Reasons to Stay Alive – by Matt Haig

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We’ve previously reviewed Matt Haig’s (excellent) The Comfort Book, and now it’s time for his more famous book: Reasons To Stay Alive. So, what’s this one, beyond the obvious?

It narrates the experience of anxiety, depression, and suicidality, and discovering how to find beauty and joy in the world despite it all. It’s not that the author found a magical cure—he still experiences depression and anxiety (cannot speak for suicidality) but he knows now how to manage it, and live his life.

You may be wondering: is this book instructional; is it reproducible, or is it just an autobiography? It’s centered around his own experience and learnings, but it gives a huge sense of not feeling alone, of having hope, and it gives a template for making sense of one’s own experience, even if every person will of course have some points of differences, the commonalities are nonetheless of immense value.

The writing style is similar to The Comfort Book; it’s lots of small chapters, and all very easy-reading. Well, the subject matter is sometimes rather heavy, but the language is easy-reading! In other words, just the thing for when one is feeling easily overwhelmed, or not feeling up to reading a lot.

Bottom line: whether or not you suffer with anxiety and/or depression, whether or not you sometimes feel suicidal, the contents of this book are important, valuable insights for everyone.

Click here to check out Reasons To Stay Alive, and see through the highs and lows of life.

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Recommended

  • The Salt Fix – by Dr. James DiNicolantonio
  • Why Zebras Don’t Get Ulcers – by Dr. Robert M. Sapolsky
    Stressed out? Find out why zebras don’t get ulcers and learn how to recover from the constant stressors of modern life.

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  • A new government inquiry will examine women’s pain and treatment. How and why is it different?

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    The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.

    The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.

    The gender pain gap

    Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.

    Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.

    These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.

    It feels worse

    Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.

    Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.

    Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.

    woman lies in bed in pain
    Women seem to feel pain more acutely and often feel ignored by doctors.
    Shutterstock

    Medical misogyny

    Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.

    Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.

    It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.

    Misogyny exists in research too

    Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.

    The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.

    These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.

    When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.

    So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.

    What will the inquiry involve?

    Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.

    Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.

    The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.The Conversation

    Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia

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

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  • When “Normal” Health Is Not What You Want

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝When going to sleep, I try to breathe through my nose (since everyone says that’s best). But when I wake I often find that I am breathing through my mouth. Is that normal, or should I have my nose checked out?❞

    It is quite normal, but when it comes to health, “normal” does not always mean “optimal”.

    • Good news: it is correctable!
    • Bad news: it is correctable by what may be considered rather an extreme practice that comes with its own inconveniences and health risks.

    Some people correct this by using medical tape to keep their mouth closed at night, ensuring nose-breathing. Advocates of this say that after using it for a while, nose-breathing in sleep will become automatic.

    We know of no hard science to confirm this, and cannot even offer a personal anecdote on this one. Here are some pop-sci articles that do link to the (very few) studies that have been conducted:

    This writer’s personal approach is simply to do breathing exercises when going to sleep and first thing upon awakening, and settle for imperfection in this regard while asleep.

    Meanwhile, take care!

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  • The Bare-Bones Truth About Osteoporosis

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    In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

    The Bare-bones Truth About Osteoporosis

    In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

    At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.

    This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.

    We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.

    Let’s get to the myths and facts:

    Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”

    The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.

    Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!

    About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.

    Learn more: Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society

    On the topic of that glass of milk…

    • Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
    • People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
    • Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
    • Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.

    See also: An update on magnesium and bone health

    Next most common myth: “bone health is all about calcium”

    We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:

    Read more: The effects of potassium on bone health

    While we’re on the topic…

    People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:

    We Are Such Stuff As Fish Are Made Of

    Want to really maximize your bone health?

    You might want to check out this well-sourced LiveStrong article:

    Bone Health: Best and Worst Foods

    (Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)

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Related Posts

  • The Salt Fix – by Dr. James DiNicolantonio
  • Saffron For The Brain (& More)

    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.

    Saffron For The Brain (& More)

    In yesterday’s edition of 10almonds, one of the items in the “health news from around the world” section was:

    Clinical trial finds herbal medicine Sailuotong effective for brain health in older people

    But, what is it?

