The Distracted Mind – by Dr. Adam Gazzaley and Dr. Larry Rosen
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Yes, yes, we know, unplug once in a while. But what else do this highly-qualified pair of neuroscientists have to offer?
Rather than being a book for the sake of being a book, with lots of fluff and the usual advice about single-tasking, the authors start with a reframe:
Neurologically speaking, the hit of dopamine we get when looking for information is the exact same as the hit of dopamine that we, a couple of hundred thousand years ago, got when looking for nuts and berries.
- When we don’t find them, we become stressed, and search more.
- When we do find them, we are encouraged and search more nearby, and to the other side of nearby, and near around, to find more.
But in the case of information (be it useful information or celebrity gossip or anything in between), the Internet means that’s always available now.
So, we jitter around like squirrels, hopping from one to the next to the next.
A strength of this book is where it goes from there. Specifically, what evidence-based practices will actually keep our squirrel-brain focused… and which are wishful thinking for anyone who lives in this century.
Bringing original research from their own labs, as well as studies taken from elsewhere, the authors present a science-based toolkit of genuinely useful resources for actual focus.
Bottom line: if you think you could really optimize your life if you could just get on track and stay on track, this is the book for you.
Click here to check out The Distracted Mind, and get yours to focus!
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Miss Diagnosis: Anxiety, ADHD, & Women
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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
❝Why is ADHD so often misdiagnosed as anxiety in women?❞
A great question! A short and slightly flippant answer could be “it’s the medical misogyny”:
Women and Minorities Bear the Brunt of Medical Misdiagnosis
…and if you’d like to learn more in-depth about this, we recommend this excellent book:
Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn ← you can read our review here
However, in this case there is more going on too!
Part of this is because ADHD is, like many psychiatric issues, a collection of symptoms that may or may not all always be present. Since clinical definitions are decided by clinicians, rather than some special natural law of the universe, sometimes this results in “several small conditions in a trenchcoat”, and if one symptom is or isn’t present, it can make things look quite different:
What’s The Difference Between ADD and ADHD?
There are two things at hand here: as in the above example, there’s the presence or absence of hyperactivity, but also, that “attention deficit”?
It’s often not really a deficit of attention, so much as the attention is going somewhere else—an example of naming psychiatric disorders for how they affect other people, rather than the person in question.
Sidenote: personality disorders really get the worst of this!
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
etc
In the case of ADHD and anxiety and women, a lot of this comes down to how the redirection of focus is perceived:
❝For some time, it has been held that women with ADHD are more likely to internalize symptoms and become anxious and depressed and to suffer emotional dysregulation❞
This internalization of symptoms, vs the externalization more generally perceived in boys and men, is more likely to be seen as anxiety.
Double standards also abound for social reasons, e.g:
- He is someone who thinks ten steps ahead and covers all bases
- She is anxious and indecisive and unable to settle on one outcome
Here’s a very good overview of how this double-standard makes its way into diagnostic processes, along with other built-in biases:
Miss. Diagnosis: A Systematic Review of ADHD in Adult Women
Want to learn more?
We’ve reviewed quite a few books about ADHD, but if we had to pick one to spotlight, we’d recommend this one:
The Silent Struggle: Taking Charge of ADHD in Adults – by L. William Ross-Child, MLC
Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!
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Why scrapping the term ‘long COVID’ would be harmful for people with the condition
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The assertion from Queensland’s chief health officer John Gerrard that it’s time to stop using the term “long COVID” has made waves in Australian and international media over recent days.
Gerrard’s comments were related to new research from his team finding long-term symptoms of COVID are similar to the ongoing symptoms following other viral infections.
But there are limitations in this research, and problems with Gerrard’s argument we should drop the term “long COVID”. Here’s why.
A bit about the research
The study involved texting a survey to 5,112 Queensland adults who had experienced respiratory symptoms and had sought a PCR test in 2022. Respondents were contacted 12 months after the PCR test. Some had tested positive to COVID, while others had tested positive to influenza or had not tested positive to either disease.
Survey respondents were asked if they had experienced ongoing symptoms or any functional impairment over the previous year.
The study found people with respiratory symptoms can suffer long-term symptoms and impairment, regardless of whether they had COVID, influenza or another respiratory disease. These symptoms are often referred to as “post-viral”, as they linger after a viral infection.
