The Blue Zones, Second Edition – by Dan Buettner
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.
Eat beans & greens, take walks, have a purpose; you can probably list off the top of your head some of the “advices from Blue Zones”, so what makes this book stand out?
This is perhaps one of the most thoughtful investigations; the author (a National Geographic researcher) toured and researched all the Blue Zones, took many many notes (we get details), and asked a lot of questions that others skipped.
For example, a lot of books about the Blue Zones mention the importance of community—but they don’t go into much detail of what that looks like… And they certainly don’t tend to explain what we should do about it.
And that’s because community is often viewed as environmental in a way that we can’t control. If we want to take supplements, eat a certain way, exercise, etc, we can do all those things alone if we want. But if we want community? We’re reliant on other people—and that’s a taboo in the US, and US-influenced places.
So, one way this book excels is in describing how exactly people foster community in the Blue Zones (hint: the big picture—the form of the community—is different in each place, but the individual actions taken are similar), with particular attention to the roles actively taken on by the community elders.
In a similar vein, “reduce stress” is good, but what mindsets and mechanisms do they use that are still reproducible if we are not, for example, Okinawan farmers? Again, Buettner delivers in spades.
Bottom line: this is the Blue Zones book that digs deeper than others, and makes the advices much more applicable no matter where we live.
Click here to check out The Blue Zones, and build these 9 things into your life!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Accidental falls in the older adult population: What academic research shows
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.
Accidental falls are among the leading causes of injury and death among adults 65 years and older worldwide. As the aging population grows, researchers expect to see an increase in the number of fall injuries and related health spending.
Falls aren’t unique to older adults. Nealy 684,000 people die from falls each year globally. Another 37.3 million people each year require medical attention after a fall, according to the World Health Organization. But adults 65 and older account for the greatest number of falls.
In the United States, more than 1 in 4 older adults fall each year, according to the National Institute on Aging. One in 10 report a fall injury. And the risk of falling increases with age.
In 2022, health care spending for nonfatal falls among older adults was $80 billion, according to a 2024 study published in the journal Injury Prevention.
Meanwhile, the fall death rate in this population increased by 41% between 2012 and 2021, according to the latest CDC data.
“Unfortunately, fall-related deaths are increasing and we’re not sure why that is,” says Dr. Jennifer L. Vincenzo, an associate professor at the University of Arkansas for Medical Sciences in the department of physical therapy and the Center for Implementation Research. “So, we’re trying to work more on prevention.”
Vincenzo advises journalists to write about how accidental falls can be prevented. Remind your audiences that accidental falls are not an inevitable consequence of aging, and that while we do decline in many areas with age, there are things we can do to minimize the risk of falls, she says. And expand your coverage beyond the national Falls Prevention Awareness Week, which is always during the first week of fall — Sept. 23 to 27 this year.
Below, we explore falls among older people from different angles, including injury costs, prevention strategies and various disparities. We have paired each angle with data and research studies to inform your reporting.
Falls in older adults
In 2020, 14 million older adults in the U.S. reported falling during the previous year. In 2021, more than 38,700 older adults died due to unintentional falls, according to the CDC.
A fall could be immediately fatal for an older adult, but many times it’s the complications from a fall that lead to death.
The majority of hip fractures in older adults are caused by falls, Vincenzo says, and “it could be that people aren’t able to recover [from the injury], losing function, maybe getting pneumonia because they’re not moving around, or getting pressure injuries,” she says.
In addition, “sometimes people restrict their movement and activities after a fall, which they think is protective, but leads to further functional declines and increases in fall risk,” she adds.
Factors that can cause a fall include:
- Poor eyesight, reflexes and hearing. “If you cannot hear as well, anytime you’re doing something in your environment and there’s a noise, it will be really hard for you to focus on hearing what that noise is and what it means and also moving at the same time,” Vincenzo says.
- Loss of strength, balance, and mobility with age, which can lessen one’s ability to prevent a fall when slipping or tripping.
- Fear of falling, which usually indicates decreased balance.
- Conditions such as diabetes, heart disease, or problems with nerves or feet that can affect balance.
- Conditions like incontinence that cause rushed movement to the bathroom.
- Cognitive impairment or certain types of dementia.
