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Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

<a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Around <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">3.2 million</a> Australians live with depression. At the same time, <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">few</a> Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other? Our world-first trial, <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065%2824%2900136-6/fulltext">published this week</a>, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression. Previous studies (including <a href="https://link.springer.com/article/10.1186/s12916-017-0791-y">our own</a>) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now. Amid a nation-wide <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">shortage</a> of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression. <h2>What did our study measure?</h2> During the prolonged COVID lockdowns, Victorians’ distress levels were <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50831">high and widespread</a>. Face-to-face mental health services were limited. Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful. We partnered with our <a href="https://www.barwonhealth.org.au/mhdas/">local mental health service</a> to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals. Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals: <ul> <li>eating a wide variety of foods</li> <li>choosing high-fibre plant foods</li> <li>including high quality fats</li> <li>limiting discretionary foods, such as those high in saturated fats and added sugars</li> <li>doing enjoyable physical activity.</li> </ul> The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2730724">groups and when delivered remotely</a>. In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups <a href="https://link.springer.com/article/10.1186/s12888-022-03840-3">workbooks and hampers</a>. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager. <h2>Lifestyle therapies just as effective</h2> We found similar results in each program. At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program. Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other. There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment. Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy. There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists. <h2>What does this mean for mental health workforce shortages?</h2> Demand for mental health services is increasing in Australia, while at the same time the workforce <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">faces worsening nation-wide shortages</a>. Psychologists, who provide <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">about half</a> of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap. Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait. Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing <a href="https://link.springer.com/content/pdf/10.1007/978-3-030-67929-3_38-1.pdf">eating disorders</a> or <a href="https://www.nature.com/articles/s41572-020-0200-2">gastrointestinal conditions</a>, which commonly overlap with depression. There is also a cost argument. It is <a href="https://journals.sagepub.com/doi/full/10.1177/1355819616668202">overall cheaper</a> to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time. <h2>Potential barriers</h2> Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite <a href="https://dietitiansaustralia.org.au/sites/default/files/2024-04/Dietitians%20Australia%20Mental%20Health%20Evidence%20Brief%202024.pdf">peak bodies</a> urging them to do so. Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues. <a href="https://foodandmoodcentre.com.au/academy">Our training</a> and clinical <a href="https://www.tandfonline.com/doi/full/10.1080/15622975.2022.2112074">guidelines</a> are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake). <h2>Future directions</h2> Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running <a href="https://foodandmoodcentre.com.au/projects/the-harmone-trial/">a study</a> open to Australians with mental health conditions such as major depression or bipolar disorder. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235952/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, Professor, Food & Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, Associate Research Fellow, Food and Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/food-and-exercise-can-treat-depression-as-well-as-a-psychologist-our-study-found-and-its-cheaper-235952">original article</a>.

Body

"Fly high, Bette!": World's longest-serving flight attendant dies aged 88

Bette Nash, the world's longest-serving flight attendant has passed away aged 88, after a short battle with breast cancer. American Airlines, where Nash devoted almost seven decades of her life, announced her death on social media on Saturday. "We mourn the passing of Bette Nash, who spent nearly seven decades warmly caring for our customers in the air," they began their post. “Bette was a legend at American and throughout the industry, inspiring generations of flight attendants. “Fly high, Bette. We’ll miss you.” A spokesperson for the airlines confirmed that she was still an active employee at the time of her death. Nash, who was born on December 31, 1935, began her flight-attendant career with Eastern Airlines in 1957, at just 21-years-old. In January 2022, she was officially recognised as the world’s longest-serving flight attendant by Guinness World Records, after surpassing the previous record a year earlier. She continued to hold the title until her passing. Tributes have poured in from people all over the world on social media, with many praising her for her unwavering dedication and kindness. "Fly high Bette! It was a pleasure being your passenger," wrote one person on X, alongside a selfie he took with her. <blockquote class="twitter-tweet"> Fly high Bette! It was a pleasure being your passenger. <a href="https://t.co/9N63YPB5Ia">pic.twitter.com/9N63YPB5Ia</a> — Jon Kruse (@JonKruseYacht) <a href="https://twitter.com/JonKruseYacht/status/1794459429997273423?ref_src=twsrc%5Etfw">May 25, 2024</a></blockquote> "She was flying as a passenger when she sat next to me, pinned her jacket to the bulkhead, gave me a three minute story of her life then said 'So what's your story?'. She was a dynamo. Rest easy," another added. "She was an absolute delight in my earliest airline life working the USAir shuttle at LGA. Godspeed and eternal silvered wings Bette!" a third wrote. <blockquote class="twitter-tweet"> She was an absolute delight in my earliest airline life working the USAir shuttle at LGA. Godspeed and eternal silvered wings Bette! — Ryan Spellman (@JustJettingThru) <a href="https://twitter.com/JustJettingThru/status/1794480142766531034?ref_src=twsrc%5Etfw">May 25, 2024</a></blockquote> "Rest in Peace Bette Nash," wrote a fourth. "Bette was a class act. Truly a loss for the skies. She was truly an Angel," added another. Image: CBS/ X

Caring

Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression

<div class="theconversation-article-body"> Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”. Some stress in daily life is unavoidable. But remaining stressed is unhealthy. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/">Chronic stress</a> increases <a href="https://pubmed.ncbi.nlm.nih.gov/32886587/">chronic health conditions</a>, including heart disease and stroke and diabetes. It can also lead to <a href="https://theconversation.com/were-all-exhausted-but-are-you-experiencing-burnout-heres-what-to-look-out-for-164393">burnout</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/">depression</a>. Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle. <h2>What does the stress cycle look like?</h2> Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">self-help experts</a> but it does have a scientific basis. The <a href="https://www.ncbi.nlm.nih.gov/books/NBK541120/">stress cycle</a> is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation. The stress cycle has three stages: <ul> <li> stage 1 is perceiving the threat </li> <li> stage 2 is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol </li> <li> stage 3 is relief, including physiological and psychological relief. This completes the stress cycle. </li> </ul> Different people will respond to stress differently based on their life experiences and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/#:%7E:text=The%20major%20findings%20regarding%20the,renin%2Dangiotensin%2Daldosterone%20system%20or">genetics</a>. Unfortunately, many people experience <a href="https://www.weforum.org/agenda/2023/01/polycrisis-global-risks-report-cost-of-living/">multiple and ongoing stressors</a> out of their control, including the cost-of-living crisis, extreme weather events and <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/types-of-violence/family-domestic-violence">domestic violence</a>. Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. <a href="https://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194">Chronic stress</a> and high cortisol can increase <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/">inflammation</a>, which damages our brain and other organs. When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are <a href="https://onlinelibrary.wiley.com/doi/10.1111/acer.14518">unhelpful strategies</a> that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an <a href="https://www.apa.org/monitor/2022/11/strain-media-overload">increased stress response</a>. <h2>Stress and the brain</h2> In the brain, chronic high cortisol can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561403/">shrink the hippocampus</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557684/#:%7E:text=The%20hippocampal%20formation%20plays%20a,%2C%20memory%2C%20motivation%20and%20emotion.&text=Therefore%2C%20reduced%20hippocampal%20volumes%20should,in%20patients%20with%20major%20depression">impair a person’s memory</a> and their capacity to think and concentrate. Chronic high cortisol also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/#:%7E:text=The%20prefrontal%20cortex%20(PFC)%20intelligently,brain%20regions%20(BOX%201).">reduces activity</a> in the prefrontal cortex but <a href="https://www.sciencedirect.com/science/article/pii/S2352289514000101">increases activity</a> in the amygdala. The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">goal-directed</a> and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed. There are five <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">types of activities</a> that can help our brains complete the stress cycle. <figure><iframe src="https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>It can help to understand how the brain encounters stress.</figcaption></figure> <h2>1. Exercise – its own complete stress cycle</h2> When we exercise we get a short-term spike in cortisol, followed by a <a href="https://www.health.harvard.edu/staying-healthy/exercising-to-relax">healthy reduction</a> in cortisol and adrenaline. Exercise also <a href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469#:%7E:text=Exercise%20in%20almost%20any%20form,distract%20you%20from%20daily%20worries.&text=You%20know%20that%20exercise%20does,fit%20it%20into%20your%20routine.">increases endorphins and serotonin</a>, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have <a href="https://pubmed.ncbi.nlm.nih.gov/33396962/">anti-inflammatory effects</a>. When you exercise, there is more blood flow to the brain and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721405/">higher activity</a> in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to <a href="https://www.healthline.com/health/heart-disease/exercise-stress-relief">relieve feelings of stress</a>. Exercise can also increase the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041121/">volume</a> of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915811/">hippocampus</a>. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety. <h2>2. Cognitive activities – reduce negative thinking</h2> Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987429/">stronger in people with more negative thinking</a>. Higher amygdala activity and less rational thinking when you are stressed can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/18628348/">distorted thinking</a> such as focusing on negatives and rigid “black-and-white” thinking. Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called <a href="https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt">cognitive behaviour therapy</a>. At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle. <h2>3. Getting creative – a pathway out of ‘flight or fight’</h2> Creative activities can be art, craft, gardening, cooking or <a href="https://heartmindonline.org/resources/10-exercises-for-your-prefrontal-cortex">other activities</a> such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work. Such pursuits increase <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">prefrontal cortex activity</a> and promote flow and focus. Flow is a <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.645498/full">state of full engagement</a> in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses. <h2>4. Getting social and releasing feel-good hormones</h2> Talking with someone else, physical affection with a person or pet and laughing can all <a href="https://theconversation.com/what-happens-in-our-brain-and-body-when-were-in-love-198885">increase oxytocin</a>. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe. Laughing is also a social activity that <a href="https://neurosciencenews.com/laughter-physical-mental-psychology-17339/">activates parts</a> of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases <a href="https://www.jneurosci.org/content/37/36/8581">endorphins</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27439375/">serotonin</a> and improves our mood. <h2>5. Self-soothing</h2> Breathing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">exercises</a> and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">vagus nerves</a>, and <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1760727">reduce cortisol</a>. A good <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035568/#:%7E:text=We%20conclude%20that%2C%20in%20addition,self%2Dsoothing%20effects%20of%20crying.">cry can help too</a> by releasing stress energy and increasing oxytocin and endorphins. <a href="https://www.medicalnewstoday.com/articles/319631#:%7E:text=Possible%20benefits%20of%20crying%20include,of%201.9%20times%20a%20month.">Emotional tears</a> also remove cortisol and the hormone prolactin from the body. Our prior research showed <a href="https://pubmed.ncbi.nlm.nih.gov/29096223/">cortisol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216608/">prolactin</a> were associated with depression, anxiety and hostility.<a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> <h2>Action beats distraction</h2> Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle. Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing. Importantly, chronic stress and <a href="https://theconversation.com/are-you-burnt-out-at-work-ask-yourself-these-4-questions-118128">burnout</a> can also indicate the need for change, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20311">such as in our workplaces</a>. However, not all stressful circumstances can be easily changed. Remember help is always available. If you have concerns about your stress or health, please talk to a doctor. If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218599/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, Associate professor in Mental Health and Behavioural Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">original article</a>. </div>

