The CBT Workbook for Mental Health – by Dr. Simon Rego & Sarah Fader

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We have often reviewed psychology books here with a note saying “and no, it’s not just a book of the standard CBT techniques that you probably already know”.

So today, this one’s for anyone who was ever thinking “but I don’t know the standard CBT techniques and I would like to know them!”.

The authors outline specific solutions to many common quantifiable problems, with simple exercises that are well-explained and easy to implement.

Cognitive Behavioral Therapy (CBT) is not a panacea, but for the things it can be used for, it’s very effective and is a very good “first thing to reach for” to see if it works, because its success rate for a lot of problems is very high.

What kinds of things is this book most likely to help with? A lot of common forms of stress, anxiety, self-esteem issues, cravings, shame, and relationship issues. Other things too, but we can’t list everything and that list already covers a lot of very high-incidence stuff.

Bottom line: if CBT isn’t something already in your toolbox, this book will help you add all its best tips and tricks.

Click here to check out The CBT Workbook for Mental Health, and get tooled up!

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Recommended

  • The Mindful Body – by Dr. Ellen Langer
  • Do Breathe – by Michael Williams
    Streamline your life with Do Breathe. This book combines advice from top sources like “Getting Things Done” and “Atomic Habits” for an efficient, all-in-one guide. Simplify your life today!

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  • Waist Size Worries: Age-Appropriate Solutions

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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

    ❝My BMI is fine, but my waist is too big. What do I do about that? I am 5′ 5″ tall and 128 pounds and 72 years old.❞

    It’s hard to say without knowing about your lifestyle (and hormones, for that matter)! But, extra weight around the middle in particular is often correlated with high levels of cortisol, so you might find this of benefit:

    Lower Your Cortisol! (Here’s Why & How)

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  • Matcha is having a moment. What are the health benefits of this green tea drink?

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    Matcha has experienced a surge in popularity in recent months, leading to reports of global shortages and price increases.

    If you haven’t been caught up in the craze, matcha is a powdered version of green tea. On a cafe menu you might see a hot or iced matcha latte, or even a matcha-flavoured cake or pastry. A quick google brings up countless recipes incorporating matcha, both sweet and savoury.

    Retailers and cafe owners have suggested the main reasons for matcha’s popularity include its “instagrammable” looks and its purported health benefits.

    But what are the health benefits of matcha? Here’s what the evidence says.

    Rawpixel.com/Shutterstock

    First, what is matcha?

    Matcha is a finely ground powder of green tea leaves, which come from the plant Camellia sinensis. This is the same plant used to make green and black tea. However, the production process differentiates matcha from green and black tea.

    For matcha, the tea plant is grown in shade. Once the leaves are harvested, they’re steamed and dried and the stems are removed. Then the leaves are carefully ground at controlled temperatures to form the powder.

    The production process for green tea is simpler. The leaves are picked from the unshaded plants, heated and then dried. We then steep the dried leaves in hot water to get tea (whereas with matcha the whole leaf is consumed).

    With black tea, after the leaves are picked they’re exposed to air, which leads to oxidation. This makes the leaves black and gives the tea a different flavour.

    Hands holding a cup of matcha.
    In countries such as Japan, matcha is traditionally whisked with water and served in a stone bowl. Charlotte May/Pexels

    A source of phytonutrients

    Phytonutrients are chemical compounds found in plants which have a range of benefits for human health. Matcha contains several.

    Chlorophyll gives plants such as Camellia sinensis their green colour. There’s some evidence chlorophyll may have health benefits – including anti-inflammatory, anti-cancer and anti-obesity effects – due to its antioxidant properties. Antioxidants neutralise free radicals, which are unstable molecules that harm our cells.

    Theanine has been shown to improve sleep and reduce stress and anxiety. The only other known dietary source of theanine is mushrooms.

    Caffeine is a phytonutrient we know well. Aside from increasing alertness, caffeine has also demonstrated antioxidant effects and some protection against a range of chronic and neurodegenerative diseases. However, too much caffeine can have negative side effects.