- Unsafe footwear such as backless shoes or high heels.
- Medications or medication interactions that can cause dizziness or confusion.
- Safety hazards in the home or outdoors, such as poor lighting, steps and slippery surfaces.
Related Research
Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021
Ramakrishna Kakara, Gwen Bergen, Elizabeth Burns and Mark Stevens. Morbidity and Mortality Weekly Report, September 2023.Summary: Researchers analyzed data from the 2020 Behavioral Risk Factor Surveillance System — a landline and mobile phone survey conducted each year in all 50 U.S. states and the District of Columbia — and data from the 2021 National Vital Statistics System to identify patterns of injury and death due to falls in the U.S. by sex and state for adults 65 years and older. Among the findings:
- The percentage of women who reported falling was 28.9%, compared with 26.1% of men.
- Death rates from falls were higher among white and American Indian or Alaska Native older adults than among older adults from other racial and ethnic groups.
- In 2020, the percentage of older adults who reported falling during the past year ranged from 19.9% in Illinois to 38.0% in Alaska. The national estimate for 18 states was 27.6%.
- In 2021, the unintentional fall-related death rate among older adults ranged from 30.7 per 100,000 older adults in Alabama to 176.5 in Wisconsin. The national estimate for 26 states was 78.
“Although common, falls among older adults are preventable,” the authors write. “Health care providers can talk with patients about their fall risk and how falls can be prevented.”
Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012-2018
Briana Moreland, Ramakrishna Kakara and Ankita Henry. Morbidity and Mortality Weekly Report, July 2020.Summary: Researchers compared data from the 2018 Behavioral Risk Factor Surveillance System. Among the findings:
- The percentage of older adults reporting a fall increased from 2012 to 2016, then slightly decreased from 2016 to 2018.
- Even with this decrease in 2018, older adults reported 35.6 million falls. Among those falls, 8.4 million resulted in an injury that limited regular activities for at least one day or resulted in a medical visit.
“Despite no significant changes in the rate of fall-related injuries from 2012 to 2018, the number of fall-related injuries and health care costs can be expected to increase as the proportion of older adults in the United States grows,” the authors write.
Understanding Modifiable and Unmodifiable Older Adult Fall Risk Factors to Create Effective Prevention Strategies
Gwen Bergen, et al. American Journal of Lifestyle Medicine, October 2019.Summary: Researchers used data from the 2016 U.S. Behavioral Risk Factor Surveillance System to better understand the association between falls and fall injuries in older adults and factors such as health, state and demographic characteristics. Among the findings:
- Depression had the strongest association with falls and fall injuries. About 40% of older adults who reported depression also reported at least one fall; 15% reported at least one fall injury.
- Falls and depression have several factors in common, including cognitive impairment, slow walking speed, poor balance, slow reaction time, weakness, low energy and low levels of activity.
- Other factors associated with an increased risk of falling include diabetes, vision problems and arthritis.
“The multiple characteristics associated with falls suggest that a comprehensive approach to reducing fall risk, which includes screening and assessing older adult patients to determine their unique, modifiable risk factors and then prescribing tailored care plans that include evidence-based interventions, is needed,” the authors write.
Health care use and cost
In addition to being the leading cause of injury, falls are the leading cause of hospitalization in older adults. Each year, about 3 million older adults visit the emergency department due to falls. More than 1 million get hospitalized.
In 2021, falls led to more than 38,000 deaths in adults 65 and older, according to the CDC.
The annual financial medical toll of falls among adults 65 years and older is expected to be more than $101 billion by 2030, according to the National Council on Aging, an organization advocating for older Americans.
Related research
Healthcare Spending for Non-Fatal Falls Among Older Adults, USA
Yara K. Haddad, et al. Injury Prevention, July 2024.Summary: In 2015, health care spending related to falls among older adults was roughly $50 billion. This study aims to update the estimate, using the 2017, 2019 and 2021 Medicare Current Beneficiary Survey, the most comprehensive and complete survey available on the Medicare population. Among the findings:
- In 2020, health care spending for non-fatal falls among older adults was $80 billion.
- Medicare paid $53.3 billion of the $80 billion, followed by $23.2 billion paid by private insurance or patients and $3.5 billion by Medicaid.
