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Love is in the air! Pilot proposes to flight attendant girlfriend before take off

A pilot has proposed to his flight attendant girlfriend just minutes before take off in a heart-warming display of love. Polish pilot Konrad Hanc was captured emerging from the cockpit before embarking on a flight to Kraków to make a surprising announcement over the PA system. Hanc introduced himself to the passengers before explaining the real reason for his message. “On today’s flight there is a very special person," he began. “Ladies and gentlemen, about one and a half years ago in this job I met the most wonderful person that completely changed my life." “You are most precious to me. You are my greatest dream come true. This is why I have to ask you a favour, honey." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by LOT Polish Airlines (@flylot)</a> </div> </blockquote> “Will you marry me?” he asked while getting down on one knee, as another flight attendant handed him a bouquet of flowers. His girlfriend, Paula, sprinted up the aisle of the plane before leaping into the arms of her future husband. Passengers watched on in anticipation for her answer with one yelling, “Did she say yes?” to which the beaming captain responded: “She said yes!” Hanc explained that he chose to pop the question on the flight to the Polish city as he met Paula on the same flight just 18 months ago. As the pair embraced in a hug and kiss, passengers erupted in applause, with many taking to the now viral Facebook post to send them well wishes. “I love this! Sweet couple!” one person wrote. ”TOTALLYYYYY LOVE IN THE AIR,” another enthusiastic person commented, to which the airline responded: “YES, love IS in the air!” Image credits: LOT Polish Airlines

Relationships

“Love is so sweet": Man's sweet mid-air proposal goes viral

Love is in the air! A smitten passenger took his love to the skies and proposed to his girlfriend while on board an Air Peace flight, with the romantic moment captured on camera. A social media user took to TikTok to share the sweet proposal, with the caption: “POV: My friend was proposed to in a plane.” The minute-long video showed a man getting out of his seat on board the packed plane to use the aircraft’s PA system so that he could ask for his girlfriend’s hand in marriage. “She’s so precious and her name is Precious,” the man said before popping the question. “Please, my Precious, I want to ask, will you marry me?” “If you will, just come out and say ‘yes’ to me, my precious,” he added before walking down the aisle of the aircraft. Other passengers cheered for the couple, and in a second video, the man is seen greeting Precious, then getting down on one knee to offer her the ring. Precious was overjoyed at the proposal and said yes, hugging her new fiance. While it is unclear where the plane was travelling, Air Peace is a Nigerian carrier that operates flights to destinations in West Africa and the Middle East, according to the NY Post. TikTok users were also touched by the romantic act, with many of them congratulating the couple. “This is beautiful,” one wrote. “Love is so sweet for real,” another swooned. Images: TikTok

Relationships

Is attachment theory actually important for romantic relationships?

<a href="https://theconversation.com/profiles/marissa-nivison-1454992">Marissa Nivison</a>, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a> and <a href="https://theconversation.com/profiles/sheri-madigan-417151">Sheri Madigan</a>, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a> There has been a recent surge of attention toward attachment theory: from <a href="https://www.tiktok.com/t/ZTL2aW9va/">TikTok videos</a> to <a href="https://quiz.attachmentproject.com/">online quizzes</a> that claim to “assess your attachment style.” It’s become a hot topic, especially in the context of romantic relationships, with <a href="https://medium.com/curious/the-theory-that-explains-all-your-failed-relationships-fb2dc2551617">some articles</a> claiming that one person (or partner’s) attachment styles are the reason why relationships fail. As experts in developmental and clinical psychology focusing on attachment theory, we seek to provide an accessible resource to better understand the science of attachment, and what it means for one’s romantic relationships. <h2>What is attachment?</h2> Attachment theory stems from the field of developmental psychology. It is the notion that in the first year of life, the ways in which a parent and caregiver respond to a child’s needs shape a child’s expectation of relationships across their lifespan. In research, attachment has been associated with well-being across the lifespan including: <a href="https://doi.org/10.1017/S0954579499002035">mental</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/14616734.2018.1541517">physical</a> health, <a href="https://doi.org/10.1037/a0032671">brain functioning</a> and even <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=092354a82953ac321429f84b00607bcd44ac4c63">romantic relationships</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=455&fit=crop&dpr=1 600w, https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=455&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=455&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=572&fit=crop&dpr=1 754w, https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=572&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/587576/original/file-20240411-16-x97xu0.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=572&fit=crop&dpr=3 2262w" alt="Illustrations of four different attachment styes" /><figcaption>There are two overarching types of attachment: secure and insecure. Types of insecure attachment include disorganized, avoidant and anxious attachment. (Shutterstock)</figcaption></figure> <h2>How is attachment related to romantic relationships?</h2> Among professionals in the field, there is diversity in perspectives regarding how attachment relates with romantic relationships. As developmental psychologists, we tend to think that attachment is associated with romantic relationships through what we call the “<a href="https://doi.org/10.1080/14616739900134191">internal working model</a>.” In childhood, when a parent is consistent and responsive in tending to their child, the child learns that their parent can be counted on in times of need. These expectations and beliefs about relationships are then internalized as a blueprint, sometimes in popular media referred to as a “<a href="https://medium.com/live-your-life-on-purpose/love-maps-are-a-gamechanger-when-you-have-an-anxious-attachment-style-dc8f219ab0af">love map</a>.” Just like how an architect uses a blueprint to design a building, a child’s attachment to their parents provides a blueprint for understanding how to approach other relationships. Based on this blueprint, people develop expectations of how relationships should work, and how other important people in their life, including partners, should respond to their needs. Sometimes attachment is also described in terms of attachment “styles.” There are two overarching types of attachment: <a href="https://doi.org/10.4324/9780203758045">secure and insecure</a>. Those with a secure attachment style tend to have expectations that their attachment figures (and later, partners) will be responsive, sensitive and caring in times of distress. People with secure “blueprints” find it easier to build new structures (i.e., relationships) with the same design. People with insecure blueprints — such as disorganized, avoidant or anxious attachment styles — may face relationship challenges when their current relationship doesn’t align with their childhood experiences, and may need to renovate their blueprint design together with their partner. Whether you think about attachment as a style or a love map, they both are related to expectations of relationships, which are shaped by past experiences. In research we see that people who had consistent, reliable and sensitive parents are more likely to have more positive relationships — including <a href="https://doi.org/10.1111/j.1475-6811.1997.tb00135.x">friendships</a>, <a href="https://doi.org/10.1111/cdev.13322">teacher-child relationships</a> and yes, <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=092354a82953ac321429f84b00607bcd44ac4c63">romantic relationships too</a>. <h2>Relationships with parents and relationships with partners</h2> Although we do see in research that better childhood relationships are associated with better romantic relationships, there is still a large part of the population who have good relationships with partners, despite their history of lower-quality relationships with their parents. <figure class="align-center "><img src="https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=453&fit=crop&dpr=1 600w, https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=453&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=453&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=569&fit=crop&dpr=1 754w, https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=569&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/587575/original/file-20240411-16-fn5xgk.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=569&fit=crop&dpr=3 2262w" alt="Illustration of loving parents with a child, and the grown child in a loving relationship" /><figcaption>In research we see that people who had consistent, reliable and sensitive parents are more likely to have more positive relationships. (Shutterstock)</figcaption></figure> It is possible for romantic relationships to serve as a <a href="https://doi.org/10.1037/1089-2680.4.2.155">“healing relationship”</a> and improve one’s own internal working model of relationships. Specifically, when a partner is consistently sensitive, responsive and available, a person may begin to adjust their blueprint and develop new expectations from relationships. Attachment theory consistently supports the idea that one’s patterns of attachment <a href="https://eric.ed.gov/?id=EJ960225">can change</a>. So, all in all, the answer is no: Your relationship with your parents influences but does not determine the quality of your romantic relationships. <h2>Is attachment the reason why my relationships don’t work out?</h2> It is possible that your expectations of a romantic relationship may not align with the expectations of your partner, and may affect the quality of the relationship. For example, sometimes individuals with insecure attachments may withdraw when they are upset, but their partner who has a secure attachment may be upset that their partner is not coming to them for comfort. Thinking through your own attachment history and expectations of relationships may be a great opportunity for self-reflection, but it is important to remember that attachment is only one part of a relationship. Communication, trust and respect, to name a few, are also critically important aspects of a relationship. <h2>Can I improve my attachment expectations?</h2> The short answer: Yes! Improving attachment quality has been one of the cornerstones of attachment theory and research since its conception. Most commonly, attachment is targeted in <a href="https://www.youtube.com/channel/UC0LCPe5CMarYi1NmqNttDcg/videos">childhood through interventions</a>, but also in adulthood through individual therapy, or various forms of couples therapy, such as <a href="https://www.youtube.com/watch?v=xaHms5z-yuM">Emotionally Focused Therapy</a> or the <a href="https://www.gottman.com/about/the-gottman-method/">Gottman Method</a>. It is also possible that through positive relationships you may be able to improve your own expectations of relationships. There are many different avenues to explore, but improvement is always possible. In sum, attachment can be an important factor in romantic relationships, but it is not a “catch-all” to be blamed for why relationships may not work out. Thinking about your own expectations for relationships and talking through those with your partner may do great things in improving the quality of your relationships! <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/226101/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marissa-nivison-1454992">Marissa Nivison</a>, Postdoctoral Research Fellow, Department of Psychology, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a> and <a href="https://theconversation.com/profiles/sheri-madigan-417151">Sheri Madigan</a>, Professor, Canada Research Chair in Determinants of Child Development, Owerko Centre at the Alberta Children’s Hospital Research Institute, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-attachment-theory-actually-important-for-romantic-relationships-226101">original article</a>.

