Neuroaffirming care values the strengths and differences of autistic people, those with ADHD or other profiles. Here’s how
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We’ve come a long way in terms of understanding that everyone thinks, interacts and experiences the world differently. In the past, autistic people, people with attention deficit hyperactive disorder (ADHD) and other profiles were categorised by what they struggled with or couldn’t do.
The concept of neurodiversity, developed by autistic activists in the 1990s, is an emerging area. It promotes the idea that different brains (“neurotypes”) are part of the natural variation of being human – just like “biodiversity” – and they are vital for our survival.
This idea is now being applied to research and to care. At the heart of the National Autism Strategy, currently in development, is neurodiversity-affirming (neuroaffirming) care and practice. But what does this look like?
Reframing differences
Neurodiversity challenges the traditional medical model of disability, which views neurological differences solely through a lens of deficits and disorders to be treated or cured.
Instead, it reframes it as a different, and equally valuable, way of experiencing and navigating the world. It emphasises the need for brains that are different from what society considers “neurotypical”, based on averages and expectations. The term “neurodivergent” is applied to Autistic people, those with ADHD, dyslexia and other profiles.
Neuroaffirming care can take many forms depending on each person’s needs and context. It involves accepting and valuing different ways of thinking, learning and experiencing the world. Rather than trying to “fix” or change neurodivergent people to fit into a narrow idea of what’s considered “normal” or “better”, neuroaffirming care takes a person-centered, strengths-based approach. It aims to empower and support unique needs and strengths.
Adaptation and strengths
Drawing on the social model of disability, neuroaffirming care acknowledges there is often disability associated with being different, especially in a world not designed for neurodivergent people. This shift focuses away from the person having to adapt towards improving the person-environment fit.
This can include providing accommodations and adapting environments to make them more accessible. More importantly, it promotes “thriving” through greater participation in society and meaningful activities.
At school, at work, in clinic
In educational settings, this might involve using universal design for learning that benefits all learners.
For example, using systematic synthetic phonics to teach reading and spelling for students with dyslexia can benefit all students. It also could mean incorporating augmentative and alternative communication, such as speech-generating devices, into the classroom.
Teachers might allow extra time for tasks, or allow stimming (repetitive movements or noises) for self-regulation and breaks when needed.
In therapy settings, neuroaffirming care may mean a therapist grows their understanding of autistic culture and learns about how positive social identity can impact self-esteem and wellbeing.
They may make efforts to bridge the gap in communication between different neurotypes, known as the double empathy problem. For example, the therapist may avoid relying on body language or facial expressions (often different in autistic people) to interpret how a client is feeling, instead of listening carefully to what the client says.
Affirming therapy approaches with children involve “tuning into” their preferred way of communicating, playing and engaging. This can bring meaningful connection rather than compliance to “neurotypical” ways of playing and relating.
In workplaces, it can involve flexible working arrangements (hours, patterns and locations), allowing different modes of communication (such as written rather than phone calls) and low-sensory workspaces (for example, low-lighting, low-noise office spaces).
In public spaces, it can look like providing a “sensory space”, such as at large concerts, where neurodivergent people can take a break and self-regulate if needed. And staff can be trained to recognise, better understand and assist with hidden disabilities.
Combining lived experience and good practice
Care is neuroaffirmative when it centres “lived experience” in its design and delivery, and positions people with disability as experts.
As a result of being “different”, people in the neurodivergent community experience high rates of bullying and abuse. So neuroaffirming care should be combined with a trauma-informed approach, which acknowledges the need to understand a person’s life experiences to provide effective care.
Culturally responsive care acknowledges limited access to support for culturally and racially marginalised Autistic people and higher rates of LGBTQIA+ identification in the neurodivergent community.
Authentic selves
The draft National Autism Strategy promotes awareness that our population is neurodiverse. It hopes to foster a more inclusive and understanding society.
It emphasises the societal and public health responsibilities for supporting neurodivergent people via public education, training, policy and legislation. By providing spaces and places where neurodivergent people can be their authentic, unmasked selves, we are laying the foundations for feeling seen, valued, safe and, ultimately, happy and thriving.
The author would like to acknowledge the assistance of psychologist Victoria Gottliebsen in drafting this article. Victoria is a member of the Oversight Council for the National Autism Strategy.
Josephine Barbaro, Associate Professor, Principal Research Fellow, Psychologist, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Does This New Machine Cure Depression?
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Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).
TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:
The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.
Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:
Antidepressants: Personalization Is Key!
Transcranial stimulation… At home?
Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).
First, what it’s not: electroconvulsive therapy (ECT). Rather, it uses a very low current.
What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.
In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).
See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies
And as for the study, here it is:
…which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…
Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:
Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode
This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.
And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.
Want something else against depression meanwhile?
Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:
The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like
Take care!
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What happens when I stop taking a drug like Ozempic or Mounjaro?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Drugs like Ozempic are very effective at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.
