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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Can a child legally take puberty blockers? What if their parents disagree?
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Young people’s access to gender-affirming medical care has been making headlines this week.
Today, federal Health Minister Mark Butler announced a review into health care for trans and gender-diverse children and adolescents. The National Health and Medical Research Council will conduct the review.
Yesterday, The Australian published an open letter to Prime Minister Anthony Albanese calling for a federal inquiry, and a nationwide pause on puberty blockers and hormone therapy for minors.
This followed Queensland Health Minister Tim Nicholls earlier this week announcing an immediate pause on access to puberty blockers and hormone therapies for new patients under 18 in the state’s public health system, pending a review.
In the United States, President Donald Trump signed an executive order this week directing federal agencies to restrict access to gender-affirming care for anyone under 19.
This recent wave of political attention might imply gender-affirming care for young people is risky, controversial, perhaps even new.
But Australian courts have already extensively tested questions about its legitimacy, the conditions under which it can be provided, and the scope and limits of parental powers to authorise it.
MirasWonderland/Shutterstock What are puberty blockers?
Puberty blockers suppress the release of oestrogen and testosterone, which are primarily responsible for the physical changes associated with puberty. They are generally safe and used in paediatric medicine for various conditions, including precocious (early) puberty, hormone disorders and some hormone-sensitive cancers.
International and domestic standards of care state that puberty blockers are reversible, non-harmful, and can prevent young people from experiencing the distress of undergoing a puberty that does not align with their gender identity. They also give young people time to develop the maturity needed to make informed decisions about more permanent medical interventions further down the line.
Puberty blockers are one type of gender-affirming care. This care includes medical, psychological and social interventions to support transgender, gender-diverse and, in some cases, intersex people.
Young people in Australia need a medical diagnosis of gender dysphoria to receive this care. Gender dysphoria is defined as the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth. This diagnosis is only granted after an exhaustive and often onerous medical assessment.
After a diagnosis, treatment may involve hormones such as oestrogen or testosterone and/or puberty-blocking medications.
Hormone therapies involving oestrogen and testosterone are only prescribed in Australia once a young person has been deemed capable of giving informed consent, usually around the age of 16. For puberty blockers, parents can consent at a younger age.
Gender dysphoria comes with considerable psychological distress. slexp880/Shutterstock Can a child legally access puberty blockers?
Gender-affirming care has been the subject of extensive debate in the Family Court of Australia (now the Federal Circuit and Family Court).
Between 2004 and 2017, every minor who wanted to access gender-affirming care had to apply for a judge to approve it. However, medical professionals, human rights organisations and some judges condemned this process.
In research for my forthcoming book, I found the Family Court has heard at least 99 cases about a young person’s gender-affirming care since 2004. Across these cases, the court examined the potential risks of gender-affirming treatment and considered whether parents should have the authority to consent on their child’s behalf.
When determining whether parents can consent to a particular medical procedure for their child, the court must consider whether the treatment is “therapeutic” and whether there is a significant risk of a wrong decision being made.
However, in a landmark 2017 case, the court ruled that judicial oversight was not required because gender-affirming treatments meet the standards of normal medical care.
It reasoned that because these therapies address an internationally recognised medical condition, are supported by leading professional medical organisations, and are backed by robust clinical research, there is no justification for treating them differently from any other standard medical intervention. These principles still stand today.
What if parents disagree?
Sometimes parents disagree with decisions about gender-affirming care made by their child, or each other.
As with all forms of health care, under Australian law, parents and legal guardians are responsible for making medical decisions on behalf of their children. That responsibility usually shifts once those children reach a sufficient age and level of maturity to make their own decisions.
However, in another landmark case in 2020, the court ruled gender-affirming treatments cannot be given to minors without consent from both parents, even if the child is capable of providing their own consent. This means that if there is any disagreement among parents and the young person about either their capacity to consent or the legitimacy of the treatment, only a judge can authorise it.
In such instances, the court must assess whether the proposed treatment is in the child’s best interests and make a determination accordingly. Again, these principals apply today.
If a parent disagrees with their child, the matter can go to court. PeopleImages.com – Yuri A/Shutterstock Have the courts ever denied care?
Across the at least 99 cases the court has heard about gender-affirming care since 2004, 17 have involved a parent opposing the treatment and one has involved neither parent supporting it.
Regardless of parental support, in every case, the court has been responsible for determining whether gender-affirming treatment was in the child’s best interests. These decisions were based on medical evidence, expert testimony, and the specific circumstances of the young person involved.
In all cases bar one, the court has found overwhelming evidence to support gender-affirming care, and approved it.