Mind

Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a> Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above. Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>. While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey. As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way. <h2>The science behind altitude sickness</h2> Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research. The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent. When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>. Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations. As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level. <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Tips for preventing or reducing the risk of altitude sickness.</figcaption></figure> <h2>The importance of gradual ascent</h2> High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness. This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>. People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed. Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>. <h2>Effective medications</h2> For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye. If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent. Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>. A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken. Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize. <h2>Unproven therapies and remedies are common</h2> As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend. Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective. <a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>. <a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness. Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective. Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness. The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.

Travel Trouble

Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>. <a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment. Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it. <h2>Walk, run, lift, or dance away depression</h2> We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together. We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them. Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants. But of these exercises, people were most likely to stick with strength training and yoga. <iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe> Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing. Still, our evidence shows that if you have depression, you should get a psychologist and an exercise plan, whether or not you’re taking antidepressants. <h2>Join a program and go hard (with support)</h2> Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.” But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression. We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results. <h2>Yes, it’s hard to keep motivated</h2> We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results. Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free. We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression. Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result. Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult. A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted. Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it. So, when starting out, it seems wise to avoid going it alone. Instead: <ul> <li> join a fitness group or yoga studio </li> <li> get a trainer or an exercise physiologist </li> <li> ask a friend or family member to go for a walk with you. </li> </ul> Taking a few steps towards getting that support makes it more likely you’ll keep exercising. <h2>Let’s make this official</h2> Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”. Based on our research, this recommendation is withholding a potent treatment from many people who need it. In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression. Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression. I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.

Body

Why prices are so high – 8 ways retail pricing algorithms gouge consumers

<a href="https://theconversation.com/profiles/david-tuffley-13731">David Tuffley</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> The just-released report of the inquiry into <a href="https://pricegouginginquiry.actu.org.au/">price gouging and unfair pricing</a> conducted by Allan Fels for the Australian Council of Trades Unions does more than identify the likely offenders. It finds the biggest are supermarkets, banks, airlines and electricity companies. It’s not enough to know their tricks. Fels wants to give the Australian Competition and Consumer Commission more power to investigate and more power to prohibit mergers. But it helps to know how they try to trick us, and how technology has enabled them to get better at it. After reading the report, I’ve identified eight key maneuvers. <h2>1. Asymmetric price movements</h2> Otherwise known as <a href="https://www.jstor.org/stable/25593733">Rocket and Feather</a>, this is where businesses push up prices quickly when costs rise, but cut them slowly or late after costs fall. It seems to happen for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0140988323002074">petrol</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S105905601730240X">mortgage rates</a>, and the Fels inquiry was presented with evidence suggesting it happens in supermarkets. Brendan O’Keeffe from NSW Farmers told the inquiry wholesale lamb prices had been falling for six months before six Woolworths announced a cut in the prices of lamb it was selling as a “<a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">Christmas gift</a>”. <h2>2. Punishment for loyal customers</h2> A <a href="https://theconversation.com/simple-fixes-could-help-save-australian-consumers-from-up-to-3-6-billion-in-loyalty-taxes-119978">loyalty tax</a> is what happens when a business imposes higher charges on customers who have been with it for a long time, on the assumption that they won’t move. The Australian Securities and Investments Commission has alleged a big <a href="https://theconversation.com/how-qantas-might-have-done-all-australians-a-favour-by-making-refunds-so-hard-to-get-213346">insurer</a> does it, setting premiums not only on the basis of risk, but also on the basis of what a computer model tells them about the likelihood of each customer tolerating a price hike. The insurer disputes the claim. It’s often done by offering discounts or new products to new customers and leaving existing customers on old or discontinued products. It happens a lot in the <a href="https://www.finder.com.au/utilities-loyalty-costing-australians-billions-2024">electricity industry</a>. The plans look good at first, and then less good as providers bank on customers not making the effort to shop around. Loyalty taxes appear to be less common among mobile phone providers. Australian laws make it easy to switch <a href="https://www.reviews.org/au/mobile/how-to-switch-mobile-carriers-and-keep-your-number/">and keep your number</a>. <h2>3. Loyalty schemes that provide little value</h2> Fels says loyalty schemes can be a “low-cost means of retaining and exploiting consumers by providing them with low-value rewards of dubious benefit”. Their purpose is to lock in (or at least bias) customers to choices already made. Examples include airline frequent flyer points, cafe cards that give you your tenth coffee free, and supermarket points programs. The purpose is to lock in (or at least bias) consumers to products already chosen. The <a href="https://www.accc.gov.au/consumers/advertising-and-promotions/customer-loyalty-schemes">Australian Competition and Consumer Commission</a> has found many require users to spend a lot of money or time to earn enough points for a reward. Others allow points to expire or rules to change without notice or offer rewards that are not worth the effort to redeem. They also enable businesses to collect data on spending habits, preferences, locations, and personal information that can be used to construct customer profiles that allow them to target advertising and offers and high prices to some customers and not others. <h2>4. Drip pricing that hides true costs</h2> The Competition and Consumer Commission describes <a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">drip pricing</a> as “when a price is advertised at the beginning of an online purchase, but then extra fees and charges (such as booking and service fees) are gradually added during the purchase process”. The extras can add up quickly and make final bills much higher than expected. Airlines are among the best-known users of the strategy. They often offer initially attractive base fares, but then add charges for baggage, seat selection, in-flight meals and other extras. <h2>5. Confusion pricing</h2> Related to drip pricing is <a href="https://www.x-mol.net/paper/article/1402386414932836352">confusion pricing</a> where a provider offers a range of plans, discounts and fees so complex they are overwhelming. Financial products like insurance have convoluted fee structures, as do electricity providers. Supermarkets do it by bombarding shoppers with “specials” and “sales”. When prices change frequently and without notice, it adds to the confusion. <h2>6. Algorithmic pricing</h2> <a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">Algorithmic pricing</a> is the practice of using algorithms to set prices automatically taking into account competitor responses, which is something akin to computers talking to each other. When computers get together in this way they can <a href="https://www.x-mol.net/paper/article/1402386414932836352">act as it they are colluding</a> even if the humans involved in running the businesses never talk to each other. It can act even more this way when multiple competitors use the same third-party pricing algorithm, effectively allowing a single company to influence prices. <h2>7. Price discrimination</h2> Price discrimination involves charging different customers different prices for the same product, setting each price in accordance with how much each customer is prepared to pay. Banks do it when they offer better rates to customers likely to leave them, electricity companies do it when they offer better prices for business customers than households, and medical specialists do it when they offer vastly different prices for the same service to consumers with different incomes. It is made easier by digital technology and data collection. While it can make prices lower for some customers, it can make prices much more expensive to customers in a hurry or in urgent need of something. <h2>8. Excuse-flation</h2> <a href="https://www.bloomberg.com/news/articles/2023-03-09/how-excuseflation-is-keeping-prices-and-corporate-profits-high">Excuse-flation</a> is where general inflation provides “cover” for businesses to raise prices without justification, blaming nothing other than general inflation. It means that in times of general high inflation businesses can increase their prices even if their costs haven’t increased by as much. On Thursday Reserve Bank Governor <a href="https://www.afr.com/policy/economy/inflation-is-cover-for-pricing-gouging-rba-boss-says-20240215-p5f58d">Michele Bullock</a> seemed to confirm that she though some firms were doing this saying that when inflation had been brought back to the Bank’s target, it would be "much more difficult, I think, for firms to use high inflation as cover for this sort of putting up their prices." <h2>A political solution is needed</h2> Ultimately, our own vigilance won’t be enough. We will need political help. The government’s recently announced <a href="https://treasury.gov.au/review/competition-review-2023">competition review</a> might be a step in this direction. The legislative changes should police business practices and prioritise fairness. Only then can we create a marketplace where ethics and competition align, ensuring both business prosperity and consumer wellbeing. This isn’t just about economics, it’s about building a fairer, more sustainable Australia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223310/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/david-tuffley-13731">David Tuffley</a>, Senior Lecturer in Applied Ethics & CyberSecurity, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-prices-are-so-high-8-ways-retail-pricing-algorithms-gouge-consumers-223310">original article</a>.