    Interestingly, shading the plants while growing appears to change the nutritional composition of the leaf and may lead to higher levels of these phytonutrients in matcha compared to green tea.

    Another compound worth mentioning is called catechins, of which there are several different types. Matcha powder similarly has more catechins than green tea. They are strong antioxidants, which have been shown to have protective effects against bacteria, viruses, allergies, inflammation and cancer. Catechins are also found in apples, blueberries and strawberries.

    What are the actual health benefits?

    So we know matcha contains a variety of phytonutrients, but does this translate to noticeable health benefits?

    A review published in 2023 identified only five experimental studies that have given matcha to people. These studies gave participants about 2–4g of matcha per day (equivalent to 1–2 teaspoons of matcha powder), compared to a placebo, as either a capsule, in tea or in foods. Matcha decreased stress and anxiety, and improved memory and cognitive function. There was no effect on mood.

    A more recent study showed 2g of matcha in older people aged 60 to 85 improved sleep quality. However, in younger people aged 27 to 64 in another study, matcha had little effect on sleep.

    A study in people with obesity found no difference in the weight loss observed between the matcha group and the control group. This study did not randomise participants, and people knew which group they had been placed in.

    It could be hypothesised that given you consume all of the leaf, and given levels of some phytonutrients may be higher due to the growing conditions, matcha may have more nutritional benefits than green tea. But to my knowledge there has been no direct comparison of health outcomes from green tea compared to matcha.

    A matcha latte in a black cup on a brown table.
    Matcha has grown in popularity – but evidence for its health benefits is still limited. Usanee/Shutterstock

    There’s lots of evidence for green tea

    While to date a limited number of studies have looked at matcha, and none compared matcha and green tea, there’s quite a bit of research on the health benefits of drinking green tea.

    A systematic review of 21 studies on green tea has shown similar benefits to matcha for improvements in memory, plus evidence for mood improvement.

    There’s also evidence green tea provides other health benefits. Systematic reviews have shown green tea leads to weight loss in people with obesity, lower levels of certain types of cholesterol, and reduced blood pressure. Green tea may also lower the risk of certain types of cancer.

    So, if you can’t get your hands on matcha at the moment, drinking green tea may be a good way to get your caffeine hit.

    Although the evidence on green tea provides us with some hints about the health benefits of matcha, we can’t be certain they would be the same. Nonetheless, if your local coffee shop has a good supply of matcha, there’s nothing to suggest you shouldn’t keep enjoying matcha drinks.

    However, it may be best to leave the matcha croissant or cronut for special occasions. When matcha is added to foods with high levels of added sugar, salt and saturated fat, any health benefits that could be attributed to the matcha may be negated.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

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

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  • What is Ryeqo, the recently approved medicine for endometriosis?

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    For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.

    A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.

    Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.

    What does Ryeqo do?

    Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.

    Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.

    Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.

    All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.

    Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).

    Is it really new?

    The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.

    But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.

    Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.

    In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.

    The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.

    hands taking pill out of contraceptive blister pack
    You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
    Shutterstock

    How to take it and what not to do

    Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.

    It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.

    Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.

    Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.

    The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.

    It’s costly for now

    Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.

    While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.

    Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.The Conversation

    Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney

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

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Related Posts

  • The Mindful Body – by Dr. Ellen Langer
  • The Biological Mind – by Dr. Alan Jasanoff

    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.

    How special is our brain? According to Dr. Alan Jasanoff, it’s not nearly as special as we think it is.

    In this work, he outlines the case for how we have collectively overstated the brain’s importance. That it’s just another organ like a heart or a kidney, and that who we are is as much a matter of other factors, as what goes on in our brain.

    In this reviewer’s opinion, he overcorrects a bit. The heart and kidneys are very simple organs, as organs go. The brain is not. And while everything from our gut microbiota to our environment to our hormones may indeed contribute to what is us, our brain is one thing that can’t just be swapped out.

