The Silent Struggle – by L. William Ross-Child, MLC

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The vast majority of literature out there about ADHD is about children. And fair enough, there are enough popular misunderstandings of ADHD in children so it’s good those works exist… but what about adults?

Adults face different challenges than children, and have different responsibilities. People have different expectations. And even if you say you have ADHD… If you’re not behaving like a squirrel, they will often not accept this, much less understand it, because half the actual symptoms are not what most people think they are.

Ross-Child first lays out the neurobiological underpinnings of ADHD. This is a good place to start, because the physiology of it explains a lot of the other parts of it that can otherwise seem quite mystifying.

Thereafter, he looks one-by-one at the various cognitive and behavioral aspects of ADHD in adults, which will surely help the reader to better understand themself (or perhaps a loved one).

The next part of the book is given over to an exploration of ADHD and the differences it can make in the workplace, relationships (incl. ADHD and sex), as well as parenting, and how these things can all be navigated better by all concerned.

The style throughout is light and very readable, peppered with science made comprehensible. If there’s any flaw, it’s that there are only two pages of references in the bibliography—we’d have liked to have seen more.

All in all though, a really useful guide if you or a loved one has ADHD and you’d like strategies for working with (or around) this condition in a world not made to be kind to such.

Order your copy of “The Silent Struggle: Taking Charge of ADHD in Adults” from Amazon today!

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    Break the loop of overthinking by acknowledging emotions, problem-solving, and letting go of the need for control. Manage stress and seek help if needed.

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  • Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)

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    Why You’re Probably Not Getting Enough Fiber (And How To Fix It)

    First things first… How much fiber should we be eating?

    *This one is also a great read to understand more about the “why” of fiber

    Meanwhile, the average American gets 16g of fiber per day.

    So, how to get more fiber, without piling on too many carbs?

    Foods that contain fiber generally contain carbs (there’s a limit to how much celery most people want to eat), so there are two key ideas here:

    • Getting a good carb:fiber ratio
    • Making substitutions that boost fiber without overdoing (or in some case, even changing) carbs

    Meat → Lentils

    Well-seasoned lentils can be used to replaced ground beef or similar. A cup of boiled lentils contains 18g of fiber, so you’re already outdoing the average American’s daily total.

    Meat → Beans

    Black beans are a top-tier option here (15g per cup, cooked weight), but many kinds of beans are great.

    Chicken/Fish → Chickpeas

    Yes, chicken/fish is already meat, but we’re making a case for chickpeas here. Cooked and seasoned appropriately, they do the job, and pack in 12g of fiber per cup. Also… Hummus!

    Bonus: Hummus, eaten with celery sticks.

    White pasta/bread → Wholewheat pasta/bread

    This is one where “moderation is key”, but if you’re going to eat pasta/bread, then wholewheat is the way to go. Fiber amounts vary, so read labels, but it will always have far more than white.

    Processed salty snacks → Almonds and other nuts

    Nuts in general are great, but almonds are top-tier for fiber, amongst other things. A 40g handful of almonds contains about 10g of fiber.

    Starchy vegetables → Non-starchy vegetables

    Potatoes, parsnips, and their friends have their place. But they cannot compete with broccoli, peas, cabbage, and other non-starchy vegetables for fiber content.

    Bonus: if you’re going to have starchy vegetables though, leave the skins on!

    Fruit juice → Fruit

    Fruit juice has had most, if not all, of its fiber removed. Eat an actual juicy fruit, instead. Apples and bananas are great options; berries such as blackberries and raspberries are even better (at around 8g per cup, compared to the 5g or so depending on the size of an apple/banana)

    Processed cereals → Oats

    5g fiber per cup. Enough said.

    Summary

    Far from being a Herculean task, getting >30g of fiber per day can be easily accomplished by a lentil ragù with wholewheat pasta.

    If your breakfast is overnight oats with fruit and some chopped almonds, you can make it to >20g already by the time you’ve finished your first meal of the day.

    Enjoy!

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  • Can a drug like Ozempic help treat addictions to alcohol, opioids or other substances?

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    Semaglutide (sold as Ozempic, Wegovy and Rybelsus) was initially developed to treat diabetes. It works by stimulating the production of insulin to keep blood sugar levels in check.

    This type of drug is increasingly being prescribed for weight loss, despite the fact it was initially approved for another purpose. Recently, there has been growing interest in another possible use: to treat addiction.

