The Meds That Impair Decision-Making

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Impairment to cognitive function is often comorbid with Parkinson’s disease. That is to say: it’s not a symptom of Parkinson’s, but it often occurs in the same people. This may seem natural: after all, both are strongly associated with aging.

However, recent (last month, at time of writing) research has brought to light a very specific way in which medication for Parkinson’s may impair the ability to make sound decisions.

Obviously, this is a big deal, because it can affect healthcare decisions, financial decisions, and more—greatly impacting quality of life.

See also: Age-related differences in financial decision-making and social influence

(in which older people were found more likely to be influenced by the impulsive financial preferences of others than their younger counterparts, when other factors are controlled for)

As for how this pans out when it comes to Parkinson’s meds…

Pramipexole (PPX)

This drug can, due to an overlap in molecular shape, mimic dopamine in the brains of people who don’t have enough—such as those with Parkinson’s disease. This (as you might expect) helps alleviate Parkinson’s symptoms.

However, researchers found that mice treated with PPX and given a touch-screen based gambling game picked the high-risk, high reward option much more often. In the hopes of winning strawberry milkshake (the reward), they got themselves subjected to a lot of blindingly-bright flashing lights (the risk, to which untreated mice were much more averse, as this is very stressful for a mouse).

You may be wondering: did the mice have Parkinson’s?

The answer: kind of; they had been subjected to injections with 6-hydroxydopamine, which damages dopamine-producing neurons similarly to Parkinson’s.

This result was somewhat surprising, because one would expect that a mouse whose depleted dopamine was being mimicked by a stand-in (thus, doing much of the job of dopamine) would be less swayed by the allure of gambling (a high-dopamine activity), since gambling is typically most attractive to those who are desperate to find a crumb of dopamine somewhere.

They did find out why this happened, by the way, the PPX hyperactivated the external globus pallidus (also called GPe, and notwithstanding the name, this is located deep inside the brain). Chemically inhibiting this area of the brain reduced the risk-taking activity of the mice.

This has important implications for Parkinson’s patients, because:

  • on an individual level, it means this is a side effect of PPX to be aware of
  • on a research-and-development level, it means drugs need to be developed that specifically target the GPe, to avoid/mitigate this side effect.

You can read the study in full here:

Pramipexole Hyperactivates the External Globus Pallidus and Impairs Decision-Making in a Mouse Model of Parkinson’s Disease

Don’t want to get Parkinson’s in the first place?

While nothing is a magic bullet, there are things that can greatly increase or decrease Parkinson’s risk. Here’s a big one, as found recently (last week, at the time of writing):

Air Pollution and Parkinson’s Disease in a Population-Based Study

Also: knowing about its onset sooner rather than later is scary, but beneficial. So, with that in mind…

Recognize The Early Symptoms Of Parkinson’s Disease

Finally, because Parkinson’s disease is theorized to be caused by a dysfunction of alpha-synuclein clearance (much like the dysfunction of beta-amyloid clearance, in the case of Alzheimer’s disease), this means that having a healthy glymphatic system (glial cells doing the same clean-up job as the lymphatic system, but in the brain) is critical:

How To Clean Your Brain (Glymphatic Health Primer)

Take care!

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  • Parents are increasingly saying their child is ‘dysregulated’. What does that actually mean?

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    Welcome aboard the roller coaster of parenthood, where emotions run wild, tantrums reign supreme and love flows deep.

    As children reach toddlerhood and beyond, parents adapt to manage their child’s big emotions and meltdowns. Parenting terminology has adapted too, with more parents describing their child as “dysregulated”.

    But what does this actually mean?

    ShUStudio/Shutterstock

    More than an emotion

    Emotional dysregulation refers to challenges a child faces in recognising and expressing emotions, and managing emotional reactions in social settings.

    This may involve either suppressing emotions or displaying exaggerated and intense emotional responses that get in the way of the child doing what they want or need to do.

    Dysregulation” is more than just feeling an emotion. An emotion is a signal, or cue, that can give us important insights to ourselves and our preferences, desires and goals.

    An emotionally dysregulated brain is overwhelmed and overloaded (often, with distressing emotions like frustration, disappointment and fear) and is ready to fight, flight or freeze.

    Developing emotional regulation

    Emotion regulation is a skill that develops across childhood and is influenced by factors such as the child’s temperament and the emotional environment in which they are raised.

    In the stage of emotional development where emotion regulation is a primary goal (around 3–5 years old), children begin exploring their surroundings and asserting their desires more actively.

    Child sits next to her parent's bed
    A child’s temperament and upbringing affect how they regulate emotions. bluedog studio/Shutterstock

    It’s typical for them to experience emotional dysregulation when their initiatives are thwarted or criticised, leading to occasional tantrums or outbursts.

    A typically developing child will see these types of outbursts reduce as their cognitive abilities become more sophisticated, usually around the age they start school.