“The burden of falls on healthcare systems and healthcare spending will continue to rise if the risk of falls among the aging population is not properly addressed,” the authors write. “Many older adult falls can be prevented by addressing modifiable fall risk factors, including health and functional characteristics.”
Cost of Emergency Department and Inpatient Visits for Fall Injuries in Older Adults Lisa Reider, et al. Injury, February 2024.
Summary: The researchers analyzed data from the 2016-2018 National Inpatient Sample and National Emergency Department Sample, which are large, publicly available patient databases in the U.S. that include all insurance payers such as Medicare and private insurance. Among the findings:
- During 2016-2018, more than 920,000 older adults were admitted to the hospital and 2.3 million visited the emergency department due to falls. The combined annual cost was $19.2 billion.
- More than half of hospital admissions were due to bone fractures. About 14% of these admissions were due to multiple fractures and cost $2.5 billion.
“The $20 billion in annual acute treatment costs attributed to fall injury indicate an urgent need to implement evidence-based fall prevention interventions and underscores the importance of newly launched [emergency department]-based fall prevention efforts and investments in geriatric emergency departments,” the authors write.
Hip Fracture-Related Emergency Department Visits, Hospitalizations and Deaths by Mechanism of Injury Among Adults Aged 65 and Older, United States 2019
Briana L. Moreland, Jaswinder K. Legha, Karen E. Thomas and Elizabeth R. Burns. Journal of Aging and Health, June 2024.Summary: The researchers calculated hip fracture-related U.S. emergency department visits, hospitalizations and deaths among older adults, using data from the Healthcare Cost and Utilization Project and the National Vital Statistics System. Among the findings:
- In 2019, there were 318,797 emergency department visits, 290,130 hospitalizations and 7,731 deaths related to hip fractures among older adults.
- Nearly 88% of emergency department visits and hospitalizations and 83% of deaths related to hip fractures were caused by falls.
- These rates were highest among those living in rural areas and among adults 85 and older. More specifically, among adults 85 and older, the rate of hip fracture-related emergency department visits was nine times higher than among adults between 65 and 74 years old.
“Falls are common among older adults, but many are preventable,” the authors write. “Primary care providers can prevent falls among their older patients by screening for fall risk annually or after a fall, assessing modifiable risk factors such as strength and balance issues, and offering evidence-based interventions to reduce older adults’ risk of falls.”
Fall prevention
Several factors, including exercising, managing medication, checking vision and making homes safer can help prevent falls among older adults.
“Exercise is one of the best interventions we know of to prevent falls,” Vincenzo says. But “walking in and of itself will not help people to prevent falls and may even increase their risk of falling if they are at high risk of falls.”
The National Council on Aging also has a list of evidence-based fall prevention programs, including activities and exercises that are shown to be effective.
The National Institute on Aging has a room-by-room guide on preventing falls at home. Some examples include installing grab bars near toilets and on the inside and outside of the tub and shower, sitting down while preparing food to prevent fatigue, and keeping electrical cords near walls and away from walking paths.
There are also national and international initiatives to help prevent falls.
Stopping Elderly Accidents, Deaths and Injuries, or STEADI, is an initiative by the CDC’s Injury Center to help health care providers who treat older adults. It helps providers screen patients for fall risk, assess their fall risk factors and reduce their risk by using strategies that research has shown to be effective. STEADI’s guidelines are in line with the American and British Geriatric Societies’ Clinical Practice Guidelines for fall prevention.
“We’re making some iterations right now to STEADI that will come out in the next couple of years based on the World Falls Guidelines, as well as based on clinical providers’ feedback on how to make [STEADI] more feasible,” Vincenzo says.
The World Falls Guidelines is an international initiative to prevent falls in older adults. The guidelines are the result of the work of 14 international experts who came together in 2019 to consider whether new guidelines on fall prevention were needed. The task force then brought together 96 experts from 39 countries across five continents to create the guidelines.
The CDC’s STEADI initiative has a screening questionnaire for consumers to check their risk of falls, as does the National Council on Aging.
On the policy side, U.S. Rep. Carol Miller, R-W.V., and Melanie Stansbury, D-N.M., introduced the Stopping Addiction and Falls for the Elderly (SAFE) Act in March 2024. The bill would allow occupational and physical therapists to assess fall risks in older adults as part of the Medicare Annual Wellness Benefit. The bill was sent to the House Subcommittee on Health in the same month.
