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Do you have a mental illness? Why some people answer ‘yes’, even if they haven’t been diagnosed

<p><em><a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nick-haslam-10182">Nick Haslam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>Mental illnesses such as depression and anxiety disorders have become more prevalent, especially among <a href="https://www.aihw.gov.au/mental-health/overview/prevalence-and-impact-of-mental-illness#changeovertime">young people</a>. Demand for treatment is surging and prescriptions of some <a href="https://pubmed.ncbi.nlm.nih.gov/35176912/">psychiatric medications</a> have climbed.</p> <p>These upswinging prevalence trends are paralleled by rising public attention to mental illness. Mental health messages saturate traditional and social media. Organisations and governments are developing awareness, prevention and treatment initiatives with growing urgency.</p> <p>The mounting cultural focus on mental health has obvious benefits. It increases awareness, reduces stigma and promotes help-seeking.</p> <p>However, it may also have costs. Critics worry <a href="https://www.bacp.co.uk/bacp-journals/therapy-today/2023/april-2023/the-big-issue/">social media</a> sites are incubating mental illness and that ordinary unhappiness is being pathologised by the overuse of diagnostic concepts and “<a href="https://www.bustle.com/wellness/is-therapy-speak-making-us-selfish">therapy speak</a>”.</p> <p>British psychologist <a href="https://www.psych.ox.ac.uk/team/lucy-foulkes">Lucy Foulkes</a> argues the trends for rising attention and prevalence are linked. Her “<a href="https://www.sciencedirect.com/science/article/pii/S0732118X2300003X">prevalence inflation hypothesis</a>” proposes that increasing awareness of mental illness may lead some people to diagnose themselves inaccurately when they are experiencing relatively mild or transient problems.</p> <p>Foulkes’ hypothesis implies that some people develop overly broad concepts of mental illness. Our research supports this view. In a new study, <a href="https://www.sciencedirect.com/science/article/pii/S2666560324000318?via%3Dihub">we show</a> that concepts of mental illness have broadened in recent years – a phenomenon we call “<a href="https://www.tandfonline.com/doi/full/10.1080/1047840X.2016.1082418">concept creep</a>” – and that <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05152-6">people differ</a> in the breadth of their concepts of mental illness.</p> <h2>Why do people self-diagnose mental illnesses?</h2> <p>In our new <a href="https://doi.org/10.1016/j.ssmmh.2024.100326">study</a>, we examined whether people with broad concepts of mental illness are, in fact, more likely to self-diagnose.</p> <p>We defined self-diagnosis as a person’s belief they have an illness, whether or not they have received the diagnosis from a professional. We assessed people as having a “broad concept of mental illness” if they judged a wide variety of experiences and behaviours to be disorders, including relatively mild conditions.</p> <p>We asked a nationally representative sample of 474 American adults if they believed they had a mental disorder and if they had received a diagnosis from a health professional. We also asked about other possible contributing factors and demographics.</p> <p>Mental illness was common in our sample: 42% reported they had a current self-diagnosed condition, a majority of whom had received it from a health professional.</p> <p>Unsurprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.</p> <p>The second most important factor after distress was having a broad concept of mental illness. When their levels of distress were the same, people with broad concepts were substantially more likely to report a current diagnosis.</p> <p>The graph below illustrates this effect. It divides the sample by levels of distress and shows the proportion of people at each level who report a current diagnosis. People with broad concepts of mental illness (the highest quarter of the sample) are represented by the dark blue line. People with narrow concepts of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad concepts were much more likely to report having a mental illness, especially when their distress was relatively high.</p> <p>People with greater mental health literacy and less stigmatising attitudes were also more likely to report a diagnosis.</p> <p>Two interesting further findings emerged from our study. People who self-diagnosed but had not received a professional diagnosis tended to have broader illness concepts than those who had.</p> <p>In addition, younger and politically progressive people were more likely to report a diagnosis, consistent with some <a href="https://www.sciencedirect.com/science/article/pii/S2666560321000438">previous research</a>, and held broader concepts of mental illness. Their tendency to hold these more expansive concepts partially explained their higher rates of diagnosis.</p> <h2>Why does it matter?</h2> <p>Our findings support the idea that expansive concepts of mental illness promote self-diagnosis and may thereby increase the apparent prevalence of mental ill health. People who have a lower threshold for defining distress as a disorder are more likely to identify themselves as having a mental illness.