    Nevertheless, this very well-written book can teach us a lot about everything else that makes us us, including many biological factors that many people don’t know about or consider.

    Towards the end of the book, he switches into futurist speculation, and his speculation can be summed up as “we cannot achieve anything worthwhile in the future”.

    Bottom line: if you’ve an interest in such things as how transplanting glial cells can give a 30% cognitive enhancement, and how a brain transplant wouldn’t result in the same us in a different body, this is the book for you.

    Click here to check out The Biological Mind, and learn about yours!

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  • What Size Breakfast Is Best, By Science?

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    “Breakfast is the most important meal of the day”, the popular wisdom goes. But, what should it consist of, and how much should we be eating for breakfast?

    It has been previously established that it is good if breakfast is the largest meal of the day:

    Mythbusting Breaktime

    …with meals getting progressively smaller thereafter.

    Of course, very many people do the inverse: small (or skipped) breakfast, moderate lunch, larger dinner. This, however, is probably more a result of when eating fits around the modern industrialized workday (and thus gets normalized), rather than actual health considerations.

    So, what’s the latest science?

    A plucky band of researchers led by Dr. Karla-Alejandra Pérez-Vega investigated the importance of breakfast in the context of heart health. This research was done as part of a larger study into the effects of the Mediterranean Diet on cardiovascular health, so if anyone wants a quick recap before we carry on, then:

    The Mediterranean Diet: What Is It Good For? ← the answer, by the way, is “pretty much everything”

    …and there are also different versions that each use the Mediterranean Diet as the core, while focussing extra on a different area of health, including one to make it extra heart-healthy:

    Four Ways To Upgrade The Mediterranean ← most anti-inflammatory / gut-healthiest / heart-healthiest / brain-healthiest

    What they found

    In their sample population (n=383) of Spanish adults aged 55–75 with pre-diagnosed metabolic syndrome who, as part of the intervention of this 36-month interventional study, had now for the past 36 months been on a Mediterranean diet but without specific guidance on portion sizes:

    • Participants with insufficient breakfast energy intake had the highest adiposity (which is a measure of body fat expressed as a percentage of total mass)
    • Participants with low or high (but not moderate) breakfast energy intake had the larger BMI and waist circumference over time
    • Participants with low or high (but not moderate) breakfast energy intake had higher triglyceride and lower HDL (good) cholesterol levels
    • Participants who consumed 20–30% of their daily calories at breakfast enjoyed the greatest improvements in lipid profiles, with lower triglycerides and higher HDL (good) cholesterol levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood pressure levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood sugar levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had lower estimated glomerular filtration rate (which is an indicator of kidney function)
    • Participants with higher breakfast quality (higher adherence to Mediterranean Diet) had lower waist circumference, higher HDL cholesterol, and better kidney function

    You can see the paper itself here in the Journal of Nutrition, Health, and Aging:

    Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults

    What this means

    According to this research, the heart-healthiest breakfast is:

    • not skipped
    • Mediterranean Diet adherent
    • within the range of of 20–30% of the total calories for the day

    Want to make it even better?

    Consider:

    Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting

    Enjoy!

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  • The Best Form Of Sugar During Exercise

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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 😎

    ❝What is the best form of sugar for an energy kick during exercise? Both type of sugar eg glicoae fructose dextrose etc and medium, ie drink, gel, solids etc❞

    Great question! Let’s be clear first that we’re going to answer this specifically for the context of during exercise.

    Because, if you’re not actively exercising strenuously right at the time when you’re taking the various things we’re going to be talking about, the results will not be the same.

    For scenarios that are anything less than “I am exercising right now and my muscles (not joints, or anything else) are feeling the burn”, then instead please see this:

    Snacks & Hacks: Eating For Energy (In Ways That Actually Work)

    Because, to answer your question, we’re going to be going 100% against the first piece of advice in that article, which was “Skip the quasi-injectables”, i.e., anything marketed as very quick release. Those things are useful for diabetics to have handy just in case of needing to urgently correct a hypo, but for most people most of the time, they’re not. See also:

    Which Sugars Are Healthier, And Which Are Just The Same?