Supporting transgender young people
The history of Australia’s legal debates about gender-affirming care shows it has already been the subject of intense legal and medical scrutiny.
Gender-affirming care is already difficult for young people to access, with many lacking the parental support required or facing other barriers to care.
Gender-affirming care is potentially life-saving, or at the very least life-affirming. It almost invariably leads to better social and emotional outcomes. Further restricting access is not the “protection” its opponents claim.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. For LGBTQIA+ peer support and resources, you can also contact Switchboard, QLife (call 1800 184 527), Queerspace, Transcend Australia (support for trans, gender-diverse, and non-binary young people and their families) or Minus18 (resources and community support for LGBTQIA+ young people).
Matthew Mitchell, Lecturer in Criminology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How to Fall Asleep Faster: CBT-Insomnia Treatment
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Insomnia affects a lot of people, and is even more common as we get older. Happily, therapist Emma McAdam is here with a drug-free solution that will work for most people most of the time.
Cognitive Behavioral Therapy for Insomnia (CBTI)
While people think of causes of insomnia as being things such as stress, anxiety, overthinking, disturbances, and so forth, these things affect sleep in the short term, but don’t directly cause chronic insomnia.
We say “directly”, because chronic insomnia is usually the result of the brain becoming accustomed to the above, and thus accidentally training itself to not sleep.
The remedy: cut the bad habit of staying in bed while awake. Lying in bed awake trains the brain to associate lying in bed with wakefulness (and any associated worrying, etc). In essence, we lie down, and the brain thinks “Aha, we know this one; this is the time and place for worrying, ok, let’s get to work”.
So instead: if you’re in bed and not asleep within 15 minutes, get up and do something non-stimulating until you feel sleepy, then return to bed. This may cause some short term tiredness, but it will usually correct the chronic insomnia within a week.
For more details, tips, and troubleshooting with regard to the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How to Fall Back Asleep After Waking Up in the Middle of the Night
Take care!
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Broccoli Sprouts & Sulforaphane
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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 😎
❝How much science is there behind sulforaphane / broccoli spirits and its health claims??❞
So, first of all, what it is: sulforaphane is a compound found in Brassica oleracea, of which species broccoli is a cultivar. It’s found in the other Brassica oleracea cultivars too (e.g. cauliflower, various cabbages, Brussels sprouts, kale, etc), but for whatever reason*, most research has been on broccoli and broccoli sprouts.
*Likely the reason is: research begets research—it’s easier to get funding to expand upon previous research, than it is to break ground on researching a different plant, where for the first third of your paper you have almost no existing scientific literature to cite. So once they got started on broccoli sprouts, everything else has been broccoli sprouts too.
And for clarity on what broccoli sprouts are: this means that when broccoli seeds have been germinated and just begun to sprout, they are harvested and eaten. That’s the one-line explanation, anyway; there’s a little more to it than that, so anyone interested should check out our previous main feature:
Good Things Come In Small Packages: Sprout Your Seeds, Grains, Beans, Etc
…and for more depth than we have room for in a one-page article, check out this book we reviewed:
The Sprout Book: Tap Into The Power Of The Planet’s Most Nutritious Food – by Doug Evans
One thing that the science is clear on: sprouts of a given plant indeed have much higher general nutritional density than their “adult” siblings. And in the case of sulforaphane specifically, it’s about 100x higher in broccoli sprouts than in adult broccoli:
Broccoli or Sulforaphane: Is It the Source or Dose That Matters? ← we suggest skipping down to the section “broccoli-based clinical trials”
So, that prompts the next question: do we care?
In other words: is sulforaphane really particularly important?
Sulforaphane vs cancer
The most well-evidenced health-giving property of sulforaphane is its anticancer activity:
Brassicaceae-Derived Anticancer Agents: Towards a Green Approach to Beat Cancer
A lot of the research there is epidemiological rather than RCTs, and where there are RCTs, they are mostly small ones, like this 10-person broccoli soup study about bioavailability (rather than the effects themselves):
Bioavailability of Glucoraphanin and Sulforaphane from High-Glucoraphanin Broccoli
To get into sulforaphane’s anticancer potential in seriousness, we have to look at a lot of in-vitro studies trialling it to limit carcinogenesis, or to shrink tumors with it, or specifically targetting cancer stem cells with it, which make for quite compelling reading:
A quick aside: if you’re reading that and thinking “Why is sonic the hedgehog in here?” it’s because after the observation of the influence of certain genes that influence cuticular denticles (the growth of spikes) on fruit fly larvae (bearing in mind the fruit fly Drosophila melanogaster is used for so much first- or second-line genetic research, being either the go-to or the go-to after the nematode C. elegans) caused the whole group of genes to get called “hedgehog genes” and then it became scientific convention to name each newly researched gene in that set after a different kind of hedgehog. One of them, instead of being named after a real-world hedgehog species like the others, got named after the videogame character.