</p> <p>Our findings do not directly show that people with broad concepts over-diagnose or those with narrow concepts under-diagnose. Nor do they prove that having broad concepts <em>causes</em> self-diagnosis or results in <em>actual</em> increases in mental illness. Nevertheless, the findings raise important concerns.</p> <p>First, they suggest that rising mental health awareness may <a href="https://www.newscientist.com/article/mg25934573-900-why-being-more-open-about-mental-health-could-be-making-us-feel-worse/">come at a cost</a>. In addition to boosting mental health literacy it may increase the likelihood of people incorrectly identifying their problems as pathologies.</p> <p>Inappropriate self-diagnosis can have adverse effects. Diagnostic labels may become identity-defining and self-limiting, as people come to believe their problems are enduring, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032724002489?via%3Dihub">hard-to-control</a> aspects of who they are.</p> <p>Second, unwarranted self-diagnosis may lead people experiencing relatively mild levels of distress to seek help that is unnecessary, inappropriate and ineffective. Recent <a href="https://pubmed.ncbi.nlm.nih.gov/37844607/">Australian research</a> found people with relatively mild distress who received psychotherapy worsened more often than they improved.</p> <p>Third, these effects may be particularly problematic for young people. They are most liable to hold broad concepts of mental illness, in part due to <a href="https://www.sciencedirect.com/science/article/pii/S0010440X22000682?via%3Dihub">social media</a> <a href="https://www.tandfonline.com/doi/full/10.1080/10810730.2023.2235563">consumption</a>, and they experience mental ill health at relatively high and rising rates. Whether expansive concepts of illness play a role in the youth mental health crisis remains to be seen.</p> <p>Ongoing cultural shifts are fostering increasingly expansive definitions of mental illness. These shifts are likely to have mixed blessings. By normalising mental illness they may help to remove its stigma. However, by pathologising some forms of everyday distress, they may have an unintended downside.</p> <p>As we wrestle with the mental health crisis, it is crucial we find ways to increase awareness of mental ill health without inadvertently inflating it.<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/231687/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, PhD Candidate at Melbourne 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/nick-haslam-10182">Nick Haslam</a>, Professor of Psychology, <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/do-you-have-a-mental-illness-why-some-people-answer-yes-even-if-they-havent-been-diagnosed-231687">original article</a>.</em></p>

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To-do list got you down? Understanding the psychology of goals can help tick things off – and keep you on track

<p><em><a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a></em></p> <p>It feels like we are living in busy times.</p> <p>According to the <a href="https://www.oecdbetterlifeindex.org/topics/work-life-balance/">OECD Better Life Index</a>, 12.5% of Australians report working at least 50 hours a week, higher than the OECD average. Many Australians are also <a href="https://www.abc.net.au/news/2023-08-03/multiple-job-holders-hit-record-high-abs/102679190">working more than one job to buffer against cost-of-living pressures</a>.</p> <p>Psychology has long been interested in our goals – our mental representations of desirable outcomes. Much of this research is on how we form, pursue and attain goals, plus how goals make us feel. Across studies, we see a consistent pattern of <a href="https://link.springer.com/article/10.1007/s10902-013-9493-0#Sec34">successful goal pursuit and wellbeing</a>. So, having time to work toward our goals is important.</p> <p>With this in mind, what is the best way to get things done – and how can we get better at achieving our goals, especially when we feel time poor?</p> <h2>Make a list</h2> <p>Most of us approach multiple goals with the age-old “to-do” list. First, you write down everything you need to do. Then you “check” or tick things off as you do them.</p> <p>One reason to-do lists are useful is because we are more likely to remember things we haven’t completed, rather than things we have. This is known as the <a href="https://www.youtube.com/watch?v=E-F1U4bV2m8">Zeigarnik effect</a>.</p> <p>While to-do lists are easy to write, they don’t always work. There are however <a href="https://hbr.org/2021/01/i-tried-4-to-do-list-methods-heres-what-worked">various approaches for to-do lists</a> that may improve their effectiveness.</p> <p>Another thing to consider is the wide range of apps, tools and platforms that can make tasks more fun and outsource mental load. Adding elements of game play like point scoring or competition – called “<a href="https://theconversation.com/how-gamification-could-revolutionise-creative-thinking-in-the-workplace-122852">gamification</a>” – can <a href="https://www.sciencedirect.com/science/article/pii/S0747563221002867">help people work toward goals in educational and work settings</a>. Similarly, app-based reminders can help people reach <a href="https://doi.org/10.1177/2047487320905717">physical rehabilitation goals and form good exercise habits</a>.