Meanwhile, older adults’ attitudes toward falls and fall prevention are also pivotal. For many, coming to terms with being at risk of falls and making changes such as using a cane, installing railings at home or changing medications isn’t easy for all older adults, studies show.
“Fall is a four-letter F-word in a way to older adults,” says Vincenzo, who started her career as a physical therapist. “It makes them feel ‘old.’ So, it’s a challenge on multiple fronts: U.S. health care infrastructure, clinical and community resources and facilitating health behavior change.”
Related research
Environmental Interventions for Preventing Falls in Older People Living in the Community
Lindy Clemson, et al. Cochrane Database of Systematic Reviews, March 2023.Summary: This review includes 22 studies from 10 countries involving a total of 8,463 older adults who live in the community, which includes their own home, a retirement facility or an assisted living facility, but not a hospital or nursing home. Among the findings:
- Removing fall hazards at home reduced the number of falls by 38% among older adults at a high risk of having a fall, including those who have had a fall in the past year, have been hospitalized or need support with daily activities. Examples of fall hazards at home include a stairway without railings, a slippery pathway or poor lighting.
- It’s unclear whether checking prescriptions for eyeglasses, wearing special footwear or installing bed alarm systems reduces the rate of falls.
- It’s also not clear whether educating older adults about fall risks reduces their fall risk.
The Influence of Older Adults’ Beliefs and Attitudes on Adopting Fall Prevention Behaviors
Judy A. Stevens, David A. Sleet and Laurence Z. Rubenstein. American Journal of Lifestyle Medicine. January 2017.Summary: Persuading older adults to adopt interventions that reduce their fall risk is challenging. Their attitudes and beliefs about falls play a large role in how well they accept and adopt fall prevention strategies, the authors write. Among the common attitudes and beliefs:
- Many older adults believe that falls “just happen,” are a normal result of aging or are simply due to bad luck.
- Many don’t acknowledge or recognize their fall risk.
- For many, falls are considered to be relevant only for frail or very old people.
- Many believe that their home environment or daily activities can be a risk for fall, but do not consider biological factors such as dizziness or muscle weakness.
- For many, fall prevention simply consists of “being careful” or holding on to things when moving about the house.
“To reduce falls, health care practitioners have to help patients understand and acknowledge their fall risk while emphasizing the positive benefits of fall prevention,” the authors write. “They should offer patients individualized fall prevention interventions as well as provide ongoing support to help patients adopt and maintain fall prevention strategies and behaviors to reduce their fall risk. Implementing prevention programs such as CDC’s STEADI can help providers discuss the importance of falls and fall prevention with their older patients.”
Reframing Fall Prevention and Risk Management as a Chronic Condition Through the Lens of the Expanded Chronic Care Model: Will Integrating Clinical Care and Public Health Improve Outcomes?
Jennifer L. Vincenzo, Gwen Bergen, Colleen M. Casey and Elizabeth Eckstrom. The Gerontologist, June 2024.Summary: The authors recommend approaching fall prevention from the lens of chronic disease management programs because falls and fall risk are chronic issues for many older adults.
“Policymakers, health systems, and community partners can consider aligning fall risk management with the [Expanded Chronic Care Model], as has been done for diabetes,” the authors write. “This can help translate high-quality research on the effectiveness of fall prevention interventions into daily practice for older adults to alter the trajectory of older adult falls and fall-related injuries.”
Disparities
Older adults face several barriers to reducing their fall risk. Accessing health care services and paying for services such as physical therapy is not feasible for everyone. Some may lack transportation resources to go to and from medical appointments. Social isolation can increase the risk of death from falls. In addition, physicians may not have the time to fit in a fall risk screening while treating older patients for other health concerns.
Moreover, implementing fall risk screening, assessment and intervention in the current U.S. health care structure remains a challenge, Vincenzo says.