    Express, don’t suppress

    Expressing emotions in childhood is crucial for social and emotional development. It involves the ability to convey feelings verbally and through facial expressions and body language.

    When children struggle with emotional expression, it can manifest in various ways, such as difficulty in being understood, flat facial expressions even in emotionally charged situations, challenges in forming close relationships, and indecisiveness.

    Several factors, including anxiety, attention-deficit hyperactivity disorder (ADHD), autism, giftedness, rigidity and both mild and significant trauma experiences, can contribute to these issues.

    Common mistakes parents can make is dismissing emotions, or distracting children away from how they feel.

    These strategies don’t work and increase feelings of overwhelm. In the long term, they fail to equip children with the skills to identify, express and communicate their emotions, making them vulnerable to future emotional difficulties.

    We need to help children move compassionately towards their difficulties, rather than away from them. Parents need to do this for themselves too.

    Caregiving and skill modelling

    Parents are responsible for creating an emotional climate that facilitates the development of emotion regulation skills.

    Parents’ own modelling of emotion regulation when they feel distressed. The way they respond to the expression of emotions in their children, contributes to how children understand and regulate their own emotions.

    Children are hardwired to be attuned to their caregivers’ emotions, moods, and coping as this is integral to their survival. In fact, their biggest threat to a child is their caregiver not being OK.

    Unsafe, unpredictable, or chaotic home environments rarely give children exposure to healthy emotion expression and regulation. Children who go through maltreatment have a harder time controlling their emotions, needing more brainpower for tasks that involve managing feelings. This struggle could lead to more problems with emotions later on, like feeling anxious and hypervigilant to potential threats.

    Recognising and addressing these challenges early on is essential for supporting children’s emotional wellbeing and development.

    A dysregulated brain and body

    When kids enter “fight or flight” mode, they often struggle to cope or listen to reason. When children experience acute stress, they may respond instinctively without pausing to consider strategies or logic.

    If your child is in fight mode, you might observe behaviours such as crying , clenching fists or jaw, kicking, punching, biting, swearing, spitting or screaming.

    In flight mode, they may appear restless, have darting eyes, exhibit excessive fidgeting, breathe rapidly, or try to run away.

    A shut-down response may look like fainting or a panic attack.

    When a child feels threatened, their brain’s frontal lobe, responsible for rational thinking and problem-solving, essentially goes offline.

    The amygdala, shown here in red, triggers survival mode. pikovit/Shutterstock

    This happens when the amygdala, the brain’s alarm system, sends out a false alarm, triggering the survival instinct.

    In this state, a child may not be able to access higher functions like reasoning or decision-making.

    While our instinct might be to immediately fix the problem, staying present with our child during these moments is more effective. It’s about providing support and understanding until they feel safe enough to engage their higher brain functions again.

    Reframe your thinking so you see your child as having a problem – not being the problem.

    Tips for parents

    Take turns discussing the highs and lows of the day at meal times. This is a chance for you to be curious, acknowledge and label feelings, and model that you, too, experience a range of emotions that require you to put into practice skills to cope and has shown evidence in numerous physical, social-emotional, academic and behavioural benefits.

    Family dinner
    Talk about your day over dinner. Monkey Business Images/Shutterstock

    Spending even small amounts (five minutes a day!) of quality one-on-one time with your child is an investment in your child’s emotional wellbeing. Let them pick the activity, do your best to follow their lead, and try to notice and comment on the things they do well, like creative ideas, persevering when things are difficult, and being gentle or kind.

    Take a tip from parents of children with neurodiversity: learn about your unique child. Approaching your child’s emotions, temperament, and behaviours with curiosity can help you to help them develop emotion regulation skills.

    When to get help

    If emotion dysregulation is a persistent issue that is getting in the way of your child feeling happy, calm, or confident – or interfering with learning or important relationships with family members or peers – talk to their GP about engaging with a mental health professional.

    Many families have found parenting programs helpful in creating a climate where emotions can be safely expressed and shared.

    Remember, you can’t pour from an empty cup. Parenting requires you to be your best self and tend to your needs first to see your child flourish.

    Cher McGillivray, Assistant Professor Psychology Department, Bond University and Shawna Mastro Campbell, Assistant Professor Psychology, Bond University

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

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  • Working Smarter < Working Brighter!

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    When it comes to working smarter, not harder, there’s plenty of advice and honestly, it’s mostly quite sensible. For example:

    (Nice to see they featured a method we talked about last week—great minds!)

    But, as standards of productivity rise, the goalposts get moved too, and the treadmill just keeps on going

    Not that these things are confined to Millennials, by any stretch, but Millennials make up a huge portion of working people. Ideally, this age group should be able to bring the best of both worlds to the workplace by combining years of experience with youthful energy.

    So clearly something is going wrong; the question is: what can be done about it?