Gerrard’s research will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases. It hasn’t been published in a peer-reviewed journal.
After the research was publicised last Friday, some experts highlighted flaws in the study design. For example, Steven Faux, a long COVID clinician interviewed on ABC’s television news, said the study excluded people who were hospitalised with COVID (therefore leaving out people who had the most severe symptoms). He also noted differing levels of vaccination against COVID and influenza may have influenced the findings.
In addition, Faux pointed out the survey would have excluded many older people who may not use smartphones.
The authors of the research have acknowledged some of these and other limitations in their study.
Ditching the term ‘long COVID’
Based on the research findings, Gerrard said in a press release:
We believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.
But Gerrard and his team’s findings cannot substantiate these assertions. Their survey only documented symptoms and impairment after respiratory infections. It didn’t ask people how fearful they were, or whether a term such as long COVID made them especially vigilant, for example.
Tens of thousands of Australians, and millions of people worldwide, have long COVID.
New Africa/ShutterstockIn discussing Gerrard’s conclusions about the terminology, Faux noted that even if only 3% of people develop long COVID (the survey found 3% of people had functional limitations after a year), this would equate to some 150,000 Queenslanders with the condition. He said:
To suggest that by not calling it long COVID you would be […] somehow helping those people not to focus on their symptoms is a curious conclusion from that study.
Another clinician and researcher, Philip Britton, criticised Gerrard’s conclusion about the language as “overstated and potentially unhelpful”. He noted the term “long COVID” is recognised by the World Health Organization as a valid description of the condition.
A cruel irony
An ever-growing body of research continues to show how COVID can cause harm to the body across organ systems and cells.
We know from the experiences shared by people with long COVID that the condition can be highly disabling, preventing them from engaging in study or paid work. It can also harm relationships with their friends, family members, and even their partners.
Despite all this, people with long COVID have often felt gaslit and unheard. When seeking treatment from health-care professionals, many people with long COVID report they have been dismissed or turned away.
Last Friday – the day Gerrard’s comments were made public – was actually International Long COVID Awareness Day, organised by activists to draw attention to the condition.
The response from people with long COVID was immediate. They shared their anger on social media about Gerrard’s comments, especially their timing, on a day designed to generate greater recognition for their illness.
Since the start of the COVID pandemic, patient communities have fought for recognition of the long-term symptoms many people faced.
The term “long COVID” was in fact coined by people suffering persistent symptoms after a COVID infection, who were seeking words to describe what they were going through.
The role people with long COVID have played in defining their condition and bringing medical and public attention to it demonstrates the possibilities of patient-led expertise. For decades, people with invisible or “silent” conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have had to fight ignorance from health-care professionals and stigma from others in their lives. They have often been told their disabling symptoms are psychosomatic.
Gerrard’s comments, and the media’s amplification of them, repudiates the term “long COVID” that community members have chosen to give their condition an identity and support each other. This is likely to cause distress and exacerbate feelings of abandonment.
Terminology matters
The words we use to describe illnesses and conditions are incredibly powerful. Naming a new condition is a step towards better recognition of people’s suffering, and hopefully, better diagnosis, health care, treatment and acceptance by others.
The term “long COVID” provides an easily understandable label to convey patients’ experiences to others. It is well known to the public. It has been routinely used in news media reporting and and in many reputable medical journal articles.
Most importantly, scrapping the label would further marginalise a large group of people with a chronic illness who have often been left to struggle behind closed doors.
Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Measles cases are rising—here’s how to protect your family
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The U.S. is currently experiencing a spike in measles cases across several states. Measles a highly contagious and potentially life-threatening disease caused by a virus. The measles-mumps-rubella (MMR) vaccine prevents measles; unvaccinated people put themselves and everyone around them at risk, including babies who are too young to receive the vaccine.
Read on to learn more about measles: what it is, how to stay protected, and what to do if a measles outbreak happens near you.
What are the symptoms of measles?
Measles symptoms typically begin 10 to 14 days after exposure. The disease starts with a fever followed by a cough, runny nose, and red eyes and then produces a rash of tiny red spots on the face and body. Measles can affect anyone, but is most serious for children under 5, immunocompromised people, and pregnant people, who may give birth prematurely or whose babies may have low birth weight as a result of a measles infection.
