Statin and Antidepressant Side Effects

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Questions and Answers at 10almonds

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This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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

Side effects of statins, are they worth it? Depression, are antidepressants worth it?

About statins, that depends a lot on you, your circumstances, and—as it happens—your gender. We covered this in a main feature recently, but a short answer is: for most people, they may not be the best first choice, and could even make things worse. For some people, however, they really are just what’s needed.

  • Factors that make them more likely better for you: being a man, or having atherosclerosis
  • Factors that make them more likely worse for you: being a woman in general

Check out the main feature we did: Statins: His & Hers?

As for antidepressants? That depends a lot on you, your physiology, your depression, your circumstances, and more. We’ll definitely do a main feature on that sometime soon, as there’s a lot that most people don’t know!

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  • What’s the difference between a psychopath and a sociopath? Less than you might think

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    Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as 7 signs your boss is a psychopath or How to avoid the sociopath next door.

    You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from The Silence of the Lambs.

    In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with something else entirely.

    So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.

    Benoit Daoust/Shutterstock

    What’s a psychopath?

    Psychopathy has been mentioned in the psychiatric literature since the 1800s. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) doesn’t list it as a recognised clinical disorder.

    Since the 1950s, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with antisocial personality disorder, which is what we have today.

    The Silence of the Lambs movie poster
    Was Hannibal Lecter from The Silence of the Lambs a psychopath, a sociopath or something else entirely? Ralf Liebhold/Shutterstock

    Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.

    To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.

    US psychiatrist Hervey Cleckley provided the first formal description of psychopathy traits in his 1941 book The Mask of Sanity. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.

    Canadian psychologist Professor Robert Hare refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.

    When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.

    Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.

    So how about a sociopath?

    The term sociopath first appeared in the 1930s, and was attributed to US psychologist George Partridge. He emphasised the societal consequences of behaviour that habitually violates the rights of others.

    Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some preferred the term sociopath because they said the public sometimes confused the word psychopath with psychosis.

    “Sociopathic personality disturbance” was the term used in the first edition of the DSM in 1952. This aligned with the prevailing views at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules.

    Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 definition of a psychopath.

    In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.

    Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.

    Born or made?

    Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.

    For example, people with psychopathic traits have certain brain differences especially in regions associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their nervous system, including a reduced heart rate.

    However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to run in families. These behaviours has been associated with physical abuse and parental conflict.

    What are the consequences?

    Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series Killing Evenot all people with psychopathy or sociopathy traits are serial killers or are physically violent.

    But psychopathy predicts a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.

    In the general population, psychopathy is associated with drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted failure to follow COVID restrictions.

    But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.

    In a nutshell

    Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.

    Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.

    Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.

    Bruce Watt, Associate Professor in Psychology, Bond University and Katarina Fritzon, Associate Professor of Psychology, Bond University

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

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  • Why Adult ADHD Often Leads To Anxiety & Depression

    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.

    ADHD’s Knock-On Effects On Mental Health

    We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:

    ADHD… As An Adult?

    In women in particular, it can get missed and/or misdiagnosed:

    Miss Diagnosis: Anxiety, ADHD, & Women

    …but what we’re really here to talk about today is:

    It’s the comorbidities that get you

    When it comes to physical health conditions:

    • if you have one serious condition, it will (usually) be taken seriously
    • if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
    • if you have three, people will think you are making at least one of them up for attention now
    • if you have more than three, you are considered a hypochondriac and pathological liar

    Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.

    Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.

    If this is you, by the way, we hope at least something in the following might ease things for you a bit:

    It’s the same for mental health

    In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.

    (Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).

    Why?

    Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.

    • “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
    • “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
    • “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.

    Overwhelm and breakdown are almost inevitable.

    And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.

    Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).

    What to do about it

    How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.

    Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.

    Here’s a good starting point for that kind of thing:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:

    Behavioral Activation Against Depression & Anxiety

    If things are already bad, then you might also consider:

    And if things are truly at the worst they can possibly be, then:

    How To Stay Alive (When You Really Don’t Want To)

    Take care!

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  • Hair-Loss Remedies, By Science

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    10almonds Gets Hairy

    Hair loss is a thing that at some point affects most men and a large minority of women. It can be a source of considerable dysphoria for both, as it’s often seen as a loss of virility/femininity respectively, and is societally stigmatized in various ways.

    Today we’re going to focus on the most common kind: androgenic alopecia, which is called “male pattern baldness” in men and “female pattern baldness” in women, despite being the same thing.

    We won’t spend a lot of time on the science of why this happens (we’re going to focus on the remedies instead), but suffice it to say that genes and hormones both play a role, with dihydrogen testosterone (DHT) being the primary villain in this case.

    We’ve talked before about the science of 5α-reductase inhibitors to block the conversion of regular testosterone* to DHT, its more potent form:

    One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens…

    *We all make this to a greater or lesser degree, unless we have had our ovaries/testes removed.

    Finasteride

    Finasteride is a 5α-reductase inhibitor that performs similarly to saw palmetto, but comes in tiny pills instead of needing to take a much higher dose of supplement (5mg of finasteride is comparable in efficacy to a little over 300mg of saw palmetto).

    Does it work? Yes!

    Any drawbacks? A few:

    • It’ll take 3–6 months to start seeing effects. This is because of the hormonal life-cycle of human hairs.
    • Common side-effects include ED.
    • It is popularly labelled/prescribed as “only for men

    On that latter point: the warnings about this are severe, detailing how women must not take it, must not even touch it if it has been cut up or crushed.

