Mind

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Why we feel like Christmas comes around more quickly each year

<p><em><a href="https://theconversation.com/profiles/ruth-ogden-1182467">Ruth Ogden</a>, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores University</a></em></p> <p>Think back to your childhood. December was the longest of months. It might have been filled with rehearsing school nativity performances, writing up your wishlist and savouring the morning’s advent calendar chocolate. But at times it felt like Santa would never arrive.</p> <p>As an adult it’s a different experience. One minute it’s summer holidays, barbecues and sunburn and then, in the blink of an eye, it’s mince pies, tinsel and turkey. Is it just me, or is Christmas coming around faster?</p> <p>If you cannot believe the festive season is upon us already, you’re not alone. My colleagues and recently conducted a survey of 918 adults in the UK (full results still to be published) and found 77% of respondents agreed Christmas seems to arrive more rapidly each year.</p> <p>One reason may be the way we experience the <a href="https://brill.com/view/journals/time/9/3/article-p275_275.xml">passage of time changes as we age</a>, often resulting in the feeling that <a href="https://journals.sagepub.com/doi/abs/10.1177/0961463x13478052">time speeds up as we get older</a>. For a seven-year- old, the 12 months between Christmases are a huge proportion of their life. For a 45-year-old, those same 12 months are a small portion of their experience. This <a href="https://journals.sagepub.com/doi/10.2466/pms.1975.41.1.235">difference in ratio</a> compresses the relative time between Christmases each year.</p> <p>Our experience of time also changes because we rely on memory to estimate duration. When we judge how long something lasted for, we base our estimate on <a href="https://psycnet.apa.org/record/2004-18721-003">how many memories we made during the period of interest</a>. Whether we are trying to remember the length of a film, car journey or relationship, the number of memories we encoded during it will serve as an indicator of its length.</p> <p>Periods of time in which fewer new memories are made, either because there was a lack of stimulating tasks, novel activities or heightened emotions, are interpreted by <a href="https://philpapers.org/rec/BLORAP">our brains as short</a>.</p> <h2>Where has the year gone</h2> <p>As we age, memory becomes more fallible and we recall less from our day to day lives. We’re also less likely to try new things than when we were younger. Together these factors may contribute to the sensation that less time has passed since last Christmas than we were expecting.</p> <p>Because what we do has such a strong influence on how we experience time, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235871">changes to our routine distort the passage of time</a>. A predictable day helps time to flow steadily.</p> <p>This was illustrated on a global scale during the pandemic. One minute we were all going about our daily lives. Then all of a sudden, our routines were scrambled. People from <a href="https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0266261">Buenos Aries</a> to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266877">Bagdad</a> reported an overwhelming sense time did not pass as normal during the pandemic.</p> <p>While Christmas does not cause the same level of disruption as a global pandemic, it disrupts our habits.</p> <h2>Can’t wait ‘til it’s Christmas?</h2> <p>Another factor which may make us feel like Christmas is here too fast is the amount of energy we put into anticipating it. For many children, Christmas is arguably the most eagerly awaited event of the year. Advent calendars count down the days until Father Christmas arrives. All this excitement means children pay a lot of attention to the passage of time in the run up to Christmas. Unfortunately for them, focusing on the passage of time <a href="https://digitalcommons.usm.maine.edu/facbooks/472/">typically makes it drag</a>.</p> <p>For most adults, Christmas is less thrilling. So adults probably think less about the countdown. Paying less attention to time <a href="https://pubmed.ncbi.nlm.nih.gov/35902608/">makes it pass more quickly</a>. The effect may have been particularly pronounced this year because, in the post-pandemic normality, life is busier than ever and we have even less time to think about Christmas.</p> <p>Technological change also affects our perception of time. Advances in technology enable us to accomplish more tasks, more quickly, than ever before. This acceleration in the <a href="https://journals.sagepub.com/doi/10.2466/pms.1975.41.1.235">pace of life</a> over the past 20 years may also contribute to the sensation that Christmas now comes around too soon.</p> <h2>Running out of time</h2> <p>Despite paying less attention to time, adults experience significantly more demands on their schedules than children in the run up to Christmas. For children, Christmas happens by magic. For adults however the festive mystique is replaced by large amounts of planning, shopping, wrapping and cooking. The added time pressure created by Christmas may contribute to time passing more quickly.</p> <p>The lack of control children have over Christmas likely increases their level of <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053810015300465">temporal uncertainty</a>. Not knowing when, or indeed if, something will happen can also slow the passage of time.</p> <p>However, maybe we feel like Christmas comes around faster each year because it really does. In years gone by Christmas advertising wasn’t seen until the start of Advent. Nowadays it is normal to see chocolate Santas on the supermarket shelves in early October. This literal <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165176505002284">shifting of the Christmas timeline</a> undoubtedly adds to the psychological sense of Christmas coming earlier.</p> <p>However, retailers’ attempts to increase profits by starting the festive period earlier each year come at a price. When retailer Very.com launched it’s Christmas <a href="https://metro.co.uk/2022/10/10/christmas-advert-in-october-from-very-outrages-viewers-17534895/">advertising campaign on October 7</a> in 2021 there was public outrage. We don’t want to actually see Christmas coming around more quickly. Very didn’t repeat their mistake this year.<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/194575/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/ruth-ogden-1182467"><em>Ruth Ogden</em></a><em>, Reader in Experimental Psychology, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-we-feel-like-christmas-comes-around-more-quickly-each-year-194575">original article</a>.</em></p>

Mind

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Sweet secrets – the science of keeping good news hush hush

<p>Most people keep secrets, and staying hush about good news – like pregnancy, presents, proposals and promotions – tends to be freely chosen, enjoyable and energising according to new research.</p> <div class="copy"> <p>Conventional wisdom holds that secrecy is a burden, and good news is <a href="https://cosmosmagazine.com/health/body-and-mind/seeing-emotions/">meant to be shared</a>. But Australian and United States researchers <a href="https://dx.doi.org/10.1037/pspa0000352" target="_blank" rel="noopener">publishing</a> in the <em>Journal of Personality and Social Psychology</em> investigated the effects of keeping positive news to one’s self, finding the motivations and effects are quite different to other types of secrets.</p> <p>Associate Professor Katharine Greenaway researches <a href="https://cosmosmagazine.com/people/society/are-sciences-equal/">social psychology</a> at the University of Melbourne and is an author of the paper. She tells <em>Cosmos</em>: “secrecy is extremely common – on average, 97% of people are keeping a secret right now.” </p> <p>“It’s obviously fascinating to know, people’s secrets, and why they keep them,” she says. </p> <p>Greenaway adds studying secrecy is “really interesting theoretically because we’re social creatures. From our evolutionary past, we’ve always had to be social, we’ve had to communicate in order to co-operate. So, from that perspective it’s really interesting, why would we ever want to keep information from other people? […] It’s particularly interesting why we would keep positive information from others.” </p> <p>Across 5 different experiments involving 2,500 participants the researchers tested different elements of positive secrecy: the effect of secret and non-secret good news; deliberately keeping news secret for personal reasons compared to external reasons ; and the effects of positive secrets compared to other kinds of secrets.</p> <p>“Positive secrets, we’ve found, tend to be the types of secrets people choose freely, and they actually quite enjoy keeping,” Greenaway says.</p> <p>In one study, involving 194 people, participants were provided with a list of 38 common categories of good news, such as: pregnancy; won something; new possession; financial windfall; family news; and self-development. They were asked to indicate which items were relevant, and any they were keeping secret.</p> <p>On average, participants held 14 to 15 pieces of good news, keeping 5 to 6 positive items to themselves.</p> <p>A second study tested motivation. A new group of 600 participants in committed relationships were asked to imagine a plausible piece of good news (from the list of common good news). </p> <p>They were randomly assigned to imagine either: deciding to keep the news secret until they chose share it with their partner, or the information remaining unknown due to external factors like being in meetings all day. For a further group, no reason was specified for not sharing the news. Participants were then asked about how “tired, depleted, weak, passive, active, invigorated, strong, energized, awake and alert, and alive they felt” on a scale from not at all ‘1’ to very much ‘7’.</p> <p>When people elected to keep a piece of good news private, they felt energised. But when external factors got in the way of sharing information, they felt fatigued.</p> <p><iframe title="People are Seriously becoming Friends with their Robotic Vacuums" src="https://omny.fm/shows/huh-science-explained/people-are-seriously-becoming-friends-with-their-r/embed?in_playlist=podcast&amp;style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>Three further experiments tested the effect of positive or negative secrets. Finding positive secrets were more likely to be kept for personal reasons, freely chosen, generating greater feelings of energy.</p> <p>“When people keep a positive secret as opposed to a different type of secret, they tend to have relatively more intrinsic motivation for doing so. Intrinsic motivation is associated with feeling like something is really important, personally valuable to you. And also enjoyable,” says Greenaway.</p> <p>“If you’ve kept a negative secret, often you’re worried about what would happen if that secret got out […] you feel as though that’s something that’s being imposed on you, as opposed to something that you’re freely choosing to keep secret from others.”</p> <p>Prior research has mostly focused on negative secrets, suggesting secrecy can be harmful.</p> <p>In contrast, this new research suggests holding on to positive news is more likely to be freely chosen, for personal reasons, and can be more energising than sharing the information.</p> <p><em>Image credits: Getty Images </em></p> <div> <p align="center"><noscript data-spai="1"><em>&amp;lt;img decoding="async" fetchpriority="high" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/11/Cosmos-Catch-Up-embed_728x150-1.jpg" data-spai-egr="1" alt="Sign up to our weekly newsletter" width="600" height="154" title="sweet secrets - the science of keeping good news hush hush 2"&amp;gt;</em></noscript></p> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=288402&amp;title=Sweet+secrets+%26%238211%3B+the+science+of+keeping+good+news+hush+hush" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/people/social-sciences/sweet-secrets-science/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </em></div>

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5 reasons why climate change may see more of us turn to alcohol and other drugs