    ❝SaiLuoTong (SLT) is a modern compound Chinese herbal medicine preparation in capsule form containing standardized extracts of Panax ginseng, Ginkgo biloba, and Crocus sativus L❞

    Source: A randomized, double-blind, placebo-controlled, parallel-group 12-week pilot phase II trial of SaiLuoTong (SLT) for cognitive function in older adults with mild cognitive impairment

    We’ve written previously about ginseng and ginkgo biloba:

    So, what’s this about Crocus sativus L.?

    That is the plant better known as saffron. And, for all its wide availability (your local supermarket probably has at least a tiny amount in the spice section), there’s a reason we don’t see much of it:

    ❝Saffron blooms only once a year and should be collected within a very short duration. It is picked during 3–4 weeks in October-November. The method for the cultivation of saffron contributes greatly to its high price. According to some reports, this species is a sterile triploid and so does not produce fertile seeds. Germination can take 1–6 months at 18°C. It takes 3 years for plants to flower from seed.❞

    Source: Crocus sativus L.: A comprehensive review

    That’s fascinating, but what does it do for us?

    Well, in the words of El Midaoui et al. (2022):

    ❝In the frame of a double-blind-placebo-controlled study, 30 mg per day supplementation with saffron for 16 weeks resulted in improved cognitive function in patients suffering from mild to moderate Alzheimer’s disease.

    Moreover, the follow-up of this study in which the authors evaluated the effects of saffron (30 mg/day) for 22 weeks showed that saffron was as effective as donepezil in the treatment of mild-to-moderate Alzheimer’s disease❞

    Read the full review: Saffron (Crocus sativus L.): A Source of Nutrients for Health and for the Treatment of Neuropsychiatric and Age-Related Diseases

    Not just that, but it also has powerful antioxidant and anti-inflammatory properties beyond the brain (though the brain is where research has been most focused, due to its neuroprotective effects).

    See: Antioxidant Properties of Crocus Sativus L. and Its Constituents and Relevance to Neurodegenerative Diseases; Focus on Alzheimer’s and Parkinson’s Disease

    (this, too, is a full research review in its own right; we’re getting a lot of “bang for buck” on papers today)

    And more?

    Yes, and more. Lots more. To bullet-pointify even just the abstract from another research review:

    • Saffron has been suggested to be effective in the treatment of a wide range of disorders including coronary artery diseases, hypertension, stomach disorders, dysmenorrhea and learning and memory impairments.
    • In addition, different studies have indicated that saffron has anti-inflammatory, anti-atherosclerotic, antigenotoxic and cytotoxic activities. (This is all good; the cytotoxic activities are about killing cancer cells)
    • Antitussive effects of stigmas and petals of C. sativus and its components, safranal and crocin have also been demonstrated.
    • The anticonvulsant and anti-Alzheimer properties of saffron extract were shown in human and animal studies.
    • The efficacy of C. sativus in the treatment of mild to moderate depression was also reported in clinical trial.
    • Administration of C. sativus and its constituents increased glutamate and dopamine levels in the brain in a dose-dependent manner.
    • It also interacts with the opioid system to reduce withdrawal syndrome.
    • C. sativus and its components can be considered as promising agents in the treatment of nervous system disorders.

    For more details on any of those items, see:

    The effects of Crocus sativus (saffron) and its constituents on nervous system: a review

    Is it safe?

    The effective dose is 30mg/kg and the LD50 is more than 20g/kg, so yes, it’s very safe. Given the price of it, this also means that if you’re the size of this writer (a little over 70kg, or a little over 150lbs) to poison yourself effectively you’d need to consume about 1.4kg of saffron at a time, which would cost well over $6,000.

    Where can I get it?

    Your local supermarket probably has a tiny amount in the spice section, or you can get better prices buying it in “bulk” online. Here’s an example product on Amazon, for your convenience

    Enjoy!

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  • When And Why Do We Pick Up Our Phones?

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    The School of Life’s Alain de Botton makes the argument that—if we pay attention, if we keep track—there’s an understory to why we pick up our phones:

    It’s not about information

    Yes, our phones (or rather, the apps therein) are designed to addict us, to draw us back, to keep us scrolling and never let us go. We indeed seek out information like our ancestors once sought out berries; searching, encouraged by a small discovery, looking for more. The neurochemistry is similar.

