’s patients are covered by Medicare or Medicaid, said CEO Sunny Eappen. Both government programs pay providers lower rates than private insurance, which Eappen said makes it difficult to afford rising prices for drugs, medical devices, and labor.

    Officials at the University of Vermont Medical Center point to several ways they are trying to adapt. They cited, for example, $9 million the hospital system has contributed to the construction of two large apartment buildings to house new workers, at a subsidized price for lower-income employees.

    The hospital also has worked with community partners to open a mental health urgent care center, providing an alternative to the emergency room.

    In the ER, curtains separate areas in the hallway where patients can lie on beds or gurneys for hours waiting for a room. The hospital also uses what was a storage closet as an overflow room to provide care.

    “It’s good to get patients into a hallway, as it’s better than a chair,” said Mariah McNamara, an ER doctor and associate chief medical officer with the hospital.

    For the about 250 days a year when the hospital is full, doctors face pressure to discharge patients without the ideal home or community care setup, she said. “We have to go in the direction of letting you go home without patient services and giving that a try, because otherwise the hospital is going to be full of people, and that includes people that don’t need to be here,” McNamara said.

    Searching for solutions, the Green Mountain Care Board hired a consultant who recommended a number of changes, including converting four rural hospitals into outpatient facilities, in a worst-case scenario, and consolidating specialty services at several others.

    The consultant, Bruce Hamory, said in a call with reporters that his report provides a road map for Vermont, where “the health care system is no match for demographic, workforce, and housing challenges.”

    But he cautioned that any fix would require sacrifice from everyone, including patients, employers, and health providers. “There is no simple single policy solution,” he said.

    One place Hamory recommended converting to an outpatient center only was North Country Hospital in Newport, a village in Vermont’s least populated region, known as the Northeast Kingdom.

    The 25-bed hospital has lost money for years, partly because of an electronic health record system that has made it difficult to bill patients. But the hospital also has struggled to attract providers and make enough money to pay them.

    Officials said they would fight any plans to close the hospital, which recently dropped several specialty services, including pulmonology, neurology, urology, and orthopedics. It doesn’t have the cash to upgrade patient rooms to include bathroom doors wide enough for wheelchairs.

    On a recent morning, CEO Tom Frank walked the halls of his hospital. The facility was quiet, with just 14 admitted patients and only a couple of people in the ER. “This place used to be bustling,” he said of the former pulmonology clinic.

    Frank said the hospital breaks even treating Medicare patients, loses money treating Medicaid patients, and makes money from a dwindling number of privately insured patients.

    The state’s strict regulations have earned it an antihousing, antibusiness reputation, he said. “The cost of health care is a symptom of a larger problem.”

    About 30 miles south of Newport, Andy Kehler often worries about the cost of providing health insurance to the 85 workers at Jasper Hill Farm, the cheesemaking business he co-owns.

    “It’s an issue every year for us, and it looks like there is no end in sight,” he said.

    Jasper Hill pays half the cost of its workers’ health insurance premiums because that’s all it can afford, Kehler said. Employees pay $1,700 a month for a family, with a $5,000 deductible.

    “The coverage we provide is inadequate for what you pay,” he said.

     

    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.

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

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  • Black Tea or Green Tea – Which is Healthier?

    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.

    Our Verdict

    When comparing black tea to green tea, we picked the black tea.

    Why?

    It was close! Ultimately we picked the black tea as the “best all-rounder”.

    Both teas are great for the health, insofar as tea in general is a) a very good way to hydrate (better absorption than plain water) and b) an excellent source of beneficial phytochemicals—mostly antioxidants of various kinds, but there’s a lot in there.

    We did a run-down previously of the relative benefits of each of four kinds of tea (black, white, green, red):

    Which Tea Is Best, By Science?

    Which concluded in its final summary:

    Black, white, green, and red teas all have their benefits, and ultimately the best one for you will probably be the one you enjoy drinking, and thus drink more of.

    If trying to choose though, we offer the following summary:

    • Black tea: best for total beneficial phytochemicals
    • White tea:best for your oral health
    • Green tea: best for your brain
    • ❤️ Red tea: best if you want naturally caffeine-free

    Enjoy!

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  • Honeydew vs Cantaloupe – Which is Healthier?

    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.

    Our Verdict

    When comparing honeydew to cantaloupe, we picked the cantaloupe.

    Why?

    In terms of macros, there’s not a lot between them—they’re both mostly water. Nominally, honeydew has more carbs while cantaloupe has more fiber and protein, but the differences are very small. So, a very slight win for cantaloupe.

    Looking at vitamins: honeydew has slightly more of vitamins B5 and B6 (so, the vitamins that are in pretty much everything), while cantaloupe has a more of vitamins A, B1, B2, B3, C, and E (especially notably 67x more vitamin A, whence its color). A more convincing win for cantaloupe.

    The minerals category is even more polarized: honeydew has more selenium (and for what it’s worth, more sodium too, though that’s not usually a plus for most of us in the industrialized world), while cantaloupe has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An overwhelming win for cantaloupe.

    No surprises: adding up the slight win for cantaloupe, the convincing win for cantaloupe, and the overwhelming win for cantaloupe, makes cantaloupe the overall best pick here.

    Enjoy!

    Want to learn more?

    You might like to read:

    From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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  • Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others

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    ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.

    Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.

    “He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.

    Warren told her the noise hurt.

    Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.

    The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.

    “I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.

    “It can get to the extreme where it can cause physical discomfort,” she said.

    When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.

    That can be stressful, not melodic, Follmer said.

    To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.

    “When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.

    Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.

    “For him, researching it and looking into it I think grounds him a little bit,” Reed said.

    Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.

    Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.

    “Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.

    For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.

    It’s not always bad, though. The cicada’s song can also be a relief.

    For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.

    “The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.

    As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.

    Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.

    “If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.

    Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.

    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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    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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