The Stress Prescription (Against Aging!)
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The Stress Prescription (Against Aging!)
This is Dr. Elissa Epel, whose work has for the past 20 years specialized in the effect of stress on aging. She’s led groundbreaking research on cortisol, telomeres, and telomerase, all in the context of aging, especially in women, as well as the relationship between stress and weight gain. She was elected member of the National Academy of Medicine for her work on stress pathways, and has been recognized as a key “Influencer in Aging” by the Alliance for Aging Research.
Indeed, she’s also been named in the top 0.1% of researchers globally, in terms of publication impact.
What’s that about stress and aging?
In her words,
❝Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women❞
Source: Accelerated telomere shortening in response to life stress
We say “in her words”, as she is the top-listed author on this paper—an honour reserved for the lead researcher of any given study/paper.
However, we’d be remiss not to note that the second-listed author is Nobel Prize Laureate Dr. Elizabeth Blackburn. What a team! Maybe we’ll do a spotlight feature on Dr. Blackburn’s work one of these days, but for now, back to Dr. Epel…
What does she want us to do about it?
She has the following advice for us:
Let go of what we can’t control
This one is simple enough, and can be as simple as learning how to set anxiety aside, and taking up the practice of radical acceptance of what we cannot control.
Be challenged, not afraid
This is about eustress, and being the lion, not the gazelle. Dr. Epel uses the example of how when lions are hunting gazelles, both are stressed, but both are feeling the physiological effects of that stress in terms of the augmentation to their immediate abilities, but only one of them is suffering by it.
We’ll let her explain how to leverage this:
TED ideas | Here’s how you can handle stress like a lion, not a gazelle | Dr. Elissa Epel
Build resilience through controlled discomfort
Don’t worry, you don’t have to get chased by lions. A cold shower will do it! This is about making use of hormesis, the body’s ability to build resilience to stressors by small doses of controlled cortisol release—as for example when one undergoes thermal shock, which sounds drastic, but for most people, a cold shower (or even an ice bath) is safe enough.
You can read more about this here:
A Cold Shower A Day Keeps The Doctor Away
Connect with nature
You don’t have to hug a tree, but you do have get to a natural (or at least, natural-seeming) environment once in a while. Simply put, we did not evolve to be in the urban or even suburban settings where most of us spend most of our time. Getting to be around greenery with at least some kind of regularity is hugely beneficial. It doesn’t have to be a national park; a nice garden or local park can suffice, and potted plants at home are better than nothing. Even spending time in virtual reality “nature” is an option:
(you can see an example there, of the kind of scenery this study used)
Breathe deeply, and rest deeply
Mindful breathing, and good quality sleep, are very strongly evidence-based approaches to reduce stress, for example:
Practice gratitude to build optimism
Optimism has a huge positive impact on health outcomes, even when other factors (including socioeconomic factors, pre-existing conditions, and general reasons for one person to be more optimistic than another) are controlled for.
Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study
There are various ways to increase optimism, and practising gratitude is one of them—but that doesn’t necessarily mean abandoning realism, either:
How To Practise (Non-Toxic) Positivity
There are other ways too, though, and Dr. Epel discusses some with her friend and colleague, Dr. Elizabeth Blackburn, here:
Want to learn more from Dr. Epel?
We reviewed one of her books, The Telomere Effect, previously. It’s about what we can do to lengthen our telomeres (a key factor in health aging; effectively, being biologically younger). You also might enjoy her newer book, The Stress Prescription, as well as her blog.
Enjoy!
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The Easiest Way To Take Up Journaling
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Dear Diary…
It’s well-established that journaling is generally good for mental health. It’s not a magical panacea, as evidenced by The Diaries of Franz Kafka for example (that man was not in good mental health). But for most of us, putting our thoughts and feelings down on paper (or the digital equivalent) is a good step for tidying our mind.
And as it can be said: mental health is also just health.
But…
What to write about?
It’s about self-expression (even if only you will read it), and…
❝Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in non-clinical and clinical populations.
In the expressive writing paradigm, participants are asked to write about such events for 15–20 minutes on 3–5 occasions.
Those who do so generally have significantly better physical and psychological outcomes compared with those who write about neutral topics.❞
Source: Emotional and physical health benefits of expressive writing
In other words, write about whatever moves you.
Working from prompts
If you read the advice above and thought “but I don’t know what moves me”, then fear not. It’s perfectly respectable to work from prompts, such as:
- What last made you cry?
- What last made you laugh?
- What was a recent meaningful moment with family?
- What is a serious mistake that you made and learned from?
- If you could be remembered for just one thing, what would you want it to be?
In fact, sometimes working from prompts has extra benefits, precisely because it challenges us to examine things we might not otherwise think about.