Measles isn’t just a rash—the disease can cause serious health problems and even death. About one in five unvaccinated people in the U.S. who get measles will be hospitalized and could suffer from pneumonia, dehydration, or brain swelling.
If you get measles, it can also damage your immune system, making you more vulnerable to other diseases.
How do you catch measles?
Measles spreads through the air when an infected person coughs or sneezes. It’s so contagious that unvaccinated people have a 90 percent chance of becoming infected if exposed.
An infected person can spread measles to others before they have symptoms.
Why are measles outbreaks happening now?
The pandemic caused many children to miss out on routine vaccinations, including the MMR vaccine. Delayed vaccination schedules coincided with declining confidence in vaccine safety and growing resistance to vaccine requirements.
Skepticism about the safety and effectiveness of COVID-19 vaccines has resulted in some people questioning or opposing the MMR vaccine and other routine immunizations.
How do I protect myself and my family from measles?
Getting an MMR vaccine is the best way to prevent getting sick with measles or spreading it to others. The CDC recommends that children receive the MMR vaccine at 12 to 15 months and again at 4 to 6 years, before starting kindergarten.
One dose of the MMR vaccine provides 93 percent protection and two doses provide 97 percent protection against all strains of measles. Because some children are too young to be immunized, it’s important that those around them are vaccinated to protect them.
Is the MMR vaccine safe?
The MMR vaccine has been rigorously tested and monitored over 50 years and determined to be safe. Adverse reactions to the vaccine are extremely rare.
Receiving the MMR vaccine is much safer than contracting measles.
What do I do if there’s a measles outbreak in my community?
Anyone who is not fully vaccinated for measles should be immunized with a measles vaccine as soon as possible. Measles vaccines given within 72 hours after exposure may prevent or reduce the severity of disease.
Children as young as 6 months old can receive the MMR vaccine if they are at risk during an outbreak. If your child isn’t fully vaccinated with two doses of the MMR vaccine—or three doses, if your child received the first dose before their first birthday—talk to your pediatrician.
Unvaccinated people who have been exposed to the virus should stay home from work, school, day care, and other activities for 21 days to avoid spreading the disease.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Shame and blame can create barriers to vaccination
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Understanding the stigma surrounding infectious diseases like HIV and mpox may help community health workers break down barriers that hinder access to care.
Looking back in history can provide valuable lessons to confront stigma in health care today, especially toward Black, Latine, LGBTQ+, and other historically underserved communities disproportionately affected by COVID-19 and HIV.
Public Good News spoke with Sam Brown, HIV prevention and wellness program manager at Civic Heart, a community-based organization in Houston’s historic Third Ward, to understand the effects of stigma around sexual health and vaccine uptake.
Brown shared more about Civic Heart’s efforts to provide free confidential testing for sexually transmitted infections, counseling and referrals, and information about COVID-19, flu, and mpox vaccinations, as well as the lessons they’re learning as they strive for vaccine equity.
Here’s what Brown said.
[Editor’s note: This content has been edited for clarity and length.]
PGN: Some people on social media have spread the myth that vaccines cause AIDS or other immune deficiencies when the opposite is true: Vaccines strengthen our immune systems to help protect against disease. Despite being frequently debunked, how do false claims like these impact the communities you serve?
Sam Brown: Misinformation like that is so hard to combat. And it makes the work and the path to overall community health hard because people will believe it. In the work that we do, 80 percent of it is changing people’s perspective on something they thought they knew.
You know, people don’t even transmit AIDS. People transmit HIV. So, a vaccine causing immunodeficiency doesn’t make sense.
With the communities we serve, we might have a person that will believe the myth, and because they believe it, they won’t get vaccinated. Then later, they may test positive for COVID-19.
And depending on social determinants of health, it can impact them in a whole heap of ways: That person is now missing work, they’re not able to provide for their family—if they have a family. It’s this mindset that can impact a person’s life, their income, their ability to function.
So, to not take advantage of something like a vaccine that’s affordable, or free for the most part, just because of misinformation or a misunderstanding—that’s detrimental, you know.
For example, when we talk to people in the community, many don’t know that they can get mpox from their pet, or that it’s zoonotic—that means that it can be transferred between different species or different beings, from animals to people. I see a lot of surprise and shock [when people learn this].
It’s difficult because we have to fight the misinformation and the stigma that comes with it. And it can be a big barrier.