Relationships

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind. It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment. Stop wanting to fall asleep It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep. Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep. Start a journal If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel. Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep. Find yourself a "3am friend" Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place. Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake. Take a warm shower Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally. (That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast. Stretch yourself to sleep Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible. There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits. Read (or listen!) to something new When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts. Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep. Image credits: Getty Images This article by Deepak Kashyap originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one

<a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness. Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as <a href="https://link.springer.com/referenceworkentry/10.1007/978-3-319-69892-2_1006-1">anticipatory grief</a>. While not experienced by everyone, anticipatory grief is a <a href="https://spcare.bmj.com/content/bmjspcare/early/2022/02/10/bmjspcare-2021-003338.full.pdf?casa_token=IWNMDFN5SoIAAAAA:2EybwyPcKu73VdrACTNk7jITor-mMIXK8rv76arXgdjV9cA2Y0MV0LyZLLwcYe1rZUAQymOzFYo">common</a> part of the grieving process and can include a range of conflicting, often difficult thoughts and emotions. For example, as well as feelings of loss, some people can experience guilt from wanting their loved one to be free of pain, or imagining what life will be like after they die. <h2>Difficult to define, distressing to experience</h2> Anticipatory grief has proved <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">challenging to define</a>. A <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">systematic review</a> of research studies on anticipatory grief identified over 30 different descriptions of pre-death grief. This lack of consensus has limited research progress, because there’s no shared understanding of how to identify anticipatory grief. Therese Rando, a <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781315800806-9/grief-mourning-accommodating-loss-therese-rando">prominent theorist</a>, has proposed that anticipatory grief can help prepare for death, contributing to a more positive grieving experience post-bereavement. Rando also suggests that pre-death mourning can aid with adjustment to the loss of a loved one and reduce the risk of <a href="https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/">“complicated grief”</a>, a term that describes persistent and debilitating emotional distress. <figure><iframe src="https://www.youtube.com/embed/AapGn60DZSA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> But pre-death mourning doesn’t necessarily mean grief will be easier to work through once a loved one has died. Other <a href="https://www.sciencedirect.com/science/article/pii/S0277953621005724?casa_token=I9mbdSv3d3gAAAAA:MqxN5X_iWbcqa6BYj7IXmImUviheOQWAVA4UBy6795UDuS1uOHG9b245qMkyOiLcvjv_SU6yVA">research evidence</a> shows that it’s possible to experience severe anticipatory grief yet remain unprepared for death. <h2>Carers should seek support</h2> Carers of people with life-limiting illnesses may notice distressing changes in the health of their loved ones. Witnessing close-up someone’s deterioration and decline in independence, memory or ability to perform routine daily tasks, such as personal care, is a painful experience. It is essential, then, for carers to acknowledge difficult emotions and seek support from those around them – especially because caring for a loved one at the end of their life <a href="https://www.mind.org.uk/information-support/helping-someone-else/carers-friends-family-coping-support/your-mental-health/">can be an isolating time</a>. Where possible, it can also be beneficial for carers to offer their loved one <a href="https://compassionatecommunitiesni.com/our-programs/dying-to-talk/">opportunities to reflect</a> on significant life events, attend to unfinished business, and to discuss preferences for funeral arrangements. For some, this may involve supporting loved ones to reconnect with friends and family, helping them to put legal or financial affairs in order, talking about how the illness is affecting them, or making an <a href="https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/">advance care plan</a>. <figure><iframe src="https://www.youtube.com/embed/wrJaTXW1Xvk?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Talking is key</h2> Living with altered family dynamics, multiple losses, transition and uncertainty can be <a href="https://www.tandfonline.com/doi/full/10.1080/07481187.2021.1998935">distressing for all family members</a>. It may be difficult to manage the emotional strain of knowing death is unavoidable, to make sense of the situation, and to <a href="https://hospicefoundation.ie/i-need-help/i-am-seriously-ill/how-to-talk-to-those-you-care-about/">talk about dying</a>. However, talking is key in <a href="https://www.cruse.org.uk/about/blog/important-conversations-death/">preparing for an impending death</a>. Organisations who offer specialist palliative care have information and trained professionals to help with difficult conversations, including <a href="https://www.mariecurie.org.uk/help/support/diagnosed/talking-children/children">talking to children</a> about death and dying. Navigating anticipatory grief can involve self-compassion for both the patient and carer. This includes acknowledging difficult emotions and treating oneself with kindness. Open communication with the person nearing the end of their life can foster emotional connection and help address their concerns, alongside support from the wider circle of family and friends. Extending empathy and understanding to those nearing death – and those grieving their impending loss – will help contribute to a compassionate community that supports those experiencing death, dying and bereavement.<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/221629/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, Lecturer of Health Psychology, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, Professor of Social Work in Palliative Care, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mourning-happens-after-bereavement-for-some-grief-can-start-years-before-the-death-of-a-loved-one-221629">original article</a>.