</p> <h2>Finding your why</h2> <p>Researchers have focused a lot on the psychology of <em>why</em> people pursue goals – and how this affects their approach to tasks.</p> <p>For example, some people want to complete a university degree because they want to get a job. Others may be more interested in developing skills or knowledge. In both cases, there is a desired outcome – albeit with differing reasons.</p> <p>Our goals can be differentiated by who or what is driving them. Goals that feel like our own, and for which we experience a sense of intrinsic motivation, are known as “self-concordant”. These goals represent enduring personal interests, are aligned with values and are positively <a href="https://link.springer.com/article/10.1007/s12144-020-01156-7">linked to wellbeing</a>.</p> <p><a href="https://link.springer.com/article/10.1007/s10648-006-9012-5">Goal orientation theory</a> offers a similar perspective. Using the same example, you may study so you score well on a test (a performance goal) or because you want to be sure you develop your knowledge (a mastery goal). Mastery goals tend to lead to <a href="https://link.springer.com/article/10.1007/s10869-010-9201-6">better results and self-regulation</a>.</p> <h2>Juggling goals – 4 to-do tips</h2> <p>So, what happens when we have multiple – perhaps even competing – goals, or goals that aren’t so enjoyable? We might want to finish writing a report or assignment, then read a few chapters of a textbook – but also go to the gym and binge a few episodes of our favourite TV show.</p> <p>In such scenarios, psychological science offers some insights into how we might stay task-focused, and on track to tick more items off our to-do list.</p> <p><strong>1. Beware the <a href="https://www.pwc.pl/en/articles/planning-fallacy-part-I-cognitive-traps.html">planning fallacy</a>.</strong> This happens when we underestimate the amount of resources (such as time) it will take to reach a goal. As writer and religious thinker William Penn put it: “Time is what we want most, but what we use worst”. Think through the all the steps and time required to complete your goal.</p> <p><strong>2. Monitor your progress.</strong> <a href="https://eprints.whiterose.ac.uk/91437/8/3_PDFsam_Does%20monitoring%20goal.pdf">Incorporating goal monitoring</a> into an activity can boost progress. And reviewing your estimations and expectations against your actual times and achievements can be used to calculate a “<a href="https://www.indeed.com/career-advice/career-development/estimating-time-for-tasks">fudge ratio</a>” to aid future planning. For instance, you could multiply your expected time on tasks by 1.5 to help buffer against the planning fallacy.</p> <p><strong>3. Focus on mastery.</strong> Self-concordant goals and tasks feel easier, and their underlying tasks may be <a href="https://journals.sagepub.com/doi/full/10.1177/0146167215575730">less subject to forgetting</a>. Tedious but necessary goals (such as doing the dishes or filling out forms) are less intrinsically motivating. This means <a href="https://www.emerald.com/insight/content/doi/10.1108/EBHRM-04-2014-0013/full/html#idm45933122746592">planning, reminders and support become more important to goal progress</a>.</p> <p><strong>4. Plan for derailments.</strong> People vary in their ability to plan and might forget to take a goal-directed action at an appropriate time (this could be one reason the <a href="https://www.sbs.com.au/news/article/the-streaming-services-winning-the-battle-for-attention-and-the-feature-australians-want/9crrpafgd">average Australian streams 27 hours of video each week</a>). <a href="https://www.tandfonline.com/doi/full/10.1080/10463283.2024.2334563">Implementation intentions</a> bring our attention back toward our goals by linking them to an environmental marker. These simple “if-then” plans are shown to <a href="https://cancercontrol.cancer.gov/brp/research/constructs/implementation-intentions#:%7E:text=Implementation%20intentions%20are%20formed%20for,might%20otherwise%20undermine%20goal%20striving.">help overcome issues with self-regulation</a>. Such a statement might be “if I see the ‘next episode’ icon appear, I will get up and turn off the TV so I can read a chapter of my textbook”.</p> <p>With time being frustratingly finite, it is inevitable we will run out of time to do all of the things on our to-do list. Finding an approach that works for us will take time and effort. But it’s probably a worthy goal in itself.<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/230399/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, Senior Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin 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/to-do-list-got-you-down-understanding-the-psychology-of-goals-can-help-tick-things-off-and-keep-you-on-track-230399">original article</a>.</em></p>

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What’s the difference between Alzheimer’s and dementia?