Unfortunately, this now means that because the gene is associated with a certain congenital brain disorder, sometimes a doctor has to explain to a family that the reason their baby has a brain defect is because of a mutated sonic hedgehog.
Ok, back to talking about cancer. Let’s just quickly drop a few more papers so it’s clear that this is well-established:
- Multi-targeted prevention of cancer by sulforaphane ← this shows how it works on the cellular level
- Cruciferous vegetables: dietary phytochemicals for cancer prevention ← this shows how it works on the population level
However, that’s not the only established benefit:
❝SFN has other beneficial effects in addition to cancer protection. SFN exhibits neuroprotective effects and is implemented in treating conditions such as traumatic brain injury, Alzheimer’s disease and Parkinson’s disease.❞
Source: Sulforaphane in broccoli: The green chemoprevention!! Role in cancer prevention and therapy
Now, after the extract we quoted above, the rest of the section “other health benefits of sulforaphane” includes a lot of speculation, weak science, and/or things attributable to other phytochemicals in broccoli, including various polyphenols, vitamins, and minerals.
About those broccoli spirits
Ok, we know it was a typo, but… Actually, there is something worth mentioning here, and that’s that sulforaphane is only activated when glucoraphanin (its inactive form) comes into contact with myrosinase (an enzyme that’s only released when the plant is damaged).
In other words, it’s necessary to injure the broccoli before consuming it, in order to release the
spiritsmyrosinase. Now, while very few people are out there swallowing adult broccoli plants whole, it could well happen that people might wolf down uncut broccoli sprouts, since they are only small, after all.For this reason, it’s best that broccoli, even if it’s broccoli sprouts, be cut while raw before consumption.
In terms of cooking, heat in excess of 140℃ / 284℉ will destroy the glucoraphanin, and less/no glucoraphanin means less/no sulforaphane.
So, enjoying them raw or lightly steaming them seems to be best for this purpose:
Impact of thermal processing on sulforaphane yield from broccoli (Brassica oleracea L. ssp. italica)
Just want a supplement?
Many studies (including some cited by the research reviews we cited above) deal with sulforaphane in extract form, rather than whole plants, so there’s no shame in taking it that way if you’re not a fan of broccoli.
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Not quite an introvert or an extrovert? Maybe you’re an ambivert
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Our personalities are generally thought to consist of five primary factors: openness to experience, conscientiousness, extroversion, agreeableness and neuroticism, with each of us ranking low to high for each.
Extroversion is one of the Big Five personality traits. Big 5 personality traits graphic Those who rank high in extroversion, known as extroverts, typically focus on their external world. They tend to be more optimistic, recharge by socialising and enjoy social interaction.
On the other end of the spectrum, introverts are more likely to be quiet, deep thinkers, who recharge by being alone and learn by observing (but aren’t necessarily shy).
But what if you’re neither an introvert or extrovert – or you’re a bit of both? Another category might fit better: ambiverts. They’re the middle of the spectrum and are also called “social introverts”.
What exactly is an ambivert?
The term ambivert emerged in 1923. While it was not initially embraced as part of the introvert-extrovert spectrum, more recent research suggests ambiverts are a distinct category.
Ambiverts exhibit traits of both extroverts and introverts, adapting their behaviour based on the situation. It may be that they socialise well but need solitude and rest to recharge, and they intuitively know when to do this.
Ambiverts seems to have the following characteristics:
- good communication skills, as a listener and speaker
- ability to be a peacemaker if conflict occurs
- leadership and negotiation skills, especially in teams
- compassion and understanding for others.
Some research suggests ambiverts make up a significant portion of the population, with about two-thirds of people falling into this category.
What makes someone an ambivert?
Personality is thought to be 50% inherited, with the remaining being influenced by environmental factors and individual experiences.
Emerging research has found physical locations of genes on chromosomes closely aligned with extroversion-introversion traits.
So, chances are, if you are a blend of the two styles as an ambivert, one of your parents may be too.
What do ambiverts tend to be good at?
Ambiverts are flexible with talking and also listening. Cotton Bro Studios/Pexels One area of research focus in recent decades has been personality type and job satisfaction. One study examined 340 introverts, extroverts and ambiverts in sales careers.
It has always been thought extroverts were more successful with sales. However, the author found ambiverts were more influential and successful.
They may have a sales advantage because of their ability to read the situation and modify their behaviour if they notice a customer is not interested, as they’re able to reflect and adapt.