Caring

‘Self-love’ might seem selfish. But done right, it’s the opposite of narcissism

<a href="https://theconversation.com/profiles/ian-robertson-1372650">Ian Robertson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> “To love what you are, the thing that is yourself, is just as if you were embracing a glowing red-hot iron” <a href="https://archive.org/details/jungsseminaronni0000jung">said psychonalyst Carl Jung</a>. Some may argue this social media generation does not seem to struggle with loving themselves. But is the look-at-me-ism so easily found on TikTok and Instagram the kind of self-love we need in order to flourish? The language of <a href="https://theconversation.com/teaching-positive-psychology-skills-at-school-may-be-one-way-to-help-student-mental-health-and-happiness-217173">positive psychology</a> can be – and often is – appropriated for all kinds of self-importance, as well as cynical marketing strategies. Loving yourself, though, psychological experts stress, is not the same as behaving selfishly. There’s a firm line between healthy and appropriate forms of loving yourself, and malignant or <a href="https://theconversation.com/how-many-types-of-narcissist-are-there-a-psychology-expert-sets-the-record-straight-207610">narcissistic</a> forms. But how do we distinguish between them? In 2023, researchers Eva Henschke and Peter Sedlmeier conducted <a href="https://www.researchgate.net/publication/355152846_What_is_self-love_Redefinition_of_a_controversial_construct">a series of interviews</a> with psychotherapists and other experts on what self-love is. They’ve concluded it has three main features: self-care, self-acceptance and self-contact (devoting attention to yourself). But as an increasingly individualistic society, are we already devoting too much attention to ourselves? <h2>Philosophy and self-love</h2> Philosophers and psychology experts alike have considered the ethics of self-love. Psychology researcher Li Ming Xue and her colleagues, <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2021.585719/full">exploring the notion of self-love in Chinese culture</a>, claim “Western philosophers believe that self-love is a virtue”. But this is a very broad generalisation. In the Christian tradition and in much European philosophy, <a href="https://www.tandfonline.com/doi/full/10.1080/10848770.2020.1839209">says philosopher Razvan Ioan</a>, self-love is condemned as a profoundly damaging trait. On the other hand, <a href="https://www.jstor.org/stable/2107991">many of the great Christian philosophers</a>, attempting to make sense of the instruction to love one’s neighbour as oneself, admitted certain forms of self-love were virtuous. In order to love your neighbour as yourself, you must, it would seem, love yourself. In the Western philosophical context, claim Xue and her colleagues, self-love is concerned with individual rights – “society as a whole only serves to promote an individual’s happiness”. This individualistic, self-concerned notion of self-love, they suggest, might come from the Ancient Greek philosophers. In particular, Aristotle. But <a href="https://www.psychologytoday.com/intl/blog/philosophy-stirred-not-shaken/201502/love-yourself-love-your-character">Aristotle thought only the most virtuous</a>, who benefited the society around them, should love themselves. By making this connection, he avoided equating self-love with self-centredness. We should love ourselves not out of vanity, he argued, but in virtue of our capacity for good. Does Aristotle, then, provide principled grounds for distinguishing between proper and improper forms of self-love? <h2>Bar too high?</h2> Aristotle might set the bar too high. If only the most virtuous should try to love themselves, this collides head-on with the idea loving yourself can help us improve and become more virtuous – as <a href="https://link.springer.com/chapter/10.1057/9781137383310_6">philosophers Kate Abramson and Adam Leite have argued</a>. Many psychologists claim self-love is important for adopting the kind and compassionate self-perception crucial for overcoming conditions that weaponise self-criticism, like <a href="https://theconversation.com/clinical-perfectionism-when-striving-for-excellence-gets-you-down-43704">clinical perfectionism</a> and <a href="https://theconversation.com/how-many-people-have-eating-disorders-we-dont-really-know-and-thats-a-worry-121938">eating disorders</a>. More broadly, some argue compassion for oneself is necessary to support honest insights into your own behaviour. They believe we need warm and compassionate self-reflection to avoid the defensiveness that comes with the fear of judgement – even if we’re standing as our own judge. For this reason, a compassionate form of self-love is often necessary to follow Socrates’ advice to “know thyself”, says <a href="https://link.springer.com/article/10.1007/s10677-015-9578-4">philosopher Jan Bransen</a>. Positive self-love, by these lights, can help us grow as people. <h2>Self-love ‘misguided and silly’</h2> But not everyone agrees you need self-love to grow. The late philosopher <a href="https://www.theguardian.com/news/2005/nov/29/guardianobituaries.obituaries">Oswald Hanfling</a> was deeply sceptical of this idea. In fact, he argued the notion of loving oneself was misguided and silly. His ideas are mostly rejected by philosophers of love, but pointing out where they go wrong can be useful. When you love someone, he said, you’re prepared to sacrifice your own interests for those of your beloved. But he thought the idea of sacrificing your own interests made no sense – which shows, he concluded, we can’t love ourselves. <a href="https://www.jstor.org/stable/3751159">He wrote</a>: "I may sacrifice an immediate satisfaction for the sake of my welfare in the future, as in the case of giving up smoking. In this case, however, my motive is not love but self-interest. What I reveal in giving up smoking is not the extent of my love for myself, but an understanding that the long-term benefits of giving it up are likely to exceed the present satisfaction of going on with it." We often have conflicting interests (think of someone who is agonising over two different career paths) – and it’s not at all strange to sacrifice certain interests for the sake of others. This is not just a question of sacrificing short-term desires in favour of a long-term good, but a matter of sacrificing something of value for your ultimate benefit (or, so you hope). <h2>Self-compassion</h2> Hanfling fails to consider the role of compassionate self-love. While we might understand it’s in our interests to do something (for instance, repair bridges with someone we’ve fallen out with), it might take a compassionate and open disposition towards ourselves to recognise what’s in our best interests. We might need this self-compassion, too, in order to admit our failures – so we can overcome our defensiveness and see clearly how we’re failing to fulfil <a href="https://link.springer.com/article/10.1007/s10677-015-9578-4">these interests</a>. Self-acceptance in this context does not mean giving ourselves licence to run roughshod over the interests of those around us, nor to justify our flaws as “valid” rather than work on them. Self-love, as promoted by contemporary psychologists, means standing in a compassionate relationship to ourselves. And there’s nothing contradictory about this idea. Just as we strive to develop a supportive, kind relationship to the people we care about – and just as this doesn’t involve uncritical approval of everything they do – compassionate self-love doesn’t mean abandoning valid self-criticism. In fact, self-compassion has the opposite effect. It promotes comfort with the kind of critical self-assessment that helps us grow – which leads to resilience. It breeds the opposite of narcissistic self-absorption.<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/205938/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-robertson-1372650">Ian Robertson</a>, PhD Candidate (Teaching roles at Macquarie & Wollongong), <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/self-love-might-seem-selfish-but-done-right-its-the-opposite-of-narcissism-205938">original article</a>.

Mind

How much weight do you actually need to lose? It might be a lot less than you think

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> If you’re one of the <a href="https://www.finder.com.au/new-years-resolutions-statistics">one in three</a> Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards. But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers. Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range. Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight. Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits. <h2>Using BMI to define our target weight is flawed</h2> We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio. BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening. But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">because</a> it: <ul> <li> fails to consider two critical factors related to body weight and health – body fat percentage and distribution </li> <li> does not account for significant differences in body composition based on gender, ethnicity and age. </li> </ul> <h2>How does losing weight benefit our health?</h2> Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways. 1. Reducing cholesterol Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy. Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987606/">research</a> shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss. 2. Lowering blood pressure Our blood pressure is considered high if it reads more than 140/90 on at least two occasions. Excess weight is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">linked to</a> high blood pressure in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">several ways</a>, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure. Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke. Like the improvements in cholesterol, a 5% weight loss <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21358">improves</a> both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number). A <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000094221.86888.ae">meta-analysis of 25 trials</a> on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point. 3. Reducing risk for type 2 diabetes Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat). Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels. Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system. <a href="https://www.nejm.org/doi/full/10.1056/nejmoa012512">Research</a> shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%. 4. Reducing joint pain and the risk of osteoarthritis Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis. <a href="https://pubmed.ncbi.nlm.nih.gov/21425246/">Observational studies</a> show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold. Small amounts of weight loss alleviate this stress on our joints. <a href="https://pubmed.ncbi.nlm.nih.gov/15986358/">In one study</a> each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities. <h2>Focus on long-term habits</h2> If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">analysis</a> of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%. When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">physiological responses</a> to defend our body weight and “survive” starvation. Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<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/217287/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-weight-do-you-actually-need-to-lose-it-might-be-a-lot-less-than-you-think-217287">original article</a>.