Money & Banking

2023 Drone Photo Awards fly high as winners are revealed

The winners of the 2023 Drone Photo Awards have been announced, with photographers all around the world recognised for their commitment to aerial photography in the fierce international competition. Thousands of submissions were received for the annual contest across nine different categories: photo of the year, urban, wildlife, sport, people, nature, abstract, wedding, series, and video. The Drone Photo Awards are open to both aerial photography and video, with platforms including “fixed-wing aircraft, helicopters, unmanned aerial vehicles, balloons, blimps and dirigibles, rockets, kites, and parachutes.” The competition’s top award, Photo of the Year, went to a shot by Israeli photographer Or Adar. His submission, ‘Must resist’, presents the image of “protesters holding banners during a demonstration again Israeli Prime Minister Benjamin Netanyahu’s judicial overhaul plans” from an aerial perspective, capturing the moment in Tel Aviv when “tens of thousands of protesters took to the streets of Israeli cities for the ninth straight week, on Saturday March 4th, to fight a government plan to overhaul the country's court system.” <blockquote class="twitter-tweet"> 🏆“𝐃𝐫𝐨𝐧𝐞 𝐏𝐡𝐨𝐭𝐨 𝐀𝐰𝐚𝐫𝐝𝐬 𝟐𝟎𝟐𝟑” 𝐏𝐡𝐨𝐭𝐨 𝐨𝐟 𝐭𝐡𝐞 𝐘𝐞𝐚𝐫 🏆 Congrats to Or Adar for his stunning image “Must resist”. 👏👏👏<a href="https://t.co/leaZw2sazu">https://t.co/leaZw2sazu</a><a href="https://twitter.com/hashtag/sienawards?src=hash&ref_src=twsrc%5Etfw">#sienawards</a> <a href="https://twitter.com/hashtag/dronephotoawards?src=hash&ref_src=twsrc%5Etfw">#dronephotoawards</a> <a href="https://twitter.com/hashtag/photocontest?src=hash&ref_src=twsrc%5Etfw">#photocontest</a> <a href="https://twitter.com/hashtag/dronephotography?src=hash&ref_src=twsrc%5Etfw">#dronephotography</a> <a href="https://t.co/pyReGOTMC9">pic.twitter.com/pyReGOTMC9</a> — Siena Awards (@SIPAContest) <a href="https://twitter.com/SIPAContest/status/1671458317472866313?ref_src=twsrc%5Etfw">June 21, 2023</a></blockquote> Polish photographer Sebastian Piórek took home the win in the Urban category for his shot of Chorzów in southern Poland, which was described by The Siena Awards as a photo that “beautifully juxtaposes the colourful ambiance and harmony of the playground against the backdrop of the city.” Indian photographer Danu Paran won the Wildlife category with his shot of a napping elephant, where “the elephant’s grey and wrinkled skin perfectly merges with the natural landscape, creating a harmonious composition that showcases the beauty of wildlife.” French photographer David Machet won for Sport with his photo of tightrope walker Nathan Paulin in the French Alps, as Paulin traversed a ‘highline’ almost 2.5 km in the air. The People category went to British photographer Simon Heather’s picture of people in Portugal enjoying a sunny day by the sea, while the Series award went to American photographer George Steinmetz for his photo series of farmland. Indian photographer Thomas Vijayan took home the Nature award for his photo of Svalbard, with Vijayan sharing that “it was surprisingly sad to see that the ice had already melted in June, and we were able to reach the ice cap with our ship.” The Abstract winner was Spanish photographer Ignacio Medem for a shot demonstrating how drought and poor water resource management has impacted a river in the American West. Polish photographer Krzysztof Krawczyk found success in the Wedding category, with his snap of newlyweds on a boat in the middle of a lake, while “they are enveloped by voluminous clouds and surrounded by thousands of dry leaves, resembling stars and creating gentle waves.” And last but not least, Bashir Abu won the Video category with “Why I Travel the World Alone”. <iframe title="YouTube video player" src="https://www.youtube.com/embed/Z6t4y3A28uA" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> And for anyone hoping to check the winners out for themselves, Adar’s image - as well as the top photographs from the other winning categories - will be available for viewing in the Above Us Only Sky exhibition set to take place for the first time at Italy’s San Galgano Abbey from July 8 to November 19. Images: Drone Photo Awards

Art

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

How to tell if your loved one is depressed

Around one in 10 people suffer from depression and anxiety, meaning it’s likely at some stage in your life someone you know will be suffering and need your help. These are five of the less-obvious signs and symptoms that a friend or family member might be going through a hard time. 1. They seem exhausted all the time Changes to a sleeping patterns can be a sign of depression, whether it’s not sleeping enough or sleeping too much. Tip: Help your loved one by taking them out for the day to re-set their body clock. 2. They never want to socialise anymore If your loved one is finding it difficult to leave the house and attend any social events, even for a catch-up over coffee, that they would normally enjoy, it could be a sign Tip: Recognise that at the time it is very hard for your loved one to go out and socialise. Reassure them that you’d love to catch-up with them, and if it does get too much that you’re happy to do something they’d be happy with. 3. They get frustrated at everything Does your loved one seem to be losing their patience more than usual? Anger and irritability, more than usual, can be a sign of depression. Tip: Chat to your friend about their feelings of frustration and irritability. You will be better placed to see if it’s a passing mood or longer-term change. 4. Their appetite has changed Whether your loved one is constantly and consistently “not hungry” or they’re eating a lot more than usual and gaining weight, changes in appetite are a common sign of depression. Tip: People living with depression are often exhausted, where the thought of making meals or even what to eat, can be an overwhelming decision. Help prepare some meals for your loved one. 5. They’ve suddenly lost self-confidence A loss of self-confidence and self-esteem is a common sign of depression. When a loved one starts to feel like everything they do is rubbish, it can be difficult to feel otherwise. Tip: When a loved one says they feel useless, reassure them with specific examples and evidence that it’s not true at all. Image credits: Getty Images