Related research
Mortality Due to Falls by County, Age Group, Race, and Ethnicity in the USA, 2000-19: A Systematic Analysis of Health Disparities
Parkes Kendrick, et al. The Lancet Public Health, August 2024.Summary: Researchers analyzed death registration data from the U.S. National Vital Statistics System and population data from the U.S. National Center for Health Statistics to estimate annual fall-related mortality. The data spanned from 2000 to 2019 and includes all age groups. Among the findings:
- The disparities between racial and ethnic populations varied widely by age group. Deaths from falls among younger adults were highest for the American Indian/Alaska Native population, while among older adults it was highest for the white population.
- For older adults, deaths from falls were particularly high in the white population within clusters of counties across states including Florida, Minnesota and Wisconsin.
- One factor that could contribute to higher death rates among white older adults is social isolation, the authors write. “Studies suggest that older Black and Latino adults are more likely to have close social support compared with older white adults, while AIAN and Asian individuals might be more likely to live in multigenerational households,” they write.
“Among older adults, current prevention techniques might need to be restructured to reduce frailty by implementing early prevention and emphasizing particularly successful interventions. Improving social isolation and evaluating the effectiveness of prevention programs among minoritized populations are also key,” the authors write.
Demographic Comparisons of Self-Reported Fall Risk Factors Among Older Adults Attending Outpatient Rehabilitation
Mariana Wingood, et al. Clinical Interventions in Aging, February 2024.Summary: Researchers analyzed the electronic health record data of 108,751 older adults attending outpatient rehabilitation within a large U.S. health care system across seven states, between 2018 and 2022. Among the findings:
- More than 44% of the older adults were at risk of falls; nearly 35% had a history of falls.
- The most common risk factors for falls were diminished strength, gait and balance.
- Compared to white older adults, Native American/Alaska Natives had the highest prevalence of fall history (43.8%) and Hispanics had the highest prevalence of falls with injury (56.1%).
“Findings indicate that rehabilitation providers should perform screenings for these impairments, including incontinence and medication among females, loss of feeling in the feet among males, and all Stay Independent Questionnaire-related fall risk factors among Native American/Alaska Natives, Hispanics, and Blacks,” the authors write.
Resources and articles
- National Institute on Aging
- National Council on Aging
- Gerontological Society of America
- Home Health Agencies Failed To Report Over Half of Falls With Major Injury and Hospitalization Among Their Medicare Patients, a 2023 report from the U.S Department of Health and Human Services’ Office of Inspector General.
- 6 tips for improving new coverage of older people, a tip sheet from The Journalist’s Resource.
- Crosswalk and pedestrian safety: What you need to know from recent research, from The Journalist’s Resource.
- Aging-in-place technology challenges and trends, a resource from the Association of Health Care Journalists.
- Successful aging at home: what reporters should know, a resource from the Association of Health Care Journalists.
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
Share This Post
Why Has Nobody Told Me This Before? – by Dr. Julie Smith
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.
Superficially, this can be called a “self-help” book, but that undersells it rather. It’s a professionally-written (as in, by a professional psychologist) handbook full of resources. Its goal? Optimizing your mental health to help you stay resilient no matter what life throws your way.
While the marketing of this book is heavily centered around Dr. Smith’s Internet Celebrity™ status, a lot of her motivation for writing it seems to be precisely so that she can delve deeper into the ideas that her social media “bites” don’t allow room for.
Many authors of this genre pad their chapters with examples; there are no lengthy story-telling asides here, and her style doesn’t need them. She knows her field well, and knows well how to communicate the ideas that may benefit the reader.
The main “meat” of the book? Tips, tricks, guides, resources, systems, flowcharts, mental frameworks, and “if all else fails, do this” guidance. The style of the book is clear and simple, with very readable content that she keeps free from jargon without “dumbing down” or patronizing the reader.
All in all, a fine set of tools for anyone’s “getting through life” toolbox.
Get Your Personal Copy Of “Why Has Nobody Told Me This Before?” on Amazon Now!
Share This Post
Beat The Heat, With Fat
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.
Surviving Summer
Summer is upon us, for those of us in the Northern Hemisphere anyway, and given that nowadays each year tends to be hotter than the one before, on average, it pays to be prepared.
We’ve talked about dealing with the heat before:
Sun, Sea, And Sudden Killers To Avoid
All the above advice stands this summer too, but today we’re going to speak a little extra on not having a “default body”.
For much of medical literature and common health advice, the default body is that of a slim and/or athletic white cis man aged 25–35 with no disabilities.
When it comes to “women’s health”, this is often confined to “the bikini zone” and everything else is commonly treated based on research conducted with men.
Today we’ll be looking at a particular challenge for a wide variety of people, when it comes to heat…
Beating the heat, with fat
If you are fat, and/or have a bit of a tummy, and/or have breasts, this one’s for you.
Fat acts as an insulator, which naturally does no favors in hot weather. Carrying the weight around is also extra exercise, which also becomes a problem in hot weather. Fat people usually sweat more than thin people do, as a result.
Sweat is great for cooling down the body, because it takes heat with it when it evaporates off. However, that only works if it can evaporate off, and it can’t evaporate off if it’s trapped in a skin fold / fat roll.
If you’re fat, you may have plenty of those; if you have a bit of a tummy (if you’re not fat generally, this might be a leftover from pregnancy, or weight loss, or something else; how it got there doesn’t matter for our purposes today), you’ll have at least one under it, and if you have breasts, unless they’re quite small, you’ll have one under each breast, and potentially your cleavage may become an issue too.
Note: if you are perhaps a man who has fat in the place where breasts go, then medically this goes for you too, except that there’s not a societal expectation that you wear bra. Use today’s information as you see fit.
Sweat-wicking hacks
We don’t want sweat to stay in those folds—both because then it’s not doing its cooling-down job, and also, because it can cause a rash, and even yeast infections and/or bacterial infections.
So, we want there to be some barrier there. You could use something like vaseline or baby powder, as to prevent chafing, but fat better (more effective, and less messy) is to have some kind of cloth there that can wick the sweat away.
There are made-for-purpose curved cotton bands that exist, called “tummy liners”; here’s an example product on Amazon, or you could make your own if you’re so inclined. They’re breathable, absorbent, and reduce friction too, making everything a lot more comfortable.
And for breasts? Same deal, there are made-for-purpose cotton bra-liners that exist; here’s an example product on Amazon, or again, you could make your own if you feel so inclined. The important part is that it makes things so much comfortable, because let’s face it: wearing a bra in the summer is not comfortable.
So with these, it can become more comfortable (and the cotton liners are flat, so they’re not visible if one’s wearing a t-shirt or similar-coverage garment). You could go braless, of course, but then you’re back to having sweaty folds, so if you’re doing something other than swimming or lying on your back, you might want something there.
Different hydration rules
“People should drink this much per day” and guess what, those guidelines were based on, drumroll please, not fat people.
Sweating more means needing to hydrate more, and even without breaking a sweat, having a larger body than average (be it muscle, fat, or both) means having more body to hydrate. That’s simple math.
So instead, a good general guideline is half an ounce of water per your weight in pounds, per day:
How much water do I need each day?
Another good general guideline is to simply drink “little and often”, that is to say, always have a (hydrating!) drink on the go.
Take care!
Share This Post
Related Posts
We looked at genetic clues to depression in more than 14,000 people. What we found may surprise you
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.
The core experiences of depression – changes in energy, activity, thinking and mood – have been described for more than 10,000 years. The word “depression” has been used for about 350 years.
Given this long history, it may surprise you that experts don’t agree about what depression is, how to define it or what causes it.
But many experts do agree that depression is not one thing. It’s a large family of illnesses with different causes and mechanisms. This makes choosing the best treatment for each person challenging.
Reactive vs endogenous depression
One strategy is to search for sub-types of depression and see whether they might do better with different kinds of treatments. One example is contrasting “reactive” depression with “endogenous” depression.
Reactive depression (also thought of as social or psychological depression) is presented as being triggered by exposure to stressful life events. These might be being assaulted or losing a loved one – an understandable reaction to an outside trigger.
Endogenous depression (also thought of as biological or genetic depression) is proposed to be caused by something inside, such as genes or brain chemistry.
Many people working clinically in mental health accept this sub-typing. You might have read about this online.
But we think this approach is way too simple.
While stressful life events and genes may, individually, contribute to causing depression, they also interact to increase the risk of someone developing depression. And evidence shows that there is a genetic component to being exposed to stressors. Some genes affect things such as personality. Some affect how we interact with our environments.
What we did and what we found
Our team set out to look at the role of genes and stressors to see if classifying depression as reactive or endogenous was valid.
