Senior Meetup Groups Combating Loneliness
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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 would like to read more on loneliness, meetup group’s for seniors. Thank you”
Well, 10almonds is an international newsletter, so it’s hard for us to advise about (necessarily: local) meetup groups!
But a very popular resource for connecting to your local community is Nextdoor, which operates throughout the US, Canada, Australia, and large parts of Europe including the UK.
In their own words:
Get the most out of your neighborhood with Nextdoor
It’s where communities come together to greet newcomers, exchange recommendations, and read the latest local news. Where neighbors support local businesses and get updates from public agencies. Where neighbors borrow tools and sell couches. It’s how to get the most out of everything nearby. Welcome, neighbor.
Curious? Click here to check it out and see if it’s of interest to you
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Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
Researchers have been investigating ketamine for depression for 30 years.
SB Arts Media/ShutterstockThe first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Set Anxiety Aside
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How To Set Anxiety Aside
We’ve talked previously about how to use the “release” method to stop your racing mind.
That’s a powerful technique, but sometimes we need to be calm enough to use it. So first…
Breathe
Obviously. But, don’t underestimate the immediate power of focusing on your breath, even just for a moment.
There are many popular breathing exercises, but here’s one of the simplest and most effective, “4–4 breathing”:
- Breathe in for a count of four
- Hold for a count four
- Breathe out for a count of four
- Hold for a count of four
- Repeat
Depending on your lung capacity and what you’re used to, it may be that you need to count more quickly or slowly to make it feel right. Experiment with what feels comfortable for you, but the general goal should breathing deeply and slowly.
Identify the thing that’s causing you anxiety
We’ve also talked previously about how to use the RAIN technique to manage difficult emotions, and that’s good for handling anxiety too.
Another powerful tool is journaling.
Read: How To Use Journaling to Challenge Anxious Thoughts
If you don’t want to use any of those (very effective!) methods, that’s fine too—journaling isn’t for everyone.
You can leverage some of the same benefits by simply voicing your worries, even to yourself:
There’s an old folk tradition of “worry dolls”; these are tiny little dolls so small they can be kept in a pocket-size drawstring purse. Last thing at night, the user whispers their worries to the dolls and puts them back in their bag, where they will work on the person’s problem overnight.
We’re a health and productivity newsletter, not a dealer of magic and spells, but you can see how it works, right? It gets the worries out of one’s head, and brings about a helpful placebo effect too.
Focus on what you can control
- Most of what you worry about will not happen.
- Some of what you worry about may happen.
- Worrying about it will not help.
In fact, in some cases it may bring about what you fear, by means of the nocebo effect (like the placebo effect, but bad). Additionally, worrying drains your body and makes you less able to deal with whatever life does throw at you.
So while “don’t worry; be happy” may seem a flippant attitude, sometimes it can be best. However, don’t forget the other important part, which is actually focusing on what you can control.
- You can’t control whether your car will need expensive maintenance…
- …but you can control whether you budget for it.
- You can’t control whether your social event will go well or ill…
- …but you can control how you carry yourself.
- You can’t control whether your loved one’s health will get better or worse…
- …but you can control how you’re there for them, and you can help them take what sensible precautions they may.
…and so forth.
Look after your body as well!
Your body and mind are deeply reliant on each other. In this case, just as anxiety can drain your body’s resources, keeping your body well-nourished, well-exercised, and well-rested and can help fortify you against anxiety. For example, when it comes to diet, exercise, and sleep:
- Read: Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan
- Read: Exercise and anxiety: physical activity appears to be protective against anxiety disorders in clinical and non-clinical populations
- Read: Sleep problems predict and are predicted by generalized anxiety/depression
Don’t know where to start? How about the scientifically well-researched, evidence-based, 7-minute workout?
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When Doctors Make House Calls, Modern-Style!
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In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:
- About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
- About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
- And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”
*We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.
So, what does the science say?
A quick note first
Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.
Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.
Nevertheless, we’ll do what we can with the science we have!
Telehealth is more accessible than in-person consultations: True or False?
True, for most people. For example…
❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.
Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.
Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞
whereas…
❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞
~ Ibid.
Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review
Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.
The quality of care provided via telehealth is as good as in-person: True or False?
True, ostensibly, with caveats. The caveats are:
- We’re going offreported patient satisfaction, not objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
- We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.
*we did find some, but it wasn’t very helpful yet. For example:
An electronic trigger to detect telemedicine-related diagnostic errors
this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.
While most oft-considered demographic groups reported comparable patient satisfaction (per race, gender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).
However!
Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:
❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞
Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology
There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?
True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:
❝The doctor uses his five senses to assess. This cannot be attained over the phone❞
~ 10almonds subscriber
A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!
Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).
However, nowadays indeed a doctor will use sight, sound, touch, and sometimes even smell.
In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.
With this in mind, it really comes down to what you need from your doctor in that consultation.
- If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
- If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
- If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.
If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.
Take care!
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Sarah Raven’s Garden Cookbook – by Sarah Raven
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.
Note: the US Amazon site currently (incorrectly) lists the author as “Jonathan Buckley”. The Canadian, British, and Australian sites all list the author correctly as Sarah Raven, and some (correctly) credit Jonathan Buckley as the photographer she used.
First, what it’s not: a gardening book. Beyond a few helpful tips, pointers, and “plant here, harvest here” instructions, this book assumes you are already capable of growing your own vegetables.
She does assume you are in a temperate climate, so if you are not, this might not be the book for you. Although! The recipes are still great; it’s just you’d have to shop for the ingredients and they probably won’t be fresh local produce for the exact same reason that you didn’t grow them.
If you are in a temperate climate though, this will take you through the year of seasonal produce (if you’re in a temperate climate but it’s in for example Australia, you’ll need to make a six-month adjustment for being in the S. Hemisphere), with many recipes to use not just one ingredient from your garden at a time, but a whole assortment, consistent with the season.