Caring

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

Body

Tracking the shift in meanings of ‘anxiety’ and ‘depression’ over time

The mental health terms ‘anxiety’ and ‘depression’ have become increasingly pathologised since the 1970s, according to analysis by Australian researchers of more than a million academic and general text sources. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0288027" target="_blank" rel="noreferrer noopener">Publishing</a> in PLOS ONE, psychology and computer science researchers from the University of Melbourne tracked the frequency and meaning of the concepts ‘anxiety’ and ‘depression’ from 1970 to 2018, and words that occurred in their vicinity. Using natural language processing, the team analysed more than 630 million words across 871,340 academic psychology papers, as well as 400,000 texts from general sources such as magazines, newspapers and non-fiction books. Paper co-author psychologist Professor Nicholas Haslam has a long standing interest in how mental health terms change their meanings over time, particularly the way harm-related words like bullying, abuse and trauma tend to expand over time, incorporating new, and often less severe kinds of experiences. Haslam says that trend reflects progressive social change and a rising sensitivity to harm and suffering in our culture. “We emphasize [that’s] mostly a good thing,” he says. <iframe title="The Emoji Squad: The Mysterious Group Behind the Little Icons We Love 🤝" src="https://omny.fm/shows/huh-science-explained/the-emoji-squad-the-mysterious-group-behind-the-li/embed?in_playlist=podcast&style=Cover" width="100%" height="180" frameborder="0"></iframe> The terms ‘anxiety’ and ‘depression’ were selected for analysis as prevalent, prominent mental health concepts. The researchers expected the emotional intensity and severity of the two terms to reduce over time as the frequency of their use increased. That expectation was informed by previous research using a similar approach, co-authored by Haslam and <a href="https://sciendo.com/article/10.58734/plc-2023-0002" target="_blank" rel="noreferrer noopener">publishing in</a> Sciendo, where increasing use of the word ‘trauma’ since the 1970s was associated with a shift in meaning including a broadening of use and declining severity. They hypothesised a similar trend for ‘anxiety’ and ‘depression’. “Well, we didn’t find what we expected,” Haslam says. Contrary to expectation, the emotional severity associated with anxiety and depression increased linearly over time. The authors say this is possibly due to growing pathologising of the terms, given their analysis shows use of the words increasingly linked to clinical concepts. In particular, the terms ‘disorder’ and ‘symptom’ have become more commonly associated with ‘anxiety’ and ‘depression’ in more recent decades, the paper says, finding similar patterns in both the academic and general texts. Anxiety and depression were also increasingly used together, compared to use in the ‘70s where the terms were more likely to refer to separate things. Haslam says, these shifts in meaning could reflect growing awareness of mental health in society and more research is needed into the implications, he says. But he notes this is an area where there can be “mixed blessings”. On the one hand, greater awareness of anxiety and depression can help people to seek appropriate treatment; and on the other, pathologising more ordinary variations in mood can risk become self-fulfilling or self-defeating. At a more systemic level, pathologising the milder end of the mental health spectrum could risk leading to a misallocation of resources away from the more severe and urgent mental health problems, Haslam says. Image credits: Getty Images <a href="https://cosmosmagazine.com/people/social-sciences/tracking-the-shift-in-meanings-of-anxiety-and-depression-over-time/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>.

Mind

How 1920s high society fashion pushed gender boundaries through ‘freaking’ parties

<a href="https://theconversation.com/profiles/dominic-janes-347508">Dominic Janes</a>, <a href="https://theconversation.com/institutions/keele-university-1012">Keele University</a> The 1920s brought about a rise in androgynous fashion among a high society set that broke boundaries and caused controversy. This drew on a subculture that had existed for decades, perhaps centuries, but after the first world war gender-bending fashions became front page news. It was a time of upheaval. Established regimes were toppling across Europe. In Britain, women over 30 had finally been given the vote and there was widespread concern about the new hedonism of their younger “flapper” sisters. There was also a new market for novels, such as Radcylffe Hall’s <a href="https://www.pbs.org/wgbh/roadshow/stories/articles/2019/4/1/radclyffe-hall-well-of-loneliness-legacy#:%7E:text=On%20November%2016%2C%201928%2C%20Biron,its%20immediate%20removal%20from%20circulation.">banned book</a> <a href="https://www.bbc.com/culture/article/20221121-the-well-of-loneliness-the-most-corrosive-book-ever">The Well of Loneliness</a> (1928) that focused on, rather than merely hinted at, queer lives. Daring male university students <a href="https://doi.org/10.1093/tcbh/hwab036">started wearing makeup</a>. One of these was <a href="https://www.vam.ac.uk/articles/cecil-beaton-an-introduction">Cecil Beaton</a>, the future celebrity photographer, who <a href="https://www.digitaltransgenderarchive.net/files/ht24wj66t">delighted in cross-dressing</a> both on stage and off. Beaton became part of a set of high society socialites who were known as the “<a href="https://www.npg.org.uk/whatson/cecil-beaton-bright-young-things/exhibition">bright young things</a>”. They were often socially privileged, many of them were queer and their antics were <a href="https://djtaylorwriter.co.uk/page10.htm">widely followed in the media</a> with a mixture of horror and fascination. The “things” took partying seriously and paid great attention to their outfits. They dressed to transgress. In 1920, high society magazine <a href="https://www.bloomsbury.com/uk/freak-to-chic-9781350172609/">The Sketch reported</a> that what it termed “freak parties” were suddenly in vogue with the younger set. Before the war, <a href="https://www.bloomsbury.com/uk/freak-to-chic-9781350172609/">articles had appeared</a> condemning unusual styles as “freak fashions”, but suddenly “<a href="https://www.bloomsbury.com/uk/freak-to-chic-9781350248083/">freaking</a>” was all the rage. Until this point, menswear had been heavily circumscribed. Black was the default colour for formal occasions and tweed for informal settings. But suddenly there was a circle who were keen to try out new looks, no matter how bizarre – or queer-looking – the results. <h2>Queer parties, queer fashions</h2> These styles were often worn as fancy dress, but they borrowed looks from marginalised queer communities such as feminine-styled queer men, some of whom made a living by selling sexual services. One such man was Quentin Crisp, whose memoir <a href="https://www.penguinrandomhouse.com/books/324730/the-naked-civil-servant-by-quentin-crisp/">The Naked Civil Servant</a> (1968) was dramatised as a <a href="http://www.crisperanto.org/news/NCSusa2007.html">pioneering TV drama</a>. Another source of inspiration was the <a href="https://press.uchicago.edu/ucp/books/book/chicago/S/bo3682948.html">freak show</a>. These displays, horrifying from a 21st century point of view, were a popular element of circuses at the time. They featured such stock characters as the muscled giant and the bearded lady, some of whom <a href="https://www.thehumanmarvels.com/annie-jones-the-esau-woman/">became celebrities</a> in their own right. Masquerade and fancy dress parties had long been a feature of urban social life, but the bright young things innovated in that they impressed less through the expense of their outfits and more through their queer implications. Many such parties were themed, such as a Greek-themed freak party that was hailed as the greatest “Dionysia” of 1929 (Dionysus being the Greek god of sex and pleasure). Androgynous and cross dressing looks were common and men such as Beaton designed their own frocks. In July 1927, <a href="https://www.routledge.com/Her-Husband-was-a-Woman-Womens-Gender-Crossing-in-Modern-British-Popular/Oram/p/book/9780415400077">one magazine declared</a> that an event attended by Beaton’s friend Stephen Tennant dressed as the Queen of Sheba and bisexual actress Tallulah Bankhead dressed as a male tennis star was: “one of the queerest of all the ‘freak’ parties ever given in London”. <h2>The party’s over</h2> The Wall Street crash of 1929 led to a rapid shift in public mood. Economic recession led people to favour sobriety over flamboyance. Money for the parties ran out and media attention faltered. Gender-bending style vanished from the fashionable arena, although it persisted on inner cities streets. Quentin Crisp’s mode of <a href="https://bodleianshop.co.uk/products/british-dandies">queer dandyism</a> was daring for its time, but it only became extraordinary by virtue of his unwillingness to modernise. Seemingly he, and pretty much he alone, continued to wear the queer looks of the interwar period into the television age. He duly <a href="http://www.crisperanto.org/news/AnEnglishmanInNYmovie.html">became a transatlantic celebrity</a> late in life when he became the inspiration for Sting’s song <a href="https://www.sting.com/discography/album/189/Singles">Englishman in New York</a> in 1987. Cecil Beaton, meanwhile, became a leading photographer for Vogue magazine and was commissioned to take official <a href="https://www.rct.uk/cecil-beaton-1904-80">coronation portraits of Elizabeth II</a>. He also designed the fantastic dresses worn by Audrey Hepburn in the film <a href="https://www.tatler.com/article/in-cecil-beatons-show-stopping-designs-for-my-fair-lady-lies-a-story-of-tantrums-and-top-hats">My Fair Lady</a> (1964), inspired by the gowns he and his compatriots had dreamed up for themselves some 40 years earlier.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205893/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dominic-janes-347508">Dominic Janes</a>, Professor of Modern History, <a href="https://theconversation.com/institutions/keele-university-1012">Keele University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-1920s-high-society-fashion-pushed-gender-boundaries-through-freaking-parties-205893">original article</a>.