    However… That’s because it can carry a big risk to our unborn fetuses. So, if we are confident we definitely don’t have one of those, it’s not actually applicable to us.

    That said, finasteride’s results in women aren’t nearly so clear-cut as in men (though also, there has been less research, largely because of the above). Here’s an interesting breakdown in more words than we have room for here:

    Finasteride for Women: Everything You Need to Know

    Spironolactone

    This one’s generally prescribed to women, not men, largely because it’s the drug sometimes popularly known as a “chemical castration” drug, which isn’t typically great marketing for men (although it can be applied topically, which will have less of an effect on the rest of the body). For women, this risk is simply not an issue.

    We’ll be brief on this one, but we’ll just drop this, so that you know it’s an option that works:

    Spironolactone is an effective and safe treatment of androgenic alopecia which can enhance the efficacy when combined with other conventional treatments such as minoxidil.

    Topical spironolactone is safer than oral administration and is suitable for both male and female patients, and is expected to become a common drug for those who do not have a good response to minoxidil❞

    Read more: The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review

    Minoxidil

    This one is available (to men and women) without prescription. It’s applied topically, and works by shortcutting the hair’s hormonal growth cycle, to reduce the resting phase and kick it into a growth phase.

    Does it work? Yes!

    Any drawbacks? A few:

    • Whereas you’ll remember finasteride takes 3–6 months to see any effect, this one will have an effect very quickly
      • Specifically, the immediate effect is: your rate of hair loss will appear to dramatically speed up
      • This happens because when hairs are kicked into their growth phase if they were in a resting phase, the first part of that growth phase is to shed each old hair to make room for the new one
    • You’ll then need the same 3–6 months as with finasteride, to see the regrowth effects
    • If you stop using it, you will immediately shed whatever hair you gained by this method

    Why do people choose this over finasteride? For one of three reasons, mainly:

    • They are women, and not offered finasteride
    • They are men, and do not want the side effects of finasteride
    • They just saw an ad and tried it

    As to how it works:

    Minoxidil upregulates the expression of vascular endothelial growth factor in human hair dermal papilla cells

    Some final notes:

    There are some other contraindications and warnings with each of these drugs by the way, so do speak with your doctor/pharmacist. For example:

    There are other hair loss remedies and practices, but the above three are the heavy-hitters, so that’s what we spent our time/space on today. We’ll perhaps cover the less powerful (but less risky) options one of these days.

    Meanwhile, take care!

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  • Thriving Beyond Fifty – by Will Harlow

    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.

    We’ve featured this author sometimes in our video section; he’s an over-50s specialist physiotherapist with a lot of very functional advice to offer.

    In this book, Harlow focusses heavily on three things: mobility, strength, endurance.

    You may not want to be a gymnast, powerlifter, or marathon-runner, but these things are important for us all to maintain to at least a fair degree:

    • Mobility can be the difference between tweaking one’s shoulder getting something from a high shelf, or not
    • Strength can be the difference between being able to get back up, or not
    • Endurance can be the difference between coming back from a long day on your feet and thinking “that was a good day; I’m looking forward to tomorrow now”, or not

    One of the greatest strengths of this book is its comprehensive troubleshooting aspect; if you have a weak spot, chances are this book has the remedy.

    As for the style, it’s quite casual/conversational in tone, but without skimping on science and detail. It’s clear, explanatory, and helpful throughout.

    Bottom line: if you’d like to maintain/improve mobility, strength, and endurance, then this book is a very recommendable resource.

    Click here to check out Thriving Beyond Fifty, and keep thriving at every age!

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  • Mango vs Guava – Which is Healthier?

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    Our Verdict

    When comparing mango to guava, we picked the guava.

    Why?

    Looking at macros first, these two fruits are about equal on carbs (nominally mango has more, but it’s by a truly tiny margin), while guava has more than 3x the protein and more than 3x the fiber. A clear win for guava.

    In terms of vitamins, mango has more of vitamins A, E, and K, while guava has more of vitamins B1, B2, B3, B5, B7, B9, and C. Another win for guava.

    In the category of minerals, mango is not higher in any minerals, while guava is higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc.

    In short, enjoy both; both are healthy. But if you’re choosing one, there’s a clear winner here, and it’s guava.

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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  • 7 Principles of Becoming a Leader – by Riku Vuorenmaa

    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.

    We urge you to overlook the cliché cover art (we don’t know what they were thinking, going for the headless suited torso) because…

    This one could be the best investment you make in your career this year! You may be wondering what the titular 7 principles are. We won’t keep you guessing; they are:

    1. Professional development: personal excellence, productivity, and time management
    2. Leadership development: mindset and essential leadership skills
    3. Personal development: your motivation, character, and confidence as a leader
    4. Career management: plan your career, get promoted and paid well
    5. Social skills & networking: work and connect with the right people
    6. Business- & company-understanding: the big picture
    7. Commitment: make the decision and commit to becoming a great leader

    A lot of leadership books repeat the same old fluff that we’ve all read many times before… padded with a lot of lengthy personal anecdotes and generally editorializing fluff. Not so here!

    While yes, this book does also cover some foundational things first, it’d be remiss not to. It also covers a whole (much deeper) range of related skills, with down-to-earth, brass tacks advice on putting them into practice.

    This is the kind of book you will want to set as a recurring reminder in your phone, to re-read once a year, or whatever schedule seems sensible to you.

    There aren’t many books we’d put in that category!

    Pick Up Your Copy of the “7 Principles of Becoming a Leader” on Amazon Today!

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