    However…

    When strenuously exercising in a way that is taxing our muscles, we do not have to worry about the usual problem of messing up our glucose metabolism by overloading our body with sugars faster than it can use it (thus: it has to hurriedly convert glucose and shove it anywhere it’ll fit to put it away, which is very bad for us), because right now, in the exercise scenario we’re describing, the body is already running its fastest metabolism and is grabbing glucose anywhere it can find it.

    Which brings us to our first key: the best type of sugar for this purpose is glucose. Because:

    • glucose: the body can use immediately and easily convert whatever’s spare to glycogen (a polysaccharide of glucose) for storage
    • fructose: the body cannot use immediately and any conversion of fructose to glycogen has to happen in the liver, so if you take too much fructose (without anything to slow it down, such as the fiber in whole fruit), you’re not only not going to get usable energy (the sugar is just going to be there in your bloodstream, circulating, not getting used, because it doesn’t trigger insulin release and insulin is the gatekeeper that allows sugar to be used), but also, it’s going to tax the liver, which if done to excess, is how we get non-alcoholic fatty liver disease.
    • sucrose: is just a disaccharide of glucose and fructose, so it first gets broken down into those, and then its constituent parts get processed as above. Other disaccharides you’ll see mentioned sometimes are maltose and lactose, but again, they’re just an extra step removed from useful metabolism, so to save space, we’ll leave it at that for those today.
    • dextrose: is just glucose, but when the labeller is feeling fancy. It’s technically informational because it specifies what isomer of glucose it is, but basically all glucose found in food is d-glucose, i.e. dextrose. Other isomers of glucose can be synthesized (very expensively) in laboratories or potentially found in obscure places (the universe is vast and weird), but in short: unless someone’s going to extreme lengths to get something else, all glucose we encounter is dextrose, and all (absolutely all) dextrose is glucose.

    We’d like to show scientific papers contesting these head-to-head for empirical proof, but since the above is basic chemistry and physiology, all we could find is papers taking this for granted and stating in their initial premise that sports drinks, gels, bars usually contain glucose as their main sugar, potentially with some fructose and sucrose. Like this one:

    A Comprehensive Study on Sports and Energy Drinks

    As for how to take it, again this is the complete opposite of our usual health advice of “don’t drink your calories”, because in this case, for once…

    (and again, we must emphasize: only while actively doing strenuous exercise that is making specifically your muscles burn, not your joints or anything else; if your joints are burning you need to rest and definitely don’t spike your blood sugars because that will worsen inflammation)

    …just this once, we do want those sugars to be zipping straight into the blood. Which means: liquid is best for this purpose.

    And when we say liquid: gel is the same as a drink, so far as the body is concerned, provided the body in question is adequately hydrated (i.e., you are also drinking water).

    Here are a pair of studies (by the same team, with the same general methodology), testing things head-to-head, with endurance cyclists on 6-hour stationary cycle rides:

    CHO Oxidation from a CHO Gel Compared with a Drink during Exercise

    Meanwhile, liquid beat solid, but only significantly so from the 90-minute mark onwards, and even that significant difference was modest (i.e. it’s clinically significant, it’s a statistically reliable result and improbable as random happenstance, but the actual size of the difference was not huge):

    Oxidation of Solid versus Liquid CHO Sources during Exercise

    We would hypothesize that the reason that liquids only barely outperformed solids for this task is precisely because the solids in question were also designed for the task. When a company makes a fast-release energy bar, they don’t load it with fiber to slow it down. Which differentiates this greatly from, say, getting one’s sugars from whole fruit.

    If the study had compared apples to apple juice, we hypothesize the results would have been very different. But alas, if that study has been done, we couldn’t find it.

    Today has been all about what’s best during exercise, so let’s quickly finish with a note on what’s best before and after:

    Before: What To Eat, Take, And Do Before A Workout

    After: Overdone It? How To Speed Up Recovery After Exercise

    Take care!

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