<div class="theconversation-article-body"> <p><a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <em><a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Changes in thinking and memory as we age can occur for a variety of reasons. These changes are <a href="https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging#changes">not always cause for concern</a>. But when they begin to disrupt daily life, it could indicate the first signs of dementia.</p> <p>Another term that can crop up when we’re talking about dementia is Alzheimer’s disease, or Alzheimer’s for short.</p> <p>So what’s the difference?</p> <h2>What is dementia?</h2> <p>Dementia is an umbrella term used to describe a range of syndromes that result in changes in memory, thinking and/or behaviour due to degeneration in the brain.</p> <p>To meet the <a href="https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1016/j.jalz.2011.03.005">criteria</a> for dementia these changes must be sufficiently pronounced to interfere with usual activities and are present in at least two different aspects of thinking or memory.</p> <p>For example, someone might have trouble remembering to pay bills and become lost in previously familiar areas.</p> <p>It’s less-well known that dementia can also occur in <a href="https://www.childhooddementia.org/what-is-childhood-dementia">children</a>. This is due to progressive brain damage associated with more than 100 rare genetic disorders. This can result in similar cognitive changes as we see in adults.</p> <h2>So what’s Alzheimer’s then?</h2> <p><a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers">Alzheimer’s</a> is the most common type of dementia, accounting for <a href="https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12068">about 60-80%</a> of cases.</p> <p>So it’s not surprising many people use the terms dementia and Alzheimer’s interchangeably.</p> <p>Changes in memory are the most common sign of Alzheimer’s and it’s what the public <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01219-4">most often</a> associates with it. For instance, someone with Alzheimer’s may have trouble recalling recent events or keeping track of what day or month it is.</p> <p>We still don’t know exactly what <a href="https://link.springer.com/article/10.1134/s002689332104004x">causes Alzheimer’s</a>. However, we do know it is associated with a build-up in the brain of two types of protein called <a href="https://www.dementiasplatform.uk/news-and-media/blog/amyloid-and-tau-the-proteins-involved-in-dementia">amyloid-β and tau</a>.</p> <p>While we all have some amyloid-β, when too much builds up in the brain it clumps together, forming plaques in the spaces between cells. These plaques cause damage (inflammation) to surrounding brain cells and leads to disruption in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468450/">tau</a>. Tau forms part of the structure of brain cells but in Alzheimer’s tau proteins become “tangled”. This is toxic to the cells, causing them to die. A <a href="https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180583">feedback loop</a> is then thought to occur, triggering production of more amyloid-β and more abnormal tau, perpetuating damage to brain cells.</p> <p>Alzheimer’s can also occur with other forms of dementia, such as <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This combination is the most common example of a <a href="https://www.dementiauk.org/information-and-support/types-of-dementia/mixed-dementia/">mixed dementia</a>.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&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/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Vascular dementia</h2> <p>The second most common type of dementia is <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This results from disrupted blood flow to the brain.</p> <p>Because the changes in blood flow can occur throughout the brain, signs of vascular dementia can be more varied than the memory changes typically seen in Alzheimer’s.</p> <p>For example, vascular dementia may present as general confusion, slowed thinking, or difficulty organising thoughts and actions.</p> <p>Your <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">risk of vascular dementia</a> is greater if you have heart disease or high blood pressure.</p> <h2>Frontotemporal dementia</h2> <p>Some people may not realise that dementia can also affect behaviour and/or language. We see this in different forms of frontotemporal dementia.</p> <p>The behavioural variant of <a href="https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.20090238#:%7E:text=The%20behavioral%20variant%20of%20frontotemporal,often%20delayed%20for%20several%20years.">frontotemporal dementia</a> is the second most common form (after Alzheimer’s disease) of <a href="https://www.healthdirect.gov.au/younger-onset-dementia">younger onset dementia</a> (dementia in people under 65).</p> <p>People living with this may have difficulties in interpreting and appropriately responding to social situations. For example, they may make uncharacteristically rude or offensive comments or invade people’s personal space.</p> <p><a href="https://www.sciencedirect.com/topics/neuroscience/semantic-dementia">Semantic dementia</a> is also a type of frontotemporal dementia and results in difficulty with understanding the meaning of words and naming everyday objects.</p> <h2>Dementia with Lewy bodies</h2> <p><a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies">Dementia with Lewy bodies</a> results from dysregulation of a different type of protein known as α-synuclein. We often see this in people with Parkinson’s disease.</p> <p>So people with this type of dementia may have altered movement, such as a stooped posture, shuffling walk, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428504/">changes in handwriting</a>. Other symptoms include changes in alertness, visual hallucinations and significant <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029467/">disruption to sleep</a>.</p> <h2>Do I have dementia and if so, which type?