    Anecdotal reports from patients taking semaglutide for weight loss suggest it reduces their appetite and craving for food, but surprisingly, it also may reduce their desire to drink alcohol, smoke cigarettes or take other drugs.

    But does the research evidence back this up?

    Animal studies show positive results

    Semaglutide works on glucagon-like peptide-1 receptors and is known as a “GLP-1 agonist”.

    Animal studies in rodents and monkeys have been overwhelmingly positive. Studies suggest GLP-1 agonists can reduce drug consumption and the rewarding value of drugs, including alcohol, nicotine, cocaine and opioids.

    Out team has reviewed the evidence and found more than 30 different pre-clinical studies have been conducted. The majority show positive results in reducing drug and alcohol consumption or cravings. More than half of these studies focus specifically on alcohol use.

    However, translating research evidence from animal models to people living with addiction is challenging. Although these results are promising, it’s still too early to tell if it will be safe and effective in humans with alcohol use disorder, nicotine addiction or another drug dependence.

    What about research in humans?

    Research findings are mixed in human studies.

    Only one large randomised controlled trial has been conducted so far on alcohol. This study of 127 people found no difference between exenatide (a GLP-1 agonist) and placebo (a sham treatment) in reducing alcohol use or heavy drinking over 26 weeks.

    In fact, everyone in the study reduced their drinking, both people on active medication and in the placebo group.

    However, the authors conducted further analyses to examine changes in drinking in relation to weight. They found there was a reduction in drinking for people who had both alcohol use problems and obesity.

    For people who started at a normal weight (BMI less than 30), despite initial reductions in drinking, they observed a rebound increase in levels of heavy drinking after four weeks of medication, with an overall increase in heavy drinking days relative to those who took the placebo.

    There were no differences between groups for other measures of drinking, such as cravings.

    Man shops for alcohol

    Some studies show a rebound increase in levels of heavy drinking. Deman/Shutterstock

    In another 12-week trial, researchers found the GLP-1 agonist dulaglutide did not help to reduce smoking.

    However, people receiving GLP-1 agonist dulaglutide drank 29% less alcohol than those on the placebo. Over 90% of people in this study also had obesity.

    Smaller studies have looked at GLP-1 agonists short-term for cocaine and opioids, with mixed results.

    There are currently many other clinical studies of GLP-1 agonists and alcohol and other addictive disorders underway.

    While we await findings from bigger studies, it’s difficult to interpret the conflicting results. These differences in treatment response may come from individual differences that affect addiction, including physical and mental health problems.

    Larger studies in broader populations of people will tell us more about whether GLP-1 agonists will work for addiction, and if so, for whom.

    How might these drugs work for addiction?

    The exact way GLP-1 agonists act are not yet well understood, however in addition to reducing consumption (of food or drugs), they also may reduce cravings.

    Animal studies show GLP-1 agonists reduce craving for cocaine and opioids.

    This may involve a key are of the brain reward circuit, the ventral striatum, with experimenters showing if they directly administer GLP-1 agonists into this region, rats show reduced “craving” for oxycodone or cocaine, possibly through reducing drug-induced dopamine release.

    Using human brain imaging, experimenters can elicit craving by showing images (cues) associated with alcohol. The GLP-1 agonist exenatide reduced brain activity in response to an alcohol cue. Researchers saw reduced brain activity in the ventral striatum and septal areas of the brain, which connect to regions that regulate emotion, like the amygdala.

    In studies in humans, it remains unclear whether GLP-1 agonists act directly to reduce cravings for alcohol or other drugs. This needs to be directly assessed in future research, alongside any reductions in use.

    Are these drugs safe to use for addiction?

    Overall, GLP-1 agonists have been shown to be relatively safe in healthy adults, and in people with diabetes or obesity. However side effects do include nausea, digestive troubles and headaches.

    And while some people are OK with losing weight as a side effect, others aren’t. If someone is already underweight, for example, this drug might not be suitable for them.

    In addition, very few studies have been conducted in people with addictive disorders. Yet some side effects may be more of an issue in people with addiction. Recent research, for instance, points to a rare risk of pancreatitis associated with GLP-1 agonists, and people with alcohol use problems already have a higher risk of this disorder.

    Other drugs treatments are currently available

    Although emerging research on GLP-1 agonists for addiction is an exciting development, much more research needs to be done to know the risks and benefits of these GLP-1 agonists for people living with addiction.