But does weight come back when you stop using it?
The short answer is yes. Stopping tirzepatide and semaglutide will result in weight regain in most people.
So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.
It’s a long-term treatment, not a short course
If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.
For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.
Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)
Obesity drugs only work while you’re taking them. KK Stock/Shutterstock Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.
Why do people stop?
Research trials show anywhere from 6% to 13.5% of participants stop taking these drugs, primarily because of side effects.
But these studies don’t account for those forced to stop because of cost or widespread supply issues. We don’t know how many people have needed to stop this medication over the past few years for these reasons.
Understanding what stopping does to the body is therefore important.
So what happens when you stop?
When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to move out of your system. As it does, a number of things happen:
- you start feeling hungry again, because both your brain and your gut no longer have the medication working to make you feel full
When you stop taking it, you feel hungry again. Stock-Asso/Shutterstock - blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a low glycemic index to stabilise your blood sugars
- over the longer term, most people experience a return to their previous blood pressure and cholesterol levels, as the weight comes back
- weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.
While you were on the medication, you will have lost proportionally less skeletal muscle than fat, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.
Is stopping and starting the medications a problem?
People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of yo-yo dieting.
When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to deal with spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can stress your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.
Interestingly, the risk to the body from weight fluctuations is greater for people who are not obese. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.
How can you avoid gaining weight when you stop?
Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:
- getting quality sleep
- exercising in a way that builds and maintains muscle. While on the medication, you will likely have lost muscle as well as fat, although this is not inevitable, especially if you exercise regularly while taking it
Prioritise building and maintaining muscle. EvMedvedeva/Shutterstock - addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is fat-phobic and discriminates against people in larger bodies
- eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.
Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.
Read the other articles in The Conversation’s Ozempic series here.
Natasha Yates, General Practitioner, PhD Candidate, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Apricots vs Oranges – Which is Healthier?
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Our Verdict
When comparing apricots to oranges, we picked the apricots.
Why?
Both are great, and it was close!
In terms of macros, apricots have more protein while oranges have more carbs and fiber, the ratio of of which means that apricots have the slightly lower glycemic index, though really, nobody is getting metabolic disease from eating whole fruit. All in all, we’ll call this category a tie.
In the category of vitamins, apricots have more of vitamins A, B3, E, and K, while oranges have more of vitamins B1, B9, C, and choline, meaning another tie in this category.
When it comes to minerals, apricots have more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while oranges have more calcium and selenium. A win for apricots, then!
In terms of beneficial phytochemicals, apricots have more, and you can read about some of them in the link below.
Adding up the sections makes for an overall win for apricots, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Top 8 Fruits That Prevent & Kill Cancer
Enjoy!
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People on Ozempic may have fewer heart attacks, strokes and addictions – but more nausea, vomiting and stomach pain
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Ozempic and Wegovy are increasingly available in Australia and worldwide to treat type 2 diabetes and obesity.
The dramatic effects of these drugs, known as GLP-1s, on weight loss have sparked huge public interest in this new treatment option.
However, the risks and benefits are still being actively studied.
In a new study in Nature Medicine, researchers from the United States reviewed health data from about 2.4 million people who have type 2 diabetes, including around 216,000 people who used a GLP-1 drug, between 2017 and 2023.
The researchers compared a range of health outcomes when GLP-1s were added to a person’s treatment plan, versus managing their diabetes in other ways, often using glucose-lowering medications.
Overall, they found people who used GLP-1s were less likely to experience 42 health conditions or adverse health events – but more likely to face 19 others.
myskin/Shutterstock What conditions were less common?
Cardiometabolic conditions
GLP-1 use was associated with fewer serious cardiovascular and coagulation disorders. This includes deep vein thrombosis, pulmonary embolism, stroke, cardiac arrest, heart failure and myocardial infarction.
Neurological and psychiatric conditions
GLP-1 use was associated with fewer reported substance use disorders or addictions, psychotic disorders and seizures.
Infectious conditions
GLP-1 use was associated with fewer bacterial infections and pneumonia.
What conditions were more common?
Gastrointestinal conditions
Consistent with prior studies, GLP-1 use was associated with gastrointestinal conditions such as nausea, vomiting, gastritis, diverticulitis and abdominal pain.
Other adverse effects
Increased risks were seen for conditions such as low blood pressure, syncope (fainting) and arthritis.
People who took Ozempic were more likely to experience stomach upsets than those who used other type 2 diabetes treatments. Douglas Cliff/Shutterstock How robust is this study?
The study used a large and reputable dataset from the US Department of Veterans Affairs. It’s an observational study, meaning the researchers tracked health outcomes over time without changing anyone’s treatment plan.
A strength of the study is it captures data from more than 2.4 million people across more than six years. This is much longer than what is typically feasible in an intervention study.
Observational studies like this are also thought to be more reflective of the “real world”, because participants aren’t asked to follow instructions to change their behaviour in unnatural or forced ways, as they are in intervention studies.