Beauty & Style

Climate change protester crashes high-profile wedding

Climate change protesters have crashed the wedding of former UK politician George Osbourne and his former aide Thea Rodgers. The ceremony, which took place in Somerset, England, had more than 200 guests and was attended by several high-profilers – including former prime ministers, other UK politicians and various journalists. A few of the guests in attendance included former Prime Minister David Cameron and his wife, Samantha, longstanding minister Michael Gove, and former Sky News political editor Adam Boulton among others. The protester, who claimed to be part of the environmental group Just Stop Oil, waited until the couple walked out of St Mary’s Church after the ceremony to throw handfuls of orange confetti over them. The woman had a big smile on her face as she continued emptying the confetti from a Union Jack bag, before being dragged away by security. Just Stop Oil tweeted footage of the incident with the caption: “You look good in orange @George_Osborne – congratulations to the newlyweds.” Despite applauding the protester’s action, the environmental group has denied their connection to the incident. "If it was a form of protest (which is yet to be established) we applaud it and thank the person concerned,” they tweeted. "It was peaceful and not especially disruptive but got massive media attention for Just Stop Oil's demand." <blockquote class="twitter-tweet"> Confettigate: A Statement From Just Stop Oil The lady who threw confetti in Bruton yesterday was upholding a tradition that is common across many cultures. We absolutely defend the right for people to throw confetti (of whatever colour) at weddings and other celebrations. If it… <a href="https://t.co/e0uRJkV2S6">pic.twitter.com/e0uRJkV2S6</a> — Just Stop Oil (@JustStop_Oil) <a href="https://twitter.com/JustStop_Oil/status/1678014729216770048?ref_src=twsrc%5Etfw">July 9, 2023</a></blockquote> Another protester was reportedly spotted outside of the gates of the church. The group also added that people should focus on more important issues like the UK government’s decision to licence over 100 new oil and gas projects and the wildfires in Canada. This is Osbourne’s second wedding; he was previously married to Frances Osborne, but the pair divorced in 2019 after 21 years of marriage. Images: Finnbarr Webster/Getty Images

Relationships

Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

<a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> As of July 1, authorised psychiatrists have been allowed to prescribe MDMA (the chemical found in “ecstasy”) to treat post-traumatic stress disorder (PTSD), and psilocybin (found in “magic mushrooms”) to treat depression that hasn’t responded to other treatment. Psychedelic therapies have researchers excited because evidence suggests they might have lasting beneficial effects on factors that cause psychological distress beyond the treatment period. These include <a href="https://link.springer.com/article/10.1007/s00213-017-4701-y">feeling disconnected from other people</a>, <a href="https://link.springer.com/article/10.1007/s00213-019-05391-0">fear of death</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S2212144719301140?casa_token=OP6tKGxjPHAAAAAA:NTQ4khgsOY5wmsQ5HzCMcZ4eZ43wQV-sdhUbf5LXFiIeKWNwdonhfCxo77k7QbNk4G69EfX-">rigid ways of thinking</a>. This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly. But how strong is the evidence for psychedelic therapy? <h2>Early promise</h2> Early results from studies around the world have found psychedelic therapy <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">might be effective</a> for treating a range of psychological issues. For instance, most studies (<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">but not all</a>) have found patients tend to report <a href="https://pubmed.ncbi.nlm.nih.gov/37357767/">fewer depression symptoms</a> for periods ranging from several weeks to several months after psilocybin therapy. Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy. <h2>Not so fast</h2> However, as psychedelic research has grown, <a href="https://pubmed.ncbi.nlm.nih.gov/35243919/">limitations</a> of the research have been identified by researchers both <a href="https://psyarxiv.com/ak6gx/">within</a> and <a href="https://www.sciencefictions.org/p/psychedelics">outside</a> the psychedelic field. One issue is that we aren’t sure whether findings might be due to a <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo effect</a>, which occurs when a treatment works because people expect it to work. In clinical trials, participants are often given either a medication or a placebo (inactive) drug – and it’s important they don’t know which they have been given. However, due to the strong effects, it is difficult to prevent participants from knowing whether they have been given a psychedelic drug. Researchers have tried to use a range of different drugs (such as Ritalin) as a placebo in order to “trick” those participants not given a psychedelic into thinking they have received one. But this can be difficult to achieve. In 2021, researchers <a href="https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1933434?casa_token=Dovn7x_rkdUAAAAA%3AsPzBTYNTPnNwqj9NvwN0m9ptrP4x4-c83gp3tGcshs30dWHNnmB_Vx-X5H5Y3pZJdG02IWW6X2E">reviewed</a> clinical trials involving psychedelics such as LSD, psilocybin, and dimethyltryptamine (found in animals and plants) for mood and anxiety disorders. They found trials either had not assessed whether participants guessed correctly which drug they had been given, or that this had been tested and participants tended to guess correctly. More recent trials <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">either don’t measure this</a> or find participants have a <a href="https://journals.sagepub.com/doi/full/10.1177/02698811231154852?casa_token=VsPt344fVGwAAAAA%3AA-i1VPBE1EWyFITWNncZEt876lWMiC7rtTOLJBQnb2pHI2775imUJhrzeSZW6r9doaBeDaj61D0">pretty good idea</a> of whether they’ve had a placebo or a psychedelic drug. Given the publicity and excitement around psychedelic research in recent years, it is likely most participants have <a href="https://culanth.org/fieldsights/the-pollan-effect-psychedelic-research-between-world-and-word">strong beliefs</a> such therapies work. This could lead to a significant placebo effect for participants given a psychedelic dose. Additionally, participants who realise they have received a placebo could experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184717/">disappointment and frustration</a>, resulting in worse symptoms. The benefits of a psychedelic may seem even greater when they are compared to the experiences of disappointed participants. <h2>Translating trials to practice</h2> Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t. On a 2021 podcast, one clinical trial participant <a href="https://www.psymposia.com/powertrip/">described</a> how, in hindsight, the information they provided to the trial did not accurately capture the worsening of their symptoms. Trial participants are likely aware their results might affect whether treatments are legalised. They may not want to “ruin” the research by admitting the treatment didn’t work for them. There is also uncertainty about whether the findings from clinical trials mean treatments will work in private practice. There may be a lack of clarity around <a href="https://psyarxiv.com/ak6gx/">how trial participants</a> are recruited and selected. Therefore participants may not represent the typical person with PTSD or treatment-resistant depression. And while <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">the safety of psychedelics</a> within controlled contexts is often emphasised by advocates, less is known about safety of psychedelic therapy <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737738/full">outside</a> clinical trials. <h2>Resolving issues</h2> These issues do not mean the promising psychedelic research conducted over the past several decades is worthless. Nevertheless, a <a href="https://pubmed.ncbi.nlm.nih.gov/35285280/#full-view-affiliation-1">recent review</a> of the effects of MDMA and psilocybin on mental, behavioural or developmental disorders by Australian researchers concluded the “overall certainty of evidence was low or very low”. Dutch researchers recently drafted a <a href="https://psyarxiv.com/ak6gx/">roadmap for psychedelic science</a> with a checklist for future research to help avoid these pitfalls. When more research is done, it might turn out psychedelic treatments help patients and don’t come with unacceptable harms – we simply don’t know that yet.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">original article</a>.