    Workers of the World, Unwind

    A knee-jerk response might be “work to rule”—a tactic long-used by disgruntled exploited workers to do no more than the absolute minimum required to not get fired. And it’s arguably better for them than breaking themselves at work, but that’s not exactly enriching, is it?

    This is Brittany Berger, founder of “Work Brighter”.

    She’s a content marketing consultant, mental health advocate, and (in her words) a highly ridiculous human who always has a pop culture reference at the ready.

    What, besides pop culture references, is she bringing to the table? What is Working Brighter?

    ❝Working brighter means going beyond generic “work smarter” advice on the internet and personalizing it to work FOR YOU. It means creating your own routines for work, productivity, and self-care.❞

    Brittany Berger

    Examples of working brighter include…

    Asking:

    • What would your work involve, if it were more fun?
    • How can you make your work more comfortable for you?
    • What changes could you make that would make your work more sustainable (i.e., to avoid burnout)?

    Remembering:

    • Mental health is just health
    • Self-care is a “soft skill”
    • Rest is work when it’s needed

    This is not one of those “what workers really want is not more pay, it’s beanbags” things, by the way (but if you want a beanbag, then by all means, get yourself a beanbag).

    It’s about making time to rest, it’s about having the things that make you feel good while you’re working, and making sure you can enjoy working. You’re going to spend a lot of your life doing it; you might as well enjoy it.

    ❝Nobody goes to their deathbed wishing they’d spent more time at the office❞

    Anon

    On the contrary, having worked too hard is one of the top reported regrets of the dying!

    Article: The Top Five Regrets Of The Dying

    And no, they don’t wish they’d “worked smarter, not harder”. They wish (also in the above list, in fact) that they’d had the courage to live a life more true to themselves.

    You can do that in your work. Whatever your work is. And if your work doesn’t permit that (be it the evil boss trope, or even that you are the boss and your line of work just doesn’t work that way), time to change that up. Stop focusing on what you can’t do, and look for what you can do.

    Spoiler: you can have a blast just trying things out!

    That doesn’t mean you should quit your job, or replace your PC with a Playstation, or whatever.

    It just means that you deserve comfort and happiness while working, and around your work!

    Need a helping hand getting started?

    Like A Boss

    And pssst, if you’re a business-owner who is thinking “but I have quotas to meet”, your customers are going to love your staff being happier, and will enjoy their interactions with your company much more. Or if your staff aren’t customer-facing, then still, they’ll work better when they enjoy doing it. This isn’t rocket science, but all too many companies give a cursory nod to it before proceeding to ignore it for the rest of the life of the company.

    So where do you start, if you’re in those particular shoes?

    Read on…

    *straightens tie because this is the serious bit* —just kidding, I’m wearing my comfiest dress and fluffy-lined slipper-socks. But that makes this absolutely no less serious:

    The Institute for Health and Productivity Management (IHPM) and WorkPlace Wellness Alliance (WPWA) might be a good place to get you on the right track!

    ❝IHPM/WPWA is a global nonprofit enterprise devoted to establishing the full economic value of employee health as a business asset—a neglected investment in the increased productivity of human capital.

    IHPM helps employers identify the full economic cost impact of employee health issues on business performance, design and implement the best programs to reduce this impact by improving functional health and productivity, and measure the success of their efforts in financial terms.❞

    The Institute for Health and Productivity Management

    They offer courses and consultations, but they also have free downloadables and videos, which are awesome and in many cases may already be enough to seriously improve things for your business already:

    Check Out IHPM’s Resources Here!

    What can you do to make your working life better for you? We’d love to hear about any changes you make inspired by Brittany’s work—you can always just hit reply, and we’re always glad to hear from you!

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  • The Power Foods Diet – by Dr. Neal Barnard

    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.

    First, what this is not: it’s not a cookbook. There are recipes, more than a hundred if we consider such things as “barbecue sauce” as a standalone recipe, and if we overlook such things as how “perfect hot oatmeal” is followed on the next page by a recipe for “perfect hot oatmeal with berries”.

    However, as we say, it’s not a cookbook; it’s first and foremost an educational text on the topic of nutrition.

    Here we will learn about good eating for general health, which foods are natural appetite-suppressants, which foods reduce our body’s absorption of sugars from foods (not merely slowing, but flushing them away so they cannot be absorbed at all), and which foods actually boost metabolism for a few hours after the meal.

    Dr. Barnard also talks about some foods that are more healthy, or less healthy, than popularly believed, and how to use all this information to craft a good, optimized, dietary plan for you.

    Bottom line: there’s a lot of good information here, and the recipes are simply a bonus.

    Click here to check out The Power Foods Diet, and optimize yours!

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  • Behavioral Activation Against Depression & Anxiety

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    Behavioral Activation Against Depression & Anxiety

    Psychologists do love making fancy new names for things.