Body

Couple who found love in chemotherapy raise funds for final trip

Ainslie Plumb, 22, and Joe Fan, 29, found love in an unexpected place, at the Royal Brisbane and Women’s Hospital. The couple met in 2022 while they were both undergoing leukaemia treatment. “We met at an event for young people with cancer and became friends following that,” Plumb told 7News. “(We) would hang out during our hospital stays, I asked him out in October 2022 and (we) have been together ever since.” While Plumb successfully entered remission, last October, Fan was told that he was now terminal, as doctors had run out of options to treat his Philadelphia chromosome positive acute lymphoblastic leukaemia. With only months left to live, Fan, who has actively given back to the hospital and cancer community by playing his violin for patients and staff and worked with the Queensland Youth Cancer Service, has one final wish - to travel. The couple have set a <a href="https://www.gofundme.com/f/help-joe-live-his-dreams" target="_blank" rel="noopener">GoFundMe</a>, to help raise funds which cover flights, accommodation and specialised travel insurance, for Fan's final trip. “I go through my cancer treatments and observe the toll that takes on my physical and mental wellbeing,” Fan said. “The end of a trip can hopefully mark the start of another — and I have held onto hope, looked forward and dreamed for one more trip, more time, one more experience with that someone I love.” Their first destination will be Taiwan and Hong Kong, where Fan's parents are from and where he spent a majority of his childhood. They also intend to travel to New Zealand and Western Australia to swim with whale sharks at Ningaloo in the state’s north. “We’re aiming at going at the end of February to give us time to co-ordinate with his doctors around his appointments and infusions, which are all booked in advance,” Plumb said. “We recently reached 75 per cent on the fundraiser and are hoping to hit 100 per cent perhaps by the end of January.” As of today, the couple have successfully raised over $21,000 from their $20,000 goal, and have thanked everyone in their community and strangers for their support. “Truly, words do not suffice,” the couple said. Images: 7News

Relationships

Readers Respond: What's a book you love that most people have never heard of?

Looking for a new book to kickstart your year? Look no further we've got you covered. Here are a few of our reader's book recommendations that you may not have heard of. Ruth Fontaine - I’m reading We of the Never Never atm. Not sure if it’s still well known. I’ve read it before but awhile back and love it. I love reading how they lived nearly 120 years ago. Elaine Rosenberg - The Abbey Girls Series by Elsie J Oxenham. Maryika Welter - The courage to be disliked. ... Furmitake Kogan, Ichiro Kishimi. Janice Stewart - A Fortunate Life by Albert Facey Suzanne Midson - On Our Selection by Steele Rudd. Read it when I was about 10/12. Best laugh ever. Australian humour at its best. Julie Anderson - Episode of Sparrows by Rumor Goddin Nancie Golsby - The Half Burned Tree by Dympna Cusack June Maynard - Sahara, by Paula Constant. Preceded by Slow Journey South. A thrilling, actual account of her adventure. Peter Rayner - Enforcer by Caesar Campbell Meg Milton - I Heard the Owl Call My Name by Margaret Craven Edie Dore - The Curious Incident of the Dog in the Night-time by Mark Haddon. Christine Cornforth - A Grief Observed by CS Lewis. Wendy Oliver - The Good Earth by Pearl Buck Do you have any other recommendations that we might have missed? Image: Getty

Books

4 tips to help your loved one with dementia enjoy the festive season

<a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The festive season is fast approaching, and if you’re organising celebrations with family or friends, you might be grappling with a seemingly endless to-do list. But as you make these plans, it’s important to consider how you can best include any friends or loved ones living with dementia. While no two people experience dementia in the exact same way, <a href="https://www.dementia.org.au/about-dementia/what-is-dementia">dementia</a> often affects the way people process and respond to their environment. Too much stimulation – like a lot of noise and activity at a Christmas party – can be overwhelming and may cause confusion or agitation. Finding ways to create a <a href="https://www.healthdirect.gov.au/creating-a-calming-home-for-people-with-dementia#:%7E:text=The%20physical%20environment%20is%20important,in%20and%20enjoy%20everyday%20activities.">safe environment</a> at home for your loved one with dementia will help maximise the chances everyone has a good time. <h2>1. Plan ahead, but be flexible</h2> Planning celebrations can be overwhelming for everyone involved, and having excessive expectations can raise stress levels. Try to keep <a href="https://www.dementia.org.au/information/about-you/i-am-a-carer-family-member-or-friend">expectations realistic</a> and in line with the current needs of your friend or loved one living with dementia. For example, people with dementia may experience <a href="https://www.dementia.org.au/information/about-you/i-am-a-carer-family-member-or-friend/personal-care/eating">changes in their appetite</a> or food preferences, or difficulties chewing and swallowing. These changes might make some of the things on your festive menu unappetising or difficult to eat. Be guided by the needs and preferences of the person with dementia and keep options limited to one or two special foods if larger banquets are likely to be overwhelming. Things can change quickly for people living with dementia and their abilities will likely <a href="https://www.dementia.org.au/about-dementia/what-is-dementia/progression-of-dementia#:%7E:text=A%20person%20with%20dementia's%20abilities,over%20a%20number%20of%20years.">vary from day to day</a>. Try to be flexible and have a backup plan in place. For special events, plan to record speeches or ceremonies to share when things are quieter. If you’re planning a large event, consider having a smaller gathering with your loved one with dementia and just a few special people. <h2>2. Stick to the familiar</h2> The sudden appearance of lots of decorations <a href="https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-TipsToAssistSocialEngagement03-TipsForHolidayCheer_english.pdf">may be overwhelming</a> for a person with dementia and trigger a negative sensory reaction or distress. Ensure decorations are safe and familiar and put them up slowly over a period of a few days. Try to also stick to familiar traditions and routines. <a href="https://www.alz.org/help-support/caregiving/daily-care/daily-care-plan">Daily routines</a> are an important way of supporting people with dementia and sudden changes <a href="https://memory.ucsf.edu/caregiving-support/behavior-personality-changes#I-Investigate-Possible-Causes">may result in agitation and distress</a>. Stick to routine eating, bathing, and rest times where possible throughout the holiday period. For many people with dementia, long-term memories are less affected than <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/memory-loss">more recent memories</a>. Familiar family traditions can therefore be a good way to <a href="https://www.dementia.org.au/national/support-and-services/carers/therapies-and-communication-approaches">reminisce</a>. Family keepsakes or <a href="https://www.dementia.org.au/sites/default/files/20110303-NSW-LifeHistoryBook.pdf">memory books</a> can also help connect with stories from past celebrations. <h2>3. Have a quiet space</h2> Try to have <a href="https://www.scie.org.uk/dementia/supporting-people-with-dementia/dementia-friendly-environments/noise.asp">a quiet place</a> where the person living with dementia can go if things become overwhelming. Designating a support person who can stay with them throughout the day and take them to a separate room or area away from the action can help to keep things calm. Having some familiar objects or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432607/#:%7E:text=Passive%20music%20listening%20is%20reported,et%20al.%2C%202013">quiet music</a> in the space can be a good way to block out the noise of activities and reduce agitation. <h2>4. Make sure everyone has a part</h2> Everyone wants to feel a part of the activities on a special day, including people living with dementia. Ensuring everyone has a role to play may mean modifying tasks to suit the abilities of the person with dementia. For example, if you’re hosting an event at home, try to get your friend or relative with dementia involved in the kitchen by tossing the salad or helping to set the table. People with dementia are still the same person, even if their abilities have changed or they can no longer communicate their needs and feelings like they used to. It’s important to treat everyone with dignity and try to include your friends and loved ones with dementia in celebrations whenever possible. <h2>Sometimes, you can’t be together</h2> Despite the best laid plans, sometimes it won’t be possible to share in festive celebrations with your loved one living with dementia. More advanced dementia, <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Pages/racf-latest-advice.aspx">aged care visitor restrictions</a> or even just distance can keep many of us apart from our loved ones. Be prepared for this separation to bring up your own feelings of <a href="https://www.alz.org/help-support/caregiving/caregiver-health/grief-loss-as-alzheimers-progresses">grief or sadness</a>. Look after your mental health as well as the person with dementia. Caring responsibilities still largely <a href="https://www.pmc.gov.au/sites/default/files/resource/download/national-strategy-gender-equality-discussion-paper_0.pdf">fall to women</a> and it’s important to share the load. Where possible, the holidays can be a good time to think about giving primary carers a break to help them recharge for the year ahead. If you’re caring for someone with dementia and need support, <a href="https://www.dementia.org.au/support">Dementia Australia</a> or <a href="https://www.carergateway.gov.au/about?utm_source=google&utm_medium=paid-search&utm_campaign=10841470526&utm_adgroup=146956908840&utm_term=&gclid=CjwKCAjw9-6oBhBaEiwAHv1QvI1uJVJRppcDJtdgYNTDeObUk1tyrNUtLGBqpp3ytjb_khYkGExICBoC_5EQAvD_BwE">Carer Gateway</a> offer useful resources.<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/214944/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/4-tips-to-help-your-loved-one-with-dementia-enjoy-the-festive-season-214944">original article</a>.

Caring

Do dogs actually watch TV?

Doggy mysteries Have you ever been cuddled on the couch with your dog and noticed him fixate on something on the TV? Maybe it’s another dog, a bird, or some other animal, or just some action taking place in your favourite TV show or movie. It sure looks like your pup is watching TV, but is it your imagination? We know that dogs experience colour and light differently than humans do, so their eyes don’t see things the same way. So, do dogs watch TV? It’s one of those <a href="https://www.readersdigest.com.au/food-home-garden/pets/decode-your-dogs-behaviour-17-dog-behaviours-explained" target="_blank" rel="noopener">questions about weird dog behaviour</a> that pet lovers are always curious about, so we asked pet experts to weigh in. Do dogs watch TV? The answer is basically a yes. Dr Cherice Roth, Chief Veterinary Officer with the pet health care company Fuzzy, confirms that your pup’s apparent TV-watching habits are indeed the real thing. “Some dogs do watch TV!” says Dr Roth, adding that dogs can actually become engrossed by what’s on the tube. “Much like with humans, [a dog’s interest will vary] based on their attention span and attention to motion.” Plus, depending on how high the volume is, they’ll also react to sounds on the TV – especially anything that sounds like their favourite squeaky dog toy – and may be fixated on that as much as the action on the screen. Is it OK for dogs to watch TV? Just because dogs can watch TV, does it mean they should? Dr Albert Ahn, a veterinary advisor with Myos Pet, offers a qualified yes. “Many owners leave the television on to provide their dogs with a distraction while they leave for work or run errands,” he says, adding that TV can be a helpful tool to help reduce feelings of mild separation anxiety. However, Dr Ahn cautions that TV should not be used as a replacement for real owner-pet interaction. “Dogs are social animals,” he explains, “and they need interactions with their pet parents, as well as appropriate amounts of daily exercise.” So unlike your moody teen, who may be more interested in a smartphone than in your company, your dog always wants to hang out with you, whether that means going for a walk, playing a game of fetch, or just chilling on the couch at your side. Dr Roth highlights another potential issue: Some commercials or programming may emit sounds that are distressing to dogs. Typically, bothersome noises for dogs include explosions, gunshots, sirens and crying, and TV sounds that are loud to us are even louder for dogs, thanks to their more sensitive ears – and sounds that are barely perceptible to us might really bother them. So if you’re leaving the TV on when you’re not at home, it’s a good idea to keep the volume low. What does TV look like to dogs? When it comes to watching TV, humans have a distinct advantage over dogs, mostly because we can see colour, and dogs see only a very limited colour range (though they do see in the dark better than we do). “It’s hard to say exactly what [TV] looks like for a dog,” says Dr Ahn. “However, it is generally believed that because of the composition of the cones in the retina, dogs probably are only able to see two specific colours – blue and yellow.” Dr Roth agrees, noting that most dogs can see the movement of images and appreciate the sound, but they’re likely not able to interpret changes in colours. So if you’re looking for the right channel to entertain your pooch, live-action programs with noisy animals will probably interest them more than, say, a colourful cartoon like The Lion King. Do dogs know that TV isn't real? So we’ve answered the question of “Do dogs watch TV?” But what about their perception of TV? Do they understand that there’s not a “real” dog or cat romping on the 2D screen, or do they think it’s the real thing? “We have not been able to establish that pets can distinguish real versus fantasy,” says Dr Roth. The only one who knows for certain is the dog himself, and he’s not telling. Dr Ahn agrees that it’s hard to know exactly what dogs think about television and whether it’s real or not. “But,” he says, “one might deduce that over time, dogs are at least able to sense that there is limited (one-way) interactivity with a television.” Why do some dogs watch TV and others don't? Why does your best friend like action movies while you prefer to binge-watch Bridgerton? Because just like dogs, we all have different tastes and interests – though dogs’ interest in TV may have something to do with their breed. Dr Roth says this mostly comes down to attention span and personality. Dogs with a strong prey drive (think Dobermans and other dogs that like to chase cats) “are sensitive to small environmental movements and are more likely to react to the movement on TV. Calm dog breeds,” she adds, citing Golden Retrievers as an example, “are less likely to be reactive and have their attention captivated by the TV.” Dr Ahn notes that the type of programming may also play a role in the dog’s level of interest. “For example,” he says, “a 24-hour news channel may be less stimulating to a dog compared with a channel that is broadcasting a dog show.” Should you leave the TV on for your dog when you're not home? According to our veterinary experts, it depends. When you’re away from home, TV can be a useful way to keep your dog entertained and keep them from getting bored or getting up to mischief when you’re not around, as well as lessen separation anxiety. “There are several music video stations that can be really great to keep a pet’s environment friendly,” says Dr Roth. But if the channel plays a variety of content all day, she says there’s always a chance that something distressing to your pet might come on. “I’ve seen pets jump into TVs because they’re chasing something on a screen. Find out what your pet likes and keep to those channels.” And again, as Dr Ahn has noted, the television shouldn’t be used as a replacement for the quality bonding time your dog needs with you. That said, if you want to connect with your pup when you’re away, you can set up Skype to answer calls automatically and “talk” to your dog via video call, or use the Barkio app to leave soothing messages for your dog. Just remember: This can be a comfort to some pets, but potentially a stressor to others who might get confused that their human magically appears onscreen and then disappears. And watch out – if your dog figures out how to call you at work, things could get a little awkward during your next staff meeting! Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/food-home-garden/pets/do-dogs-actually-watch-tv" target="_blank" rel="noopener">Reader's Digest</a>.

Family & Pets

Gordon Ramsay welcomes another "bundle of love"

Gordon Ramsay is a father-of-six! The 57-year-old celebrity chef took to Instagram to announce the heartwarming news that his wife Tana, 49, had given birth to an adorable baby boy. "What an amazing birthday present please welcome Jesse James Ramsay, 7lbs 10oz whopper!!" he captioned the photo of him kissing his newborn on the head, while his wife cradled him in her arms. "One more bundle of love to the Ramsay brigade!! 3 boys, 3 girls…. Done," Ramsay added. In a few other photos, Tana is seen glowing with happiness as she held baby Jesse in her arms. Tana also took to Instagram to share that their family had been "blessed" with baby Jesse's arrival. "It's been a nerve wracking 9 months but we've made it and we have been blessed with this little bundle," she began. "Ramsay family definitely complete. Jesse James Ramsay we love you so much," she wrote with a red heart emoji. Gordon and Tana are already parents to five children: Megan, 25, twins Jack and Holly, 23, Tilly, 22, and Oscar, four. The pair, who have been married for 27 years, have kept their latest pregnancy a secret, following reports that Tana had wanted another child. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Czg4DJVRYX7/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Czg4DJVRYX7/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Gordon Ramsay (@gordongram)</a> </div> </blockquote> The happy couple were flooded with congratulatory messages from celebrity friends and fans. "Wow congratulations guys what lovely news," wrote British TV presenter and model, Kirsty Gallacher. "Fantastic! Congratulations x," British actor and comedian Paddy McGuinnes wrote, while Sky Sports F1 reporter Natalie Pinkham added: "Completely wonderful ❤️🙌👏😍 huge congratulations ❤️" "You two amaze me! Congratulations ❤️" wrote one fan. "Great stuff congrats big man 👏❤️" added another. "Congratulations! What a beautiful gift 💙" added a third. Images: Instagram

Family & Pets

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> What do British Prime Minister <a href="https://www.sciencefocus.com/the-human-body/one-meal-a-day-diet-omad">Rishi Sunak</a> and singer <a href="https://theconversation.com/one-meal-a-day-diet-popular-with-celebrities-could-do-more-harm-than-good-heres-why-203086">Bruce Springsteen</a> have in common? They’re among an ever-growing group of public figures touting the benefits of eating just one meal a day. As a result, the one meal a day (OMAD) diet is the latest attention-grabbing weight loss trend. Advocates claim it leads to fast, long-term weight loss success and better health, including delaying the ageing process. Like most weight-loss programs, the OMAD diet makes big and bold promises. Here’s what you need to know about eating one meal a day and what it means for weight loss. <h2>The OMAD diet explained</h2> Essentially, the OMAD diet is a type of intermittent fasting, where you fast for 23 hours and consume all your daily calories in one meal eaten within one hour. The OMAD diet rules are presented as simple and easy to follow: <ol> <li> You can eat whatever you want, provided it fits on a standard dinner plate, with no calorie restrictions or nutritional guidelines to follow. </li> <li> You can drink calorie-free drinks throughout the day (water, black tea and coffee). </li> <li> You must follow a consistent meal schedule, eating your one meal around the same time each day. </li> </ol> Along with creating a calorie deficit, resulting in weight loss, advocates believe the OMAD diet’s extended fasting period <a href="https://www.frontiersin.org/articles/10.3389/fphys.2021.771944/full">leads to physiological changes</a> in the body that promote better health, including boosting your metabolism by triggering a process called ketosis, where your body burns stored fat for energy instead of glucose. <h2>What does the evidence say?</h2> Unfortunately, research into the OMAD diet is limited. Most studies have examined its impact on <a href="https://www.cell.com/cell-metabolism/pdf/S1550-4131(18)30512-6.pdf">animals</a>, and the <a href="https://pubmed.ncbi.nlm.nih.gov/35087416/">primary study</a> with humans involved 11 lean, young people following the OMAD diet for a mere 11 days. Claims about the OMAD diet typically rely on research into intermittent fasting, rather than on the OMAD diet itself. There is <a href="https://www.cfp.ca/content/66/2/117.short">evidence</a> backing the efficacy of intermittent fasting to achieve weight loss. However, <a href="https://www.nature.com/articles/s41574-022-00638-x">most studies</a> have focused on short-term results only, typically considering the results achieved across 12 weeks or less. One <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">longer-term study from 2022</a> randomly assigned 139 patients with obesity to either a calorie-restricted diet with time-restricted eating between 8am and 4pm daily, or to a diet with daily calorie restriction alone for 12 months. After 12 months, both groups had lost around the same weight and experienced similar changes in body fat, blood sugar, cholesterol and blood pressure. This indicates long-term weight loss achieved with intermittent fasting is not superior and on a par with that achieved by traditional dieting approaches (daily calorie restriction). <h2>So what are the problems with the OMAD diet?</h2> 1. It can cause nutritional deficiencies and health issues. The OMAD diet’s lack of nutritional guidance on what to eat for that one meal a day raises many red flags. The meals we eat every day should include a source of protein balanced with wholegrain carbs, vegetables, fruits, protein and good fats to support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">optimum health, disease prevention and weight management</a>. Not eating a balanced diet will result in nutritional deficiencies that can result in poor immune function, fatigue and a decrease in bone density, leading to osteoporosis. Fasting for 23 hours a day is also likely to lead to extreme feelings of hunger and uncontrollable cravings, which may mean you consistently eat foods that are not good for you when it’s time to eat. 2. It’s unlikely to be sustainable. You might be able to stick with the OMAD diet initially, but it will wear thin over time. Extreme diets – especially ones prescribing extended periods of fasting – aren’t enjoyable, leading to feelings of deprivation and social isolation during meal times. It’s hard enough to refuse a piece of office birthday cake at the best of times, imagine how this would feel when you haven’t eaten for 23 hours! Restrictive eating can also lead to an unhealthy relationship with food, making it even harder to achieve and maintain a healthy weight. 3. Quick fixes don’t work. Like other popular intermittent fasting methods, the OMAD diet appeals because it’s easy to digest, and the results appear fast. But the OMAD diet is just another fancy way of cutting calories to achieve a quick drop on the scales. As your weight falls, things will quickly go downhill when your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">body activates its defence mechanisms</a> to defend your weight loss. In fact, it will regain weight – a response that stems from our hunter-gatherer ancestors’ need to survive periods of deprivation when food was scarce. <h2>The bottom line</h2> Despite the hype, the OMAD diet is unsustainable, and it doesn’t result in better weight-loss outcomes than its predecessors. Our old habits creep back in and we find ourselves fighting a cascade of physiological changes to ensure we regain the weight we lost. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-the-omad-diet-is-one-meal-a-day-actually-good-for-weight-loss-and-is-it-safe-207723">original article</a>.

Body

How do stimulants actually work to reduce ADHD symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Stimulants are <a href="https://adhdguideline.aadpa.com.au/">first-line drugs</a> for children and adults diagnosed with attention-deficit hyperactivity disorder (ADHD). But how do they actually work? <h2>First, let’s look at the brain</h2> ADHD is a neurodevelopmental condition, which means it affects how the brain functions. Medical imaging indicates people with ADHD may have slight differences in their brain’s <a href="https://jamanetwork.com/journals/jama/article-abstract/195386">structure</a>, the way their brain regions work together to perform tasks, and how their brain’s chemical messengers, called neurotransmitters, pass on information. These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory. <h2>What stimulants are prescribed in Australia?</h2> The three main stimulants prescribed for ADHD in Australia are dexamfetamine, methylphenidate (sold under the brand names Ritalin and Concerta) and lisdexamfetamine (sold as Vyvanse). Dexamfetamine and methylphenidate have been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/">since</a> the 1930s and 1940s respectively. Lisdexamfetamine is a newer stimulant that has been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">since</a> the late 2000s. Dexamfetamine and lisdexamfetamine are amphetamines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">Lisdexamfetamine</a> is inactive when it’s taken and actually changes into active dexamfetamine in the red blood cells. This is what’s known as a “prodrug”. <h2>So how do they work for ADHD?</h2> Stimulant drugs are thought to alter the activity of key neuotransmitters, dopamine and noradrenaline, in the brain. These neurotransmitters help with attention and focus, among other things. Stimulants increase the amount of dopamine and noradrenaline in the tiny gaps between neurons, known as synapses. They do this by predominantly blocking a transporter that then prevents their re-uptake back into the neuron that released them. This means more dopamine and noradrenaline can bind to their respective receptors. This <a href="https://www.tga.gov.au/sites/default/files/auspar-lisdexamfetamine-dimesilate-180515-pi.pdf">helps</a> connected neurons in the brain talk to one another. Amphetamines also increase the amount of dopamine the neuron releases into the synapse (the tiny gaps between neurons). And it stops the enzymes that break down dopamine. This results in an increase of dopamine in the synapse. <h2>What effect do they have on ADHD symptoms?</h2> We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109107/">research shows</a> stimulants that modulate noradrenaline and dopamine can improve brain processes such as: <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> They can also improve general behaviour, such as self-control, not talking over the top of others, and concentration. These behaviours are important for social interactions. Stimulants <a href="https://pubmed.ncbi.nlm.nih.gov/15737659/">reduce ADHD symptoms</a> in about 70% to 80% of children and adults who take them. Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners. <h2>Not everyone gets the same dose</h2> The optimal stimulant dose varies between individuals, with multiple dosage options available. This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual. There are also different delivery options. Dexamfetamine and methylphenidate are available in immediate-release preparations. As these have short half-lives (meaning they act quickly and wear off rapidly), they are often taken multiple times a day – usually in the morning, lunch and afternoon. Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03175-3&d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day. Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation. The long-acting stimulants are generally taken once in the morning. This avoids the need to take tablets during school or work hours (and the need to store a “controlled drug”, which has the potential for abuse, outside the home). <h2>What are the side effects?</h2> The most common side effects are sleep problems and decreased appetite. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012069.pub2/full">recent study</a> showed children and young people taking methylphenidate for ADHD were around 2.6 times more likely to have sleep problems and 15 times more likely to have a decreased appetite than those not taking methylphenidate. Headache and abdominal pain are also relatively common. <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> Stimulants are tightly controlled because of their potential for abuse. In Australia, only paediatricians, psychiatrists or neurologists (and GPs in special circumstances) can prescribe them. This follows a long assessment process. As stimulants increase dopamine, they can cause euphoria and a heightened sense of wellbeing. They can also cause <a href="https://www.ncbi.nlm.nih.gov/books/NBK576548/#:%7E:text=The%20immediate%20psychological%20effects%20of,and%20may%20result%20in%20insomnia.">weight loss</a>. A common myth about stimulant medicines is they can improve the concentration and productivity of people without ADHD. A <a href="https://www.science.org/doi/full/10.1126/sciadv.add4165">recent study shows</a> the opposite is true. This study gave a group of 40 people online arithmetic tasks to complete across four sessions. At each of the sessions, participants were given either a placebo or a stimulant before completing the task. The results showed that while stimulants did not impact getting the correct answer, it increased the number of moves and time to solve the problems compared to a placebo. This indicates a reduction in productivity. However, the myth that stimulants improve study prevails. It’s likely that users feel different – after all, they are taking a medicine that speeds up messages between the brain and body. It may make them “feel” more alert and productive, even if they’re not.<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/215801/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.

Mind

Can I actually target areas to lose fat, like my belly?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Spend some time scrolling social media and you’re all-but-guaranteed to see an ad promising to help you with targeted fat loss. These ads promote a concept known as “spot reduction”, claiming you can burn fat in a specific body area, usually the belly, with specially designed exercises or workouts. It’s also common to see ads touting special diets, pills and supplements that will blast fat in targeted areas. These ads – which often feature impressive before and after photos taken weeks apart – can seem believable. Unfortunately, spot reduction is another weight-loss myth. It’s simply not possible to target the location of fat loss. Here’s why. <h2>1. Our bodies are hardwired to access and burn all our fat stores for energy</h2> To understand why spot reduction is a myth, it’s important to understand how body fat is stored and used. The fat stored in our bodies takes the form of triglycerides, which are a type of lipid or fat molecule we can use for energy. Around 95% of the dietary fats <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">we consume are triglycerides</a>, and when we eat, our bodies also convert any unused energy consumed into triglycerides. Triglycerides are stored in special fat cells called adipocytes, and they’re released into our bloodstream and transported to adipose tissue – tissue we more commonly refer to as body fat. This body fat is found all over our bodies, but it’s primarily stored as subcutaneous fat under our skin and as visceral fat around our internal organs. These fat stores serve as a vital energy reserve, with our bodies mobilising to access stored triglycerides to provide energy during periods of prolonged exercise. We also draw on these reserves when we’re dieting and fasting. However, contrary to what many spot-reduction ads would have us think, our muscles can’t directly access and burn specific fat stores when we exercise. Instead, they use a process called lipolysis to convert triglycerides into free fatty acids and a compound called glycerol, which then travels to our muscles via our bloodstream. As a result, the fat stores we’re using for energy when we exercise come from everywhere in our bodies – not just the areas we’re targeting for fat loss. Research reinforces how our bodies burn fat when we exercise, confirming spot reduction is a weight-loss myth. This includes a randomised <a href="https://pubmed.ncbi.nlm.nih.gov/25766455/">12-week clinical trial</a> which found no greater improvement in reducing belly fat between people who undertook an abdominal resistance program in addition to changes in diet compared to those in the diet-only group. Further, <a href="https://www.termedia.pl/A-proposed-model-to-test-the-hypothesis-of-exerciseinduced-localized-fat-reduction-spot-reduction-including-a-systematic-review-with-meta-analysis,129,45538,0,1.html">a 2021 meta-analysis</a> of 13 studies involving more than 1,100 participants found that localised muscle training had no effect on localised fat deposits. That is, exercising a specific part of the body did not reduce fat in that part of the body. <a href="https://www.mdpi.com/1660-4601/18/7/3845">Studies</a> purporting to show spot-reduction benefits have small numbers of participants with results that aren’t clinically meaningful. <h2>2. Our bodies decide where we store fat and where we lose it from first</h2> Factors outside of our control influence the areas and order in which our bodies store and lose fat, namely: <ul> <li> our genes. Just as DNA prescribes whether we’re short or tall, genetics plays a significant role in how our fat stores are managed. Research shows our genes can account for <a href="https://pubmed.ncbi.nlm.nih.gov/24632736/">60% of where fat is distributed</a>. So, if your mum tends to store and lose weight from her face first, there’s a good chance you will, too </li> <li> our gender. Our bodies, by nature, have distinct fat storage characteristics <a href="https://pubmed.ncbi.nlm.nih.gov/11706283/">driven by our gender</a>, including females having more fat mass than males. This is primarily because the female body is designed to hold fat reserves to support pregnancy and nursing, with women tending to lose weight from their face, calves and arms first because they impact childbearing the least, while holding onto fat stored around the hips, thighs and buttocks </li> <li> our age. The ageing process triggers changes in muscle mass, metabolism, and hormone levels, which can impact where and how quickly fat is lost. Post-menopausal <a href="https://theconversation.com/is-menopause-making-me-put-on-weight-no-but-its-complicated-198308">women</a> and middle-aged <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/sex-differences-in-fat-storage-fat-metabolism-and-the-health-risks-from-obesity-possible-evolutionary-origins/00950AD6710FB3D0414B13EAA67D4327">men</a> tend to store visceral fat around the midsection and find it a stubborn place to shift fat from. </li> </ul> <h2>3. Over-the-counter pills and supplements cannot effectively target fat loss</h2> Most advertising for these pills and dietary supplements – including products claiming to be “the best way to lose belly fat” – will also proudly claim their product’s results are backed by “clinical trials” and “scientific evidence”. But the reality is a host of independent studies don’t support these claims. This includes two recent studies by the University of Sydney that examined data from more than 120 placebo-controlled trials of <a href="https://pubmed.ncbi.nlm.nih.gov/31984610/">herbal</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33976376/">dietary</a> supplements. None of the supplements examined provided a clinically meaningful reduction in body weight among overweight or obese people. <h2>The bottom line</h2> Spot reduction is a myth – we can’t control where our bodies lose fat. But we can achieve the results we’re seeking in specific areas by targeting overall fat loss. While you may not lose the weight in a specific spot when exercising, all physical activity helps to burn body fat and preserve muscle mass. This will lead to a change in your body shape over time and it will also help you with long-term weight management. This is because your metabolic rate – how much energy you burn at rest – is determined by how much muscle and fat you carry. As muscle is more metabolically active than fat (meaning it burns more energy than fat), a person with a higher muscle mass will have a faster metabolic rate than someone of the same body weight with a higher fat mass. Successfully losing fat long term comes down to losing weight in small, manageable chunks you can sustain – periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight. It also requires gradual changes to your lifestyle (diet, exercise and sleep) to ensure you form habits that last a lifetime. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<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/205203/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-i-actually-target-areas-to-lose-fat-like-my-belly-205203">original article</a>.

Body

"You were loved": Tributes flow over tragic passing of Matthew Perry

The world was left in shock and mourning as news broke of the tragic death of beloved actor Matthew Perry, best known for his iconic role as Chandler Bing on the hit sitcom Friends. The 54-year-old actor passed away in an apparent drowning accident at his Los Angeles home, leaving a void in the hearts of countless fans and colleagues. Emergency services were summoned to Perry's residence in the Pacific Palisades neighbourhood after an assistant found him unresponsive. Initial reports indicated that it was a "water rescue or water emergency". Disturbingly, a 911 call made from Perry's home shortly before first responders arrived mentioned the word "drowning." The actor was found unresponsive in his jacuzzi, where his life was tragically cut short. In the aftermath of this heartbreaking incident, the Los Angeles Police Department confirmed the death investigation at Perry's residence, marking the untimely end of a talented and cherished actor. The circumstances surrounding Perry's death remain the subject of public speculation. While law enforcement sources reported that no drugs were discovered at the scene and foul play is not suspected, the investigation continues. The family, including his mother Suzanne Morrison, father John Bennett Perry, and stepfather Dateline NBC's Keith Morrison, issued a statement expressing their profound grief and gratitude for the outpouring of love from fans. "We are heartbroken by the tragic loss of our beloved son and brother," the family said. "Matthew brought so much joy to the world, both as an actor and a friend. You all meant so much to him, and we appreciate the tremendous outpouring of love." In the dispatch audio obtained by TMZ, emergency responders referenced a "drowning" incident. While it is reported that Perry was found in a hot tub, a source later claimed that he had just returned home from a game of pickleball. Perry's passing has sent shockwaves through the entertainment industry and beyond. Former colleagues and fellow stars have paid their heartfelt tributes to the actor who brought laughter to millions with his portrayal of Chandler Bing. Maggie Wheeler, who portrayed Chandler's unforgettable on-again, off-again girlfriend, Janice, in Friends, expressed her gratitude for the joy Perry brought into people's lives. She shared on Instagram, "The joy Matthew brought to so many in his too short lifetime will live on. I feel so very blessed by every creative moment we shared." Morgan Fairchild, who played Chandler's mother, Nora Bing, described herself as "heartbroken" by the untimely loss of her "son". She acknowledged the brilliance of the young actor and the shock that this tragedy has brought to the entertainment world. Even Canadian Prime Minister Justin Trudeau, who knew Perry from their shared history when Perry's mother worked as an aide to Trudeau's father, former Canadian Prime Minister Pierre Trudeau, expressed his grief. Trudeau remembered the schoolyard games they played and the worldwide joy that Perry brought to fans. He said, "Thanks for all the laughs, Matthew. You were loved – and you will be missed." Piers Morgan, the renowned broadcaster and journalist, acknowledged Perry's talent as an actor but also recognised the struggles he faced. Perry's candid autobiography about his battle with addiction left a profound impact, and his passing is a stark reminder of the difficulties he endured. Warner Bros Television Group, which produced Friends for its entire run, released a statement expressing their devastation over the loss of their dear friend. “We are devastated by the passing of our dear friend Matthew Perry. Matthew was an incredibly gifted actor and an indelible part of the Warner Bros Television Group family. The impact of his comedic genius was felt around the world, and his legacy will live on in the hearts of so many. This is a heartbreaking day, and we send our love to his family, his loved ones, and all of his devoted fans.” NBC, the network that aired Friends, also paid tribute to the late actor, highlighting the immense joy he brought to millions through his pitch-perfect comedic timing and wry wit. They emphasised that his legacy will continue to live on through countless generations. The passing of Matthew Perry is a loss not only for his family and friends but also for the countless individuals whose lives were brightened by his humour and talent. His portrayal of Chandler Bing on Friends remains etched in the hearts of fans around the world, and his memory will live on as an enduring source of laughter and joy. Images: Getty / NBC / Instagram

Caring

How can I get some sleep? Which treatments actually work?

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months? If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia. You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a> </li> <li> drinking coffee and taking naps might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening </li> <li> drinking alcohol might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid. </li> </ul> <h2>What to do next?</h2> If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours. So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>. Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. <a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>. <h2>What if that doesn’t work?</h2> If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines. However, we don’t know if they work or are safe over the long term. <a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>. In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment. So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term. <h2>What now?</h2> If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these. Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors. <hr /> For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.<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/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

"Uniquely, magically, indescribably us": Read the emotional love letter from Suzanne Somers' husband

Just one day before her death, Suzanne Somers' husband gave her a handwritten love letter as part of an early birthday present. Somers' husband, Alan Hamel, gave the letter to his wife of 45 years just 24 hours before she passed away at the age of 76. According to Somers' publicist, R. Couri Hay, Hamel “gave it to her a day early and she read the poem and went to bed and later died peacefully in her sleep.” The emotional poem was an expression of love from Somers' husband, as he struggled to define their intense relationships. “Love I use it every day, sometimes several times a day. I use it at the end of emails to my loving family. I even use it in emails to close friends. I use it when I’m leaving the house,” the note began, via <a href="https://people.com/read-love-letter-suzanne-somers-husband-alan-hamel-wrote-to-her-day-before-her-death-8358234">People</a>. “There’s love, then love you and I love you!! Therein lies some of the different ways we use love. Sometimes I feel obliged to use love, responding to someone who signed love in their email, when I’m uncomfortable using love but I use it anyway. “I also use love to describe a great meal. I use it to express how I feel about a show on Netflix. I often use love referring to my home, my cat Gloria, to things Gloria does, to the taste of a cantaloupe I grew in my garden.” “I love the taste of a freshly harvested organic royal jumbo medjool date. I love biting a fig off the tree. I love watching two giant blackbirds who live nearby swooping by my window in a power dive. My daily life encompasses things and people I love and things and people I am indifferent to,” he continued. “I could go on ad infinitum, but you get it. What brand of love do I feel for my wife Suzanne? Can I find it in any of the above? A resounding no!!!! There is no version of the word that is applicable to Suzanne and I even use the word applicable advisedly.” “The closest version in words isn’t even close. It’s not even a fraction of a fraction of a fraction. Unconditional love does not do it. I’ll take a bullet for you doesn’t do it. I weep when I think about my feelings for you. Feelings… That’s getting close, but not all the way.” “55 years together, 46 married and not even one hour apart for 42 of those years. Even that doesn’t do it,” he added. “Even going to bed at 6 o’clock and holding hands while we sleep doesn’t do it. Staring at your beautiful face while you sleep doesn’t do it.” “I’m back to feelings. There are no words,” he concluded. “There are no actions. No promises. No declarations. Even the green shaded scholars of the Oxford University Press have spent 150 years and still have failed to come up with that one word. So I will call it, ‘Us,’ uniquely, magically, indescribably wonderful ‘Us.’” Somers and Hamel tied the knot in 1977, giving them 45 years together as husband and wife. Somers died on Sunday morning after “an aggressive form of breast cancer for over 23 years,” her publicist said in a statement. Suzanne was best known for playing Chrissy Snow on the 1970s sitcom Three’s Company and Carol Foster Lambert on the ’90s family comedy Step by Step. Image credits: Getty Images

Caring

How to tell if your loved one is depressed

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

Caring

How do hay fever treatments actually work? And what’s best for my symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing. Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine. Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging. So what medicines can prevent or reduce hay fever symptoms, and how do they work? <h2>Antihistamines</h2> Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that anti-histamines are one of the most frequently recommended medicines to treat hay fever. Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms. In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines. Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation. The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever. The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones. Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines. The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you. Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients). <h2>Steroid nasal sprays</h2> If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended. Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation. Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever. There are also nasal sprays that contain both an antihistamine and corticosteroid. While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days. <h2>Sodium cromoglycate</h2> Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies. This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation. This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies). <h2>Decongestants</h2> Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running. However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose. <h2>Saline</h2> Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects. If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines. Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<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/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.

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