<p><em><a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a></em></p> <p>Climate change will affect every aspect of our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/fulltext">health and wellbeing</a>. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is.</p> <p>Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our <a href="https://pubmed.ncbi.nlm.nih.gov/36165756/">mental health</a> in a multitude of <a href="https://www.nature.com/articles/s41558-018-0102-4">ways</a>.</p> <p>Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences.</p> <p>We outline <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221132739">five ways</a> climate change could increase the risk of harmful substance use.</p> <h2>1. Mental health is harmed</h2> <p>Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12448">increases the risk</a> of new or worsened substance use.</p> <p>People with a mental disorder are <a href="https://www.hindawi.com/journals/psychiatry/2018/5697103/">at high risk</a> of also having a <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-25#:%7E:text=Prevalence%20of%20comorbidity%20in%20epidemiological%20studies&amp;text=Among%20subjects%20with%20an%20alcohol,a%20comorbid%20SUD%20%5B39%5D.">substance-use disorder</a>. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health.</p> <p>For example, extreme heat is linked to increased <a href="https://pubmed.ncbi.nlm.nih.gov/27727320/">distress</a> across the whole population. In extreme heat, more people go to the <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789481">emergency department</a> for psychiatric problems, including for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969720338249">alcohol</a> and <a href="https://www.nature.com/articles/s43856-023-00346-1">substance use</a> generally. This is even true for <a href="https://www.sciencedirect.com/science/article/pii/S0048969720325572">a single very hot day</a>.</p> <p>Post-traumatic stress disorder, depression, anxiety and <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.10307">other mental health</a> problems are <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00367/full">common</a> at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116266/">multiple events</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101235/">increase</a> the likelihood of using substances as a way to cope.</p> <h2>2. Worry increases</h2> <p>With <a href="https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-december-2022/">increasing public awareness</a> of how climate change is endangering wellbeing, people are <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/worriesaboutclimatechangegreatbritain/septembertooctober2022#:%7E:text=The%20level%20of%20worry%20about,lives%20right%20now%20(29%25).">increasingly worried</a> about what will happen if it remains unchecked.</p> <p>Worrying isn’t the same as meeting the criteria for a mental disorder. But <a href="https://www.undp.org/publications/peoples-climate-vote">surveys</a> show climate change generates complex emotional responses, <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00278-3/fulltext">especially in children</a>. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness.</p> <p>Some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/">emotional states</a>, such as <a href="https://www.pnas.org/doi/full/10.1073/pnas.1909888116">sadness</a>, are linked with long-term tobacco use and also make substance use <a href="https://pubmed.ncbi.nlm.nih.gov/16011392/">relapse</a> more likely.</p> <h2>3. Physical injuries hurt us in many ways</h2> <p>Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they <a href="https://pubmed.ncbi.nlm.nih.gov/20033251/">increase</a> the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs.</p> <p>Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are <a href="https://www.tandfonline.com/doi/abs/10.3109/00952999609001655">linked with</a> higher rates of harmful substance use.</p> <h2>4. Our day-to-day lives change</h2> <p>A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue.</p> <p>Take, for example, hotter temperatures, which disrupt <a href="https://www.cell.com/one-earth/fulltext/S2590-3322(22)00209-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2590332222002093%3Fshowall%3Dtrue">sleep</a>, undermine <a href="https://jhr.uwpress.org/content/57/2/400">academic performance</a>, <a href="https://www.nature.com/articles/s41562-017-0097">reduce physical activity</a>, and promote <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00173-5/fulltext">hostile language</a> and <a href="https://www.cambridge.org/core/elements/abs/climate-change-and-human-behavior/F64471FA47B8A6F5524E7DDDDE571D57">violent behaviour</a>.</p> <h2>5. It destabilises communities</h2> <p>Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical <a href="https://www.nature.com/articles/s41558-018-0102-4">systems</a> on which human wellbeing – <a href="https://theconversation.com/climate-change-and-health-ipcc-reports-emerging-risks-emerging-consensus-24213">indeed survival</a> – depends.</p> <p>Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant <a href="https://www.nature.com/articles/s41558-018-0102-4">sources of psychosocial distress</a> that prompt acute (short-term) and chronic (long-term) stress responses.</p> <p><a href="https://doi.org/10.1196/annals.1441.030">Stress</a>, in turn, can <a href="https://doi.org/10.1007/s002130100917">increase</a> the risk of <a href="https://link.springer.com/article/10.1007/s002130100917">harmful substance use</a> and make people more likely to relapse.</p> <h2>Why are we so concerned?</h2> <p>Substance-use disorders are economically and socially <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext">very costly</a>. Risky substance use that doesn’t meet the criteria for a formal diagnosis <a href="https://digitalcommons.fiu.edu/srhreports/health/health/32/">can also harm</a>.</p> <p>Aside from its direct physical harm, harmful substance use disrupts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843305/">education</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234116/">employment</a>. It increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676144/">accidents</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/09595230600944479">crime</a>, and it undermines social relationships, intimate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795906/#:%7E:text=Results%20indicated%20that%20alcohol%20use,drinkers%20with%20low%20relationship%20satisfaction.">partnerships</a> and <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/abs/longitudinal-relations-between-parental-drinking-problems-family-functioning-and-child-adjustment/CE508589A9E799FD6DC9E23DF364FB8F">family functioning</a>.</p> <h2>Politicians take note</h2> <p>As we head towards the <a href="https://www.cop28.com">COP28 global climate talks</a> in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act.</p> <p>As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional <a href="https://www.nature.com/articles/s41558-018-0102-4">prevention strategies</a> are needed. As well as addressing climate change more broadly, we need strategies including:</p> <ul> <li> <p>supporting vulnerable individuals, especially <a href="https://journals.sagepub.com/doi/full/10.1177/21677026211040787">young people</a>, and marginalised commmunities, who are <a href="https://www.nature.com/articles/s41558-018-0102-4">hit hardest</a> by extreme weather-related events</p> </li> <li> <p>focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support</p> </li> <li> <p>investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use.</p> </li> </ul> <p>There is now <a href="https://news.un.org/en/story/2022/10/1129912">no credible pathway</a> to avoiding dangerous climate change. However, if <a href="https://carnegieendowment.org/2023/01/12/climate-protests-tracking-growing-unrest-pub-88778#:%7E:text=These%20are%20just%20a%20few,even%20more%20numerous%20and%20influential.">increasing rates</a> of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.<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/217894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, Honorary Professor, Centre for Health Systems and Safety Research, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, Associate Professor, Psychosocial Difficulties, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/5-reasons-why-climate-change-may-see-more-of-us-turn-to-alcohol-and-other-drugs-217894">original article</a>.</em></p>

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How do stimulants actually work to reduce ADHD symptoms?

<p><em><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></em></p> <p>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?</p> <h2>First, let’s look at the brain</h2> <p>ADHD is a neurodevelopmental condition, which means it affects how the brain functions.</p> <p>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.</p> <p>These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory.</p> <h2>What stimulants are prescribed in Australia?</h2> <p>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).</p> <p>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.</p> <p>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”.</p> <h2>So how do they work for ADHD?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What effect do they have on ADHD symptoms?</h2> <p>We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD.</p> <p>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:</p> <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> <p>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.</p> <p>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.</p> <p>Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners.</p> <h2>Not everyone gets the same dose</h2> <p>The optimal stimulant dose varies between individuals, with multiple dosage options available.</p> <p>This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual.</p> <p>There are also different delivery options.</p> <p>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.</p> <p>Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2010-PI-03175-3&amp;d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day.</p> <p>Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation.</p> <p>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).</p> <h2>What are the side effects?</h2> <p>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.</p> <p>Headache and abdominal pain are also relatively common.</p> <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> <p>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.</p> <p>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>.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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" /></p> <p><a href="https://theconversation.com/profiles/mary-bushell-919262"><em>Mary Bushell</em></a><em>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.</em></p>

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Why do people with hoarding disorder hoard, and how can we help?

<p><em><a href="https://theconversation.com/profiles/jessica-grisham-37825">Jessica Grisham</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/keong-yap-1468967">Keong Yap</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/melissa-norberg-493004">Melissa Norberg</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Hoarding disorder is an under-recognised serious mental illness that <a href="https://pubmed.ncbi.nlm.nih.gov/25909628/">worsens with age</a>. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/31200169/">2.5% of the working-age population</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27939851/">7% of older adults</a>. That’s about 715,000 Australians.</p> <p>People who hoard and their families often feel ashamed and don’t get the support they need. Clutter can make it hard to do things most of us take for granted, such as eating at the table or sleeping in bed.</p> <p>In the gravest cases, homes are completely unsanitary, either because it has become impossible to clean or because the person <a href="https://pubmed.ncbi.nlm.nih.gov/23482436/">saves garbage</a>. The <a href="https://pubmed.ncbi.nlm.nih.gov/18275935/">strain on the family</a> can be extreme – couples get divorced, and children grow up feeling unloved.</p> <p>So why do people with hoarding disorder hoard? And how can we help?</p> <h2>What causes hoarding disorder?</h2> <p>Saving millions of objects, many worthless by objective standards, often makes little sense to those unfamiliar with the condition.</p> <p>However, most of us<a href="https://www.sciencedirect.com/science/article/pii/S2352250X21000282?via%3Dihub"> become attached to at least a few possessions</a>. Perhaps we love the way they look, or they trigger fond memories.</p> <p>Hoarding involves this same type of object attachment, as well over-reliance on possessions and <a href="https://pubmed.ncbi.nlm.nih.gov/32402421/">difficulty being away from them</a>.</p> <p>Research has shown genetic factors play a role but there is no one <a href="https://pubmed.ncbi.nlm.nih.gov/27445875/">single gene that causes hoarding disorder</a>. Instead, a range of psychological, neurobiological, and social factors can be at play.</p> <p>Although some who hoard report being deprived of material things in childhood, emotional deprivation may play a <a href="https://pubmed.ncbi.nlm.nih.gov/20934847/">stronger role</a>.</p> <p>People with hoarding problems often report excessively cold parenting, difficulty connecting with others, and more <a href="https://pubmed.ncbi.nlm.nih.gov/34717158/">traumatic experiences</a>.</p> <p>They may end up believing people are unreliable and untrustworthy, and that it’s better to rely on objects for comfort and safety.</p> <p>People with hoarding disorder are often as attached or perhaps <a href="https://akjournals.com/view/journals/2006/11/3/article-p941.xml">more attached to possessions</a> than to the people in their life.</p> <p>Their experiences have taught them their self-identity is tangled up in what they own; that if they part with their possessions, they will lose themselves.</p> <p>Research shows <a href="https://www.sciencedirect.com/science/article/pii/S0005789421000253?via%3Dihub">interpersonal problems</a>, such as loneliness, are linked to greater <a href="https://pubmed.ncbi.nlm.nih.gov/32853881/">attachment to objects</a>.</p> <p>Hoarding disorder is also associated with high rates of <a href="https://pubmed.ncbi.nlm.nih.gov/34923357/">attention deficit and hyperactivity disorder</a>. Difficulties with <a href="https://pubmed.ncbi.nlm.nih.gov/30907337/">decision-making</a>, planning, <a href="https://akjournals.com/view/journals/2006/12/3/article-p827.xml">attention</a> and categorising can make it hard to organise and <a href="https://pubmed.ncbi.nlm.nih.gov/20542489/">discard possessions</a>.</p> <p>The person ends up avoiding these tasks, which leads to unmanageable levels of clutter.</p> <h2>Not everyone takes the same path to hoarding</h2> <p>Most people with hoarding disorder also have strong beliefs about their possessions. For example, they are more likely to see beauty or usefulness in things and believe objects possess <a href="https://link.springer.com/article/10.1023/A:1025428631552">human-like qualities</a> such as intentions, emotions, or free will.</p> <p>Many also feel responsible for objects and for the environment. While others may not think twice about discarding broken or disposable things, people with hoarding disorder can <a href="https://pubmed.ncbi.nlm.nih.gov/30041077/">anguish over their fate</a>.</p> <p>This need to control, rescue, and protect objects is often at odds with the beliefs of friends and family, which can lead to conflict and <a href="https://pubmed.ncbi.nlm.nih.gov/32853881/">social isolation</a>.</p> <p>Not everyone with hoarding disorder describes the same pathway to overwhelming clutter.</p> <p>Some report more cognitive difficulties while others may have experienced more emotional deprivation. So it’s important to take an individualised approach to treatment.</p> <h2>How can we treat hoarding disorder?</h2> <p>There is specialised cognitive-behavioural therapy (CBT) tailored for hoarding disorder. <a href="https://academic.oup.com/edited-volume/46862/chapter-abstract/413932715?redirectedFrom=fulltext">Different strategies</a> are used to address the different factors contributing to a person’s hoarding.</p> <p>Cognitive-behavioural therapy can also help people understand and gradually challenge their beliefs about possessions.</p> <p>They may begin to consider how to remember, connect, feel safe, or express their identity in ways other via inanimate objects.</p> <p>Treatment can also help people learn the skills needed to organise, plan, and discard.</p> <p>Regardless of their path to hoarding, most people with hoarding disorder will benefit from a degree of exposure therapy.</p> <p>This helps people gradually learn to let go of possessions and resist acquiring more.</p> <p>Exposure to triggering situations (such as visiting shopping centres, op-shops or mounds of clutter without collecting new items) can help people learn to tolerate their urges and distress.</p> <p>Treatment can happen in an individual or group setting, and/or via <a href="https://pubmed.ncbi.nlm.nih.gov/35640322/">telehealth</a>.</p> <p>Research is underway on ways to <a href="https://pubmed.ncbi.nlm.nih.gov/34409679/">improve</a> the <a href="https://www.sciencedirect.com/science/article/pii/S2666915322001421">treatment</a> options further through, for example, learning different emotional regulation strategies.</p> <h2>Sometimes, a harm-avoidance approach is best</h2> <p>Addressing the emotional and behavioural drivers of hoarding through cognitive behavioural therapy is crucial.</p> <p>But hoarding is different to most other psychological disorders. Complex cases may require lots of different agencies to work together.</p> <p>For example, health-care workers may work with fire and housing officers to ensure the person can <a href="https://pubmed.ncbi.nlm.nih.gov/31984612/">live safely at home</a>.</p> <p>When people have severe hoarding problems but are reluctant to engage in treatment, a <a href="https://pubmed.ncbi.nlm.nih.gov/21360706/">harm-avoidance approach</a> may be best. This means working with the person with hoarding disorder to identify the most pressing safety hazards and come up with a practical plan to address them.</p> <p>We must continue to improve our understanding and treatment of this complex disorder and address barriers to accessing help.</p> <p>This will ultimately help reduce the devastating impact of hoarding disorder on individuals, their families, and the community.<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/208102/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/jessica-grisham-37825">Jessica Grisham</a>, Professor in Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/keong-yap-1468967">Keong Yap</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/melissa-norberg-493004">Melissa Norberg</a>, Professor in Psychology, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-people-with-hoarding-disorder-hoard-and-how-can-we-help-208102">original article</a>.</em></p>

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

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

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Princess Beatrice reveals the “most terrifying moment” in her life

<p dir="ltr">Princess Beatrice has shared the “most terrifying moment” that she encountered at work. </p> <p dir="ltr">The 35-year-old royal has been open about her struggles with dyslexia, and has opened up on a podcast about a major challenge she faced at work. </p> <p>"I was anecdotally talking about how difficult it was at work," Beatrice, who works for US-based technology firm Afiniti, told podcast host Kate Griggs. </p> <p>"Sometimes you get handed a whiteboard pen and you've got to do the group think again and collaborate and off you go to the whiteboard."</p> <p dir="ltr">"And I was thinking that's the most terrifying moment for me in my life, and please don't ever make me do it. I'll do a speech tomorrow but don't give me a pen and a whiteboard."</p> <p dir="ltr">Beatrice also shared the difficulties she faced as a child, and having to go through school before being formally diagnosed with dyslexia. </p> <p dir="ltr">"The early days of school really, really stand out as to those moments where you just don't fit in and you can't figure out what it is about you," the royal said candidly.</p> <p dir="ltr">"I remember trying to do extra lessons with teachers and just sort of blankly staring up at her face, and she was like, 'why are you looking at me? The words are not on my face' [and] I said 'well, they're not on the page either'."</p> <p dir="ltr">"So the early days, in and around that understanding that my brain worked slightly differently, I remember them being a real challenge."</p> <p dir="ltr">Princess Beatrice became emotional when talking about the teachers who helped her during her schooling career, saying she "probably wouldn't be the person I am today if they hadn't been there in my life".</p> <p dir="ltr">The princess also paid tribute to her mum, Sarah Ferguson, for championing her to find a new way to do things.</p> <p dir="ltr">"My family and I are incredibly close, so I would say that all throughout our lives, we've been able to go through everything with humour and with joy and my mum really instilled that," Beatrice said.</p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

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Is it normal to forget words while speaking? And when can it spell a problem?