Ambiverts stress less than introverts
Generally, people lower in extroversion have higher stress levels. One study found introverts experience more stress than both ambiverts and extroverts.
It may be that highly sensitive or introverted individuals are more susceptible to worry and stress due to being more perfectionistic.
Ambiverts are adept at knowing when to be outgoing and when to be reflective, showcasing a high degree of situational awareness. This may contribute to their overall wellbeing because of how they handle stress.
What do ambiverts tend to struggle with?
Ambiverts may overextend themselves attempting to conform or fit in with many social settings. This is termed “overadaptation” and may force ambiverts to feel uncomfortable and strained, ultimately resulting in stress or burnout.
Ambiverts tend to handle stress well but feel strained when overadapting. Cottonbro Studios/Pexels But personality traits aren’t fixed
Regardless of where you sit on the scale of introversion through to extroversion, the reality is it may not be fixed. Different situations may be more comfortable for introverts to be social, and extroverts may be content with quieter moments.
And there are also four other key personality traits – openness to experience, conscientiousness, agreeableness and neuroticism – which we all possess in varying levels, and are expressed in different ways, alongside our levels of extroversion.
There is also evidence our personality traits can change throughout our life spans are indeed open to change.
Peta Stapleton, Associate Professor in Psychology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Can Home Tests Replace Check-Ups?
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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
❝I recently hit 65 and try to get regular check-ups, but do you think home testing can be as reliable as a doctor visit? I try to keep as informed as I can and am a big believer in taking responsibility for my own health if I can, but I don’t want to miss something important either. Best as a supplemental thing, perhaps?❞
Depends what’s being tested! And your level of technical knowledge, though there’s always something to be said for ongoing learning.
- If you’re talking blood tests, urine tests, etc per at-home test kits that get sent off to a lab, then provided they’re well-sourced (and executed correctly by you), they should be as accurate as what a doctor will give, since they are basically doing the same thing (taking a sample and sending it off to a lab).
- If you’re talking about checking for lumps etc, then a dual approach is best: check yourself at home as often as you feel is reasonable (with once per month being advised at a minimum, especially if you’re aware of an extra risk factor for you) and check-ups with the doctor per their recommendations.
- If you’re talking about general vitals (blood pressure, heart rate, heart rate variability, VO₂ max, etc), then provided you have a reliable way of testing them, then doing them very frequently at home, to get the best “big picture” view. In contrast, getting them done once a year at your doctor’s could result in a misleading result, if you just ate something different that day or had a stressful morning, for example.
Enjoy
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The Unchaste Berry
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A Chasteberry, By Any Other Name…
Vitex agnus castus, literally “chaste lamb vine”, hence its modern common English name “chasteberry”, gets its name from its traditional use as an anaphrodisiac for monks (indeed, it’s also called “monk’s pepper”), which traditional use is not in the slightest backed up by modern science.
Nor is its second most popular traditional use (the increase in production of milk) well-supported by science either:
❝Its traditional use as a galactagogue (i.e., a substance that enhances breast milk production) is not well supported in the literature and should be discouraged. There are no clinical data to support the use of chasteberry for reducing sexual desire, which has been a traditional application❞
Source: American Family Physician | Chasteberry
Both of those supposed effects of the chasteberry go against the fact that it has a prolactin-lowering effect:
❝It appears that [chasteberry] may represent a potentially useful and safe phytotherapic option for the management of selected patients with mild hyperprolactinaemia who wish to be treated with phytotherapy.❞
Source: Vitex agnus castus effects on hyperprolactinaemia
Prolactin, by the way, is the hormone that (as the name suggests) stimulates milk production, and also reduces sexual desire (and motivation in general)
- In most women, it spikes during breastfeeding
- In most men, it spikes after orgasm
- In both, it can promote anhedonic depression, as it antagonizes dopamine
In other words, the actual pharmacological effect of chasteberry, when it comes to prolactin, is the opposite of what we would expect from its traditional use.
Ok, so it’s an unchaste berry after all…. Does it have any other claims to examine?
Yes! It genuinely does help relieve PMS, for those who have it, and reduce menopause symptoms, for those who have those, for example:
❝Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome.❞
❝That [Vitex agnus castus] trial indicated strong symptomatic relief of common menopausal symptoms❞
Source: Vitex agnus castus essential oil and menopausal balance: a research update
Is it safe?
Generally speaking, yes. It has been described as “well-tolerated” in the studies we mentioned above, which means it has a good safety profile.
However, it may interfere with some antipsychotic medications, certain kinds of hormone replacement therapy, or hormonal birth control.
As ever, speak with your doctor/pharmacist if unsure!
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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