</h2> <p>If you or someone close to you is concerned, the first thing to do is to <a href="https://cdpc.sydney.edu.au/research/clinical-guidelines-for-dementia/">speak to your GP</a>. They will likely ask you some questions about your medical history and what changes you have noticed.</p> <p>Sometimes it might not be clear if you have dementia when you first speak to your doctor. They may suggest you watch for changes or they may refer you to a specialist for <a href="https://www.nia.nih.gov/health/alzheimers-and-dementia/what-dementia-symptoms-types-and-diagnosis#diagnosis">further tests</a>.</p> <p>There is no single test to clearly show if you have dementia, or the type of dementia. A diagnosis comes after multiple tests, including brain scans, tests of memory and thinking, and consideration of how these changes impact your daily life.</p> <p>Not knowing what is happening can be a challenging time so it is important to speak to someone about how you are feeling or to reach out to <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">support services</a>.</p> <h2>Dementia is diverse</h2> <p>As well as the different forms of dementia, everyone experiences dementia in different ways. For example, the speed dementia progresses varies a lot from person to person. Some people will continue to <a href="https://livingwellwithdementia.org.au">live well with dementia</a> for some time while others may decline more quickly.</p> <p>There is still significant <a href="https://academic.oup.com/gerontologist/article-abstract/64/5/gnad130/7281753">stigma</a> surrounding dementia. So by learning more about the various types of dementia and understanding differences in how dementia progresses we can all do our part to create a more <a href="https://www.dementiafriendly.org.au/">dementia-friendly community</a>.</p> <hr /> <p><em>The <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">National Dementia Helpline</a> (1800 100 500) provides information and support for people living with dementia and their carers. To learn more about dementia, you can take this <a href="https://www.utas.edu.au/wicking/understanding-dementia">free online course</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225271/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></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/whats-the-difference-between-alzheimers-and-dementia-225271">original article</a>.</em></p> </div>

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Boomers vs millennials? Free yourself from the phoney generation wars

<p><em><a href="https://theconversation.com/profiles/bobby-duffy-98570">Bobby Duffy</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a></em></p> <p>Generational thinking is a big idea that’s been horribly corrupted and devalued by endless myths and stereotypes. These clichés have fuelled fake battles between “snowflake” millennials and “selfish” baby boomers, with younger generations facing a “war on woke” and older generations accused of “stealing” the future from the young.</p> <p>As I argue in my book, <a href="https://atlantic-books.co.uk/book/generations/">Generations</a>, this is a real shame. A more careful understanding of what’s really different between generations is one of the best tools we have to understand change – and predict the future.</p> <p>Some of the great names in sociology and philosophy saw understanding generational change as central to understanding society overall. <a href="http://dhspriory.org/kenny/PhilTexts/Comte/Philosophy2.pdf">Auguste Comte</a>, for example, identified the generation as a key factor in “the basic speed of human development”.</p> <p>He argued that “we should not hide the fact that our social progress rests essentially upon death; which is to say that the successive steps of humanity necessarily require a continuous renovation … from one generation to the next”. We humans get set in our ways once we’re past our formative years, and we need the constant injection of new participants to keep society moving forward.</p> <p>Understanding whether, and how, generations are different is vital to understanding society. The balance between generations is constantly shifting, as older cohorts die out and are replaced by new entrants. If younger generations truly do have different attitudes or behaviours to older generations, this will reshape society, and we can, to some extent, predict how it will develop if we can identify those differences.</p> <p>But in place of this big thinking, today we get clickbait headlines and bad research on millennials “<a href="https://www.businessinsider.com/millennials-hate-napkins-2016-3?r=US&amp;IR=T">killing the napkin industry</a>” or on how baby boomers have “<a href="https://www.theatlantic.com/ideas/archive/2019/06/boomers-are-blame-aging-america/592336/">ruined everything</a>”. We’ve fallen a long way.</p> <h2>Myth busting</h2> <p>To see the true value of generational thinking, we need to identify and discard the many myths. For example, as I outline in the book, gen Z and millennials are not lazy at work or disloyal to their employers. They’re also no more materialistic than previous generations of young: a focus on being rich is something we tend to grow out of.</p> <p>Old people are not uncaring or unwilling to act on climate change: in fact, they are more likely than young people to boycott products for social purpose reasons.</p> <p>And our current generation of young are not a particularly unusual group of “culture warriors”. Young people are always at the leading edge of change in cultural norms, around race, immigration, sexuality and gender equality. The issues have changed, but the gap between young and old is not greater now than in the past.</p> <p>Meanwhile, there are real, and vitally important, generational differences hidden in this mess. To see them, we need to separate the three effects that explain all change in societies. Some patterns are simple “lifecycle effects”, where attitudes and behaviours are to do with our age, not which generation we are born into. Some are “period effects” – where everyone is affected, such as in a war, economic crisis or a pandemic.</p> <p>And finally, there are “cohort effects”, which is where a new generation is different from others at the same age, and they stay different. It’s impossible to entirely separate these distinct forces, but we can often get some way towards it – and when we do, we can predict the future in a much more meaningful way.