However, this study cannot say for sure that GLP-1 use was the cause of the change in risk of different health outcomes. Such conclusions can only be confidently made from tightly controlled intervention studies, where researchers actively change or control the treatment or behaviour.
The authors note the data used in this study comes from predominantly older, white men so the findings may not apply to other groups.
Also, the large number of participants means that even very small effects can be detected, but they might not actually make a real difference in overall population health.
Observational studies track outcomes over time, but can’t say what caused the changes. Jacob Lund/Shutterstock Other possible reasons for these links
Beyond the effect of GLP-1 in the body, other factors may explain some of the findings in this study. For example, it’s possible that:
- people who used GLP-1 could be more informed about treatment options and more motivated to manage their own health
- people who used GLP-1 may have received it because their health-care team were motivated to offer the latest treatment options, which could lead to better care in other areas that impact the risk of various health outcomes
- people who used GLP-1 may have been able to do so because they lived in metropolitan centres and could afford the medication, as well as other health-promoting services and products, such as gyms, mental health care, or healthy food delivery services.
Did the authors have any conflicts of interest?
Two of the study’s authors declared they were “uncompensated consultants” for Pfizer, a global pharmaceutical company known for developing a wide range of medicines and vaccines. While Pfizer does not currently make readily available GLP-1s such as Ozempic or Wegovy, they are attempting to develop their own GLP-1s, so may benefit from greater demand for these drugs.
This research was funded by the US Department of Veterans Affairs, a government agency that provides a wide range of services to military veterans.
No other competing interests were reported.
Diabetes vs weight-loss treatments
Overall, this study shows people with type 2 diabetes using GLP-1 medication generally have more positive health outcomes than negative health outcomes.
However, the study didn’t include people without type 2 diabetes. More research is needed to understand the effects of these medications in people without diabetes who are using them for other reasons, including weight loss.
While the findings highlight the therapeutic benefits of GLP-1 medications, they also raise important questions about how to manage the potential risks for those who choose to use this medication.
The findings of this study can help many people, including:
- policymakers looking at ways to make GLP-1 medications more widely available for people with various health conditions
- health professionals who have regular discussions with patients considering GLP-1 use
- individuals considering whether a GLP-1 medication is right for them.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Energize! – by Dr. Michael Breus & Stacey Griffith
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We previously reviewed another book book by Dr. Breus, The Power Of When. So what’s different in this one?
While the chronotypes featured in The Power Of When also feature here (and sufficient explanation is given to make this a fine stand-alone book), this book has a lot to do with metabolism also. By considering a person’s genetically predisposed metabolic rate to be fast, medium, or slow (per being an ectomorph, mesomorph, or endomorph), and then putting that next to one’s sleep chronotype, we get 12 sub-categories that in this book each get an optimized protocol of sleep, exercise (further divided into: what kind of exercise when), and eating/fasting.
Which, in effect, amounts to a personalized coaching program for optimized energy!
The guidance is based on a combination of actual science plus “if this then that” observation-based principles—of the kind that could be described as science if they had been studied clinically instead of informally. Dr. Breus is a sleep scientist, by the way, and his co-author Stacey Griffith is a fitness coach. So between the two of them, they have sleep and exercise covered, and the fasting content is very reasonable and entirely consistent with current consensus of good practice.
The style is very pop-psychology, and very readable, and has a much more upbeat feel than The Power Of When, which seems to be because of Griffith’s presence as a co-author (most of the book is written from a neutral perspective, and some parts have first-person sections by each of the authors, so the style becomes distinct accordingly).
Bottom line: if you’d like to be more energized but [personal reason why not here] then this book may not fix all your problems, but it’ll almost certainly make a big difference and help you to stop sabotaging things and work with your body rather than against it.
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Cleaning Up Your Mental Mess – by Dr. Caroline Leaf
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First of all, what mental mess is this? Well, that depends on you, but common items include:
- Anxiety
- Depression
- Stress
- Trauma
Dr. Caroline Leaf also includes the more nebulous item “toxic thoughts”, but this is mostly a catch-all term.
Given that it says “5 simple scientifically proven steps”, it would be fair if you are wondering:
“Is this going to be just basic CBT stuff?”
And… First, let’s not knock basic CBT stuff. It’s not a panacea, but it’s a great tool for a lot of things. However… Also, no, this book is not about just basic CBT stuff.
In fact, this book’s methods are presented in such a novel way that this reviewer was taken aback by how unlike it was to anything she’d read before.
And, it’s not that the components themselves are new—it’s just that they’re put together differently, in a much more organized comprehensive and systematic way, so that a lot less stuff falls through the cracks (a common problem with standalone psychological tools and techniques).
Bottom line: if you buy one mental health self-help book this year, we recommend that it be this one
Click here to check out Cleaning Up Your Mental Mess, and take a load off your mind!
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