In the Australian Genetics of Depression Study, people with depression answered surveys about exposure to stressful life events. We analysed DNA from their saliva samples to calculate their genetic risk for mental disorders.
Our question was simple. Does genetic risk for depression, bipolar disorder, schizophrenia, ADHD, anxiety and neuroticism (a personality trait) influence people’s reported exposure to stressful life events?
We looked at the genetic risk of mental illness to see how that was linked to stressful life events, such as childhood abuse and neglect. Kamira/Shutterstock You may be wondering why we bothered calculating the genetic risk for mental disorders in people who already have depression. Every person has genetic variants linked to mental disorders. Some people have more, some less. Even people who already have depression might have a low genetic risk for it. These people may have developed their particular depression from some other constellation of causes.
We looked at the genetic risk of conditions other than depression for a couple of reasons. First, genetic variants linked to depression overlap with those linked to other mental disorders. Second, two people with depression may have completely different genetic variants. So we wanted to cast a wide net to look at a wider spectrum of genetic variants linked to mental disorders.
If reactive and endogenous depression sub-types are valid, we’d expect people with a lower genetic component to their depression (the reactive group) would report more stressful life events. And we’d expect those with a higher genetic component (the endogenous group) would report fewer stressful life events.
But after studying more than 14,000 people with depression we found the opposite.
We found people at higher genetic risk for depression, anxiety, ADHD or schizophrenia say they’ve been exposed to more stressors.
Assault with a weapon, sexual assault, accidents, legal and financial troubles, and childhood abuse and neglect, were all more common in people with a higher genetic risk of depression, anxiety, ADHD or schizophrenia.
These associations were not strongly influenced by people’s age, sex or relationships with family. We didn’t look at other factors that may influence these associations, such as socioeconomic status. We also relied on people’s memory of past events, which may not be accurate.
How do genes play a role?
Genetic risk for mental disorders changes people’s sensitivity to the environment.
Imagine two people, one with a high genetic risk for depression, one with a low risk. They both lose their jobs. The genetically vulnerable person experiences the job loss as a threat to their self-worth and social status. There is a sense of shame and despair. They can’t bring themselves to look for another job for fear of losing it too. For the other, the job loss feels less about them and more about the company. These two people internalise the event differently and remember it differently.
Genetic risk for mental disorders also might make it more likely people find themselves in environments where bad things happen. For example, a higher genetic risk for depression might affect self-worth, making people more likely to get into dysfunctional relationships which then go badly.
If two people lose their jobs, one with a high genetic risk of depression the other at low risk, both will experience and remember the event differently. Inside Creative House/Shutterstock What does our study mean for depression?
First, it confirms genes and environments are not independent. Genes influence the environments we end up in, and what then happens. Genes also influence how we react to those events.
Second, our study doesn’t support a distinction between reactive and endogenous depression. Genes and environments have a complex interplay. Most cases of depression are a mix of genetics, biology and stressors.
Third, people with depression who appear to have a stronger genetic component to their depression report their lives are punctuated by more serious stressors.
So clinically, people with higher genetic vulnerability might benefit from learning specific techniques to manage their stress. This might help some people reduce their chance of developing depression in the first place. It might also help some people with depression reduce their ongoing exposure to stressors.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Jacob Crouse, Research Fellow in Youth Mental Health, Brain and Mind Centre, University of Sydney and Ian Hickie, Co-Director, Health and Policy, Brain and Mind Centre, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Staying Sane In A Hyper-Connected World
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.
Staying Sane In A Hyper-Connected World
There’s a war over there, a genocide in progress somewhere else, and another disease is ravaging the population of somewhere most Americans would struggle to point out on the map. Not only that, but that one politician is at it again, and sweeping wildfires are not doing climate change any favors.
To borrow an expression from Gen-Z…
“Oof”.
A Very Modern Mental Health Menace
For thousands of years, we have had wars and genocides and plagues and corrupt politicians and assorted major disasters. Dire circumstances are not new to us as a species. So what is new?
As some reactionary said during the dot-com boom, “the Internet doesn’t make people stupid; it just makes their stupidity more accessible”.
The same is true now of The Horrors™.