Mind

Man proposes to high school sweetheart after rekindling their romance

Over 60 years ago, Thomas and Nancy met when they were in high school and fell in love. Despite their feelings for each other, their romance didn’t last and they fell out of touch as life moved on. Sixty years on, Thomas and Nancy rekindled their relationship and spent three weeks having phone conversations to discover their affection for each other never died. Nancy then decided to fly to Thomas’ home state of Florida for an emotional reunion, and was shocked by the surprise she arrived at. Walking off the plane in the city of Tampa, Nancy was greeted by Thomas on one knee, delivering an emotional speech about how much he loves her, before he asked her to marry him. The heart-felt moment, captured by a fellow traveller and posted to TikTok, shows Thomas dressed up in a suit, waiting nervously for Nancy to arrive with a big smile on his face. Upon seeing her, he handed her a bouquet of roses and gave her a tender kiss before he pulled out his ring and started professing his love. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/CuQIG3Mr0GA/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/CuQIG3Mr0GA/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by PerezHilton.com (@perezhilton)</a> </div> </blockquote> “My dear Nancy, it's been 60 years since we first met, 56 years since we first dated, 10 years since I last saw you, and 20 days since we began this,” he said, his voice shaky with emotion. “You have always been the one I've had a crush on, since your cheerleader days.” “It brings a smile to my face, it makes my heart skip a beat [to see you]. For the last three weeks, I have thought of you every day, every hour and have talked to you every night for hours.” “I have longed to see you again, hold you in my arms, and tell you how much you mean to me.” “So Nancy, I come to you humbly today, June 30, with a proposal. I want to spend the rest of my life with you and cherish every moment we will have together.” “I love you more than words can express, more than you can ever comprehend. I want to spend the rest of my life proving that to you and making you the happiest woman in the world.” “Will you Nancy, give me the honour of being my soulmate in life? My partner in every sense of the word, my beloved wife forever? Will you marry me?” Nancy, who had started to cry while Thomas was talking, quickly said yes to the proposal, which resulted in Thomas cheering and a group of strangers who had stopped to watch clapping for the couple before they embraced in a big hug. The TikTok creator also shared a snap of Thomas and Nancy posing together while holding up a sign that read, “She said yes!” The video has gained millions of views, and it sparked a slew of comments from people who said they were “sobbing” over Nancy and Thomas' love story. “They were meant to be, nor time or distance tore them apart,” one person wrote. Another said, “When two souls are meant to be, they will find each other.” Image credits: TikTok

Relationships

Harrison Ford is back as an 80-year-old Indiana Jones – and a 40-something Indy. The highs (and lows) of returning to iconic roles

<a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Saddle up, don the fedora and crack that whip: Harrison Ford is back as the intrepid archaeologist in Indiana Jones and the Dial of Destiny. The film premiered at Cannes, where Ford was <a href="https://www.hollywoodreporter.com/movies/movie-news/harrison-ford-honorary-palme-dor-cannes-1235495463/">awarded</a> an Honorary Palme d’Or in recognition of his life’s work. Reviews for the fifth film in the franchise <a href="https://www.hollywoodreporter.com/movies/movie-news/indiana-jones-5-review-roundup-1235495961/">have been mixed</a>, and it is the first Indy film not to be directed by Steven Spielberg (this time, it’s James Mangold, best known for his motor-racing drama Ford v Ferrari). But this is “event” cinema that combines nostalgia, old-school special effects and John Williams’ <a href="https://theconversation.com/from-jaws-to-star-wars-to-harry-potter-john-williams-90-today-is-our-greatest-living-composer-176245">iconic score</a>. So, Ford is back, aged 80. What draws actors back after all this time? <figure><iframe src="https://www.youtube.com/embed/eQfMbSe7F2g?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Role returns</h2> Ford first played Indy in 1981 and last played him in 2008. That is a full 15 years since the most recent film in the series, and 42 years since his first outing in Raiders of the Lost Ark. Ford has form in returning to celebrated characters. One of the great pleasures of watching The Force Awakens back in 2015 was seeing Ford play Han Solo again for the <a href="https://www.dailymotion.com/video/x3j2j09">first time in over 30 years</a>. <figure><iframe src="https://www.youtube.com/embed/0xQSIdSRlAk?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Actors return to roles for numerous reasons: <ul> <li>financial (Ford was reportedly paid <a href="https://okmagazine.com/exclusives/harrison-ford-paid-indiana-jones-5-plagued-with-problems/">US$25 million</a> for Dial of Destiny)</li> <li>protection of their brand, image and star persona (Michael Keaton <a href="https://www.fortressofsolitude.co.za/the-flash-movies-biggest-hero-how-michael-keaton-saved-the-film/">returning to play Batman</a> after three decades and three other actors who have embodied the role)</li> <li>professional (Tom Cruise admitted over the 36 years between Top Gun films he wanted to make sure the sequel <a href="https://screenrant.com/top-gun-maverick-tom-cruise-return-how-explained/">could live up to the original</a>)</li> <li>personal (once-huge stars are working less and less, and only feel the need to return to a built-in fan base every few years – Bill Murray in the 2021 Ghostbusters sequel springs to mind).</li> </ul> It’s not always a successful endeavour. Arnold Schwarzenegger and Sylvester Stallone – two of the biggest action stars of the 1980s off the back of iconic roles as The Terminator, Rocky Balboa and John Rambo – have repeatedly returned to those roles, and critics have been <a href="https://screenrant.com/terminator-dark-fate-undermined-john-connor-storyline-franchise-bad/">particularly harsh</a>. It did not work for Sigourney Weaver in <a href="https://www.rogerebert.com/reviews/alien-resurrection-1997">Alien: Resurrection</a> in 1997, 18 years after her first time as Ripley; nor for Keanu Reeves in <a href="https://www.theguardian.com/film/2021/dec/21/the-matrix-resurrections-review-keanu-reeves">The Matrix Resurrections</a> in 2021, 23 years after the original. And still, I’m intrigued to see what Michael Mann could do with his long-rumoured sequel to Heat, his definitive 1995 crime film. Ever since Mann published his novel Heat 2 last year – a kind of origin story for Heat’s key protagonists – fans have been hoping a de-aged Al Pacino (now aged 83) <a href="https://deadline.com/2023/04/michael-mann-heat-2-warner-bros-adam-driver-young-neil-mccauley-1235316777/">might return</a> as LA cop Vincent Hanna. <h2>Undoing time</h2> “Digital de-ageing” first entered the Hollywood mainstream in 2019 with The Irishman and Captain Marvel. <a href="https://www.indiewire.com/features/craft/de-aging-actors-history-benjamin-button-dial-of-destiny-harrison-ford-1234863938/">Via this process</a>, older actors (Robert De Niro, Al Pacino and Samuel L. Jackson have all been subject to the technology) move back and forwards in time without younger actors having to play them. <figure><iframe src="https://www.youtube.com/embed/OF-lElIlZM0?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Films still tend to cast two actors to play older and younger versions of the same character, a choice that dates back at least to 1974’s The Godfather Part II, in which a young Robert de Niro plays Vito Corleone, portrayed by the much older Marlon Brando in the first film. In 1989, Indiana Jones and the Last Crusade features a delightful opening scene where River Phoenix plays the young version of Indiana Jones, before Ford takes over for the rest of the film. <figure><iframe src="https://www.youtube.com/embed/AwH6-Yh7_SM?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Actors used to just play characters of their own age when reprising earlier roles. Paul Newman finally won a Best Actor Oscar for his role as “Fast Eddie” Felson in The Color of Money (1986), a quarter of a century after first playing him in The Hustler. The sequel plays on Newman’s age, and his role as a mentor to an upcoming Tom Cruise, and bathes viewers in nostalgia and memories of <a href="https://faroutmagazine.co.uk/paul-newman-schooled-tom-cruise-the-color-of-money/">a younger Newman</a>. <figure><iframe src="https://www.youtube.com/embed/k7gmrKAFshE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> But actors no longer have to exclusively play their age. The first part of Dial of Destiny is an extended flashback, set in 1944, in which Ford has been digitally de-aged to appear in his 40s. This process used an AI system that scanned used and unused reels of footage of Ford from <a href="https://www.cbr.com/harrison-ford-de-aging-indiana-jones-dial-of-destiny/">the first three Indy films</a> to match his present-day performance. Here, it is as if we are getting two Fords for the price of one: the “younger”, fitter Indy and the older, more world-weary version. It makes for a powerfully emotional connection on screen. Yet there are some <a href="https://variety.com/2023/film/awards/indiana-jones-5-harrison-ford-de-aging-not-working-1235618698/">pitfalls to de-ageing</a>. Some viewers complain that the whole process is distracting and that the hyper-real visual look of de-aged scenes resembles a video game. Even so, de-ageing in Hollywood cinema is here to stay. Tom Hanks’s <a href="https://variety.com/2023/film/news/tom-hanks-robin-wright-digitally-deaged-robert-zemeckis-movie-1235507766/">next film</a> is using AI-based generative technology to digitally de-age him. Given its reduced cost, speed and reduced human input, AI-driven innovation might have <a href="https://filmstories.co.uk/news/new-ai-driven-de-ageing-tools-to-be-used-in-tom-hanks-project/">industry-changing ramifications</a>. <h2>The star of Ford</h2> Harrison Ford remains a bona fide “movie star” in an industry profoundly buffeted by COVID, the rise of streaming platforms, the demise of the monoculture, and the changing nature of who constitutes a star. In the midst of all this industry uncertainty, it seems there is no longer a statute of limitations on actors returning to much-loved characters. The next big ethical issue for the film industry as it further embraces AI is whether to <a href="https://collider.com/james-dean-digital-cgi-performance-in-new-movie/">resurrect deceased actors</a> and cast them in new movies. Still, I’m looking forward to seeing more actors de-aged as the technology improves and audiences acclimatise to watching older actors “playing” younger versions of themselves. We are only at the start of Hollywood’s next big adventure.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202357/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, Associate Professor of French Studies, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/harrison-ford-is-back-as-an-80-year-old-indiana-jones-and-a-40-something-indy-the-highs-and-lows-of-returning-to-iconic-roles-202357">original article</a>.