    You thought you were merely “eating your breakfast”, but now it’s “Happiness-Oriented Basic Behavioral Intervention Therapy (HOBBIT)” or something.

    This one’s quite simple, so we’ll keep it short for today, but it is one more tool for your toolbox:

    What is Behavioral Activation?

    Behavioral Activation is about improving our mood (something we can’t directly choose) by changing our behavior (something we usually can directly choose).

    An oversimplified (and insufficient, as we will explain, but we’ll use this one to get us started) example would be “whistle a happy tune and you will be happy”.

    Behavioral Activation is not a silver bullet

    Or if it is, then it’s the kind you have to keep shooting, because one shot is not enough. However, this becomes easier than you might think, because Behavioral Activation works by…

    Creating a Positive Feedback Loop

    A lot of internal problems in depression and anxiety are created by the fact that necessary and otherwise desirable activities are being written off by the brain as:

    • Pointless (depression)
    • Dangerous (anxiety)

    The inaction that results from these aversions creates a negative feedback loop as one’s life gradually declines (as does one’s energy, and interest in life), or as the outside world seems more and more unwelcoming/scary.

    Instead, Behavioral Activation plans activities (usually with the help of a therapist, as depressed/anxious people are not the most inclined to plan activities) that will be:

    • attainable
    • rewarding

    The first part is important, because the maximum of what is “attainable” to a depressed/anxious person can often be quite a small thing. So, small goals are ideal at first.

    The second part is important, because there needs to be some way of jump-starting a healthier dopamine cycle. It also has to feel rewarding during/after doing it, not next year, so short term plans are ideal at first.

    So, what behavior should we do?

    That depends on you. Behavioral Activation calls for keeping track of our activities (bullet-journaling is fine, and there are apps* that can help you, too) and corresponding moods.

    *This writer uses the pragmatic Daylio for its nice statistical analyses of bullet-journaling data-points, and the very cute Finch for more keyword-oriented insights and suggestions. Whatever works for you, works for you, though! It could even be paper and pen.

    Sometimes the very thought of an activity fills us with dread, but the actual execution of it brings us relief. Bullet-journaling can track that sort of thing, and inform decisions about “what we should do” going forwards.

    Want a ready-made brainstorm to jump-start your creativity?

    Here’s list of activities suggested by TherapistAid (a resource hub for therapists)

    Want to know more?

    You might like:

    Take care!

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  • Lime-Charred Cauliflower Popcorn

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    Called “popcorn” for its appearance and tasty-snackness, this one otherwise bears little relation to the usual movie theater snack, and it’s both tastier and healthier. All that said, it can be eaten on its own as a snack (even with a movie, if you so wish), or served as one part of a many-dish banquet, or (this writer’s favorite) as a delicious appetizer that also puts down a healthy bed of fiber ready for the main course to follow it.

    You will need

    • 1 cauliflower, cut into small (popcorn-sized) florets
    • 2 tbsp extra virgin olive oil
    • 1 tbsp lime pickle
    • 1 tsp cumin seeds
    • 1 tsp smoked paprika
    • 1 tsp chili flakes
    • 1 tsp black pepper, coarse ground
    • ½ tsp ground turmeric

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat your oven as hot as it will go

    2) Mix all the ingredients in a small bowl except the cauliflower, to form a marinade

    3) Drizzle the marinade over the cauliflower in a larger bowl (i.e. big enough for the cauliflower), and mix well until the cauliflower is entirely, or at least almost entirely, coated. Yes, it’s not a lot of marinade but unless you picked a truly huge cauliflower, the proportions we gave will be enough, and you want the end result to be crisp, not dripping.

    4) Spread the marinaded cauliflower florets out on a baking tray lined with baking paper. Put it in the oven on the middle shelf, so it doesn’t cook unevenly, but keeping the temperature as high as it goes.

    5) When it is charred and crispy golden, it’s done—this should take about 20 minutes, but we’ll say ±5 minutes depending on your oven, so do check on it periodically—and time to serve (it is best enjoyed warm).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Senior Meetup Groups Combating Loneliness

    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? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    “I would like to read more on loneliness, meetup group’s for seniors. Thank you”

    Well, 10almonds is an international newsletter, so it’s hard for us to advise about (necessarily: local) meetup groups!

    But a very popular resource for connecting to your local community is Nextdoor, which operates throughout the US, Canada, Australia, and large parts of Europe including the UK.

    In their own words:

    Get the most out of your neighborhood with Nextdoor

    It’s where communities come together to greet newcomers, exchange recommendations, and read the latest local news. Where neighbors support local businesses and get updates from public agencies. Where neighbors borrow tools and sell couches. It’s how to get the most out of everything nearby. Welcome, neighbor.

    Curious? Click here to check it out and see if it’s of interest to you

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

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    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: