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

<p><em><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></em></p> <p>Around <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">3.2 million</a> Australians live with depression.</p> <p>At the same time, <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">few</a> Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other?</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What did our study measure?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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:</p> <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> <p>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>.</p> <p>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.</p> <h2>Lifestyle therapies just as effective</h2> <p>We found similar results in each program.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What does this mean for mental health workforce shortages?</h2> <p>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>.</p> <p>Psychologists, who provide <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Potential barriers</h2> <p>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.</p> <p>Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues.</p> <p><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).</p> <h2>Future directions</h2> <p>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.</p> <p><em>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" /></em></p> <p><em><a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, Professor, Food &amp; 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></em></p> <p><em>Image </em><em>credits: Shutterstock</em></p> <p><em>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>.</em></p>

Body

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

<div class="theconversation-article-body"> <p>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”.</p> <p>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>.</p> <p>Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle.</p> <h2>What does the stress cycle look like?</h2> <p>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.</p> <p>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.</p> <p>The stress cycle has three stages:</p> <ul> <li> <p><strong>stage 1</strong> is perceiving the threat</p> </li> <li> <p><strong>stage 2</strong> is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol</p> </li> <li> <p><strong>stage 3</strong> is relief, including physiological and psychological relief. This completes the stress cycle.</p> </li> </ul> <p>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>.</p> <p>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>.</p> <p>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.</p> <p>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>.</p> <h2>Stress and the brain</h2> <p>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.&amp;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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <figure><iframe src="https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">It can help to understand how the brain encounters stress.</span></figcaption></figure> <h2>1. Exercise – its own complete stress cycle</h2> <p>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.</p> <p>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.&amp;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>.</p> <p>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>.</p> <p>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.</p> <h2>2. Cognitive activities – reduce negative thinking</h2> <p>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>.</p> <p>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.</p> <p>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>.</p> <p>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.</p> <h2>3. Getting creative – a pathway out of ‘flight or fight’</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>4. Getting social and releasing feel-good hormones</h2> <p>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.</p> <p>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.</p> <h2>5. Self-soothing</h2> <p>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>.</p> <p>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.</p> <p><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.<em><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></em></p> <h2>Action beats distraction</h2> <p>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.</p> <p>Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing.</p> <p>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.</p> <p>If you have concerns about your stress or health, please talk to a doctor.</p> <p><em>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.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image </em><em>credits: Getty Images </em></p> <p><em>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>.</em></p> </div>

Mind

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

<p><em><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></em></p> <p>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>.</p> <p><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.</p> <p>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.</p> <h2>Walk, run, lift, or dance away depression</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>But of these exercises, people were most likely to stick with strength training and yoga.</p> <p><iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>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.</p> <p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p> <h2>Join a program and go hard (with support)</h2> <p>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.”</p> <p>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.</p> <p>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.</p> <h2>Yes, it’s hard to keep motivated</h2> <p>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.</p> <p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.</p> <p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p> <p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>So, when starting out, it seems wise to avoid going it alone. Instead:</p> <ul> <li> <p>join a fitness group or yoga studio</p> </li> <li> <p>get a trainer or an exercise physiologist</p> </li> <li> <p>ask a friend or family member to go for a walk with you.</p> </li> </ul> <p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p> <h2>Let’s make this official</h2> <p>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”.</p> <p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p> <p>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.</p> <p>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.</p> <p><em>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.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>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>.</em></p>

Body

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

<p><em><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></em></p> <p>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>.</p> <p>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.</p> <p>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?</p> <h2>What the study did and found</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Important considerations</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What does other evidence say?</h2> <p><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.</p> <p>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.</p> <p>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.</p> <h2>Why the link?</h2> <p>There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia.</p> <p>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.</p> <p>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>.</p> <p>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" /></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, 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></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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>.</em></p>

Mind

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How to tell if your loved one is depressed

<p>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.</p> <p><strong>1. They seem exhausted all the time</strong></p> <p>Changes to a sleeping patterns can be a sign of depression, whether it’s not sleeping enough or sleeping too much.  </p> <p>Tip: Help your loved one by taking them out for the day to re-set their body clock.</p> <p><strong>2. They never want to socialise anymore</strong></p> <p>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</p> <p>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.</p> <p><strong>3. They get frustrated at everything</strong></p> <p>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.</p> <p>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.</p> <p><strong>4. Their appetite has changed</strong></p> <p>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.</p> <p>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.</p> <p><strong>5. They’ve suddenly lost self-confidence</strong></p> <p>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.</p> <p>Tip: When a loved one says they feel useless, reassure them with specific examples and evidence that it’s not true at all.</p> <p><em>Image credits: Getty Images</em></p>

Caring

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

<p>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. </p> <p><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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p><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&amp;style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>The terms ‘anxiety’ and ‘depression’ were selected for analysis as prevalent, prominent mental health concepts.</p> <p>The researchers expected the emotional intensity and severity of the two terms to reduce over time as the frequency of their use increased.</p> <p>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.</p> <p>They hypothesised a similar trend for ‘anxiety’ and ‘depression’.</p> <p>“Well, we didn’t find what we expected,” Haslam says.</p> <p>Contrary to expectation, the emotional severity associated with anxiety and depression increased linearly over time. </p> <p>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. </p> <p>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. </p> <p>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.</p> <p>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. </p> <p>But he notes this is an area where there can be “mixed blessings”.</p> <p>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.</p> <p>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.</p> <p><em>Image credits: Getty Images</em></p> <p><em><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>. </em></p>

Mind

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

<p><em><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></em></p> <p>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.</p> <p>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>.</p> <p>This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly.</p> <p>But how strong is the evidence for psychedelic therapy?</p> <h2>Early promise</h2> <p>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.</p> <p>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.</p> <p>Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy.</p> <h2>Not so fast</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Translating trials to practice</h2> <p>Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Resolving issues</h2> <p>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”.</p> <p>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" /></p> <p><a href="https://theconversation.com/profiles/sam-moreton-194043">Sa<em>m Moreton</em></a><em>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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>.</em></p>

Mind

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

<p dir="ltr"><em><strong>Warning: This article contains sensitive content which some readers may find distressing.</strong></em></p> <p dir="ltr">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. </p> <p dir="ltr">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.</p> <p dir="ltr">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. </p> <p dir="ltr">Postnatal depression is common, with one in five mums, and one in 10 dads, experiencing postnatal depression symptoms after their baby is born.</p> <p dir="ltr">For Lija (pronounced Le-ah), postnatal depression completely changed her life. </p> <p dir="ltr">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. </p> <p dir="ltr">When Lija discovered she was going to become a mum, she was overcome with fear. </p> <p dir="ltr">Lija spoke exclusively with <em>OverSixty</em> about her journey with postnatal depression, and how her feelings of anxiety began as soon as she fell pregnant. </p> <p dir="ltr">“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’.”</p> <p dir="ltr">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. </p> <p dir="ltr">“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.”</p> <p dir="ltr">“It took me about seven months to accept that I was having a kid.”</p> <p dir="ltr">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. </p> <p dir="ltr">“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.”</p> <p dir="ltr">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.</p> <p dir="ltr">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. </p> <p dir="ltr">“If I’ve grown a baby, I can give birth to a baby. It was all just focus.”</p> <p dir="ltr">When Harper was born, Lija remembers healthcare professionals warning her husband that her mental health could decline, but she was never spoken to directly.</p> <p dir="ltr">“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.” </p> <p dir="ltr">“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.”</p> <p dir="ltr">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.</p> <p dir="ltr">“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.”</p> <p dir="ltr">During the first few months of Harper’s life, Lija began to find simple day-to-day tasks very difficult. </p> <p dir="ltr">“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.”  </p> <p dir="ltr">Lija shared that as she began to settle into the reality of being a mum, Harper’s needs always came first. </p> <p dir="ltr">“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.”</p> <p dir="ltr">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. </p> <p dir="ltr">“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.”</p> <p dir="ltr">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. </p> <p dir="ltr">“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.”</p> <p dir="ltr">“I wanted to be better for Harper. I wanted to be a good mum for her. So I had to start working on myself.”</p> <p dir="ltr">Now, five years on, Lija is reflecting on her experience with postnatal depression in the best way she knows how: through her music. </p> <p dir="ltr">Lija’s debut single <em>Save Me</em> details her journey of becoming a mum and bettering herself, while painting an honest portrait of the first months of motherhood. </p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/tmHTlybb-rM" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p dir="ltr">After being a musician for most of her life, Lija’s passion took a backseat when she became a mother. </p> <p dir="ltr">“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.”</p> <p dir="ltr">After working on <em>Save Me</em> 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.</p> <p dir="ltr">“It’s okay to be vulnerable. Be real, because you can help others with your honesty.”</p> <p dir="ltr">“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.”</p> <p dir="ltr">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.</p> <p dir="ltr">“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.”</p> <p dir="ltr">“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’.”</p> <p dir="ltr">Musical talent is something that runs in the family, with Harper’s singing talents already at “the next level”.</p> <p dir="ltr">“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.”</p> <p dir="ltr">Lija’s debut single <em>Save Me</em> is out on now.</p> <p dir="ltr"><strong>Don't go it alone. Please reach out for help.</strong></p> <p dir="ltr"><strong><em>Lifeline: 13 11 14 or <a href="http://lifeline.org.au/">lifeline.org.au</a></em></strong></p> <p dir="ltr"><strong><em>Beyond Blue: 1300 22 4636 or <a href="http://beyondblue.org.au/">beyondblue.org.au</a></em></strong></p> <p dir="ltr"><strong><em>Headspace: 1800 650 890 or <a href="http://headspace.org.au/">headspace.org.au</a></em></strong></p> <p dir="ltr"><strong><em>PANDA (Perinatal Anxiety &amp; Depression Australia): 1300 726 306 or <a href="https://panda.org.au/">panda.org.au</a></em></strong></p> <p dir="ltr"><em>Image credits: Instagram</em></p>

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How to beat the retirement blues

<p>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.</p> <p><strong>1. Plan it out</strong></p> <p>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.</p> <p><strong>2. Routine</strong></p> <p>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.</p> <p><strong>3. Keep active</strong></p> <p>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:</p> <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> <p><strong>4. Stay in touch</strong></p> <p>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!</p> <p><em>Images: Getty</em></p>

Retirement Life

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5 changes to make around the home that combat depression

<p>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.</p> <p><strong>1. Get gardening</strong></p> <p>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"><strong><span style="text-decoration: underline;">scientifically proven</span></strong></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"><strong><span style="text-decoration: underline;">Here’s a list of plants</span> </strong></a>that will clear the air, calm you down and even help you sleep.</p> <p><strong>2. Bring the outside in</strong></p> <p>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"><em><strong><span style="text-decoration: underline;">Prevention</span></strong></em></a>. “You want to pick something that's familiar and pleasing.”</p> <p><strong>3. Light up</strong></p> <p>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.</p> <p><strong>4. Get painting</strong></p> <p>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.</p> <p><strong>5. Express yourself</strong></p> <p>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.</p> <p><em>Image credit: Shutterstock</em></p>

Mind

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13 things psychologists wish you knew about happiness

<h2>Listen to melancholy music</h2> <p>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.</p> <h2>Actually speak to the person next to you on the train or bus</h2> <p>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.”</p> <h2>Know that money sometimes can buy happiness</h2> <p>“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.</p> <h2>Call your mum </h2> <p>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.</p> <h2>Hang out with happy people</h2> <p>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.</p> <h2>Daydream about your upcoming holiday</h2> <p>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.</p> <h2>Speak to the person behind you in the supermarket</h2> <p>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.</p> <h2>Dust off your yearbook</h2> <p>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.</p> <h2>Hang out with man’s best friend</h2> <p>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.</p> <h2>Be a little selfish</h2> <p>“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.</p> <p><em>Image credit: Shutterstock</em></p> <p><em>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>. </em></p>

Mind

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Vegetarians more likely to be depressed than meat-eaters

<p>Vegetarians have around twice as many depressive episodes as meat-eaters, according to a <a href="https://www.sciencedirect.com/science/article/pii/S0165032722010643" target="_blank" rel="noopener">new study</a>.</p> <p>The study, based on survey data from Brazil, chimes with <a href="https://www.psychologytoday.com/gb/blog/animals-and-us/201812/the-baffling-link-between-vegetarianism-and-depression" target="_blank" rel="noopener">earlier research</a> that found higher rates of depression among those who forgo meat. However, the new study suggests that this link exists independent of nutritional intake.</p> <p>It may seem straightforward to look at a link between a diet and specific health problems and assume that the former is causing the latter via some form of nutritional deficiency.</p> <p>Yet the new analysis, published in the Journal of Affective Disorders, took into account a wide range of nutritional factors, including total calorie intake, protein intake, micronutrient intake, and the level of food processing. This suggests that the higher rates of depression among vegetarians are not caused by the nutritional content of their diet.</p> <p>So what might explain the link between vegetarianism and depression? Is there some non-nutritional mechanism that makes the former cause the latter? Or is the relationship down to something else entirely?</p> <p>First, it is possible that being depressed causes people to be more likely to become vegetarian rather than the other way around. The <a href="https://www.nhs.uk/mental-health/conditions/clinical-depression/symptoms/" target="_blank" rel="noopener">symptoms of depression</a> can include rumination on negative thoughts, as well as feelings of guilt.</p> <p>Assuming that depressed and non-depressed people are equally likely to encounter the upsetting truth of slaughterhouses and factory farming, it is possible that depressed people are more likely to ruminate on those thoughts, and more likely to feel guilty for their part in creating the demand.</p> <p>The depressed vegetarian, in this case, is not necessarily wrong to think this way. While depression is sometimes characterised as having unrealistically negative perceptions, <a href="https://www.psychologytoday.com/gb/blog/hide-and-seek/201206/depressive-realism" target="_blank" rel="noopener">there is evidence to suggest</a> that people with mild to moderate depression have more realistic judgments about the outcome of uncertain events and more realistic perceptions of their own role and abilities.</p> <p>In this case, there really is <a href="https://www.bryantresearch.co.uk/insights/acceptability-of-animal-farming-practices" target="_blank" rel="noopener">cruel treatment of animals in meat production</a>. And this really is caused by consumer demand for cheap meat.</p> <p>Second, it is possible that adhering to a vegetarian diet causes depression for reasons other than nutrition. Even if there is no “happy nutrient” lacking in a vegetarian diet, it could be the case that forgoing meat causes depression through other means.</p> <p>For example, adopting a vegetarian diet might affect one’s relationship with others and involvement in social activities, and sometimes may be associated with <a href="https://pubmed.ncbi.nlm.nih.gov/21361905/" target="_blank" rel="noopener">teasing or other forms of social ostracism</a>.</p> <p>Notably, the new study is based on survey data collected in Brazil, a country <a href="https://data.oecd.org/agroutput/meat-consumption.htm" target="_blank" rel="noopener">famous for its meat-heavy diet</a>. Some survey data has pointed to a <a href="https://www.nytimes.com/2020/12/26/world/americas/brazil-vegetarian.html" target="_blank" rel="noopener">sharp increase in vegetarianism in Brazil in recent years</a>, going from 8% in 2012 to 16% in 2018. However, the recent paper surveyed over 14,000 Brazilians and found just 82 vegetarians – scarcely more than half a per cent.</p> <p>One has to wonder if the same link between vegetarianism and depression would be observed in India or other countries where vegetarianism is more of a social norm. More importantly, as the <a href="https://www.bryantresearch.co.uk/insights/uk-protein-transition-in-4-graphs" target="_blank" rel="noopener">rate of vegetarianism increases in the UK</a> and other developed countries, will we see the relationship disappear over time?</p> <p>Finally, it is possible that neither vegetarianism nor depression cause the other, but both are associated with some third factor. This could be any number of characteristics or experiences that are associated with both vegetarianism and depression.</p> <p>For example, <a href="https://www.sciencedirect.com/science/article/pii/S0195666317305305" target="_blank" rel="noopener">women are more likely than men to be vegetarian</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532074/" target="_blank" rel="noopener">and to experience depression</a>. However, the Brazilian study took sex into account, ruling out this particular third variable.</p> <h2>Not examined</h2> <p>One variable that was not examined, but is plausibly linked to both vegetarianism and depression, is exposure to violent images of the meat industry. Preventing cruelty to animals is the <a href="https://www.statista.com/statistics/1062072/reasons-for-becoming-vegetarian-or-vegan-in-great-britain/" target="_blank" rel="noopener">most commonly cited reason</a> vegetarians give for avoiding meat.</p> <p>Documentaries like <a href="https://watchdominion.org/" target="_blank" rel="noopener">Dominion</a> and <a href="http://www.nationearth.com/" target="_blank" rel="noopener">Earthlings</a> that depict the cruelty in the meat industry cannot readily be described as feelgood films. One can easily imagine that a person who consumes this kind of media would become both vegetarian and, especially when most people choose to look the other way, depressed.</p> <p>There are several possible reasons for the link between vegetarianism and depression. This new study suggests that vegetarian nutrition is not the cause of depression.</p> <p>Instead, the vegetarian social experience may contribute to depression, depression may cause an increased likelihood of becoming vegetarian, or both vegetarianism and depression may be caused by a third variable, such as exposure to violent meat industry imagery.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/vegetarians-more-likely-to-be-depressed-than-meat-eaters-possible-reasons-191707" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

Body

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New study to “give hope” to childhood trauma survivors with depression

<p dir="ltr">A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression.</p> <p dir="ltr">Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions.</p> <p dir="ltr">The study, published in <em><a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a></em>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma.</p> <p dir="ltr">While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent.</p> <p dir="ltr">The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma.</p> <p dir="ltr">Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma).</p> <p dir="ltr">But, they found that both groups experienced an improvement in symptoms at a similar rate.</p> <p dir="ltr">Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope.</p> <p dir="ltr">“Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said.</p> <p dir="ltr">“Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.”</p> <p dir="ltr">Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients.</p> <p dir="ltr">“This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said.</p> <p dir="ltr">“However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.”</p> <p dir="ltr">According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood.</p> <p dir="ltr">But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective.</p> <p dir="ltr"><em>If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380.</em></p> <p><em><span id="docs-internal-guid-62551377-7fff-7a7f-9e23-d352d2c29923"></span></em></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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Magic mushrooms relieve depression and now we might know why

<p dir="ltr">Psychedelics like psilocybin, the key active ingredient in magic mushrooms, have become a beacon of hope for people with depression that is resistant to other forms of treatment - and new research has shed some light on how they affect the brain.</p> <p dir="ltr">A team of psychedelics researchers have used MRI technology to understand how psilocybin works in the brain, finding that it first “dissolves” then expands brain connections.</p> <p dir="ltr">The study, published in <em><a href="https://doi.org/10.1038/s41591-022-01744-z" target="_blank" rel="noopener">Nature Medicine</a></em>, found that certain parts of depressed people’s brains became more interconnected and flexible after two doses of psilocybin, and that the changes lasted for up to three weeks.</p> <p dir="ltr">“These findings are important,” Professor David Nutt, a psychiatrist at the Imperial College London and one of the senior authors of the study, said.</p> <p dir="ltr">“For the first time we find that psilocybin works differently from conventional antidepressants - making the brain more flexible and fluid, and less entrenched in the negative thinking patterns associated with depression.”</p> <p dir="ltr">Though magic mushrooms have been used for their healing properties by Indigenous people for a long time, per <em><a href="https://www.sciencealert.com/scientists-have-finally-figured-out-how-magic-mushrooms-might-relieve-depression" target="_blank" rel="noopener">ScienceAlert</a></em>, their use in clinical trials - and our understanding of how they work - is limited.</p> <p dir="ltr">Previous research from Professor Nutt and his colleagues found that a combination of psilocybin and psychological therapy was as effective as taking escitalopram, a common antidepressant, without the common side effects that can include weight gain, reduced libido, and insomnia.</p> <p dir="ltr">Though this and other small studies have shown the benefits of psilocybin, how it works in the brain has been poorly understood until Professor Nutt’s most recent study.</p> <p dir="ltr">He and his team analysed the brain scans of 43 people with clinical depression who had participated in two previous clinical trials, including 22 people treated with psilocybin, and 21 people who received escitalopram.</p> <p dir="ltr">They found that those who received psilocybin had greater connectivity in regions of the brain that are rich in serotonin receptors which are usually segregated in depressed patients. A day after treatment, their brain networks were more interconnected and flexible, while no such changes were seen in the people taking the antidepressant.</p> <p dir="ltr">“This supports our initial predictions and confirms psilocybin could be a real alternative approach to depression treatments,” Professor Nutt said.</p> <p dir="ltr">Their findings match those of a study from 2020, which found similar changes in brain network connectivity up to a month after one dose of psilocybin.</p> <p dir="ltr">As exciting as these findings are, neuroscientist and fellow senior author Dr Robin Carhart-Harris said more research is needed.</p> <p dir="ltr">“We don’t know yet how long the changes in brain activity seen with psilocybin therapy last and we need to do more research to understand this,” he said.</p> <p dir="ltr">“We do know that some people relapse, and it may be that after a while their brains revert to the rigid patterns of activity we see in depression.”</p> <p dir="ltr">Either way, the researchers hope their findings pave the way for studying psilocybin’s effect on other mental illnesses characterised by rigid thought patterns, such as anorexia and addiction.</p> <p dir="ltr">“We now need to test if this is the case, and if it is, then we have found something important,” Dr Carhart-Harris said.</p> <p><span id="docs-internal-guid-3043ebe9-7fff-c5f3-3351-6e620f6ff71e"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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Why this new mum lay down with her baby daughter in front of a train

<p dir="ltr"><strong>CONTENT WARNING: Distressing content</strong></p> <p dir="ltr">A Victorian courtroom has heard further details surrounding an incident in which a new mother struggling with postpartum depression killed her daughter by laying down with her on train tracks.</p> <p dir="ltr">Melissa Arbuckle appeared in the Victorian Supreme Court on Tuesday where she pleaded guilty to infanticide over the tragic incident at a train station in July last year.</p> <p dir="ltr">Defence barrister Megan Tittensor told the court that Arbuckle suffered severe postpartum depression and psychosis when she tried to kill herself and her daughter, Lily.</p> <p dir="ltr">The court heard that Arbuckle thought Lily was suffering from shaken baby syndrome and that she would eventually die.</p> <p dir="ltr">“This act was committed by someone with a significantly disturbed mind,” Tittensor told the court, <a href="https://7news.com.au/news/court-justice/vic-court-told-of-mums-disturbed-mind-c-6341505" target="_blank" rel="noopener">7News</a> reported.</p> <p dir="ltr">“She had a fixed delusional belief she had harmed her child and they were both broken.</p> <p dir="ltr">“She had a perfectionist personality and need for control...she wanted to be the perfect mother.”</p> <p dir="ltr">Arbuckle was struggling with Lily while taking her for a walk when she began looking at train timetables, the court heard.</p> <p dir="ltr">She then messaged her husband saying their daughter was unsettled, before placing Lily on the train track and laying down next to her.</p> <p dir="ltr">The pair were struck but Lily died while being airlifted to hospital, and Arbuckle survived with fractures and internal bleeding.</p> <p dir="ltr">Arbuckle remains on bail and will be sentenced on Thursday.</p> <p dir="ltr"><em>Lifeline 13 11 14</em></p> <p dir="ltr"><em>beyondblue 1300 22 4636</em></p> <p><em><span id="docs-internal-guid-24028b0b-7fff-a14b-36d0-4e28f7f0372d"></span></em></p> <p dir="ltr"><em>Image: Seven News</em></p>

Mind

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Cameras capture mother dropping daughter into bear enclosure

<p>A woman has dropped her toddler into a bear enclosure at a zoo in Uzbekistan. This incident follows her husband leaving to work in Russia to escape poverty.</p><p>The woman, who had become very depressed, was caught on camera approaching the bear enclosure at the zoo in the Uzbek capital of Tashkent and deliberately dropping the child over the railings.</p><blockquote class="twitter-tweet"><p dir="ltr" lang="en">Woman throws daughter into enclosure with live bear.<br /><br />In a blood-curdling incident captured on camera at a zoo in Uzbekistan’s capital city Tashkent on Friday, a young woman threw her three-year-old daughter into the enclosure of a massive brown bear. <a href="https://t.co/H51trJvN6z">pic.twitter.com/H51trJvN6z</a></p>— News 12PM (@News12PM) <a href="https://twitter.com/News12PM/status/1488106702994030601?ref_src=twsrc%5Etfw">January 31, 2022</a></blockquote><p>Zookeepers ran into the enclosure and rescued the girl.</p><p>Officials later said the unnamed woman now faces charges of attempted murder, with a maximum sentence of 15 years in jail.</p><p>"The woman has been depressed as her husband left for Russia and no longer lives with her," the Uzbek health ministry said.</p><p>The woman has been identified as a 30-year-old university lecturer who has two children and lives with her elderly father.</p><p>Footage released by Uzbek authorities showed that the grizzly bear was initially scared off by something dropping from the sky into the moat just below the railings, before he rushed to come closer to the girl, and then went away again.</p><p>"It's scary to even think what could have happened if the bear had reacted to the child as a predator to a prey," the zoo said.</p><p>The three-year-old was taken to hospital with a concussion sustained from the fall, but her life is not in danger.</p><p><em>Image: Getty</em></p>

Family & Pets

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What is catastrophising?

<p>Our brains are constantly building connections, forming relationships between our experiences, thoughts, actions and consequences. It’s this ongoing process that shapes each person’s view of the world – and affects everything from our reactions to daily problem-solving.</p> <p>But sometimes, our brains build cause-and-effect relationships based on overly simplistic, coincidental, or simply incorrect associations.</p> <p>These biased thought patterns – known as cognitive distortions – usually aren’t grounded in reality and tend to skew negative, says Alissa Jerud, PhD, a licensed clinical psychologist and clinical assistant professor of psychology.</p> <p>One common way people distort their worldview is by catastrophising. Here’s what experts want you to know about this cognitive distortion, including how to overcome this type of thinking.</p> <p><strong>What are the different kinds of cognitive distortion?</strong></p> <p>We all experience irrational thoughts now and again. Yet reinforcing negative thought patterns alters our sense of wellbeing for the worse.</p> <p>Psychologist Aaron Beck first proposed this theory of cognitive distortion in 1976. His student David Burns, now a psychiatrist and adjunct clinical professor emeritus at Stanford University School of Medicine, continued Beck’s work by cataloguing how our brains tend to manufacture faulty connections.</p> <p>“None of them is one-size-fits-all,” explains therapist Erica Cramer, but according to Burns’ research, some common ways we cognitively distort our view of the world include:</p> <ul> <li>filtering, magnifying, and dwelling on negative details</li> <li>black-and-white or all-or-nothing thinking</li> <li>overgeneralisation, like thinking that something “always” or “never” happens</li> <li>jumping to conclusions, mind reading and predictive fortune-telling</li> <li>emotional reasoning, or coming to conclusions based on your feelings alone</li> <li>thinking in terms of “should,” “must,” or “ought to” statements</li> <li>holding yourself personally responsible (or blaming others) for things out of your control</li> <li>catastrophising</li> </ul> <p><strong>What is catastrophising?</strong></p> <p>“[Catastrophising] is when you think the worst-case scenario is the most likely scenario,” Cramer says. “Rather than there being an equal chance of something going right or wrong, you assume you are destined to experience a negative outcome.”</p> <p>This line of thinking generally starts with information that has a kernel of truth to it, says Gail Saltz, MD, a clinical associate professor of psychiatry and host of the How Can I Help? podcast from iHeartRadio.</p> <p>But when someone has a catastrophic thought pattern, their imagination takes an otherwise small concern and unravels it to the nth degree – the worst place it can go.</p> <p>Dr Saltz says to imagine a dark and gloomy day.</p> <p>“You look outside, and you think: There’s a thundershower coming; my child’s on her way home from school. It’s probably going to suddenly hit, then she may get struck by lightning and killed, and I will never be able to survive myself because I’ll be in mourning,” she explains. “That would be catastrophising.”</p> <p><strong>What causes catastrophic thinking?</strong></p> <p>“We all engage in catastrophic thinking at times, and there are likely evolutionary roots to this type of thinking,” Dr Jerud says.</p> <p>“In fact, catastrophising may have even been adaptive for our ancestors, as it may have led them to be more vigilant and thus better able to evade potential predators.”</p> <p>But Dr Saltz says switching these evolutionary alarm bells to overdrive can turn catastrophic thinking into an automatic response. Someone living with this cognitive distortion may habitually scan their environment and over-interpret signs of potential danger, concluding the worst-case scenario is the only possible outcome.</p> <p>This snowball effect takes us beyond day-to-day worries. Dr Jerud explains catastrophising is believing that not only will you stutter during your upcoming job interview, but you won’t get that job or any other job. Therefore, you’ll be unemployed forever.</p> <p>“There are infinite causes for cognitive distortions,” Cramer says. “Different situations affect people in different ways.”</p> <p>That’s why there’s no one trigger for catastrophic thinking. People can develop an ingrained catastrophic thought cycle in response to a wide range of situations, like:</p> <ul> <li>past trauma</li> <li>bad parenting</li> <li>work or relationship stress</li> <li>low self-esteem or imposter syndrome</li> <li>conditions like depression or anxiety</li> </ul> <p><strong>Is catastrophising the same as</strong> <strong>anxiety?</strong></p> <p>Catastrophic thinking (and other cognitive distortions) is especially common among individuals who struggle with anxiety, Dr Jerud says. But they’re not mutually exclusive: Not everyone with anxiety gets caught in catastrophic thought patterns.</p> <p>Still, research published in<span> </span><em>Cognitive Therapy and Research</em><span> </span>found that catastrophising is a predictor for mental health conditions, including anxiety, panic, post-traumatic stress and obsessive-compulsive disorders.</p> <p>Catastrophic thinking can also fuel an existing anxiety disorder.</p> <p>“The more you have these catastrophic thoughts, the higher your anxiety does tend to stay,” Dr Saltz says. “It’s kind of a vicious loop.”</p> <p><strong>Is catastrophising connected to other health conditions?</strong></p> <p><span>People can engage in catastrophising without any underlying medical cause. However, research suggests a few conditions may influence catastrophic thought cycles (in addition to anxiety disorders).</span></p> <p><strong>Chronic pain</strong></p> <p>Experiencing chronic or long-term pain is a common avenue to catastrophising thoughts. Research published in<span> </span><em>Expert Review of Neurotherapeutics</em><span> </span>discusses how people with chronic pain often:</p> <ul> <li>worry that they’ll always be in pain (or that it will get continually worse)</li> <li>magnify the threat value of their pain</li> <li>feel helpless that there’s nothing they can do to reduce their pain</li> <li>exaggerate anticipated painful situations</li> </ul> <p><em>Practical Pain Management</em><span> </span>reports that these catastrophic thoughts can actually increase someone’s physical pain – while putting them at a higher risk for disability and complementary conditions like depression.</p> <p>Another 2020 study in the journal<span> </span><em>PAIN</em><span> </span>found that pain catastrophising also leads people to avoid exercise or movement altogether, increasing their potential for greater pain, depression and poor health outcomes.</p> <p><strong>Depression</strong></p> <p>While having catastrophic thoughts is more commonly associated with anxiety, these patterns have a link to depressive disorders, too.</p> <p>Cramer explains that people with depression are more likely to feel like nothing goes right in their lives or that everyone has a low opinion of them. This pattern of negative thinking can make someone more susceptible to developing cognitive distortions like catastrophising.</p> <p><strong>Fatigue</strong></p> <p>Catastrophising can cause somatic – aka physical – symptoms as well. Cramer says cognitive distortion thought patterns could cause someone so much anxiety they experience back pain or headaches, for example.</p> <p>“[Catastrophising] can also make you tired because you are overthinking everything,” she adds.</p> <p>Research backs up this association. A literature review published in the<span> </span><em>Journal of Psychosomatic Research<span> </span></em>suggests someone’s tendency to catastrophise is a good predictor of their fatigue levels and how much that fatigue disrupts their life.</p> <p><strong>How to overcome catastrophic thinking</strong></p> <p>Worries, anxieties and negative thoughts are a normal part of life. But when they evolve into habitual cognitive distortions, these thought patterns can affect your physical and mental health alike.</p> <p>“When we engage in catastrophic thinking, we often miss out on what’s happening in the present moment, which can make it hard to enjoy day-to-day life,” Dr Jerud says.</p> <p>She recommends acknowledging that a feared outcome could happen (as opposed to “will” happen) and then gently shifting your attention back to the present moment. Just don’t try to push the thoughts away, disprove them, or convince yourself that your feared outcomes won’t happen.</p> <p>“The goal here isn’t to get rid of the catastrophic thoughts, but simply to not allow them to dictate what you do or don’t do,” she explains.</p> <p>“This is key because efforts to avoid catastrophic thinking often backfire, causing these thoughts to pop up even more intensely.”</p> <p>Still, rewiring our negative thought patterns might be easier said than done. That’s why the experts recommend a few approaches to help you overcome catastrophic thinking.</p> <p><strong>Therapy </strong></p> <p>Cognitive-behavioural therapy (CBT) is a psychological treatment that aims to change thought patterns by helping patients:</p> <ul> <li>learn to recognise and re-evaluate their cognitive distortions</li> <li>develop problem-solving skills and coping mechanisms that help reduce the effect of cognitive distortion triggers</li> <li>build a greater sense of self-confidence, limiting the control that negative fears have over them</li> </ul> <p>“It analyses how your thoughts influence your feelings and behaviours,” Cramer explains.</p> <p>She says CBT not only equips people with concrete tools to recognise and combat their distortions, but when practiced regularly enough, these learned skills become habits, replacing formerly catastrophic thought patterns.</p> <p><strong>Medication</strong></p> <p>While catastrophising isn’t a medical diagnosis itself, it’s often a symptom of conditions like generalised anxiety disorder.</p> <p>Dr Saltz says that for people with high anxiety levels, medication can help reduce symptoms, including diminishing their catastrophic thinking.</p> <p><strong>Mindfulness</strong></p> <p>Cramer says building a practice around distinguishing facts from feelings – a form of mindfulness – can help stop catastrophic thinking in its tracks.</p> <p>“Whenever you are thinking a negative thought, determine if it is a feeling or fact,” she says.</p> <p>“If you do not have any evidence to support the thought, it is simply a feeling and not the actual truth. Anyone can believe anything they want, but is it actually true?”</p> <p><strong>Exercise</strong></p> <p>Physical activity reduces the impact of anxiety disorders on people’s lives, including generalised anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder.</p> <p>That’s because, according to Harvard Medical School, exercise:</p> <ul> <li>reduces levels of the body’s stress hormones</li> <li>stimulates the production of endorphins – the body’s natural painkillers and mood elevators</li> <li>improves self-image</li> <li>increases strength, stamina and energy levels</li> <li>helps people build routines and social connections</li> </ul> <p>Research published in<span> </span><em>Frontiers in Psychiatry</em><span> </span>found that regular exercise may even have a protective effect against the development or progression of mental health conditions. Similar to the medication approach, focusing on ways to treat someone’s underlying anxiety may help reduce their catastrophic thinking.</p> <p><strong>Get another perspective</strong></p> <p>“Sometimes it is helpful to share your feelings with others and get an outside perspective,” Cramer says.</p> <p>“Asking questions like ‘Do you think this will likely happen?’ or ‘How do you view this situation?’ can definitely help you stay grounded and question your negative thoughts.”</p> <p><em><span style="font-weight: 400;">Written by Leslie Finlay. This article first appeared in </span><a rel="noopener" href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/what-is-catastrophising" target="_blank"><span style="font-weight: 400;">Reader’s Digest</span></a><span style="font-weight: 400;">. For more of what you love from the world’s best-loved magazine, </span><a rel="noopener" href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA87V" target="_blank"><span style="font-weight: 400;">here’s our best subscription offer.</span></a></em></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p>

Mind

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New study finds vegetarians and vegans more likely to suffer from depression

<p><em>Image: Getty</em></p> <p>Researchers from Queensland’s Bond University have found that a low-quality plant-based diet, compared to a diet rich in fresh produce, could lead to poorer mental health.</p> <p>Nutritional psychiatry researcher Megan Lee said the finding was particularly significant given the increasing popularity of vegan and vegetarian lifestyles and the proliferation of packaged foods targeted at those groups.</p> <p>Processed foods are high in refined vegetable oils, grains, salt and sugar.</p> <p>“There is a general perception that following a plant-based diet is inherently healthy but like any diet it comes down to what you put in your mouth,” Lee said.</p> <p>“Vegans and vegetarians are not automatically eating heaps of fruit and veg because there are all these products out there that are fully processed, fully refined.”</p> <p>People may inadvertently be consuming high levels of processed plant foods which is a known risk factor for increased depression.</p> <p>During the study, researchers looked at the diet and mental health of 219 vegans and vegetarians aged 18-44 across the country, who were then asked to complete relevant questionnaires.</p> <p>Researchers found those with lots of fresh fruit, vegetables, nuts, seeds, legumes and whole grains in their diet were at a lower risk of depression compared to those on low-quality diets.</p> <p>The link in diet and the risk of depression was likely due to the presence of complex carbohydrates, fibre, probiotics and antioxidants, which have all been found to decrease symptoms of depression, Lee said.</p> <p>“It seems to have more a protective role,” she said.</p> <p>“Our research did not find that a plant-based diet was a treatment or fix for those who were already depressed.”</p> <p>Vegans and vegetarians are already more vulnerable to depression than the general population, Lee added.</p> <p>“We think this (susceptibility to depression) might be because vegans and vegetarians tend to be more conscious about external issues—animal welfare, environmental concerns—and they can be ostracised socially because of their choice of diet,” she said.</p> <p>The research also found meat-eaters can also protect their mental health by consuming more fruits and vegetables.</p>

Food & Wine

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Postnatal psychosis is rare, but symptoms can be brushed aside as ‘normal’ for a new mum

<p>The period after birth of a child is supposed to be a time of great happiness for women. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491613/pdf/WPS-19-313.pdf">a significant number</a> of new mothers will experience a mental illness at this time.</p> <p>One is <a href="https://www.thewomens.org.au/health-information/pregnancy-and-birth/mental-health-pregnancy/post-partum-psychosis">postnatal psychosis</a> (also known as postpartum or <a href="https://www.cope.org.au/health-professionals/health-professionals-3/perinatal-mental-health-disorders/puerperal-psychosis/">puerperal psychosis</a>). It’s not related to postnatal depression.</p> <p>Postnatal psychosis affects <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009991.pub2/full">one to two in every 1,000 new mothers</a>, or about 600 women each year in Australia.</p> <p>But our <a href="https://www.sciencedirect.com/science/article/pii/S026661382100245X">interviews with women</a> who have been diagnosed with this rare but serious condition show their symptoms were often dismissed as a normal part of adjusting to motherhood.</p> <h2>What is postnatal psychosis?</h2> <p>Postnatal psychosis affects women across all cultures and geographic areas.</p> <p>The condition can put a woman at risk of self-harm or suicide and, on rare occasions, of harming others including her new baby or other children.</p> <p>We don’t know what causes it. But contributing factors may include sleep deprivation, and rapid hormone changes associated with pregnancy and childbirth.</p> <p>The risk of postnatal psychosis increases if a woman has a history of <a href="https://www.sane.org/information-stories/facts-and-guides/bipolar-disorder#what-is-bipolar-disorder">bipolar disorder</a> or has had postnatal psychosis before.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/JUFRZ6PgfQE?wmode=transparent&amp;start=81" frameborder="0" allowfullscreen=""></iframe> </p> <h2>What are the symptoms?</h2> <p><a href="https://www.cope.org.au/wp-content/uploads/2017/11/Postpartum-Psychosis_Health-Prof-Fact-Sheet.pdf">Symptoms</a> can begin in the first few days after giving birth but may not appear until up to 12 weeks afterwards.</p> <p><strong>Some women have manic symptoms</strong></p> <ul> <li> <p>manic symptoms include feeling they do not need to sleep, and are powerful and strong</p> </li> <li> <p>women may have unusual experiences, such as seeing or hearing things others cannot. They may believe things that are not true</p> </li> <li> <p>they can also make unrealistic and impulsive plans, can be disorganised or forgetful, and talk very quickly</p> </li> <li> <p>their moods may change rapidly or they may seem excessively happy.</p> </li> </ul> <p><strong>Others have depressive symptoms</strong></p> <ul> <li> <p>depressive symptoms include a loss of energy and an inability to sleep or eat</p> </li> <li> <p>women may have thoughts or auditory hallucinations that they are a bad mother and they may say they wish to die. Hallucinations or delusions (false beliefs) point to postnatal psychosis rather than to postnatal depression</p> </li> <li> <p>women may find it difficult to complete activities, such as caring for themselves or their baby, or attending to other tasks in the home</p> </li> <li> <p>they may believe they are helpless, hopeless and worthless, especially as a mother</p> </li> <li> <p>they can become isolated and no longer enjoy activities.</p> </li> </ul> <h2>Women say it’s traumatic</h2> <p>Women say postnatal psychosis is traumatic, especially if they do not get help when they first report symptoms. But it can be challenging to diagnose because of the stigma surrounding mental illness around the time of giving birth.</p> <p>Women say they are <a href="https://link.springer.com/content/pdf/10.1007%2Fs00737-015-0548-6.pdf">reluctant to disclose</a> unusual symptoms as they feel ashamed they are finding motherhood difficult and worry they may lose custody of their baby.</p> <p>When we <a href="https://www.sciencedirect.com/science/article/pii/S026661382100245X">interviewed ten women</a>, who had experienced an episode of postnatal psychosis in the past ten years, we discovered another barrier to diagnosis.</p> <p>Women said they knew they had unusual symptoms, such as not being able to sleep or changes in the way they thought or behaved, but they found it difficult to get help. Often, they were told these symptoms were a normal part of adjusting to motherhood.</p> <p>Their postnatal psychosis was not identified until their only option was admission to an acute mental health unit and separation from their baby.</p> <p>So we need more education about the condition for health-care workers. By identifying the condition earlier, this gives women more treatment options.</p> <h2>There are treatments</h2> <p>Once diagnosed, the condition can be treated with antipsychotic and mood stabilising medication, prescribed by a psychiatrist or other treating doctor.</p> <p>This is <a href="https://link.springer.com/article/10.1007/s00737-009-0117-y">very effective</a> but medication is often not started until the symptoms have become very severe and the woman requires hospitalisation in an acute mental health unit, without her baby. This separation can compromise the developing bond between them.</p> <p>So early diagnosis can potentially reduce the time a woman may spend in an acute mental health unit.</p> <h2>Admission to a mother-baby unit</h2> <p>Best practice is to admit women and their babies to a <a href="https://www.cope.org.au/wp-content/uploads/2018/05/COPE-Perinatal-MH-Guideline_Final-2018.pdf">mother-baby unit</a>, which is usually linked to a hospital. This allows women to continue to care for their babies with the support of child and family health-care professionals.</p> <p>However, publicly funded units are only available in Victoria, South Australia, Western Australia and Queensland. In New South Wales, two public mother-baby units <a href="https://www.smh.com.au/national/nsw/new-unit-provides-mother-and-baby-mental-health-support-to-western-sydney-20210909-p58q9v.html">are being built</a>. In NSW, the only existing one is a <a href="https://www.sjog.org.au/our-locations/st-john-of-god-burwood-hospital/our-services/mental-health-and-therapy/mother-and-baby-unit">private facility</a>, which many families cannot afford.</p> <h2>Helping others</h2> <p>The women we interviewed said they developed support networks with each other. One woman told us:</p> <blockquote> <p>You feel like, okay, that was such a hard experience, is there a way that we could make that a little less hard for the women who are going to go through it next time?</p> </blockquote> <p>Women wanted to tell their stories so others would better understand postnatal psychosis and could find it easier to get help.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, contact the following organisations for more information or support: <a href="https://www.panda.org.au/info-support/postnatal-psychosis">Perinatal Anxiety &amp; Depression Australia</a> (PANDA), 1300 726 306; <a href="https://www.cope.org.au/">Centre of Perinatal Excellence</a>; <a href="https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents/maternal-mental-health-and-wellbeing/bipolar-disorder">Beyondblue</a>, 1300 22 4636; Lifeline, 13 11 14. You can also contact your GP or go to your nearest hospital emergency department.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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; text-shadow: none !important;" src="https://counter.theconversation.com/content/170278/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/diana-jefferies-183951">Diana Jefferies</a>, Senior lecturer, <em><a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></span></p> <p>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/postnatal-psychosis-is-rare-but-symptoms-can-be-brushed-aside-as-normal-for-a-new-mum-170278">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

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