    In the meantime, existing effective medications for addiction remain under-prescribed. Only about 3% of Australians with alcohol dependence, for example, are prescribed medication treatments such as like naltrexone, acamprosate or disulfiram. We need to ensure current medication treatments are accessible and health providers know how to prescribe them.

    Continued innovation in addiction treatment is also essential. Our team is leading research towards other individualised and effective medications for alcohol dependence, while others are investigating treatments for nicotine addiction and other drug dependence.

    Read the other articles in The Conversation’s Ozempic series here.

    Shalini Arunogiri, Addiction Psychiatrist, Associate Professor, Monash University; Leigh Walker, , Florey Institute of Neuroscience and Mental Health, and Roberta Anversa, , The University of Melbourne

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

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  • The Optimal Morning Routine, Per Neuroscience

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    Dr. Andrew Huberman, neuroscientist and professor of neurobiology, has insights:

    The foundations of a good day

    Here are some key things to consider:

    • The role of light: get sunlight exposure within an hour of waking to anchor your body’s cortisol pulse, set your circadian rhythm, and boost mood-regulating dopamine. Light exposure on the skin also boost hormone levels like testosterone and estrogen, contributing to energy, motivation, and overall wellbeing.
    • The role of caffeine: delay caffeine intake for 60–90 minutes after waking to allow adenosine to clear naturally, preventing afternoon energy crashes. Otherwise, caffeine will block the adenosine for 4–8 hours, causing the wave of adenosine-induced sleepiness to resurge later.
    • The role of exercise: morning exercise helps clear adenosine, raise core body temperature, and improve wakefulness
    • The role of cold: cold showers or ice baths trigger adrenaline and dopamine surges, enhancing mood and drive for hours.

    For more on each of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Morning Routines That Just Flow

    Take care!

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  • Black Beans vs Pinto Beans – Which is Healthier?

    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.

    Our Verdict

    When comparing black beans to pinto beans, we picked the pinto beans.

    Why?

    Both of these beans have won all their previous comparisons, so it’s no surprise that this one was very close. Despite their different appearance, taste, and texture, their nutritional profiles are almost identical:

    In terms of macros, pinto beans have a tiny bit more protein, carbs, and fiber. So, a nominal win for pinto beans, but again, the difference is very slight.

    When it comes to vitamins, black beans have more of vitamins A, B1, B3, and B5, while pinto beans have more of vitamins B2, B6, B9, C, E, K and choline. Superficially, again this is nominally a win for pinto beans, but in most cases the differences are so slight as to be potentially the product of decimal place rounding.

    In the category of minerals, black beans have more calcium, copper, iron, and phosphorus, while pinto beans have more magnesium, manganese, selenium, and zinc. That’s a 4:4 tie, but the only one with a meaningful margin of difference is selenium (of which pinto beans have 4x more), so we’re calling this one a very modest win for pinto beans.

    All in all, adding these up makes for a “if we really are pressed to choose” win for pinto beans, but honestly, enjoy either in accordance with your preference (this writer prefers black beans!), or better yet, both.

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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  • Signs That Are Present When Someone Is Dying

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    You’ve probably been there a few times, although given the emotional nature of the thing, it’s likely that you weren’t taking notes. Hospice workers, on the other hand, do take notes, so here are some things you might want to know, and if anything makes the next time even a little easier, that’ll be good:

    Last stages

    Here are the discussed signs of the “active dying” phase:

    • Increasing unconsciousness:
      • The person will be mostly unresponsive most of the time.
      • Eyes may be open or partially open but not making eye contact.
      • Mouth will likely remain open due to muscle relaxation.
    • Cessation of food and water intake
      • The person will likely not eat or drink for several days.
      • This is a natural process and does not cause suffering per se (e.g. thirst, hunger).
      • Dryness of mouth, however, can be treated with a little moistening, for comfort.
    • Changes in breathing
      • Breathing patterns will change and may be irregular.
      • This is a natural metabolic response, and is not a sign of distress.
      • Terminal secretions (“death rattle”) may occur:
        • A gurgling sound caused by saliva buildup due to loss of swallowing reflex.
        • Not painful or distressing for the person.
        • Can be managed by repositioning or using medication to dry secretions.
    • Skin color changes / mottling:
      • First appears on fingers and toes (purple or gray discoloration).
      • May spread to knees, nose, or other extremities.
    • Temperature fluctuations:
      • The body loses its ability to regulate temperature.
      • Person may feel hot but be cold (or vice versa).
      • Fevers are common—cooling measures and/or Tylenol can help.