<p><em><a href="https://theconversation.com/profiles/greig-de-zubicaray-1468234">Greig de Zubicaray</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>We’ve all experienced that moment mid-sentence when we just can’t find the word we want to use, even though we’re certain we know it.</p> <p>Why does this universal problem among speakers happen?</p> <p>And when can word-finding difficulties indicate something serious?</p> <p>Everyone will experience an occasional word-finding difficulty, but if they happen very often with a broad range of words, names and numbers, this could be a sign of a neurological disorder.</p> <h2>The steps involved in speaking</h2> <p>Producing spoken words involves several <a href="https://doi.org/10.1093/oxfordhb/9780190672027.013.19">stages of processing</a>.</p> <p>These include:</p> <ol> <li> <p>identifying the intended meaning</p> </li> <li> <p>selecting the right word from the “mental lexicon” (a mental dictionary of the speaker’s vocabulary)</p> </li> <li> <p>retrieving its sound pattern (called its “form”)</p> </li> <li> <p>executing the movements of the speech organs for articulating it.</p> </li> </ol> <p>Word-finding difficulties can potentially arise at each of these stages of processing.</p> <p>When a healthy speaker can’t retrieve a word from their lexicon despite the feeling of knowing it, this is called a “tip-of-the-tongue” phenomenon by language scientists.</p> <p>Often, the frustrated speaker will try to give a bit of information about their intended word’s meaning, “you know, that thing you hit a nail with”, or its spelling, “it starts with an <em>H</em>!”.</p> <p>Tip-of-the-tongue states are relatively common and are a type of speech error that occurs primarily during retrieval of the sound pattern of a word (step three above).</p> <h2>What can affect word finding?</h2> <p>Word-finding difficulties occur at all ages but they do happen more often as we get older. In older adults, they can cause frustration and anxiety about the possibility of developing dementia. But they’re not always a cause for concern.</p> <p>One way researchers investigate word-finding difficulties is to ask people to keep a diary to record how often and in what context they occur. <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01190/full">Diary studies</a> have shown that some word types, such as names of people and places, concrete nouns (things, such as “dog” or “building”) and abstract nouns (concepts, such as “beauty” or “truth”), are more likely to result in tip-of-the-tongue states compared with verbs and adjectives.</p> <p>Less frequently used words are also more likely to result in tip-of-the-tongue states. It’s thought this is because they have weaker connections between their meanings and their sound patterns than more frequently used words.</p> <p>Laboratory studies have also shown tip-of-the-tongue states are more likely to occur under <a href="https://www.tandfonline.com/doi/full/10.1080/13825585.2019.1641177">socially stressful</a> conditions when speakers are told they are being evaluated, regardless of their age. Many people report having experienced tip-of-the-tongue problems during job interviews.</p> <h2>When could it spell more serious issues?</h2> <p>More frequent failures with a broader range of words, names and numbers are likely to indicate more serious issues.</p> <p>When this happens, language scientists use the terms “anomia” or “<a href="https://www.aphasia.com/aphasia-library/aphasia-types/anomic-aphasia/">anomic aphasia</a>” to describe the condition, which can be associated with brain damage due to stroke, tumours, head injury or dementia such as Alzheimer’s disease.</p> <p>Recently, the actor Bruce Willis’s family <a href="https://edition.cnn.com/2023/02/16/health/frontotemporal-dementia-definition-symptoms-wellness/index.html">revealed</a> he has been diagnosed with a degenerative disorder known as primary progressive aphasia, for which one of the earliest symptoms is word-finding difficulties rather than memory loss.</p> <p>Primary progressive aphasia is typically associated with frontotemporal or Alzheimer’s dementias, although it can be associated with other <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637977/">pathologies</a>.</p> <p>Anomic aphasia can arise due to problems occurring at different stages of speech production. An assessment by a clinical neuropsychologist or speech pathologist can help clarify which processing stage is affected and how serious the problem might be.</p> <p>For example, if a person is unable to name a picture of a common object such as a hammer, a clinical neuropsychologist or speech pathologist will ask them to describe what the object is used for (the individual might then say “it’s something you hit things with” or “it’s a tool”).</p> <p>If they can’t, they will be asked to gesture or mime how it’s used. They might also be provided with a cue or prompt, such as the first letter (<em>h</em>) or syllable (<em>ham</em>).</p> <p>Most people with anomic aphasia benefit greatly from being prompted, indicating they are mostly experiencing problems with later stages of retrieving word forms and motor aspects of speech.</p> <p>But if they’re unable to describe or mime the object’s use, and cueing does not help, this is likely to indicate an actual loss of word knowledge or meaning. This is typically a sign of a more serious issue such as primary progressive aphasia.</p> <p><a href="https://en.wikipedia.org/wiki/Neuroimaging">Imaging studies</a> in healthy adults and people with anomic aphasia have shown different areas of the brain are responsible for their word-finding difficulties.</p> <p>In <a href="https://direct.mit.edu/jocn/article-abstract/35/1/111/113588/Neural-Correlates-of-Naturally-Occurring-Speech">healthy adults</a>, occasional failures to name a picture of a common object are linked with changes in activity in brain regions that control motor aspects of speech, suggesting a spontaneous problem with articulation rather than a loss of word knowledge.</p> <p>In anomia due to primary progressive aphasia, brain regions that process word meanings show a loss of nerve cells and connections or <em><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0148707">atrophy</a></em>.</p> <p>Although anomic aphasia is common after strokes to the left hemisphere of the brain, the associated word-finding difficulties do not appear to be distinguishable by <a href="https://www.sciencedirect.com/science/article/pii/S0010945215003299">specific areas</a>.</p> <p>There are <a href="https://www.tandfonline.com/doi/abs/10.1080/02687030244000563">treatments</a> available for anomic aphasia. These will often involve speech pathologists training the individual on naming tasks using different kinds of cues or prompts to help retrieve words. The cues can be various meaningful features of objects and ideas, or sound features of words, or a combination of both. <a href="https://www.sciencedirect.com/science/article/pii/S002199241730014X">Smart tablet</a> and phone apps also show promise when used to complement therapy with home-based practice.</p> <p>The type of cue used for treatment is determined by the nature of the person’s impairment. Successful treatment is associated with changes in activity in <a href="https://www.sciencedirect.com/science/article/pii/S0093934X14000054">brain regions</a> known to support speech production. Unfortunately, there is no effective treatment for primary progressive aphasia, although <a href="https://www.tandfonline.com/doi/full/10.1080/13607863.2019.1617246">some studies</a> have suggested speech therapy can produce temporary benefits.</p> <p>If you’re concerned about your word-finding difficulties or those of a loved one, you can consult your GP for a referral to a clinical neuropsychologist or a speech pathologist. <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/212852/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/greig-de-zubicaray-1468234">Greig de Zubicaray</a>, Professor of Neuropsychology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-normal-to-forget-words-while-speaking-and-when-can-it-spell-a-problem-212852">original article</a>.</em></p>

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What do people think about when they go to sleep?

<p><em><a href="https://theconversation.com/profiles/melinda-jackson-169319">Melinda Jackson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/hailey-meaklim-151642">Hailey Meaklim</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>You’re lying in bed, trying to fall asleep but the racing thoughts won’t stop. Instead, your brain is busy making detailed plans for the next day, replaying embarrassing <a href="https://www.tiktok.com/@ryanhdlombard/video/7052464974324583681?q=sleep%20thoughts&amp;t=1693536926124">moments</a> (“why did I say that?”), or producing seemingly random thoughts (“where is my birth certificate?”).</p> <p>Many social media users have shared <a href="https://www.tiktok.com/@komasawn/video/7267320333613419818">videos</a> on how to fall asleep faster by <a href="https://www.tiktok.com/@lilslvrtt/video/7225272823562997000">conjuring</a> up “<a href="https://www.tiktok.com/@ekai.is.okay/video/7169530076143439131?q=fake%20scenario%20fall%20asleep&amp;t=1693537172625">fake scenarios</a>”, such as a romance storyline where you’re the main character.</p> <p>But what does the research say? Does what we think about before bed influence how we sleep?</p> <h2>How you think in bed affects how you sleep</h2> <p>It turns out people who sleep well and those who sleep poorly have different kinds of thoughts before bed.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S1087079219302217">Good sleepers report</a> experiencing mostly visual sensory images as they drift to sleep – seeing people and objects, and having dream-like experiences.</p> <p>They may have less ordered thoughts and more hallucinatory experiences, such as imagining you’re participating in events in the real world.</p> <p>For people with insomnia, pre-sleep thoughts tend to be less visual and more focused on planning and problem-solving. These thoughts are also generally more unpleasant and less random than those of good sleepers.</p> <p>People with insomnia are also more likely to stress about sleep as they’re <em>trying</em> to sleep, leading to a vicious cycle; putting effort into sleep actually wakes you up more.</p> <p>People with insomnia often <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/014466500163284">report</a> worrying, planning, or thinking about important things at bedtime, or focusing on problems or noises in the environment and having a general preoccupation with not sleeping.</p> <p>Unfortunately, all this pre-sleep mental activity can prevent you drifting off.</p> <p>One <a href="https://academic.oup.com/sleep/article/27/1/69/2707948">study</a> found even people who are normally good sleepers can have sleep problems if they’re stressed about something at bedtime (such as the prospect of having to give a speech when they wake up). Even <a href="https://pubmed.ncbi.nlm.nih.gov/17884278/">moderate levels of stress at bedtime</a> could affect sleep that night.</p> <p>Another <a href="https://jcsm.aasm.org/doi/full/10.5664/jcsm.6704">study</a> of 400 young adults looked at how binge viewing might affect sleep. The researchers found higher levels of binge viewing were associated with poorer sleep quality, more fatigue, and increased insomnia symptoms. “Cognitive arousal”, or mental activation, caused by an interesting narrative and identifying with characters, could play a role.</p> <p>The good news is there are techniques you can use to change the style and content of your pre-sleep thoughts. They could help reduce nighttime cognitive arousal or to replace unwanted thoughts with more pleasant ones. These techniques are called “cognitive refocusing”.</p> <h2>What is cognitive refocusing?</h2> <p>Cognitive refocusing, developed by US psychology researcher <a href="https://artsandsciences.syracuse.edu/people/faculty/gellis-phd-les-a/">Les Gellis</a>, involves distracting yourself with pleasant thoughts before bed. It’s like the “fake scenarios” social media users post about – but the trick is to think of a scenario that’s not <em>too</em> interesting.</p> <p>Decide <em>before</em> you go to bed what you’ll focus on as you lie there waiting for sleep to come.</p> <p>Pick an engaging cognitive task with enough scope and breadth to maintain your interest and attention – without causing emotional or physical arousal. So, nothing too scary, thrilling or stressful.</p> <p>For example, if you like interior decorating, you might imagine redesigning a room in your house.</p> <p>If you’re a football fan, you might mentally replay a passage of play or imagine a game plan.</p> <p>A music fan might mentally recite lyrics from their favourite album. A knitter might imagine knitting a blanket.</p> <p>Whatever you choose, make sure it’s suited to you and your interests. The task needs to feel pleasant, without being overstimulating.</p> <p>Cognitive refocusing is not a silver bullet, but it can help.</p> <p>One <a href="https://doi.org/10.1080/07448481.2022.2109031">study</a> of people with insomnia found those who tried cognitive refocusing had significant improvements in insomnia symptoms compared to a control group.</p> <h2>How ancient wisdom can help us sleep</h2> <p>Another age-old technique is mindfulness meditation.</p> <p>Meditation practice can increase our self-awareness and make us more aware of our thoughts. This can be useful for helping with rumination; often when we try to block or stop thoughts, it can make matters worse.</p> <p>Mindfulness training can help us recognise when we’re getting into a rumination spiral and allow us to sit back, almost like a passive observer.</p> <p>Try just watching the thoughts, without judgement. You might even like to say “hello” to your thoughts and just let them come and go. Allow them to be there and see them for what they are: just thoughts, nothing more.</p> <p><a href="https://doi.org/10.1007/s12671-021-01714-5">Research from our group</a> has shown mindfulness-based therapies can help people with insomnia. It may also help people with <a href="https://doi.org/10.1007/s11920-022-01370-z">psychiatric conditions</a> such as bipolar disorder, obsessive-compulsive disorder and schizophrenia get more sleep.</p> <h2>What can help ease your pre-sleep thoughts?</h2> <p>Good sleep starts the moment you wake up. To give yourself your best shot at a good night’s sleep, start by getting up at the same time each day and getting some morning light exposure (regardless of how much sleep you had the night before).</p> <p>Have a consistent bedtime, reduce technology use in the evening, and do regular exercise during the day.</p> <p>If your mind is busy at bedtime, try cognitive refocusing. Pick a “fake scenario” that will hold your attention but not be too scary or exciting. Rehearse this scenario in your mind at bedtime and enjoy the experience.</p> <p>You might also like to try:</p> <ul> <li> <p>keeping a consistent bedtime routine, so your brain can wind down</p> </li> <li> <p>writing down worries earlier in the day (so you don’t think about them at bedtime)</p> </li> <li> <p>adopting a more self-compassionate mindset (don’t beat yourself up at bedtime over your imagined shortcomings!).<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/207406/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> </li> </ul> <p><a href="https://theconversation.com/profiles/melinda-jackson-169319"><em>Melinda Jackson</em></a><em>, Associate Professor at Turner Institute for Brain and Mental Health, School of Psychological Sciences, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/hailey-meaklim-151642">Hailey Meaklim</a>, Sleep Psychologist and Researcher, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image </em><em>credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-do-people-think-about-when-they-go-to-sleep-207406">original article</a>.</em></p>