    But when we look at the “when” of picking up our phones, de Botton says, it tells a different story:

    We pick them up not to find out what’s going on with the world, but rather specifically to not find out what’s going with ourselves. We pick them up to white out some anxiety we don’t want to examine, a line of thought we don’t want to go down, memories we don’t want to consider, futures we do not want to have to worry about.

    And of course, phones do have a great educational potential, are an immensely powerful tool for accessing knowledge of many kinds—if only we can remain truly conscious while using them, and not take them as the new “opiate of the masses”.

    De Botton bids us, when next we pick up our phone. ask a brave question:

    “If I weren’t allowed to consult my phone right now, what might I need to think about?”

    As for where from there? There’s more in the video:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Further reading

    Making Social Media Work For Your Mental Health

    Take care!

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  • Mimosa For Healing Your Body & Mind

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    Today we’re looking at mimosa (no relation to the cocktail!), which is a name given to several related plant species that belong to the same genus or general clade, look similar, and have similar properties and behavior.

    As a point of interest that’s not useful: mimosa is one of those plants whereby if you touch it, it’ll retract its leaves and shrink away from you. The leaves also droop at nighttime (perfectly healthily; they’re not wilting or anything; this too is just plant movement), and spring back up in the daytime.

    So that’s what we mean when we say “and behavior” 😉

    Antidepressant & anxiolytic

    Mimosa bark and leaves have long been used in Traditional Chinese Medicine, as well as (albeit different species) in the North-East of Brazil, and (again, sometimes different species) in Mexico.

    Animal studies, in vivo studies, and clinical practice in humans, have found this to be effective, for example:

    ❝[Mimosa pudica extract] has anti-anxiety, anti-depressant and memory enhancing activities that are mediated through multiple mechanisms❞

    Source: Effects of Mimosa pudica L. leaves extract on anxiety, depression and memory

    Research is ongoing with regard to how, exactly, mimosa does what it does. Here’s a paper about another species mimosa:

    Molecular basis and mechanism of action of Albizia julibrissin in depression treatment and clinical application of its formulae

    (notwithstanding the genus name, it’s still part of the mimosa clade)

    Anti-inflammatory & analgesic

    In this case, mimosa has traditionally been used as a topical tincture (for skin damage of many kinds, ranging from cuts and abrasions to burns to autoimmune conditions and more), so what does the science say about that?

    ❝In summary, the present study provided evidence that the [mimosa extract], its fractions and the isolated compound sakuranetin showed significant anti-inflammatory and antinociceptive activities❞

    Read in full: Antinoceptive and Anti-inflammatory Activities of the Ethanolic Extract, Fractions and Flavones Isolated from Mimosa tenuiflora (Willd.) Poir (Leguminosae)

    Wound healing

    About those various skin damages, here’s another application, and a study showing that it doesn’t just make it feel better, it actually helps it to heal, too:

    ❝Therapeutic effectiveness occurred in all patients of the extract group; after the 8th treatment week, ulcer size was reduced by 92% as mean value in this group, whereas therapeutic effectiveness was observed only in one patient of the control group (chi(2), p=0.0001). No side effects were observed in any patient in either group.❞

    Very compelling stats!

    Read more: Therapeutic effectiveness of a Mimosa tenuiflora cortex extract in venous leg ulceration treatment

    Is it safe?

    Yes, for most people, with some caveats:

    1. this one comes with a clear “don’t take if pregnant or breastfeeding” warning, as for unknown reasons it has caused a high incidence of fetal abnormalities or fetal death in animal studies.
    2. while the stem bark (the kind used in most mimosa supplements and most readily found online) has negligible psychoactivity, as do many species of mimosa in general, the root of M. tenuiflora has psychedelic effects similar to ayahuasca if taken orally, for example as a decoction, if in the presence of a monoamine oxidase inhibitor (MAOI), as otherwise MAO would metabolize the psychoactive component in the gut before it can enter the bloodstream.

    That’s several “ifs”, meaning that the chances of unwanted psychedelic effects are slim if you’re paying attention, but as ever, do check with your doctor/pharmacist to be sure.

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

    Don’t Forget…

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