About the recipes: they (which are 450 in number) are (as you might imagine) very plant-forward, but they’re generally not vegan and often not vegetarian. So, don’t expect that you’ll produce everything yourself—just most of the ingredients!
Bottom line: if you like cooking, and are excited by the idea of growing your own food but are unsure how regularly you can integrate that, this book will keep you happily busy for a very long time.
Click here to check out Sarah Raven’s Garden Cookbook, and level-up your home cooking!
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The Dopamine Precursor And More
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What Is This Supplement “NALT”?
N-Acetyl L-Tyrosine (NALT) is a form of tyrosine, an amino acid that the body uses to build other things. What other things, you ask?
Well, like most amino acids, it can be used to make proteins. But most importantly and excitingly, the body uses it to make a collection of neurotransmitters—including dopamine and norepinephrine!
- Dopamine you’ll probably remember as “the reward chemical” or perhaps “the motivation molecule”
- Norepinephrine, also called noradrenaline, is what powers us up when we need a burst of energy.
Both of these things tend to get depleted under stressful conditions, and sometimes the body can need a bit of help replenishing them.
What does the science say?
This is Research Review Monday, after all, so let’s review some research! We’re going to dive into what we think is a very illustrative study:
A 2015 team of researchers wanted to know whether tyrosine (in the form of NALT) could be used as a cognitive enhancer to give a boost in adverse situations (times of stress, for example).
They noted:
❝The potential of using tyrosine supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis.❞
More on this later, but first, the positive that they also found:
❝In contrast, tyrosine does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that tyrosine is an effective enhancer of cognition, but only when neurotransmitter function is intact and dopamine and/or norepinephrine is temporarily depleted❞
That “but only”, is actually good too, by the way!
You do not want too much dopamine (that could cause addiction and/or psychosis) or too much norepinephrine (that could cause hypertension and/or heart attacks). You want just the right amount!
So it’s good that NALT says “hey, if you need some more, it’s here, if not, no worries, I’m not going to overload you with this”.
Read the study: Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands
About that limitation…
Remember they said that it seemed unlikely to help in treating clinical disorders with impaired neurotransmitter function and/or synthesis?
Imagine that you employ a chef in a restaurant, and they can’t keep up with the demand, and consequently some of the diners aren’t getting fed. Can you fix this by supplying the chef with more ingredients?
Well, yes, if and only if the problem is “the chef wasn’t given enough ingredients”. If the problem is that the oven (or the chef’s wrist) is broken, more ingredients aren’t going to help at all—something different is needed in those cases.
So it is with, for example, many cases of depression.
See for example: Tyrosine for depression: a double-blind trial
About blood pressure…
You may be wondering, “if NALT is a precursor of norepinephrine, a vasoconstrictor, will this increase my blood pressure adversely?”
Well, check with your doctor as your own situation may vary, but under normal circumstances, no. The effect of NALT is adaptogenic, meaning that it can help keep its relevant neurotransmitters at healthy levels—not too low or high.
See what we mean, for example in this study where it actually helped keep blood pressure down while improving cognitive performance under stress:
Effect of tyrosine on cognitive function and blood pressure under stress
Bottom line:
For most people, NALT is a safe and helpful way to help keep healthy levels of dopamine and norepinephrine during times of stress, giving cognitive benefits along the way.
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Serotonin vs Dopamine (Know The Differences)
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Of the various neurotransmitters that people confuse with each other, serotonin and dopamine are the two highest on the list (with oxytocin coming third as people often attribute its effects to serotonin). But, for all they are both “happiness molecules”, serotonin and dopamine are quite different, and are even opposites in some ways:
More than just happiness
Let’s break it down:
Similarities:
- Both are neurotransmitters, neuromodulators, and monoamines.
- Both impact cognition, mood, energy, behavior, memory, and learning.
- Both influence social behavior, though in different ways.
Differences (settle in; there are many):
- Chemical structure:
- Dopamine: catecholamine (derived from phenylalanine and tyrosine)
- Serotonin: indoleamine (derived from tryptophan)
- Derivatives:
- Dopamine → noradrenaline and adrenaline (stress and alertness)
- Serotonin → melatonin (sleep and circadian rhythm)
- Effects on mental state:
- Dopamine: drives action, motivation, and impulsivity.
- Serotonin: promotes calmness, behavioral inhibition, and cooperation.
- Role in memory and learning:
- Dopamine: key in attention and working memory
- Serotonin: crucial for hippocampus activation and long-term memory
Symptoms of imbalance:
- Low dopamine:
- Loss of motivation, focus, emotion, and activity
- Linked to Parkinson’s disease and ADHD
- Low serotonin:
- Sadness, irritability, poor sleep, and digestive issues
- Linked to PTSD, anxiety, and OCD
- High dopamine:
- Excessive drive, impulsivity, addictions, psychosis
- High serotonin:
- Nervousness, nausea, and in extreme cases, serotonin syndrome (which can be fatal)
Brain networks:
- Dopamine: four pathways controlling movement, attention, executive function, and hormones.
- Serotonin: widely distributed across the cortex, partially overlapping with dopamine systems.
Speed of production:
- Dopamine: can spike and deplete quickly; fatigues faster with overuse.
- Serotonin: more stable, releasing steadily over longer periods.
Illustrative examples:
- Coffee boosts dopamine but loses its effect with repeated use.
- Sunlight helps maintain serotonin levels over time.
If you remember nothing else, remember this:
- Dopamine: action, motivation, and alertness.
- Serotonin: contentment, happiness, and calmness.
For more on all of the above, enjoy:
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You might also like to read:
Take care!
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