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Does running water really trigger the urge to pee? Experts explain the brain-bladder connection

<p><em><a href="https://theconversation.com/profiles/james-overs-1458017">James Overs</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/david-homewood-1458022">David Homewood</a>, <a href="https://theconversation.com/institutions/melbourne-health-950">Melbourne Health</a>; <a href="https://theconversation.com/profiles/helen-elizabeth-oconnell-ao-1458226">Helen Elizabeth O'Connell AO</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/simon-robert-knowles-706104">Simon Robert Knowles</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>We all know that feeling when nature calls – but what’s far less understood is the psychology behind it. Why, for example, do we get the urge to pee just before getting into the shower, or when we’re swimming? What brings on those “nervous wees” right before a date?</p> <p>Research suggests our brain and bladder are in constant communication with each other via a neural network called the <a href="https://www.einj.org/journal/view.php?doi=10.5213/inj.2346036.018">brain-bladder axis</a>.</p> <p>This complex web of circuitry is comprised of sensory neural activity, including the sympathetic and parasympathetic nervous systems. These neural connections allow information to be sent <a href="https://doi.org/10.3390/diagnostics12123119">back and forth</a> between the brain and bladder.</p> <p>The brain-bladder axis not only facilitates the act of peeing, but is also responsible for telling us we need to go in the first place.</p> <h2>How do we know when we need to go?</h2> <p>As the bladder fills with urine and expands, this activates special receptors detecting stretch in the nerve-rich lining of the bladder wall. This information is then relayed to the “periaqueductal gray” – a part of the brain in the brainstem which <a href="https://www.nature.com/articles/nrn2401">constantly monitors</a> the bladder’s filling status.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=454&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=454&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=454&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=570&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=570&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/547931/original/file-20230913-19-2kgkhk.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=570&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">The periaqueductal gray is a section of gray matter located in the midbrain section of the brainstem.</span> <span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Brainstem#/media/File:1311_Brain_Stem.jpg">Wikimedia/OpenStax</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <p>Once the bladder reaches a certain threshold (roughly 250-300ml of urine), another part of the brain called the “pontine micturition centre” is activated and signals that the bladder needs to be emptied. We, in turn, <a href="https://pubmed.ncbi.nlm.nih.gov/16254993/">register this</a> as that all-too-familiar feeling of fullness and pressure down below.</p> <p>Beyond this, however, a range of situations can trigger or exacerbate our need to pee, by increasing the production of urine and/or stimulating reflexes in the bladder.</p> <h2>Peeing in the shower</h2> <p>If you’ve ever felt the need to pee while in the shower (no judgement here) it may be due to the sight and sound of running water.</p> <p>In a 2015 study, <a href="https://doi.org/10.1371/journal.pone.0126798">researchers demonstrated</a> that males with urinary difficulties found it easier to initiate peeing when listening to the sound of running water being played on a smartphone.</p> <p>Symptoms of overactive bladder, including urgency (a sudden need to pee), have also been <a href="https://www.alliedacademies.org/articles/environmental-cues-to-urgency-and-incontinence-episodes-in-chinesepatients-with-overactive-urinary-bladder-syndrome.html">linked to</a> a range of environmental cues involving running water, including washing your hands and taking a shower.</p> <p>This is likely due to both physiology and psychology. Firstly, the sound of running water may have a relaxing <em>physiological</em> effect, increasing activity of the parasympathetic nervous system. This would relax the bladder muscles and prepare the bladder for emptying.</p> <p>At the same time, the sound of running water may also have a conditioned <em>psychological</em> effect. Due to the countless times in our lives where this sound has coincided with the actual act of peeing, it may trigger an instinctive reaction in us to urinate.</p> <p>This would happen in the same way <a href="https://www.simplypsychology.org/pavlov.html">Pavlov’s dog learnt</a>, through repeated pairing, to salivate when a bell was rung.</p> <h2>Cheeky wee in the sea</h2> <p>But it’s not just the sight or sound of running water that makes us want to pee. Immersion in cold water has been shown to cause a “cold shock response”, <a href="https://pubmed.ncbi.nlm.nih.gov/19945970">which activates</a> the sympathetic nervous system.</p> <p>This so-called “fight or flight” response drives up our blood pressure which, in turn, causes our kidneys to filter out more fluid from the bloodstream to stabilise our blood pressure, in a process called “<a href="https://link.springer.com/article/10.1007/BF00864230">immersion diuresis</a>”. When this happens, our bladder fills up faster than normal, triggering the urge to pee.</p> <p>Interestingly, immersion in very warm water (such as a relaxing bath) may also increase urine production. In this case, however, it’s due to activation of the parasympathetic nervous system. <a href="https://doi.org/10.1007/s004210050065">One study</a> demonstrated an increase in water temperature from 40℃ to 50℃ reduced the time it took for participants to start urinating.</p> <p>Similar to the effect of hearing running water, the authors of the study suggest being in warm water is calming for the body and activates the parasympathetic nervous system. This activation can result in the relaxation of the bladder and possibly the pelvic floor muscles, bringing on the urge to pee.</p> <h2>The nervous wee</h2> <p>We know stress and anxiety can cause bouts of nausea and butterflies in the tummy, but what about the bladder? Why do we feel a sudden and frequent urge to urinate at times of heightened stress, such as before a date or job interview?</p> <p>When a person becomes stressed or anxious, the body goes into fight-or-flight mode through the activation of the sympathetic nervous system. This triggers a cascade of physiological changes designed to prepare the body to face a perceived threat.</p> <p>As part of this response, the muscles surrounding the bladder may contract, leading to a more urgent and frequent need to pee. Also, as is the case during immersion diuresis, the increase in blood pressure associated with the stress response may <a href="https://doi.org/10.1172/JCI102496">stimulate</a> the kidneys to produce more urine.</p> <h2>Some final thoughts</h2> <p>We all pee (most of us several times a day). Yet <a href="https://doi.org/10.5489/cuaj.1150">research has shown</a> about 75% of adults know little about how this process actually works – and even less about the brain-bladdder axis and its role in urination.</p> <p><a href="https://www.continence.org.au/about-us/our-work/key-statistics-incontinence#:%7E:text=Urinary%20incontinence%20affects%20up%20to,38%25%20of%20Australian%20women1.">Most Australians</a> will experience urinary difficulties at some point in their lives, so if you ever have concerns about your urinary health, it’s extremely important to consult a healthcare professional.</p> <p>And should you ever find yourself unable to pee, perhaps the sight or sound of running water, a relaxing bath or a nice swim will help with getting that stream to flow.<!-- Below is The Conversation's page counter tag. 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More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/james-overs-1458017"><em>James Overs</em></a><em>, Research Assistant, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/david-homewood-1458022">David Homewood</a>, Urology Research Registrar, Western Health, <a href="https://theconversation.com/institutions/melbourne-health-950">Melbourne Health</a>; <a href="https://theconversation.com/profiles/helen-elizabeth-oconnell-ao-1458226">Helen Elizabeth O'Connell AO</a>, Professor, University of Melbourne, Department of Surgery. President Urological Society Australia and New Zealand, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/simon-robert-knowles-706104">Simon Robert Knowles</a>, Associate Professor and Clinical Psychologist, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-running-water-really-trigger-the-urge-to-pee-experts-explain-the-brain-bladder-connection-210808">original article</a>.</em></p>

Mind

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Probing false memories: what is the Mandela Effect?

<p>How is it possible to think you’re sure about something, only to learn that your memory’s let you down, and you were wrong all along? False memories can be so convincing that we never think to question their veracity. Denise Cullen investigates this odd, and little-understood, phenomenon.</p> <div class="copy"> <p>Imagine learning about a famous person’s death, watching footage of the funeral, and listening to the eulogies – then, decades later, finding out that this person had been alive all along.</p> <p>This was the scenario confronting Fiona Broome in 2009 when she shared her memory online, then subsequently learnt that Nelson Mandela was still alive.</p> <p>Broome, a paranormal researcher, had a distinct memory of the human rights activist and Nobel Peace Prize winner dying in prison in the 1980s.</p> <p>“I thought I remembered it clearly, complete with news clips of his funeral, the mourning in [South Africa], some riots in cities and the heartfelt speech by his widow,” she wrote on her website, in a post since removed.</p> <p>As history records, Mandela died aged 95 – a free man and revered former South African president – in 2013.</p> <p>“Recall is a more active and effortful process than mere recognition.”</p> <p>Broome would have been willing to chalk it up to a glitch in her memory. But after ­discovering that many others shared the same memory, she decided it was instead a glitch in the matrix – a sign consistent with the many-worlds theory of quantum physics that there was a parallel universe in which Mandela had, indeed, died in prison in the 1980s.</p> <p>Since then, many other examples of what’s become known as the Mandela Effect – or shared false memories – have emerged.</p> <p>Common examples include that Rich Uncle Pennybags – aka the Monopoly Man – wears a monocle (he doesn’t), that Pokémon character Pikachu has a black-tipped tail (it’s yellow) and that there’s a hyphen in KitKat (there isn’t).</p> <p>Geographically, some folks swear that there are 51 or 52 states in the United States (there are 50) or that New Zealand is located north-east of Australia (it’s south-east).</p> <p>Cinematic examples include the Evil Queen in <em>Snow White and the Seven Dwarfs</em> saying “Mirror, mirror on the wall” (it’s actually “Magic mirror on the wall”). And who can forget the chilling moment in <em>The Silence of the Lambs</em> when Hannibal Lecter first meets Agent Starling and says, “Hello Clarice”? Thing is, it never happened.</p> <p>Misremembering the finer details related to board game mascots, fictional characters or logos might sound inconsequential. Yet the Mandela Effect has spawned a fertile field of psychological research seeking to uncover why people develop false memories – and why, when they do, they are along much the same lines.</p> <p>Wilma Bainbridge, who works in the Department of Psychology at the University of Chicago, has been interested in the workings of human memory since she and others discovered that people are surprisingly consistent in what they remember, forget and make false memories about.</p> <p>In 2011, Phillip Isola and some of his colleagues at the Massachusetts Institute of Technology (MIT) identified that memorability was a stable property of an image shared across different viewers.</p> <p>Presenting at the annual Conference on Computer Vision and Pattern Recognition (CVPR), they built one of the first computer vision systems that sought to predict the memorability of different images.</p> <p>They also provided some of the first glimmers that low-level visual attributes of an image – such as its bright colours, or distinctive edges – cannot alone account for its memorability. Similarly, aesthetics (visual appeal), interest (how likely people are to be drawn to or interact with an image) or saliency (the area which draws people’s eye focus first) are insufficient to unlock the keys to memorability.</p> <p>"[There is a] tendency for people to con­sistently misremember characters or logos from popular culture – things that were, in fact, designed to be memorable."</p> <p>While completing her PhD at MIT, Bainbridge, Isola and MIT colleague Aude Oliva drew on a 10,168-image database of facial photographs to see if the same intrinsic memorability was found in human faces.</p> <p>Their research, published in the <em>Journal of Experimental Psychology</em>, found that some faces were consistently remembered or forgotten – and that this couldn’t be fully explained by attractiveness or other perceived character traits such as ‘trust­worthy’ or ‘boring’.</p> <p>Bainbridge says it was Isola’s paper in 2011 and hers in 2013 that launched the burgeoning field of memorability. Since then, 845 scientific papers have cited the two papers.</p> <p>Currently on maternity leave after having twin girls, Bainbridge told me via email that she was originally inspired to probe the visual Mandela Effect because of how pervasive discussions were online about people having the same false memories. But no memory research had then investigated this intriguing phenomenon.</p> <p>In a recent article in <em>Psychological Science</em>, Bainbridge and her colleague at The University of Chicago, Deepasri Prasad, explored the visual Mandela Effect for the first time.</p> <p>This is the tendency for people to con­sistently misremember characters or logos from popular culture – things that were, in fact, designed to be memorable.</p> <p>Over a series of experiments – using icons such as the Monopoly Man, Pikachu, Curious George, the Volkswagen logo and Waldo from <em>Where’s Waldo</em> – they provided the first experimental confirmation that the visual Mandela Effect exists. (<em>Where’s Waldo?</em> is known as <em>Where’s Wally?</em> in Australia. The discrepancy isn’t an example of the Mandela Effect. It arose because publishers believed ‘Waldo’ would better ­resonate with North Americans.)</p> <p>In the first experiment, they presented 100 adults with images of 22 characters, 16 brand logos and two symbols, and made two altered images of each.</p> <p>“Even though we’ve all lived different lives, there are some pictures that most people remember and some pictures that most people forget,”</p> <p>For instance, they modified Curious George by adding a thin tail in one image and a bushy tail in the other.</p> <p>Research participants viewed all three images and had to choose the correct one.</p> <p>The results indicated that seven out of the 40 images elicited shared – and specific – false memories.</p> <p>In the second experiment, they used eye-tracking methods to see if there were differences in the way participants looked at the images they correctly identified, versus those they got incorrect.</p> <p>“We found no attentional or visual differences that drive this phenomenon,” Prasad and Bainbridge wrote.</p> <p>In the third experiment, the researchers scraped the top 100 Google Image results for each of the seven images to see if previous exposure to non-canonical (incorrect) versions might explain it. But they concluded that there was “no ­single unifying account for how prior perceptual experiences could cause these visual false memories – which had previously elicited the visual Mandela Effect – to occur”.</p> <p>The fourth experiment involved having participants draw the images, given that recall is a more active and effortful process than mere recognition.</p> <p>Some participants viewed the canonical (correct) images prior to being required to reproduce them, while others, who’d flagged that they were already familiar with the images, did not.</p> <p>One-fifth of all images drawn by the former group, and about half of those drawn by the latter group, showed characteristic Mandela-Effect-type errors. For example, the Monopoly Man frequently appeared with a monocle, while Waldo was often depicted sans cane.</p> <p>The common production of such errors during both short- and long-term recall suggests there’s something intrinsic to these images that leads to people generating the same sorts of fallacies – but Bainbridge says that researchers are only just beginning to probe what that might be.</p> <p>Her laboratory is concerned with broader questions about why some images are intrinsically memorable.</p> <p>“Even though we’ve all lived different lives, there are some pictures that most people remember and some pictures that most people forget,” she explains.</p> <p>Interestingly, when people view an image, high-level visual and memory areas in their brains show a sensitivity to its memorability – regardless of whether they consciously remember seeing it or not.</p> <p>Several functional magnetic resonance imaging (fMRI) studies, including one conducted by Bainbridge and her colleague Jesse Rissman of the University of California Los Angeles and published in <em>Scientific Reports</em>, have demonstrated distinctive brain activation patterns (neural signatures) when memorable images are viewed.</p> <p>These processes take place outside conscious awareness, suggesting they occur automatically.</p> <p>Humans aren’t alone in this, with research led by Nicole Rust at the University of Pennsylvania and published in <em>eLife</em> in 2019 identifying similar patterns in rhesus monkeys who completed visual memory tasks.</p> <p>In a 2022 paper published in <em>Computational Brain &amp; Behavior</em>, Bainbridge and her then University of Chicago master’s student Coen Needell wrote that they had developed a deep learning neural network that can predict people’s memories.</p> <div> <p align="center"> </p> <p>“We’ve recently developed a web tool called ResMem using deep learning artificial intelligence where you can upload an image and it will tell you the per cent chance someone will remember that image,” Bainbridge says. “Anyone can try it out with their own photos.”</p> <p>Recent work shows that the images people remember or forget can even be used to identify early signs of Alzheimer’s disease.</p> <p>Research published by Bainbridge and colleagues in <em>Alzheimer’s &amp; Dementia: Diagnosis, Assessment &amp; Disease Monitoring</em> in 2019 found that a small, specific set of images reliably differentiated people with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) from healthy controls.</p> <p>Using data drawn from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE), an observational, longitudinal memory clinic–based study across 10 sites in Germany, Bainbridge and colleagues analysed the memory performance of 394 individuals.</p> <p>Each participant viewed a randomly selected subset of 88 photographs from a total pool of 835.</p> <p>The performance of 193 healthy controls was compared to 136 participants with SCD – elderly individuals who self-report a decline in cognitive abilities but don’t yet meet clinical thresholds – and 65 participants with MCI: elderly individuals who show early clinical signs of cognitive decline, but are not yet at the level of Alzheimer’s disease.</p> <p>(Bainbridge notes that Alzheimer’s disease is more severe than MCI, which is more severe than SCD; however, it is possible to have MCI or SCD and never end up developing Alzheimer’s disease.)</p> <p>The researchers found that there was a lot of overlap in what the different groups remembered and forgot.</p> <p>However, there was a small subset of images that were highly memorable to healthy controls, but highly forgettable to those with mild cognitive impairment or subjective cognitive decline.</p> <p>A subset of as few as 18.3 images could distinguish between the two groups.</p> <p>In this way, the intrinsic memorability of images might ultimately pave the way towards quicker, easier and more reliable diagnostic tests of precursors to Alzheimer’s disease.</p> <p>The study of false memories also has weighty implications for criminal defence, given that some people might be wrongfully identified as suspects just because their faces cause false memories more easily.</p> <p>Though this research is not the focus of Bainbridge’s laboratory, work in this area is continuing, with the promise of some yet-to-be-published data suggesting that these more diagnostic images also better tap into the underlying brain pathology in those with MCI.</p> <p>“We’re now interested in creating a neural network tool that can predict your chance of making­ a false memory to an image – and then, theoretically, you could make images that cause lots of false memories,” Bainbridge explains. “These next steps are still in very early stages, though, and sadly, we don’t really have anything yet [on what features may prompt false memories],” she says. One goal of the research is to make the neural network tool available to any scientist who wants to study what makes something cause false memories.</p> <p>Bainbridge’s research on memorability has potential applications for further research as well as education, which may be enriched, for example, with textbook images or ­infographics that are more likely to stick in students’ minds. The findings are also likely to enhance clinical practice, given that memory problems are the most common cognitive deficits in dementia.</p> <p>Bainbridge says those experiencing dementia typically benefit as a result of specially designed environments or tools to aid their memory – for example, memorable cues to help them remember to take essential medication.</p> <p>The study of false memories also has weighty implications for criminal defence, given that some people might be wrongfully identified as suspects just because their faces cause false memories more easily.</p> <p>“You’d want to make sure to control for that when choosing a line up,” Bainbridge says.</p> <p>“It’s pretty amazing to think about how our brains can build up vivid memories of images that don’t really exist and that we’ve never seen before.”</p> <p><em>Image credits: Getty Images</em></p> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=250856&amp;title=Probing+false+memories%3A+what+is+the+Mandela+Effect%3F" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/people/behaviour/probing-the-mandela-effect/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/denise-cullen/">Denise Cullen</a>. </em></div> </div>

Mind

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The science of dreams and nightmares – what is going on in our brains while we’re sleeping?

<p><em><a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>Last night you probably slept for <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292">seven to eight hours</a>. About one or two of these was likely in deep sleep, especially if you’re young or physically active. That’s because <a href="http://apsychoserver.psych.arizona.edu/jjbareprints/psyc501a/readings/Carskadon%20Dement%202011.pdf">sleep changes with age</a> and <a href="https://www.hindawi.com/journals/apm/2017/1364387/">exercise</a> affects brain activity. About three or four hours will have been spent in light sleep.</p> <p>For the remaining time, you were likely in rapid eye movement (REM) sleep. While this is not the only time your brain is potentially dreaming – we also dream during other sleep stages – it is the time your brain activity is most likely to be recalled and reported when you’re awake.</p> <p>That’s usually because either really weird thoughts or feelings wake you up or because the last hour of sleep is nearly all <a href="https://www.researchgate.net/profile/Elizaveta-Solomonova/publication/320356182_Dream_Recall_and_Content_in_Different_Stages_of_Sleep_and_Time-of-Night_Effect/links/5a707bdb0f7e9ba2e1cade56/Dream-Recall-and-Content-in-Different-Stages-of-Sleep-and-Time-of-Night-Effect.pdf">REM sleep</a>. When dreams or your alarm wake you, you’re likely coming out of dream sleep and your dream often lingers into the first few minutes of being awake. In this case you remember it.</p> <p>If they’re strange or interesting dreams, you might tell someone else about them, which may further <a href="https://link.springer.com/article/10.1007/s00426-022-01722-7">encode</a> the dream memory.</p> <p>Dreams and nightmares are mysterious and we’re still learning about them. They keep our brains ticking over. They wash the thoughts from the day’s events at a molecular level. They might even help us imagine what’s possible during our waking hours.</p> <h2>What do scientists know about REM sleep and dreaming?</h2> <p>It’s really hard to study dreaming because people are asleep and we can’t observe what’s going on. Brain imaging has indicated certain <a href="https://www.sciencedirect.com/science/article/pii/S1087079216300673#sec3">patterns of brain activity</a> are associated with dreaming (and with certain sleep stages where dreams are more likely to occur). But such studies ultimately rely on self-reports of the dream experience.</p> <p>Anything we spend so much time doing probably serves multiple ends.</p> <p>At the basic physiological level (indicated by <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409">brain activity, sleep behaviour and studies of conciousness</a>), all mammals dream – even the platypus and echidna probably experience something similar to dreaming (provided they are at the <a href="https://www.wired.com/2014/07/the-creature-feature-10-fun-facts-about-the-echidna/#:%7E:text=It%20was%20long%20thought%20that,re%20at%20the%20right%20temperature.">right temperature</a>). Their brain activity and sleep stages align to some degree with human <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409#b0630">REM sleep</a>.</p> <p>Less evolved species do not. Some <a href="https://www.sciencedirect.com/science/article/pii/S2468867319301993#sec0030">jellyfish</a> – who do not have a brain – do experience what could physiologically be characterised as sleep (shown by their posture, quietness, lack of responsiveness and rapid “waking” when prompted). But they do not experience the same physiological and behavioural elements that resemble REM dream sleep.</p> <p>In humans, REM sleep is thought to occur cyclically every 90 to 120 minutes across the night. It prevents us from sleeping too deeply and being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972941/">vulnerable to attack</a>. Some scientists think we dream in order to stop our brains and bodies from getting too cold. Our core body temperature is typically <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00210-1/fulltext">higher while dreaming</a>. It is typically easier to <a href="https://www.tandfonline.com/doi/pdf/10.2147/NSS.S188911">wake from dreaming</a> if we need to respond to external cues or dangers.</p> <p>The brain activity in REM sleep kicks our brain into gear for a bit. It’s like a periscope into a more conscious state, observing what’s going on at the surface, then going back down if all is well.</p> <p>Some evidence suggests “fever dreams” are far less common than we might expect. We actually experience <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00053/full">far less REM sleep</a> when we have a fever – though the dreams we do have tend to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830719/">darker in tone and more unusual</a>.</p> <p>Spending less time in REM sleep when we’re feverish might happen because we are far less capable of regulating our body temperature in this stage of sleep. To protect us, our brain tries to regulate our temperature by “skipping” this sleep stage. We tend to have fewer dreams when the weather is hot <a href="https://www.tandfonline.com/doi/abs/10.1080/23744731.2020.1756664">for the same reason</a>.</p> <h2>A deep-cleaning system for the brain</h2> <p>REM sleep is important for ensuring our brain is working as it should, as indicated by studies using <a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">electoencephalography</a>, which measures brain activity.</p> <p>In the same way deep sleep helps the body restore its physical capacity, dream sleep “<a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">back-flushes</a>” our neural circuits. At the molecular level, the chemicals that underpin our thinking are bent out of shape by the day’s cognitive activity. Deep sleep is when those chemicals are returned to their unused shape. The brain is “<a href="https://www.science.org/doi/abs/10.1126/science.1241224">washed</a>” with cerebrospinal fluid, controlled by the <a href="https://theconversation.com/on-your-back-side-face-down-mice-show-how-we-sleep-may-trigger-or-protect-our-brain-from-diseases-like-als-181954">glymphatic system</a>.</p> <p>At the next level, dream sleep “tidies up” our recent memories and feelings. During <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">REM sleep</a>, our brains consolidate procedural memories (of how to do tasks) and emotions. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">Non-REM sleep</a>, where we typically expect fewer dreams, is important for the consolidation of episodic memories (events from your life).</p> <p>As our night’s sleep progresses, we produce more cortisol - the <a href="https://psycnet.apa.org/record/2005-01907-021">stress hormone</a>. It is thought the amount of cortisol present can impact the type of memories we are consolidating and potentially the types of dreams we have. This means the dreams we have later in the night may be <a href="https://learnmem.cshlp.org/content/11/6/671.full.pdf">more fragmented or bizarre</a>.</p> <p>Both kinds of sleep help <a href="https://www.researchgate.net/profile/Jb-Eichenlaub/publication/313545620_Daily_Life_Experiences_in_Dreams_and_Sleep-Dependent_Memory_Consolidation/links/5c532b0ba6fdccd6b5d76270/Daily-Life-Experiences-in-Dreams-and-Sleep-Dependent-Memory-Consolidation.pdf?ref=nepopularna.org">consolidate</a> the useful brain activity of the day. The brain also discards less important information.</p> <h2>Random thoughts, rearranged feelings</h2> <p>This filing and discarding of the day’s activities is going on while we are sleeping. That’s why we often dream about things that happen <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264574">during the day</a>.</p> <p>Sometimes when we’re rearranging the thoughts and feelings to go in the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921176/">bin</a>” during sleep, our level of consciousness allows us to experience awareness. Random thoughts and feelings end up all jumbled together in weird and wonderful ways. Our awareness of this process may explain the bizarre nature of some of our dreams. Our daytime experiences can also fuel nightmares or anxiety-filled dreams after a <a href="https://www.sleepfoundation.org/dreams/how-trauma-can-affect-dreams">traumatic event</a>.</p> <p>Some dreams appear to <a href="https://rai.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1467-9655.2010.01668.x">foretell the future or carry potent symbolism</a>. In many societies dreams are believed to be a window into an <a href="https://digitalcommons.ciis.edu/cgi/viewcontent.cgi?article=1050&amp;context=ijts-transpersonalstudies">alternate reality</a> where we can envisage what is possible.</p> <h2>What does it all mean?</h2> <p>Our scientific understanding of the thermoregulatory, molecular and basic neural aspects of dreaming sleep is <a href="https://www.nature.com/articles/nrn2716">good</a>. But the psychological and spiritual aspects of dreaming remain largely hidden.</p> <p>Perhaps our brains are wired to try and make sense of things. Human societies have always interpreted the random – birds wheeling, tea leaves and the planets – and looked for <a href="https://brill.com/display/book/edcoll/9789047407966/B9789047407966-s003.xml">meaning</a>. Nearly every human society has regarded dreams as more than just random neural firing.</p> <p>And the history of science tells us some things once thought to be magic can later be understood and harnessed – for better or worse.<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/210901/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/drew-dawson-13517"><em>Drew Dawson</em></a><em>, Director, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-science-of-dreams-and-nightmares-what-is-going-on-in-our-brains-while-were-sleeping-210901">original article</a>.</em></p>

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Why is a messy house such an anxiety trigger for me and what can I do about it?

<p><em><a href="https://theconversation.com/profiles/erika-penney-1416241">Erika Penney</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p>Do you ever feel overwhelmed by the sight of clutter and mess in your home? Have you walked in the door only to feel overloaded by scattered papers, unwashed dishes and clothes in disarray? Maybe you’ve even had arguments because it bothers you more than it bothers you partner or housemates.</p> <p>You’re not alone. Many people report a messy house can trigger feelings of <a href="https://journals.sagepub.com/doi/abs/10.1177/0146167209352864">stress</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0272494421000062?via%3Dihub">anxiety</a>.</p> <p>So why do clutter and chaos make some of us feel so overwhelmed? Here’s what the research says – and what you can do about it.</p> <h2>Cognitive overload</h2> <p>When we’re surrounded by distractions, our brains essentially become <a href="https://pubmed.ncbi.nlm.nih.gov/21228167/">battlegrounds</a> for attention. Everything competes for our focus.</p> <p>But the brain, as it turns out, <a href="https://psycnet.apa.org/record/1994-43838-001">prefers</a> order and “<a href="https://www.frontiersin.org/articles/10.3389/fnhum.2015.00086/full%22%22">singletasking</a>” over multitasking.</p> <p>Order helps reduce the competition for our attention and reduces mental load. While some people might be better than others at <a href="https://www.pnas.org/doi/full/10.1073/pnas.1523471113">ignoring distractions</a>, distractable environments can overload our cognitive capabilities and memory.</p> <p>Clutter, disorder and mess can affect more than just our cognitive resources. They’re also linked to our <a href="https://pubmed.ncbi.nlm.nih.gov/23907542/">eating</a>, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0360132318307157?via=ihub">productivity</a>, mental health, <a href="https://www.tandfonline.com/doi/abs/10.1207/s15374424jccp3401_9">parenting</a> decisions and even our willingness to donate <a href="https://pubmed.ncbi.nlm.nih.gov/23907542/">money</a>.</p> <h2>Are women more affected than men?</h2> <p>Research suggests the detrimental effects of mess and clutter may be more pronounced in women than in men.</p> <p>One <a href="https://journals.sagepub.com/doi/10.1177/0146167209352864">study</a> of 60 dual-income couples found women living in cluttered and stressful homes had higher levels of cortisol (a <a href="https://pubmed.ncbi.nlm.nih.gov/19596045/#:%7E:text=After%2520controlling%2520for%2520the%2520individual,and%2520poor%2520self-rated%2520health.">hormone</a> associated with stress) and heightened depression symptoms.</p> <p>These effects remained consistent even when factors like marital satisfaction and personality traits were taken into account. In contrast, the men in this study seemed largely unaffected by the state of their home environments.</p> <p>The researchers theorised that women may feel a greater responsibility for maintaining the home. They also suggested the social aspect of the study (which involved giving home tours) may have induced more fear of judgement among women than men.</p> <p>We will all live with clutter and disorganisation to some degree in our lives. Sometimes, however, significant clutter problems can be linked to underlying mental health conditions such as <a href="https://beyondocd.org/information-for-individuals/symptoms/ocd-related-hoarding#:%7E:text=Examples%20of%20hoarding%20in%20the,are%20not%20needed%20any%20more">obsessive-compulsive disorder</a>, <a href="https://beyondocd.org/information-for-individuals/symptoms/ocd-related-hoarding#:%7E:text=Examples%20of%20hoarding%20in%20the,are%20not%20needed%20any%20more">hoarding disorder</a>, <a href="https://psychcentral.com/depression/messy-room-depression#does-it-exacerbate-symptoms">major depressive disorder</a>, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0005796704000531">attention deficit hyperactivity disorder</a>, and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0887618510001647">anxiety disorders</a>.</p> <p>This raises a crucial question: which came first? For some, clutter is the source of anxiety and distress; for others, poor mental health is the source of disorganisation and clutter.</p> <h2>Not all mess is a problem</h2> <p>It’s important to remember clutter isn’t all bad, and we shouldn’t aim for perfection. Real homes don’t look like the ones in magazines.</p> <p>In fact, disorganised spaces can result in increased <a href="https://pubmed.ncbi.nlm.nih.gov/23907542/">creativity</a> and elicit fresh insights.</p> <p>Living in constant disorder isn’t productive, but striving for perfectionism in cleanliness can also be counterproductive. Perfectionism itself is associated with feeling overwhelmed, anxiety and <a href="https://pubmed.ncbi.nlm.nih.gov/28026869/">poor mental health</a>.</p> <h2>Mess makes me anxious so what can I do about it?</h2> <p>It’s important to remember you have some agency over what matters to you and how you want to prioritise your time.</p> <p>One approach is to try to reduce the clutter. You might, for example, have a dedicated de-cluttering session every week. This may involve hiring a cleaner (if you can afford it) or playing some music or a podcast while tidying up for an hour with your other household members.</p> <p>Establishing this routine can reduce clutter distractions, ease your overall mental load and alleviate worry that clutter will spiral out of control.</p> <p>You can also try micro-tidying. If don’t have time for a complete cleanup, commit just five minutes to clearing one small space.</p> <p>If the clutter is primarily caused by other household members, try to calmly discuss with them how this mess is affecting your mental health. See if your kids, your partner or housemates can negotiate some boundaries as a household over what level of mess is acceptable and how it will be handled if that threshold is exceeded.</p> <p>It can also help to develop a self-compassionate mindset.</p> <p>Mess doesn’t define whether you are a “good” or “bad” person and, at times, it may even stimulate your <a href="https://pubmed.ncbi.nlm.nih.gov/23907542/">creativity</a>. Remind yourself that you deserve success, meaningful relationships and happiness, whether or not your office, home or car is a mess.</p> <p>Take comfort in <a href="https://journals.sagepub.com/doi/abs/10.1177/0013916516628178">research</a> suggesting that while disorganised environments can make us susceptible to stress and poor decision-making, your mindset can buffer you against these vulnerabilities.</p> <p>If clutter, perfectionism or anxiety has begun to seem unmanageable, talk with your GP about a referral to a <a href="https://psychology.org.au/psychology/about-psychology/what-is-psychology">psychologist</a>. The right psychologist (and you may need to try a few before you find the right one) can help you cultivate a life driven by values that are important to you.</p> <p>Clutter and mess are more than just visual nuisances. They can have a profound impact on mental wellbeing, productivity and our choices.</p> <p>Understanding why clutter affects you can empower you to take control of your mindset, your living spaces and, in turn, your life.<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/211684/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/erika-penney-1416241">Erika Penney</a>, Lecturer in Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-a-messy-house-such-an-anxiety-trigger-for-me-and-what-can-i-do-about-it-211684">original article</a>.</em></p>

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Simon Cowell opens up on secret health battle

<p>Renowned television personality and judge of <em>Britain's Got Talent</em>, Simon Cowell, has unveiled his personal journey battling mental health issues and his choice to finally seek treatment.</p> <p>Acknowledged for his acerbic demeanour, Simon Cowell has come forth to disclose a hidden confrontation with his mental well-being.</p> <p>The famous talent show judge conceded that he has grappled with depression throughout the years, though he once regarded it as an inherent aspect of his character – a challenge to be managed privately.</p> <p>While not professing medical expertise, Cowell, 63, shared during his conversation on the "Men In Mind" podcast with Tom Bryant that he has progressively come to realise his situation and embarked on self-directed endeavours to improve his mental health.</p> <p>The pandemic, as Cowell described, acted as a significant amplifier of his mental struggles. The outbreak of COVID-19, he revealed, served as a true catalyst for his introspection.</p> <p>"In the very, very, very early stages, some friends of mine got really ill and I'm talking about really ill," he said on the podcast. "So, I thought, 'God, if I catch this, maybe the same thing's going to happen to me, Eric and Lauren."</p> <p>Lauren, Cowell's partner of 14 years, and their son Eric, aged nine, joined him in navigating the lockdown, predominantly stationed in Los Angeles, USA. They conscientiously adhered to isolation measures and subjected themselves to regular testing.</p> <p>Cowell's apprehensions over his mental well-being were further compounded by the uncertainties surrounding the continuation of <em>Britain's Got Talent</em>. The lingering indecision about resuming filming for the show added an extra layer of strain to his internal battles.</p> <p>“When I see my friends, the first thing I talk about is how therapy has had this super positive effect on my life,” he now says. “I wish I had done this 10 or 20 years ago...it’s like a weight has lifted off my shoulders.” </p> <p><em>Images: Simon Cowell / Instagram</em></p>