If a prompt asks “What tends to bring you most joy recently?” and the question stumps you, then a) you now are prompted to look at what you can change to find more joy b) you probably wouldn’t have thought of this question—most depressed people don’t, and if you cannot remember recent joy, then well, we’re not here to diagnose, but let’s just say that’s a symptom.
A quick aside: if you or a loved oneare prone to depressive episodes, here’s a good resource, by the way:
The Mental Health First-Aid That You’ll Hopefully Never Need
And in the event of the mental health worst case scenario:
The six prompts we gave earlier are just ideas that came to this writer’s mind, but they’re (ok, some bias here) very good ones. If you’d like more though, here’s a good resource:
550+ Journal Prompts: The Ultimate List
The Good, The Bad, and The Ugly
While it’s not good to get stuck in ruminative negative thought spirals, it is good to have a safe outlet to express one’s negative thoughts/feelings:
Remember, your journal is (or ideally, should be) a place without censure. If you fear social consequences should your journal be read, then using an app with a good security policy and encryption options can be a good idea for journaling
Finch App is a good free option if it’s not too cutesy for your taste, because in terms of security:
- It can’t leak your data because your data never leaves your phone (unless you manually back up your data and then you choose to put it somewhere unsafe)
- It has an option to require passcode/biometrics etc to open the app
As a bonus, it also has very many optional journaling prompts, and also (optional) behavioral activation prompts, amongst more other offerings that we don’t have room to list here.
Take care!
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Dealing With Waking Up In The Night
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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
❝I’m now in my sixties and find that I invariably wake up at least once during the night. Is this normal? Even if it is, I would still like, once in a while, to sleep right through like a teenager. How might this be achieved, without pills?❞
Most people wake up briefly between sleep cycles, and forget doing so. But waking up for more than a brief moment is indeed best avoided. In men of your age, if you’re waking to pee (especially if it’s then not actually that easy to pee), it can be a sign of an enlarged prostate. Which is again a) normal b) not optimal.
By “without pills” we’ll assume you mean “without sleeping pills”. There are options to treat an enlarged prostate, including well-established supplements. We did a main feature on this:
Prostate Health: What You Should Know
If the cause of waking up is something else, then again this is common for everyone as we get older, and again it’s not optimal. But since there are so many possible causes (and thus solutions), it’s more than we can cover in less than a main feature, so we’ll have to revisit this later.
Meanwhile, take care!
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California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.
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With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.
Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.
“We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.
The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.
However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.
Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.
An App for That
Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.
“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”
The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.
But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.
“It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”
The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.
Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.
Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.
The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.
‘It’s Like Crickets’
Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”
“It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”
So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.
“Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”
The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.
The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.
KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.
“I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”
Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.
Concern Over Referrals
Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.
This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.
While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.
Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.
“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”
Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.
Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.
“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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.
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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.
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Remember – by Dr. Lisa Genova
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Memory is often viewed as one thing—either you have a good memory, or you don’t. At best, a lot of people have a vague idea of selective memory. But, the reality is much more complex—and much more interesting.
Dr. Genova lays out clearly and simply the various different kinds of memory, how they work, and how they fail. Some of these kinds of memory operate on completely different principles than others, and/or in different parts of the brain. And, it’s not just “a memory for faces” or a “memory for names”, nor even “short term vs long term”. There’s working memory, explicit and implicit memory, semantic memory, episodic memory, muscle memory, and more.
However, this is not just an interesting book—it’s also a useful one. Dr. Genova also looks at how we can guard against failing memory in later years, and how we can expand and grow the kinds of memory that are most important to us.
The style of the book is very conversational, and not at all textbook-like. It’s certainly very accessible, and pleasant to read too.
Bottom line: memory is a weird and wonderful thing, and this book shines a clear light on many aspects of it—including how to improve the various different kinds of memory.
Click here to check out Remember (we recommend to do it now before you forget!
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Dating apps could have negative effects on body image and mental health, our research shows
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Around 350 million people globally use dating apps, and they amass an estimated annual revenue of more than US$5 billion. In Australia, 49% of adults report using at least one online dating app or website, with a further 27% having done so in the past.
But while dating apps have helped many people find romantic partners, they’re not all good news.
In a recent review, my colleagues and I found using dating apps may be linked to poorer body image, mental health and wellbeing.
Dikushin Dmitry/Shutterstock We collated the evidence
Our study was a systematic review, where we collated the results of 45 studies that looked at dating app use and how this was linked to body image, mental health or wellbeing.
Body image refers to the perceptions or feelings a person has towards their own appearance, often relating to body size, shape and attractiveness.
Most of the studies we included were published in 2020 onwards. The majority were carried out in Western countries (such as the United States, the United Kingdom and Australia). Just under half of studies included participants of all genders. Interestingly, 44% of studies observed men exclusively, while only 7% included just women.
Of the 45 studies, 29 looked at the impact of dating apps on mental health and wellbeing and 22 considered the impact on body image (some looked at both). Some studies examined differences between users and non-users of dating apps, while others looked at whether intensity of dating app use (how often they’re used, how many apps are used, and so on) makes a difference.
More than 85% of studies (19 of 22) looking at body image found significant negative relationships between dating app use and body image. Just under half of studies (14 of 29) observed negative relationships with mental health and wellbeing.
The studies noted links with problems including body dissatisfaction, disordered eating, depression, anxiety and low self-esteem.
Dating apps are becoming increasingly common. But could their use harm mental health? Rachata Teyparsit/Shutterstock It’s important to note our research has a few limitations. For example, almost all studies included in the review were cross-sectional – studies that analyse data at a particular point in time.
This means researchers were unable to discern whether dating apps actually cause body image, mental health and wellbeing concerns over time, or whether there is simply a correlation. They can’t rule out that in some cases the relationship may go the other way, meaning poor mental health or body image increases a person’s likelihood of using dating apps.
Also, the studies included in the review were mostly conducted in Western regions with predominantly white participants, limiting our ability to generalise the findings to all populations.
Why are dating apps linked to poor body image and mental health?
Despite these limitations, there are plausible reasons to expect there may be a link between dating apps and poorer body image, mental health and wellbeing.
Like a lot of social media, dating apps are overwhelmingly image-centric, meaning they have an emphasis on pictures or videos. Dating app users are initially exposed primarily to photos when browsing, with information such as interests or hobbies accessible only after manually clicking through to profiles.
Because of this, users often evaluate profiles based primarily on the photos attached. Even when a user does click through to another person’s profile, whether or not they “like” someone may still often be determined primarily on the basis of physical appearance.
This emphasis on visual content on dating apps can, in turn, cause users to view their appearance as more important than who they are as a person. This process is called self-objectification.
People who experience self-objectification are more likely to scrutinise their appearance, potentially leading to body dissatisfaction, body shame, or other issues pertaining to body image.
Dating apps are overwhelmingly image-centric. Studio Romantic/Shutterstock There could be several reasons why mental health and wellbeing may be impacted by dating apps, many of which may centre around rejection.
Rejection can come in many forms on dating apps. It can be implied, such as having a lack of matches, or it can be explicit, such as discrimination or abuse. Users who encounter rejection frequently on dating apps may be more likely to experience poorer self-esteem, depressive symptoms or anxiety.
And if rejection is perceived to be based on appearance, this could lead again to body image concerns.
What’s more, the convenience and game-like nature of dating apps may lead people who could benefit from taking a break to keep swiping.
What can app developers do? What can you do?
Developers of dating apps should be seeking ways to protect users against these possible harms. This could, for example, include reducing the prominence of photos on user profiles, and increasing the moderation of discrimination and abuse on their platforms.
The Australian government has developed a code of conduct – to be enforced from April 1 this year – to help moderate and reduce discrimination and abuse on online dating platforms. This is a positive step.
Despite the possible negatives, research has also found dating apps can help build confidence and help users meet new people.
If you use dating apps, my colleagues and I recommend choosing profile images you feel display your personality or interests, or photos with friends, rather than semi-clothed images and selfies. Engage in positive conversations with other users, and block and report anyone who is abusive or discriminatory.
It’s also sensible to take breaks from the apps, particularly if you’re feeling overwhelmed or dejected.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. The Butterfly Foundation provides support for eating disorders and body image issues, and can be reached on 1800 334 673.
Zac Bowman, PhD Candidate, College of Education, Psychology & Social Work, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Cross That Bridge – by Samuel J. Lucas
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Books of this genre usually have several chapters of fluff before getting to the point. You know the sort:
- Let me tell you about some cherry-picked celebrity stories that overlook survivorship bias
- Let me tell you my life story, the bad parts
- My life story continued, the good parts now
- What this book can do for you, an imaginative pep talk that keeps circling back to me
…then there will be two or three chapters of the actual advertised content, and then a closing chapter that’s another pep talk.
This book, in contrast, throws that out of the window. Instead, Lucas provides a ground-up structure… within which, he makes a point of giving value in each section:
- exercises
- summaries
- actionable advice
For those who like outlines, lists, and overviews (as we do!), this is perfect. There are also plenty of exercises to do, so for those who like exercises, this book will be great too!
Caveat: occasionally, the book’s actionable advices are direct but unclear, for example:
- Use the potential and power of tea, to solve problems
Context: there was no context. This was a bullet-pointed item, with no explanation. It was not a callback to anything earlier; this is the first (and only) reference to tea.
However! The book as a whole is a treasure trove of genuine tips, tools, and voice-of-experience wisdom. Occasional comments may leave you scratching your head, but if you take value from the rest, then the book was already more than worth its while.
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