</p> <p>There are many real generational differences, in vitally important areas of life. For example, the probability of you owning your own home is hugely affected by when you were born. Millennials are around half as likely to be a homeowner than generations born only a couple of decades earlier.</p> <p>There is also a real cohort effect in experience of mental health disorders, particularly among recent generations of young women. Our relationship with alcohol and likelihood of smoking is also tied to our cohort, with huge generational declines in very regular drinking and smoking. Each of these point to different futures, from increased strain on mental health services to declining alcohol sales.</p> <p>But lifecycle and period effects are vitally important too. For example, there is truth in the idea that we grow more conservative as we age. One analysis suggests that this ageing effect is worth around <a href="https://www.sciencedirect.com/science/article/abs/pii/S0261379413000875">0.35% to the Conservatives each year</a>, which may not sound like a lot, but is very valuable over the course of a political lifetime.</p> <p>And, of course, the pandemic provides a very powerful example of how period effects can dramatically change things for us all.</p> <h2>Reaching beyond the avocado</h2> <p>When there is such richness in the realities, why are there so many myths? It’s partly down to bad marketing and workplace research – that is, people jumping on the generation bandwagon to get media coverage for their products or to sell consultancy to businesses on how to engage young employees.</p> <p>This has become its own mini-industry. In 2015, US companies spent up to US$70 million (£51 million) on this sort of “advice” <a href="https://www.wsj.com/articles/helping-bosses-decode-millennialsfor-20-000-an-hour-1463505666">according to the Wall Street Journal</a>, with some experts making as much as US$20,000 an hour. Over 400 LinkedIn users now describe themselves solely as a “millennial expert” or “millennial consultant”.</p> <p>Campaigners and politicians also play to these imagined differences. Our increasing focus on “<a href="https://www.kcl.ac.uk/policy-institute/assets/culture-wars-in-the-uk.pdf">culture wars</a>” often involves picking out particular incidents in universities, such as the <a href="https://www.bbc.co.uk/news/uk-england-manchester-45717841">banning of clapping</a> at events or the <a href="https://www.bbc.co.uk/news/uk-england-oxfordshire-57409743">removal of a portrait of the Queen</a> to exaggerate how culturally different young people today are.</p> <p>Maybe less obviously, politicians such as former US President Barack Obama repeatedly lionise coming generations as more focused on equality, when the evidence shows they’re often not that different. These assertions are not only wrong, but create false expectations and divides.</p> <p>Some have had enough, calling on the Pew Research Center in the US, which has been a champion of generational groups, to <a href="https://www.washingtonpost.com/opinions/2021/07/07/generation-labels-mean-nothing-retire-them/&amp;data=04%257C01%257C">stop conducting this type of analysis</a>. I think that misses the point: it’s how it’s applied rather than the idea of generations that’s wrong.</p> <p>We should defend the big idea and call out the myths, not abandon the field to the “millennial consultants”.<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/167138/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/bobby-duffy-98570">Bobby Duffy</a>, Professor of Public Policy and Director of the Policy Institute, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</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/boomers-vs-millennials-free-yourself-from-the-phoney-generation-wars-167138">original article</a>.</em></p>

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The voice in your head may help you recall and process words. But what if you don’t have one?

<p><em><a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Can you imagine hearing yourself speak? A voice inside your head – perhaps reciting a shopping list or a phone number? What would life be like if you couldn’t?</p> <p>Some people, including me, cannot have imagined visual experiences. We cannot close our eyes and conjure an experience of seeing a loved one’s face, or imagine our lounge room layout – to consider if a new piece of furniture might fit in it. This is called “<a href="https://theconversation.com/a-blind-and-deaf-mind-what-its-like-to-have-no-visual-imagination-or-inner-voice-226134">aphantasia</a>”, from a Greek phrase where the “a” means without, and “phantasia” refers to an image. Colloquially, people like myself are often referred to as having a “blind mind”.</p> <p>While most attention has been given to the inability to have imagined visual sensations, aphantasics can lack other imagined experiences. We might be unable to experience imagined tastes or smells. Some people cannot imagine hearing themselves speak.</p> <p>A <a href="https://www.sciencealert.com/we-used-to-think-everybody-heard-a-voice-inside-their-heads-but-we-were-wrong">recent study</a> has advanced our understanding of people who cannot imagine hearing their own internal monologue. Importantly, the authors have identified some tasks that such people are more likely to find challenging.</p> <h2>What the study found</h2> <p>Researchers at the University of Copenhagen in Denmark and at the University of Wisconsin-Madison in the United States <a href="https://journals.sagepub.com/doi/10.1177/09567976241243004">recruited 93 volunteers</a>. They included 46 adults who reported low levels of inner speech and 47 who reported high levels.</p> <p>Both groups were given challenging tasks: judging if the names of objects they had seen would rhyme and recalling words. The group without an inner monologue performed worse. But differences disappeared when everyone could say words aloud.