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Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

<p><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>There are thousands of mental health apps available on the app market, offering services including meditation, mood tracking and counselling, among others. You would think such “health” and “wellbeing” apps – which often present as solutions for conditions such as <a href="https://www.headspace.com/">anxiety</a> and <a href="https://www.calm.com">sleeplessness</a> – would have been rigorously tested and verified. But this isn’t necessarily the case.</p> <p>In fact, many may be taking your money and data in return for a service that does nothing for your mental health – at least, not in a way that’s backed by scientific evidence.</p> <h2>Bringing AI to mental health apps</h2> <p>Although some mental health apps connect users with a <a href="https://www.betterhelp.com/get-started/?go=true&amp;utm_source=AdWords&amp;utm_medium=Search_PPC_c&amp;utm_term=betterhelp+australia_e&amp;utm_content=133525856790&amp;network=g&amp;placement=&amp;target=&amp;matchtype=e&amp;utm_campaign=15228709182&amp;ad_type=text&amp;adposition=&amp;kwd_id=kwd-401317619253&amp;gclid=Cj0KCQjwoeemBhCfARIsADR2QCtfZHNw8mqpBe7cLfLtZBD-JZ5xvAmDCfol8npbAAH3ALJGYvpngtoaAtFlEALw_wcB¬_found=1&amp;gor=start">registered therapist</a>, most provide a fully automated service that bypasses the human element. This means they’re not subject to the same standards of care and confidentiality as a registered mental health professional. Some aren’t even designed by mental health professionals.</p> <p>These apps also increasingly claim to be incorporating artificial intelligence into their design to make personalised recommendations (such as for meditation or mindfulness) to users. However, they give little detail about this process. It’s possible the recommendations are based on a user’s previous activities, similar to Netflix’s <a href="https://help.netflix.com/en/node/100639">recommendation algorithm</a>.</p> <p>Some apps such as <a href="https://legal.wysa.io/privacy-policy#aiChatbot">Wysa</a>, <a href="https://www.youper.ai/">Youper</a> and <a href="https://woebothealth.com/">Woebot</a> use AI-driven chatbots to deliver support, or even established therapeutic interventions such as cognitive behavioural therapy. But these apps usually don’t reveal what kinds of algorithms they use.</p> <p>It’s likely most of these AI chatbots use <a href="https://www.techtarget.com/searchenterpriseai/feature/How-to-choose-between-a-rules-based-vs-machine-learning-system">rules-based systems</a> that respond to users in accordance with predetermined rules (rather than learning on the go as adaptive models do). These rules would ideally prevent the unexpected (and often <a href="https://www.vice.com/en/article/pkadgm/man-dies-by-suicide-after-talking-with-ai-chatbot-widow-says">harmful and inappropriate</a>) outputs AI chatbots have become known for – but there’s no guarantee.</p> <p>The use of AI in this context comes with risks of biased, discriminatory or completely inapplicable information being provided to users. And these risks haven’t been adequately investigated.</p> <h2>Misleading marketing and a lack of supporting evidence</h2> <p>Mental health apps might be able to provide certain benefits to users <em>if</em> they are well designed and properly vetted and deployed. But even then they can’t be considered a substitute for professional therapy targeted towards conditions such as anxiety or depression.</p> <p>The <a href="https://theconversation.com/pixels-are-not-people-mental-health-apps-are-increasingly-popular-but-human-connection-is-still-key-192247">clinical value</a> of automated mental health and mindfulness apps is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1077722918300233?casa_token=lwm1E6FhcG0AAAAA:saV7szbZl4DqbvmZiomLG9yMWi_4-zbmy3QCtQzVEQr957QX1E7Aiqkm5BcEntR0mVFgfDVo">still being assessed</a>. Evidence of their efficacy is generally <a href="https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000002">lacking</a>.</p> <p>Some apps make ambitious claims regarding their effectiveness and refer to studies that supposedly support their benefits. In many cases these claims are based on less-than-robust findings. For instance, they may be based on:</p> <ul> <li><a href="https://sensa.health/">user testimonials</a></li> <li>short-term studies with narrow <a href="https://www.wired.co.uk/article/mental-health-chatbots">or homogeneous cohorts</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533203/">studies involving</a> researchers or funding from the very group <a href="https://www.theguardian.com/us-news/2022/apr/13/chatbots-robot-therapists-youth-mental-health-crisis">promoting the app</a></li> <li>or evidence of the benefits of a <a href="https://www.headspace.com/meditation/anxiety">practice delivered face to face</a> (rather than via an app).</li> </ul> <p>Moreover, any claims about reducing symptoms of poor mental health aren’t carried through in contract terms. The fine print will typically state the app does not claim to provide any physical, therapeutic or medical benefit (along with a host of other disclaimers). In other words, it isn’t obliged to successfully provide the service it promotes.</p> <p>For some users, mental health apps may even cause harm, and lead to increases in the very <a href="https://pubmed.ncbi.nlm.nih.gov/34074221/">symptoms</a> people so often use them to address. The may happen, in part, as a result of creating more awareness of problems, without providing the tools needed to address them.</p> <p>In the case of most mental health apps, research on their effectiveness won’t have considered <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505389/">individual differences</a> such as socioeconomic status, age and other factors that can influence engagement. Most apps also will not indicate whether they’re an inclusive space for marginalised people, such as those from culturally and linguistically diverse, LGBTQ+ or neurodiverse communities.</p> <h2>Inadequate privacy protections</h2> <p>Mental health apps are subject to standard consumer protection and privacy laws. While data protection and <a href="https://cybersecuritycrc.org.au/sites/default/files/2021-07/2915_cscrc_casestudies_mentalhealthapps_1.pdf">cybersecurity</a> practices vary between apps, an investigation by research foundation Mozilla <a href="https://foundation.mozilla.org/en/privacynotincluded/articles/are-mental-health-apps-better-or-worse-at-privacy-in-2023">concluded that</a> most rank poorly.</p> <p>For example, the mindfulness app <a href="https://www.headspace.com/privacy-policy">Headspace</a> collects data about users from a <a href="https://foundation.mozilla.org/en/privacynotincluded/headspace/">range of sources</a>, and uses those data to advertise to users. Chatbot-based apps also commonly repurpose conversations to predict <a href="https://legal.wysa.io/privacy-policy">users’ moods</a>, and use anonymised user data to train the language models <a href="https://www.youper.ai/policy/privacy-policy">underpinning the bots</a>.</p> <p>Many apps share so-called <a href="https://theconversation.com/popular-fertility-apps-are-engaging-in-widespread-misuse-of-data-including-on-sex-periods-and-pregnancy-202127">anonymised</a> data with <a href="https://www.wysa.com/">third parties</a>, such as <a href="https://www.headspace.com/privacy-policy">employers</a>, that sponsor their use. Re-identification of <a href="https://www.unimelb.edu.au/newsroom/news/2017/december/research-reveals-de-identified-patient-data-can-be-re-identified">these data</a> can be relatively easy in some cases.</p> <p>Australia’s Therapeutic Goods Administration (TGA) doesn’t require most mental health and wellbeing apps to go through the same testing and monitoring as other medical products. In most cases, they are lightly regulated as <a href="https://www.tga.gov.au/how-we-regulate/manufacturing/medical-devices/manufacturer-guidance-specific-types-medical-devices/regulation-software-based-medical-devices">health and lifestyle</a> products or tools for <a href="https://www.tga.gov.au/sites/default/files/digital-mental-health-software-based-medical-devices.pdf">managing mental health</a> that are excluded from TGA regulations (provided they meet certain criteria).</p> <h2>How can you choose an app?</h2> <p>Although consumers can access third-party rankings for various mental health apps, these often focus on just a few elements, such as <a href="https://onemindpsyberguide.org/apps/">usability</a> or <a href="https://foundation.mozilla.org/en/privacynotincluded/categories/mental-health-apps/">privacy</a>. Different guides may also be inconsistent with each other.</p> <p>Nonetheless, there are some steps you can take to figure out whether a particular mental health or mindfulness app might be useful for you.</p> <ol> <li> <p>consult your doctor, as they may have a better understanding of the efficacy of particular apps and/or how they might benefit you as an individual</p> </li> <li> <p>check whether a mental health professional or trusted institution was involved in developing the app</p> </li> <li> <p>check if the app has been rated by a third party, and compare different ratings</p> </li> <li> <p>make use of free trials, but be careful of them shifting to paid subscriptions, and be wary about trials that require payment information upfront</p> </li> <li> <p>stop using the app if you experience any adverse effects.</p> </li> </ol> <p>Overall, and most importantly, remember that an app is never a substitute for real help from a human professional.<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/211513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, Associate Professor, School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, Postdoctoral Research Fellow, Disability Research Initiative, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mental-health-apps-are-helpful-experts-explain-the-risks-and-how-to-choose-one-wisely-211513">original article</a>.</em></p>

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"Miracles do exist": Astonishing return of missing teen after four years

<p>An American teenager has been found after she went missing four years ago, when she walked into a police station and asked to be taken off the missing children list. </p> <p>Alicia Navarro, who is now 18, walked into a police station in a small town in Montana, close to the Canadian border, and identified herself as the teenager who was reported missing in September 2019. </p> <p>“Alicia Navarro has been located,” Glendale public safety communications manager Jose Santiago said during a press conference.</p> <p>“She is by all accounts, safe, she is by all accounts healthy and she is by all accounts happy.”</p> <p>The teenager reportedly left her home willingly four years ago when she was 14-years-old, leaving her parents a note when she disappeared from her house overnight on September 15th 2019. </p> <p>Alicia, who has been described as a high-functioning autistic person, left a handwritten note for her parents that read, “I ran away. I will be back. I swear. I’m sorry,” before she slipped out of the house while they slept. </p> <p>Her parents then didn't hear from her for four years, until they were contacted by the Glendale Police Department to let them know their child had been found. </p> <p>Alicia had an emotional reunion with her mum, who never stopped looking for her, as she was very apologetic over the pain her mother went through not knowing where she was for the past four years or even if she was still alive. </p> <p>Her mom, Jessica Nuñez, called the discovery of her daughter four years after her disappearance a miracle in a video she posted to Facebook.</p> <p>“For everyone who has missing loved ones, I want you to use this case as an example,” she said. “Miracles do exist. Never lose hope and always fight.”</p> <p>Nuñez said she doesn’t have details on her daughter’s disappearance but said “the important thing is that she is alive.”</p> <p>Glendale police are now investigating how the teenager got to Montana, and how she has survived over the last four years by herself. </p> <p>Alicia told police that no one has harmed her and appeared to be healthy, while the girl currently remains in Montana and is able to come and go as she pleases and has asked for privacy so she can move on with her life. </p> <p>“We can only imagine what she’s going through, mentally, emotionally, as well as her family, and as much as we’d like to say this is the end, this is probably only the beginning of where this investigation will go,” Glendale PD Lt. Scott Waite said.</p> <p><em>Image credits: Fox 10</em></p>

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More than a game: Crosswords and puzzles may reduce dementia risk