    A person in discomfort may appear restless, have a furrowed brow, or show physical agitation. If on the other hand they appear peaceful and unresponsive, they are almost certainly not in distress. At such times, it’s best to focus on just keeping them clean and comfortable.

    For more on all of these, see:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Managing Mortality: When Planning Is a Matter of Life and Death

    Take care!

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  • Mythbusting The Mask Debate

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    Mythbusting The Mask Debate

    We asked you for your mask policy this respiratory virus season, and got the above-depicted, below-described, set of responses:

    • A little under half of you said you will be masking when practical in indoor public places
    • A little over a fifth of you said you will mask only if you have respiratory virus symptoms
    • A little under a fifth of you said that you will not mask, because you don’t think it helps
    • A much smaller minority of you (7%) said you will go with whatever people around you are doing
    • An equally small minority of you said that you will not mask, because you’re not concerned about infections

    So, what does the science say?

    Wearing a mask reduces the transmission of respiratory viruses: True or False?

    True…with limitations. The limitations include:

    • The type of mask
      • A homemade polyester single-sheet is not the same as an N95 respirator, for instance
    • How well it is fitted
      • It needs to be a physical barrier, so a loose-fitting “going through the motions” fit won’t help
    • The condition of the mask
      • And if applicable, the replaceable filter in the mask
    • What exactly it has to stop
      • What kind of virus, what kind of viral load, what kind of environment, is someone coughing/sneezing, etc

    More details on these things can be found in the link at the end of today’s main feature, as it’s more than we could fit here!

    Note: We’re talking about respiratory viruses in general in this main feature, but most extant up-to-date research is on COVID, so that’s going to appear quite a lot. Remember though, even COVID is not one beast, but many different variants, each with their own properties.

    Nevertheless, the scientific consensus is “it does help, but is not a magical amulet”:

    Wearing a mask is actually unhygienic: True or False?

    False, assuming your mask is clean when you put it on.

    This (the fear of breathing more of one’s own germs in a cyclic fashion) was a point raised by some of those who expressed mask-unfavorable views in response to our poll.

    There have been studies testing this, and they mostly say the same thing, “if it’s clean when you put it on, great, if not, then well yes, that can be a problem”:

    ❝A longer mask usage significantly increased the fungal colony numbers but not the bacterial colony numbers.

    Although most identified microbes were non-pathogenic in humans; Staphylococcus epidermidis, Staphylococcus aureus, and Cladosporium, we found several pathogenic microbes; Bacillus cereus, Staphylococcus saprophyticus, Aspergillus, and Microsporum.

    We also found no associations of mask-attached microbes with the transportation methods or gargling.

    We propose that immunocompromised people should avoid repeated use of masks to prevent microbial infection.❞

    Source: Bacterial and fungal isolation from face masks under the COVID-19 pandemic

    Wearing a mask can mean we don’t get enough oxygen: True or False?

    False, for any masks made-for-purpose (i.e., are by default “breathable”), under normal conditions:

    However, wearing a mask while engaging in strenuous best-effort cardiovascular exercise, will reduce VO₂max. To be clear, you will still have more than enough oxygen to function; it’s not considered a health hazard. However, it will reduce peak athletic performance:

    Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test

    …so if you are worrying about whether the mask will impede you breathing, ask yourself: am I engaging in an activity that requires my peak athletic performance?

    Also: don’t let it get soaked with water, because…

    Writer’s anecdote as an additional caveat: in the earliest days of the COVID pandemic, I had a simple cloth mask on, the one-piece polyester kind that we later learned quite useless. The fit wasn’t perfect either, but one day I was caught in heavy rain (I had left it on while going from one store to another while shopping), and suddenly, it fitted perfectly, as being soaked through caused it to cling beautifully to my face.

    However, I was now effectively being waterboarded. I will say, it was not pleasant, but also I did not die. I did buy a new mask in the next store, though.

    tl;dr = an exception to “no it won’t impede your breathing” is that a mask may indeed impede your breathing if it is made of cloth and literally soaked with water; that is how waterboarding works!

    Want up-to-date information?

    Most of the studies we cited today were from 2022 or 2023, but you can get up-to-date information and guidance from the World Health Organization, who really do not have any agenda besides actual world health, here:

    Coronavirus disease (COVID-19): Masks | Frequently Asked Questions

    At the time of writing this newsletter, the above information was last updated yesterday.

    Take care!

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