</p> <p>Importantly, people who reported less inner speech were not worse at all tasks. They could recall similar numbers of words when the words had a different appearance to one another. This negates any suggestion that aphants (people with aphantasia) simply weren’t trying or were less capable.</p> <h2>A welcome validation</h2> <p>The study provides some welcome evidence for the lived experiences of some aphants, who are still often told their experiences are not different, but rather that they cannot describe their imagined experiences. Some people feel anxiety when they realise other people can have imagined experiences that they cannot. These feelings may be deepened when others assert they are merely confused or inarticulate.</p> <p>In my own <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1374349/full">aphantasia research</a> I have often quizzed crowds of people on their capacity to have imagined experiences.</p> <p>Questions about the capacity to have imagined visual or audio sensations tend to be excitedly endorsed by a vast majority, but questions about imagined experiences of taste or smell seem to cause more confusion. Some people are adamant they can do this, including a colleague who says he can imagine what combinations of ingredients will taste like when cooked together. But other responses suggest subtypes of aphantasia may prove to be more common than we realise.</p> <p>The authors of the recent study suggest the inability to imagine hearing yourself speak should be referred to as “anendophasia”, meaning without inner speech. Other authors had suggested <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551557/">anauralia</a> (meaning without auditory imagery). Still other researchers have referred to all types of imagined sensation as being different types of “imagery”.</p> <p>Having <a href="https://www.sciencedirect.com/science/article/abs/pii/S0010945222000417">consistent names</a> is important. It can help scientists “talk” to one another to compare findings. If different authors use different names, important evidence can be missed.</p> <h2>We have more than 5 senses</h2> <p>Debate continues about how many senses humans have, but some scientists reasonably argue for a <a href="https://www.sensorytrust.org.uk/blog/how-many-senses-do-we-have#:%7E:text=Because%20there%20is%20some%20overlap,sensation%20of%20hunger%20or%20thirst.">number greater than 20</a>.</p> <p>In addition to the five senses of sight, smell, taste, touch and hearing, lesser known senses include thermoception (our sense of heat) and proprioception (awareness of the positions of our body parts). Thanks to proprioception, most of us can close our eyes and touch the tip of our index finger to our nose. Thanks to our vestibular sense, we typically have a good idea of which way is up and can maintain balance.</p> <p>It may be tempting to give a new name to each inability to have a given type of imagined sensation. But this could lead to confusion. Another approach would be to adapt phrases that are already widely used. People who are unable to have imagined sensations commonly refer to ourselves as “aphants”. This could be adapted with a prefix, such as “audio aphant”. Time will tell which approach is adopted by most researchers.</p> <h2>Why we should keep investigating</h2> <p>Regardless of the names we use, the study of multiple types of inability to have an imagined sensation is important. These investigations could reveal the essential processes in human brains that bring about a conscious experience of an imagined sensation.</p> <p>In time, this will not only lead to a better understanding of the diversity of humans, but may help uncover how human brains can create any conscious sensation. This question – how and where our conscious feelings are generated – remains one of the great mysteries of science.<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/230973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, Professor, School of Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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-voice-in-your-head-may-help-you-recall-and-process-words-but-what-if-you-dont-have-one-230973">original article</a>.</em></p>

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What’s the difference between shyness and social anxiety?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.</p> <p>However, <a href="https://theconversation.com/shyness-isnt-nice-but-shyness-shouldnt-stop-you-28010">feeling shy</a>, or having a shy personality, is not the same as experiencing <a href="https://theconversation.com/explainer-what-is-social-anxiety-disorder-36601">social anxiety</a> (short for “social anxiety disorder”).</p> <p>Here are some of the similarities and differences, and what the distinction means.</p> <h2>How are they similar?</h2> <p>It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.</p> <p>For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.</p> <p>People who are shy or socially anxious may <a href="https://theconversation.com/paralysed-with-fear-why-do-we-freeze-when-frightened-60543">respond with</a> “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “<a href="https://theconversation.com/what-is-fawning-how-is-it-related-to-trauma-and-the-fight-or-flight-response-205024">fawn</a>” (by trying to appease or placate others).</p> <p>A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.</p> <p>For example, both <a href="https://link.springer.com/article/10.3758/s13415-021-00916-7">shy children</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428215/">adults with social anxiety</a> have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.</p> <p>People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&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/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>How are they different?</h2> <p>Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.</p> <p>For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.</p> <p>To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.</p> <p>Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.</p> <p>People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.</p> <p>Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.