Movies

How one brave mum is shedding light on postnatal depression through the healing power of music

Warning: This article contains sensitive content which some readers may find distressing. It’s no secret that having a baby changes your life in every way. From sleepless nights and feeding routines, to nappy changes and seemingly endless crying, starting a family is, put simply, a life-altering experience. And while the early days of having a newborn can bring love and chaos in equal parts, for some, the days, weeks and months after giving birth can welcome a whole new set of challenges. While most parents are privy to the “baby blues” and a rough day here and there, those struggling with postnatal depression can often be overlooked. Postnatal depression is common, with one in five mums, and one in 10 dads, experiencing postnatal depression symptoms after their baby is born. For Lija (pronounced Le-ah), postnatal depression completely changed her life. Lija, a music teacher from the Central Coast of New South Wales, welcomed her first child, a beautiful daughter named Harper, into the world at the end of 2017. When Lija discovered she was going to become a mum, she was overcome with fear. Lija spoke exclusively with OverSixty about her journey with postnatal depression, and how her feelings of anxiety began as soon as she fell pregnant. “There was this lie in my head that I could not give birth… That I would die. You feel like you can’t make a way through it and you’re predicting all these complications. [Lija’s friends’ traumatic birth experience] confirmed all these feelings and i just thought ‘Maybe you die from this’.” As soon as Lija and her husband began to celebrate the news of their growing family, she quickly began to “spiral” into self-doubt and depressive episodes. “When I found out I was pregnant, it was a spiral. I didn’t think I was good enough, I was crying so much… I didn’t feel like I could tell anyone because I was so gripped in fear.” “It took me about seven months to accept that I was having a kid.” Over the course of her pregnancy, Lija’s mental health continued to plummet with her feelings of fear and self-doubt, which led her down an even darker path. “The worst part was I was suicidal. There were moments where I wanted to end my life because I just felt like my time was up.” These feelings of helplessness led Lija to reach out to a counsellor, who helped manage her mental health symptoms for the rest of her pregnancy and introduced her to hypnobirthing. Her sessions with a hypnobirthing specialist gave Lija the boost she needed to be in tune with her body, and get her through to Harper’s birth with a sense of confidence. “If I’ve grown a baby, I can give birth to a baby. It was all just focus.” When Harper was born, Lija remembers healthcare professionals warning her husband that her mental health could decline, but she was never spoken to directly. “Apparently nurses were talking to my husband after the birth saying ‘She’s going to be prone to postnatal depression, you need to watch her’, but no one told me I was going to be so lonely.” “I was so focused on the birth going well that I hadn’t thought about what happens after, and I didn’t know what postnatal depression was.” When Lija and her husband brought baby Harper home, as they encountered perfectly common issues around sleep and breastfeeding, Lija thought she had failed as a first-time mum. “I felt like I failed as a mum because I couldn't give Harper everything she needed. And that started all these terrible thoughts and I just started to mentally spiral down again. But I didn’t know for about six months that I had postnatal depression.” During the first few months of Harper’s life, Lija began to find simple day-to-day tasks very difficult. “My poor husband… I was a psycho. It began when I said no one was allowed to come over because I was constantly in my pyjamas and I felt ashamed that my house wasn’t clean.” Lija shared that as she began to settle into the reality of being a mum, Harper’s needs always came first. “I was just in such a routine. I needed to have my baby follow a good structure, which meant my mental health took a backseat. So I just kept spiralling and spiralling.” As Lija tried to better herself, she quickly found out that comparing yourself to other new parents is a slippery slope that welcomes thoughts of self-doubt. “I tried to go to a mum’s club and they all seemed so perfect. I feel like they weren’t real. It was like Instagram mums. So to try and look good, I was spending all this money to try and keep up appearances.” As Lija’s mental health continued to suffer, she said it wasn’t until a difficult conversation with her husband that she realised she needed professional help. “I wasn’t being the normal me. There was no joy, there was no laughter, and I felt like I failed as a mother and as a wife. So my husband said ‘I’ve booked you in for a therapy session’, and that was the start of it.” “I wanted to be better for Harper. I wanted to be a good mum for her. So I had to start working on myself.” Now, five years on, Lija is reflecting on her experience with postnatal depression in the best way she knows how: through her music. Lija’s debut single Save Me details her journey of becoming a mum and bettering herself, while painting an honest portrait of the first months of motherhood. <iframe title="YouTube video player" src="https://www.youtube.com/embed/tmHTlybb-rM" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> After being a musician for most of her life, Lija’s passion took a backseat when she became a mother. “I started to miss my music, because I've done music my whole life. It was so hard to walk past my studio and see the guitar going to waste. I started to miss the other half of me as a musician.” After working on Save Me for several years, Lija believes it is the right time to put her story out there in order to help and inspire other parents struggling with postnatal depression. “It’s okay to be vulnerable. Be real, because you can help others with your honesty.” “It’s also important to remember that babies aren’t going to remember the best outfits they were in, or if they had the best pram. They're going to remember if they were loved or not.” Lija has long been a champion of music and its healing power, which became a saviour in her darkest times through her postnatal depression journey. “I went back to teaching music three months after having Harper. I worked one day a week and these kids and teenagers that were singing to me were actually healing me with their music and their talent.” “Music is something I have always turned to. It has always spoken to me, and I thought if I write a song about my journey, that could heal me too. I thought ‘It’s time to kick fear in the butt and write about life’.” Musical talent is something that runs in the family, with Harper’s singing talents already at “the next level”. “I swear she came out singing! Her ability to hear pitch is insane. In lockdown, she would be singing scales while I was teaching music classes over Zoom. She is just so joyous, and she is like my healing.” Lija’s debut single Save Me is out on now. Don't go it alone. Please reach out for help. Lifeline: 13 11 14 or <a href="http://lifeline.org.au/">lifeline.org.au</a> Beyond Blue: 1300 22 4636 or <a href="http://beyondblue.org.au/">beyondblue.org.au</a> Headspace: 1800 650 890 or <a href="http://headspace.org.au/">headspace.org.au</a> PANDA (Perinatal Anxiety & Depression Australia): 1300 726 306 or <a href="https://panda.org.au/">panda.org.au</a> Image credits: Instagram

Music

How to beat the retirement blues

When people plan their retirement they don’t usually expect Post retiring depression (PRD). This kind of depression usually stems from dashed expectations, financial trouble or feeling lost and lonely. That’s why we’ve got four top tips to avoid PRD and enjoy your free time. 1. Plan it out Know what you want to do, not what you think you should be doing. Don’t hold back in indulging yourself, travelling the world, volunteering abroad – the temporary discomfort of not knowing is better than realising when it’s too late that you never completed your bucket list. 2. Routine A sudden lack of structure can become exhausting or at least unsettling. Schedule activities such as exercise, housework, errands, and social time. Then let the day flow from there. 3. Keep active There is a lot of research to show that the people who cope best with retirement are those who stay active and involved. This might include: <ul> <li>Developing an old hobby or starting a new one. </li> <li>Staying physically active, through walking, swimming, gym or sport. Make sure your exercise routine is appropriate for your physical capacities and limitations. </li> <li>Volunteering with a charity or church group. </li> <li>Working part-time. </li> <li>Studying a course.</li> </ul> 4. Stay in touch Loneliness and isolation can be easily avoided, so don’t fall into the trap of feeling alone. Make the effort to stay in contact with family and friends. Offer to babysit your grandchildren. Check out local community centres for upcoming activities you might enjoy. Even if you're not sure try something new, you might surprise yourself! Images: Getty

Retirement Life

5 changes to make around the home that combat depression

Dealing with depression is difficult no matter what environment you’re in, but studies show there are certain steps you can take around the house to improve your mental health. Here are 5 activities you can do and changes you can make to your home that will boost your mood in no time at all. 1. Get gardening Whether or not you’ve got a natural green thumb, spending time in nature, getting your hands dirty and breathing in that fresh air has been <a href="http://www.pnas.org/content/112/28/8567.abstract" target="_blank" rel="noopener">scientifically proven</a> to lower feelings of despair. No backyard or front yard? No worries. Simply putting plants on your balcony, windowsill or around the house can be beneficial. <a href="http://www.oversixty.com.au/lifestyle/home-garden/2017/01/plants-that-will-make-your-home-happier/" target="_blank" rel="noopener">Here’s a list of plants </a>that will clear the air, calm you down and even help you sleep. 2. Bring the outside in Having a view lets in lots of light, which benefits your circadian rhythm and naturally boosts your mood, but if you don’t have a bright, scenic view, there are ways around it. “There are some beautiful murals, including decals that are easy to hang, that you might put on a wall in your living room,” Dr Jean M. Larson tells <a href="http://www.preventionaus.com.au/gallery/7-simple-changes-to-your-home-that-fight-depression-474471" target="_blank" rel="noopener">Prevention</a>. “You want to pick something that's familiar and pleasing.” 3. Light up As we mentioned above, light is essential (particularly in the morning) for those suffering depression – especially those affected by seasonal affective disorder. Try to get as much natural light in the morning as possible, otherwise you can install a light box which provides the same light produced by the sun but without all those nasty UV rays. 4. Get painting Painting your walls a bright, warm colour like orange or red can “evoke feelings of happiness or optimism,” according to interior designer Suzanne Falk. These colours are most widely associated with happiness, but colour preference is personal, so whatever colour makes you happy is the one you should go for. If painting isn’t an option, try the same thing with art, furniture, rugs, throws and décor. 5. Express yourself Decorate your space with constant reminders of the people and things that make you happy. Whether it’s a painting by one of your grandchildren, a photo from your favourite holiday or one of your pet’s toys lying around, it’s always good to have something to bring you back up when you’re feeling down. Image credit: Shutterstock

Mind

13 things psychologists wish you knew about happiness

<h2>Listen to melancholy music</h2> You heard that right! You officially have another excuse to listen to Adele on repeat (as if you even needed one anyway). Studies suggest that blasting some depressing and sappy tunes can actually help boost positive and peaceful feelings, which can be therapeutic, cathartic, and calming. <h2>Actually speak to the person next to you on the train or bus</h2> People are happier during their commutes when they chat up their seat neighbour, even if they think it will make the trip less positive and productive, according to a study in the Journal of Experimental Psychology: General. Try to get over your fear of speaking to strangers or worrying that you’re bothering them – you could bring some joy to both of you! “The biggest source of misery in the workplace is actually getting there and back,” says Dr Art Markman, PhD, author of Brain Briefs. “People are generally unhappy when forces outside their control are affecting their lives.” Obviously, you can’t control other drivers or the schedule of public transportation, so it helps to find aspects of your commute that you can control. “Get in conversations with random strangers on the train or bus,” says Dr Markman. “The more you take control of the situation, the happier you’ll be.” <h2>Know that money sometimes can buy happiness</h2> “They say money can’t buy happiness,” says Dr Nancy Etcoff, PhD, an assistant clinical professor at Harvard Medical School. “But it can if what you buy is extra time, or pay to delegate tasks.” So don’t feel guilty ordering in Chinese food or hiring a house cleaner. A study found that people who spend money to save time tend to be happier than those who don’t. Yes, it might be overkill to order takeout for breakfast, lunch and dinner every day, or to have someone clean your home more than once a week. But consider sending out your dry cleaning this week to save you the time of ironing yet another shirt. <h2>Call your mum </h2> When was the last time you picked up your smartphone to actually make a call? Research has found that hearing your mum’s voice can help reduce stress, which means a happier you. Talking on the phone was found to reduce a key stress hormone and release the feel-good brain chemical oxytocin that is thought to play a key role in forming bonds. It goes without saying that you’ll also make Mum’s day. <h2>Hang out with happy people</h2> Yawns aren’t the only things that are contagious. Research has found that the more you surround yourself with positive people, the happier you’ll feel. Go ahead and enjoy a round of drinks with your girl squad, grab coffee with that woman at school pickup who’s always smiling, or schedule a visit with your cheery hairdresser. <h2>Daydream about your upcoming holiday</h2> Do you yearn to be lying on the beach, exploring the mountains, trekking in the jungle, or touring a museum – right this minute? Believe it or not, getting out of town won’t necessarily make you happier, a study found. But thinking about going out of town is another story. The fact is that we get an extra boost of joy if we delay pleasure. We build positive expectations, imagining how amazing the experience will be. That warm sun or the frozen strawberry daiquiri by the pool? It’s just an added bonus. <h2>Speak to the person behind you in the supermarket</h2> Research has found that making friends – not just online – boosts our spirits. “Face-to-face, human interactions are the elixir for nearly everything that ails us,” says Dr Kit Yarrow, PhD, a consumer psychologist, professor, author, consultant, and speaker. “Though every interaction may not create happiness, in the long run, [it’s] the sense of community that’s created will.” Say hello to the mum next to you on the sideline at the soccer game. Chat up your new co-worker in the lunchroom. You never know who you’ll meet and what kind of connections you’ll make. <h2>Dust off your yearbook</h2> It’s time to reminisce about fond memories from the past, so dig up your wedding album or high school yearbook, and then call or email your high school or childhood besties. Research published in the Personality and Social Psychology Bulletin has found that feeling nostalgic about the past will increase optimism about the future and make you happier. <h2>Hang out with man’s best friend</h2> Power to the pets! Studies show that playing fetch with your dog or cuddling up with your cat does the body good. Interacting with pets has been found to release oxytocin, and you’ll be left with a joyous feeling. <h2>Be a little selfish</h2> “Being selfish is sometimes the best thing for yourself and others,” says Antonia Hall, MA, a psychologist, relationship expert, and author of The Ultimate Guide to a Multi-Orgasmic Life. Self-care may cause disappointment to others, like when you decline an invitation or cancel plans, Hall says. “But your wellbeing is more important.” If you’re unhappy, it won’t be a positive experience for either of you anyway, she says. Image credit: Shutterstock This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/13-things-psychologists-wish-you-knew-about-happiness" target="_blank" rel="noopener">Reader's Digest</a>.

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