The Internet doesn’t, by and large, make the world worse. But what it does do is make the bad things much, much more accessible.
Understanding and empathy are not bad things, but watch out…
- When soldiers came home from the First World War, those who hadn’t been there had no conception of the horrors that had been endured. That made it harder for the survivors to get support. That was bad.
- Nowadays, while mass media covering horrors certainly doesn’t convey the half of it, even the half it does convey can be overwhelming. This is also bad.
The insidious part is: while people are subjectively reporting good physical/mental health, the reports of the symptoms of poor physical/mental health from the same population do not agree:
Stress in America 2023: A nation grappling with psychological impacts of collective trauma
Should we just not watch the news?
In principle that’s an option, but it’s difficult to avoid, unless you truly live under a rock, and also do not frequent any social media at all. And besides, isn’t it our duty as citizens of this world to stay informed? How else can we make informed choices?
Staying informed, mindfully
There are steps that can be taken to keep ourselves informed, while protecting our mental health:
- Choose your sources wisely. Primary sources (e.g. tweets and videos from people who are there) will usually be most authentic, but also most traumatizing. Dispassionate broadsheets may gloss over or misrepresent things more (something that can be countered a bit by reading an opposing view from a publication you hate on principle), but will offer more of an emotional buffer.
- Boundary your consumption of the news. Set a timer and avoid doomscrolling. Your phone (or other device) may help with this if you set a screentime limit per app where you consume that kind of media.
- Take (again, boundaried) time to reflect. If you don’t, your brain will keep grinding at it “like a fork in the garbage disposal”. Talking about your feelings on the topic with a trusted person is great; journaling is also a top-tier more private option.
- If you feel helpless, help. Taking even small actions to help in the face of suffering somewhere else (e.g. donating to relief funds, engaging in advocacy / hounding your government about it), can help alleviate feelings of anguish and helplessness. And of course, as a bonus, it actually helps in the real world too.
- When you relax, relax fully. Even critical care doctors need downtime, nobody can be “always on” without burning out. So whatever distracts and relaxes you completely, make sure to make time for that too.
Want to know more?
That’s all we have room for today, but you might like to check out:
- Distressing images and videos can take a toll on our mental health. How can we stay informed without being traumatised?
- PTSD expert on how to protect yourself and your kids from overexposure to war images from the Mideast
You also might like our previous main features:
- C-PTSD, And What To Do When Life Genuinely Sucks
- A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
The “Yes I Can” Salad
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.
Sometimes, we are given to ask ourselves: “Can I produce a healthy and tasty salad out of what I have in?” and today we show how, with a well-stocked pantry, the answer is “yes I can”, regardless of what is (or isn’t) in the fridge.
You will need
- 1 can cannellini beans, drained
- 1 can sardines (if vegetarian/vegan, substitute ½ can chickpeas, drained)
- 1 can mandarin segments
- 1 handful pitted black olives, from a jar (or from a can, if you want to keep the “yes I can” theme going)
- ½ red onion, thinly sliced (this can be from frozen, defrosted—sliced/chopped onion is always a good thing to have in your freezer, by the way; your writer here always has 1–6 lbs of chopped onions in hers, divided into 1lb bags)
- 1 oz lemon juice
- 1 tbsp chopped parsley (this can be freeze-dried, but fresh is good if you have it)
- 1 tbsp extra virgin olive oil
- 1 tbsp chia seeds
- 1 tsp miso paste
- 1 tsp honey (omit if you don’t care for sweetness; substitute with agave nectar if you do like sweetness but don’t want to use honey specifically)
- 1 tsp red chili flakes
Method
(we suggest you read everything at least once before doing anything)
1) Combine the onion and the lemon juice in a small bowl, massaging gently
2) Mix (in another bowl) the miso paste with the chili flakes, chia seeds, honey, olive oil, and the spare juice from the can of mandarin segments, and whisk it to make a dressing.
3) Add the cannellini beans, sardines (break them into bite-size chunks), mandarin segments, olives, and parsley, tossing them thoroughly (but gently) in the dressing.
4) Top with the sliced onion, discarding the excess lemon juice, and serve:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Three Daily Servings of Beans?
- We Are Such Stuff As Fish Are Made Of
- Chia: The Tiniest Seeds With The Most Value
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