People misunderstand. [They] think that “this is something that gay people or the LGBTQ+ community get,” which is stigmatizing and comes off as blaming. And blaming is the thing that leads us to be misinformed.
PGN: In the last couple years, your organization’s HIV Wellness program has taken on promoting COVID-19, flu, and mpox vaccines to the communities you serve. How do you navigate conversations between sexual health and infectious diseases? Can you share more about your messaging strategies?
S.B.: As we promoted positive sexual health and HIV prevention, we saw people were tired of hearing about HIV. They were tired of hearing about how PrEP works, or how to prevent HIV.
But, when we had an outbreak of syphilis in Houston just last year, people were more inclined to test because of the severity of the outbreak.
So, what our team learned is that sometimes you have to change the message to get people what they need.
We changed our message to highlight more syphilis information and saw that we were able to get more people tested for HIV because we correlated how syphilis and HIV are connected and how a person can be susceptible to both.
Using messages that the community wants and pairing them with what the community needs has been better for us. And we see that same thing with COVID-19, the flu, and RSV. Sometimes you just can’t be married to a message. We’ve had to be flexible to meet our clients where they are to help them move from unsafe practices to practices that are healthy and good for them and their communities.
PGN: You’ve mentioned how hard it is to combat stigma in your work. How do you effectively address it when talking to people one-on-one?
S.B.: What I understand is that no one wants to feel shame. What I see people respond to is, “Here’s an opportunity to do something different. Maybe there was information that you didn’t know that caused you to make a bad decision. And now here’s an opportunity to gain information so that you can make a better decision.”
People want to do what they want to do; they want to live how they want to live. And we all should be able to do that as long as it’s not hurting anyone, but also being responsible enough to understand that, you know, COVID-19 is here.
So, instead of shaming and blaming, it’s best to make yourself aware and understand what it is and how to treat it. Because the real enemy is the virus—it’s the infection, not the people.
When we do our work, we want to make sure that we come from a strengths-based approach. We always look at what a client can do, what that client has. We want to make sure that we’re empowering them from that point. So, even if they choose not to prioritize our message right now, we can’t take that personally. We’ll just use it as a chance to try a new way of framing it to help people understand what we’re trying to say.
And sometimes that can be difficult, even for organizations. But getting past that difficulty comes with a greater opportunity to impact someone else.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Thinking about trying physiotherapy for endometriosis pain? Here’s what to expect
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Endometriosis is a condition that affects women and girls. It occurs when tissue similar to the lining of the uterus ends up in other areas of the body. These areas include the ovaries, bladder, bowel and digestive tract.
Endometriosis will affect nearly one million Australian women and girls in their lifetime. Many high-profile Australians are affected by endometriosis including Bindi Irwin, Sophie Monk and former Yellow Wiggle, Emma Watkins.
Symptoms of endometriosis include intense pelvic, abdominal or low back pain (that is often worse during menstruation), bladder and bowel problems, pain during sex and infertility.
But women and girls wait an average of seven years to receive a diagnosis. Many are living with the burden of endometriosis and not receiving treatments that could improve their quality of life. This includes physiotherapy.
Netpixi/Shutterstock How is endometriosis treated?
No treatments cure endometriosis. Symptoms can be reduced by taking medications such as non-steriodal anti-inflammatories (ibuprofen, aspirin or naproxen) and hormonal medicines.
Surgery is sometimes used to diagnose endometriosis, remove endometrial lesions, reduce pain and improve fertility. But these lesions can grow back.
Whether they take medication or have surgery, many women and girls continue to experience pain and other symptoms.
Pelvic health physiotherapy is often recommended as a non-drug management technique to manage endometriosis pain, in consultation with a gynaecologist or general practitioner.
The goal of physiotherapy treatment depends on the symptoms but is usually to reduce and manage pain, improve ability to do activities, and ultimately improve quality of life.
What could you expect from your first appointment?
Physiotherapy management can differ based on the severity and location of symptoms. Prior to physical tests and treatments, your physiotherapist will comprehensively explain what is going to happen and seek your permission.
They will ask questions to better understand your case and specific needs. These will include your age, weight, height as well as the presence, location and intensity of symptoms.
You will also be asked about the history of your period pain, your first period, the length of your menstrual cycle, urinary and bowel symptoms, sexual function and details of any previous treatments and tests.
They may also assess your posture and movement to see how your muscles have changed because of the related symptoms.
During the consultation, your physio will assess you for painful areas and muscle tightness. Netpixi/Shutterstock They will press on your lower back and pelvic muscles to spot painful areas (trigger points) and muscle tightness.
If you consent to a vaginal examination, the physiotherapist will use one to two gloved fingers to assess the area inside and around your vagina. They will also test your ability to coordinate, contract and relax your pelvic muscles.
What type of treatments could you receive?
Depending on your symptoms, your physiotherapist may use the following treatments:
General education
Your physiotherapist will give your details about the disease, pelvic floor anatomy, the types of treatment and how these can improve pain and other symptoms. They might teach you about the changes to the brain and nerves as a result of being in long-term pain.
They will provide guidance to improve your ability to perform daily activities, including getting quality sleep.
If you experience pain during sex or difficulty using tampons, they may teach you how to use vaginal dilators to improve flexibility of those muscles.
Pelvic muscle exercises
Pelvic muscles often contract too hard as a result of pain. Pelvic floor exercises will help you contract and relax muscles appropriately and provide an awareness of how hard muscles are contracting.
This can be combined with machines that monitor muscle activity or vaginal pressure to provide detailed information on how the muscles are working.
Yoga, stretching and low-impact exercises
Yoga, stretching and low impact aerobic exercise can improve fitness, flexibility, pain and blood circulation. These have general pain-relieving properties and can be a great way to contract and relax bigger muscles affected by long-term endometriosis.
These exercises can help you regain function and control with a gradual progression to perform daily activities with reduced pain.
Low-impact exercise can reduce pain. ABO Photography/Shutterstock Hydrotherapy (physiotherapy in warm water)
Performing exercises in water improves blood circulation and muscle relaxation due to the pressure and warmth of the water. Hydrotherapy allows you to perform aerobic exercise with low impact, which will reduce pain while exercising.
However, while hydrotherapy shows positive results clinically, scientific studies to show its effectiveness studies are ongoing.
Manual therapy
Women frequently have small areas of muscle that are tight and painful (trigger points) inside and outside the vagina. Pain can be temporarily reduced by pressing, massaging or putting heat on the muscles.
Physiotherapists can teach patients how to do these techniques by themselves at home.
What does the evidence say?
Overall, patients report positive experiences pelvic health physiotherapists treatments. In a study of 42 women, 80% of those who received manual therapy had “much improved pain”.
In studies investigating yoga, one study showed pain was reduced in 28 patients by an average of 30 points on a 100-point pain scale. Another study showed yoga was beneficial for pain in all 15 patients.
But while some studies show this treatment is effective, a review concluded more studies were needed and the use of physiotherapy was “underestimated and underpublicised”.
What else do you need to know?
If you have or suspect you have endometriosis, consult your gynaecologist or GP. They may be able to suggest a pelvic health physiotherapist to help you manage your symptoms and improve quality of life.
As endometriosis is a chronic condition you may be entitled to five subsidised or free sessions per calendar year in clinics that accept Medicare.
If you go to a private pelvic health physiotherapist, you won’t need a referral from a gynaecologist or GP. Physiotherapy rebates can be available to those with private health insurance.
The Australian Physiotherapy Association has a Find a Physio section where you can search for women’s and pelvic physiotherapists. Endometriosis Australia also provides assistance and advice to women with Endometriosis.
Thanks to UTS Masters students Phoebe Walker and Kasey Collins, who are researching physiotherapy treatments for endometriosis, for their contribution to this article.
Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney and Caroline Wanderley Souto Ferreira, Visiting Professor of Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthy sex drive In Our Fifties
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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
Q: What’s a healthy sex drive for someone in their 50s?
A: If you’re happy with it, it’s healthy! If you’re not, it’s not.
This means… If you’re not (happy) and thus it’s not (healthy), you have two main options:
- Find a way to be happier without changing it (i.e., change your perspective)
- Find a way to change your sex drive (presumably: “increase it”, but we don’t like to assume)
There are hormonal and pharmaceutical remedies that may help (whatever your sex), so do speak with your doctor/pharmacist.
Additionally, if a boost to sex drive is what’s wanted, then almost anything that is good for your heart will help.
We wrote about heart health yesterday:
What Matters Most For Your Heart?
That was specifically about dietary considerations, so you might also want to check out:
Take care!
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