<p>Playing games, doing crosswords, writing letters or learning something new are all associated with reduced dementia risk in older adults, according to a large, long-term study.</p> <p>A team of Melbourne and US-based researchers study tracked 10,318 older Australians over a period of ten years (2010 to 2020), collecting detailed information on the types of leisure activities they engaged in, along with regular health checks and cognitive assessments.</p> <p>The study is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256" target="_blank" rel="noreferrer noopener">published</a> in <em>JAMA Network Open.</em></p> <p>Paper co-author Dr Joanne Ryan from Monash University says “the findings show that engaging in mentally stimulating activities can help preserve cognitive function and may help delay the onset of dementia.”</p> <p>“We know the importance of physical activity. We need to think about helping to keep our mind stimulated as well.”</p> <p><iframe title="Why do Women Live Longer than Men? And What About Gender Diverse People?" src="https://omny.fm/shows/huh-science-explained/why-do-women-live-longer-than-men-and-what-about-g/embed?in_playlist=podcast&amp;style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>Adult literacy activities such as writing, using a computer or taking education classes were associated with an 11% lower risk of dementia, the study found. </p> <p>Active mental health activities such as playing games or doing puzzles were associated with a 9% lower risk.</p> <p>Creative activities like craft or woodwork and passive mental activities (reading books, watching television or listening to the radio) also reduced risks but to a lesser extent.</p> <p>Meanwhile, social activities were not associated with dementia risk. Ryan says this was a “little bit unexpected”. But she says it’s possible one of the reasons is those who volunteered to participate in the study were broadly already socially engaged. </p> <p>The median age of those participating in the study was 73.8 years. Around 2% of the cohort participating in the study developed dementia, Ryan says. </p> <p>Dementia risk varies depending on age and health status of individuals, she says.</p> <p>For instance, “we know that the risk of dementia actually increases exponentially as you get then over 80 years and over 90 years,” she says.</p> <p><em>Image credits: Getty Images </em></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/more-than-a-game-crosswords-and-puzzles-may-reduce-dementia-risk/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>. </em></p> </div>

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Promising Alzheimer’s drug offers hope for a bright future in treatment

<p>A remarkable and significant breakthrough in the fight against Alzheimer’s disease is ushering in a new era of hope and possibilities for patients grappling with early onset dementia.</p> <p>Scientists and researchers are celebrating this groundbreaking development, viewing it as a tremendous opportunity to transform the landscape of Alzheimer's treatment.</p> <p>The drug in question, donanemab, developed by Eli Lilly, has shown remarkable success in clinical trials and is anticipated to receive approval from the Food and Drug Administration later this year, according to a report in the <a href="https://nypost.com/2023/07/17/alzheimers-drug-donanemab-lowers-risk-of-dementia/" target="_blank" rel="noopener"><em>New York Post</em></a>.</p> <p>Individuals who participated in the donanemab trials experienced a remarkable 40% reduction in the risk of transitioning from mild cognitive impairment to mild or moderate dementia. This is an extraordinary advancement that brings renewed optimism to those affected by this devastating condition.</p> <p>Donanemab would be the third Alzheimer’s drug to emerge in recent months, following the introduction of Leqembi and Aduhelm. This is just the beginning of an exciting new chapter in the realm of molecular therapies for Alzheimer's, as expressed by Dr. Gil Rabinovici, director of the University of California San Francisco’s Memory and Ageing Centre, in an editorial for <em>JAMA</em>.</p> <p>Dr. Daniel Skovronsky, the chief scientific and medical officer at Lilly, has emphasised the significance of this breakthrough. He states, "This will be a very important and meaningful drug," as quoted in <em>Fierce Biotech</em>. Skovronsky further adds, "[T]here’s a huge opportunity here for patients." Such resolute optimism is inspiring, reflecting the tremendous potential this drug holds for transforming lives.</p> <p>Similar to Leqembi and Aduhelm, donanemab is a monoclonal antibody designed to target plaque in the brain, specifically the amyloid protein. These amyloid plaques are responsible for the propagation of another protein called tau, which contributes to the development of Alzheimer's disease.</p> <p>Notably, the donanemab trial also revealed that the drug slowed cognitive decline by an impressive 35% compared to a placebo in individuals with low to intermediate levels of tau protein in the brain. In fact, donanemab demonstrated superior efficacy in clearing amyloid plaques when compared to Aduhelm and Leqembi.</p> <p>Moreover, unlike Leqembi, which necessitates long-term usage, patients taking donanemab may follow a fixed-duration dosing schedule, potentially allowing some individuals to discontinue the treatment after a certain period. "I expect that many patients will be able to stop dosing even as soon as 12 months," Skovronsky affirmed. This stands as a significant departure from being prescribed a lifelong medication, providing an exciting and meaningful prospect for patients.</p> <p>While it is important to note that these new Alzheimer’s drugs do carry limitations and risks, medical experts remain cautiously optimistic. Donanemab, along with the other emerging drugs, has been associated with brain swelling and bleeding. Tragically, three individuals in the donanemab clinical trial lost their lives due to these side effects.</p> <p>The risk of brain swelling and bleeding is heightened among those carrying the APOE4 gene, which is associated with an increased susceptibility to Alzheimer’s. Furthermore, individuals with more advanced stages of the disease showed minimal to no benefit compared to those who received a placebo.</p> <p>As a result, it is possible that donanemab will be recommended primarily for individuals with low to intermediate levels of tau proteins, indicating milder forms of the disease.</p> <p>Nevertheless, Skovronsky and other medical experts maintain their optimism regarding the FDA's approval, expressing the urgent need for it to come to fruition. Skovronsky highlights, "Every day that goes by, there are some patients who pass through this early stage of Alzheimer’s disease and become more advanced, and they won’t benefit from treatment. That’s a very pressing sense of urgency."</p> <p>While challenges and risks remain, the emergence of donanemab and its potential approval by the FDA represents a beacon of hope for the millions of individuals and families affected by Alzheimer's disease. It symbolises the start of a new chapter in the fight against this debilitating condition, offering renewed prospects for a brighter future filled with effective treatments and improved quality of life.</p> <p><em>Image: Shutterstock</em></p>

Mind

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

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

Mind

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How do I stop my mind racing and get some sleep?

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Martin turns off the light to fall asleep, but his mind quickly springs into action. Racing thoughts about work deadlines, his overdue car service, and his father’s recent surgery occupy his mind.</p> <p>As he struggles to fall asleep, the hours start to creep by. He becomes frustrated about how he will cope tomorrow. This is a pattern Martin has struggled with for many years.</p> <p>But what’s going on when your mind is racing at night? And how do you make it stop?</p> <h2>It can happen to anyone</h2> <p>In bed, with no other visual or sound cues to occupy the mind, many people start to have racing thoughts that keep them awake. This can happen at the start of the night, or when they awake in the night.</p> <p>The good news is there are effective ways to reduce these racing thoughts, and to help get some sleep. To do this, let’s take a step back and talk about insomnia.</p> <h2>What is insomnia?</h2> <p>If you are like Martin, you’re not alone. Right now, up to six in every ten people have regular <a href="https://www.sleepprimarycareresources.org.au/insomnia/epidemiology">insomnia symptoms</a>. One in ten have had these symptoms for months or years.</p> <p>Insomnia includes trouble falling asleep at the start of the night, waking up during the night, and feelings of daytime fatigue, concentration difficulties, lethargy or poor mood.</p> <p>Just like Martin, many people with insomnia find as soon as they get into bed, they feel alert and wide awake. So what’s going on?</p> <p>The more time we spend in bed doing things other than sleep, the more our brain and body start to learn that bed is a place for these non-sleep activities.</p> <p>These activities don’t just include worrying. They can be using a mobile phone, watching TV, eating, working, arguing, smoking or playing with pets.</p> <p>Gradually, our brains can learn that bed is a place for these other activities instead of rest and sleep. Over time the simple act of getting into bed can become a trigger to feel more alert and awake. This is called “<a href="https://www.med.upenn.edu/cbti/assets/user-content/documents/ppsmmodelsofinsomnia20115theditionproof.pdf">conditioned insomnia</a>”.</p> <p>Here are six ways to spend less time awake in bed with racing thoughts.</p> <h2>1. Re-learn to associate bed with sleep</h2> <p><a href="https://www.sleepprimarycareresources.org.au/insomnia/bbti/insomnia-stimulus-control-therapy">Stimulus control therapy</a> can <a href="https://www.med.upenn.edu/cbti/assets/user-content/documents/Bootzin%201972.pdf">help</a> re-build the relationship between bed and sleep.</p> <p>Follow these simple steps every night of the week:</p> <ul> <li> <p>only use your bed for sleep and intimacy. All other activities should occur out of bed, preferably in another room</p> </li> <li> <p>only go to bed if you are feeling sleepy (when your eyes are heavy and you could easily fall asleep). If you are not feeling sleepy, delay getting into bed. Use this time to do something relaxing in another room</p> </li> <li> <p>if you are still awake after about 15 minutes in bed, get out of bed and go to another room. Do something else relaxing until you are feeling sleepy again, such as reading a book, listening to the radio, catching up on some chores or doing a crossword puzzle. Avoid anything too stimulating such as work or computer gaming</p> </li> <li> <p>repeat the above two steps until you are asleep within about 15 minutes. This can take several cycles of getting in and out of bed. But during this time, you body’s natural need for sleep will increase, and you will eventually fall asleep within 15 minutes of getting into bed</p> </li> <li> <p>get out of bed at the same time each morning, no matter how much you slept the night before</p> </li> <li> <p>avoid long daytime naps, which can make it harder to fall asleep that night.</p> </li> </ul> <p>Over several nights, this therapy builds the relationship between bed and sleep, and reduces the relationship between bed and feeling alert and having racing thoughts.</p> <h2>2. Distract yourself with fond thoughts</h2> <p>Negative thoughts in bed or worrying about the consequences of losing sleep can make us feel more alert, worried, and make it more difficult to sleep.</p> <p>So try something called “<a href="https://doi.org/10.1016/j.beth.2012.07.004">cognitive re-focusing</a>”. Try to replay a fond memory, movie, or TV show in your mind, to distract yourself from these negative thoughts.</p> <p>Ideally, this will be a memory you can recall very clearly, and one that causes neutral or slightly positive feelings. Memories that are overly positive or negative might cause an increase in alertness and mental activity.</p> <h2>3. Relax into sleep</h2> <p><a href="https://www.sleepprimarycareresources.org.au/insomnia/bbti/insomnia-relaxation-techniques">Relaxation therapy</a> for insomnia aims to <a href="https://www.sciencedirect.com/science/article/abs/pii/B9780123815224000043">reduce alertness</a> and improve sleep.</p> <p>One way is to progressively tense and relax muscle groups throughout your body, known as <a href="https://youtu.be/pyxvL1O2duk">guided progressive muscle relaxation therapy</a>.</p> <p>You could also try breathing exercises, soothing music, visual imagery or other <a href="https://www.sleephealthfoundation.org.au/cognitive-behavioural-therapy-for-insomnia-cbt-i.html">relaxation exercises</a> that feel right for you.</p> <p>Part of relaxing into sleep is avoiding doing work in the late evening or screen-based activities right before bed. Give yourself a “buffer zone”, to allow yourself time to start relaxing before getting into bed.</p> <h2>4. Worry earlier in the day</h2> <p>Schedule some “<a href="https://www.psychologytoday.com/au/blog/what-mentally-strong-people-dont-do/201811/simple-effective-trick-stop-worrying-so-much">worry time</a>” earlier in the day, so these thoughts don’t happen at night. It can also help to write down some of the things that worry you.</p> <p>If you start to worry about things during the night, you can remind yourself you have already written them down, and they are waiting for you to work through during your scheduled “worry time” the next day.</p> <h2>5. Know waking in the night is normal</h2> <p>Knowing that brief awakenings from sleep are completely normal, and not a sign of ill health, may help.</p> <p>Sleep occurs in different “cycles” during the night. Each cycle lasts for about 90 minutes, and includes different stages of light, deep, and dreaming (REM) sleep.</p> <p>Most of our deep sleep occurs in the first half of the night, and most of our light sleep in the second half.</p> <p>Everyone experiences brief awakenings from sleep, but most people don’t remember these the next morning.</p> <h2>6. What if these don’t work?</h2> <p>If these don’t work, the most effective next step is “cognitive behavioural therapy for insomnia” or CBT-i.</p> <p>This non-drug therapy targets the underlying causes of insomnia, and leads to <a href="https://doi.org/10.1016/j.smrv.2019.08.002">long-lasting improvements</a> in sleep, mental health and daytime function.</p> <p>You can do a self-guided online program, or access it via your GP or a psychologist. More details, including links to online programs, are available via the <a href="https://www.sleephealthfoundation.org.au/cognitive-behavioural-therapy-for-insomnia-cbt-i.html">Sleep Health Foundation</a>.</p> <p>We are providing free access to online CBT-i through a research study. To find out more, <a href="https://www.flinders.edu.au/people/alexander.sweetman">contact me</a>.</p> <hr /> <p><em>The Sleep Health Foundation has several <a href="https://www.sleephealthfoundation.org.au/fact-sheets.html">evidence-based resources</a> about sleep health and insomnia.<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/207904/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></em></p> <p><em><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></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">original article</a>.</em></p>

Mind