</p> <p>However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.</p> <p>The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.</p> <p>The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.</p> <p>The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.</p> <p>Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or <a href="https://theconversation.com/what-is-selective-mutism-and-is-it-a-lifelong-condition-219930">refuse to speak</a> in certain situations.</p> <p>If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and <a href="https://theconversation.com/back-to-school-blues-how-to-help-your-child-with-shyness-90228">parental support</a>, patience and guidance, children can be taught <a href="https://theconversation.com/7-tips-to-help-kids-feeling-anxious-about-going-back-to-school-139207">strategies</a> to overcome social anxiety.</p> <h2>Why does the distinction matter?</h2> <p>Social anxiety disorder is a mental health condition that <a href="https://link.springer.com/article/10.1186/s12916-017-0889-2?utm_source=getftr&amp;utm_medium=getftr&amp;utm_campaign=getftr_pilot">persists</a> for people who do not receive adequate support or treatment.</p> <p>Without treatment, it can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/22306132/">difficulties</a> in education and at work, and in developing meaningful relationships.</p> <p>Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.</p> <p>A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.</p> <p>Different people have different support needs. However, <a href="https://www.nice.org.uk/guidance/cg159/chapter/Recommendations">clinical practice guidelines</a> recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">exposure therapy</a> (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">in-person</a>, <a href="https://www.semanticscholar.org/paper/Computer-therapy-for-the-anxiety-and-depression-is-Andrews-Basu/25e9ee98a1af8d2780ac3e1f687ebc40ebd1b47c">online</a> and in <a href="https://pubmed.ncbi.nlm.nih.gov/34534800/">brief treatments</a>.</p> <h2>For more support or further reading</h2> <p>Online resources about social anxiety include:</p> <ul> <li> <p>This Way Up’s <a href="https://thiswayup.org.au/programs/social-anxiety-program/">online program</a> for managing excessive shyness and fear of social situations</p> </li> <li> <p>Beyond Blue’s <a href="https://www.beyondblue.org.au/mental-health/anxiety/types-of-anxiety/social-anxiety-disorder">resources</a> on social anxiety</p> </li> <li> <p>a guide to <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Social-Anxiety">looking after yourself</a> if you have social anxiety, from the Western Australian health department</p> </li> <li> <p>social anxiety <a href="https://brave4you.psy.uq.edu.au/">online program for children and teens</a> from the University of Queensland</p> </li> <li> <p>inroads, a <a href="https://inroads.org.au/">self-guided online program</a> for young adults who drink alcohol to manage their anxiety.</p> </li> </ul> <hr /> <p><em>We thank the Black Dog Institute <a href="https://www.blackdoginstitute.org.au/about/who-we-are/lived-experience/">Lived Experience Advisory Network</a> members for providing feedback and input for this article and our research.</em><!-- Below is The Conversation's page counter tag. 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More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, Postdoctoral research fellow and clinical psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, Professor, NHMRC Emerging Leader &amp; Clinical Psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/whats-the-difference-between-shyness-and-social-anxiety-225669">original article</a>.</em></p> </div>

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Want to reduce your dementia risk? Eat these 4 foods, says new study

<p>If you are what you eat, this might make you hungrier for foods that are bright in every sense. Research has shown that living, vibrant foods can slow down aging at a cellular level; while fruit and vegetables in particular have been associated with lower incidence of cognitive decline as individuals age.</p> <p>However, research has been relatively lacking on just how much of these brain-healthy foods you really need and which fruit and vegetables are best for the job.</p> <p>In collaboration with public health experts at Harvard University, medical researchers at China’s Zhejiang University School of Medicine conducted a meta-analysis that’s slated to be published in the June 2024 issue of <em>The Journal of Nutrition, Health, and Aging</em>. They combined data from two large-scale population-representative studies that analysed the diets and cognitive function of more than 10,000 participants ages 55 and older from China and the US.</p> <h2>What daily diets revealed</h2> <p>The data included diet questionnaires that honed in on the average of participants’ total daily intake of several different types of foods, including fruit and vegetables, and also broke them down into sub-types like green leafy vegetables and berries. Over a period of five years, the participants also took part in activities designed to assess their cognitive function and the average rate of cognitive decline.</p> <p>Overall, participants who included the most fruit and vegetables in their daily diets performed best on the brain tests and maintained those results over time. This suggested that both fruit and vegetables had protective elements that slowed cognitive decline.</p> <h2>Vegetables that help protect cognition</h2> <p>Interestingly, certain types of vegetables appeared to be more beneficial than others—say the researchers: “Our findings support the potential beneficial roles of VF, especially cruciferous vegetables, green leafy vegetables, and red and yellow vegetables, in maintaining cognitive function and slowing cognitive decline in middle-aged and older adults.”</p> <p>The researchers pointed to several reasons these particular vegetables might have shown a substantial impact, including anti-inflammatory and antioxidation nutrients like flavonoids and various vitamins or even gut improvements that have been shown to help improve or protect cognition.</p> <p>While beans didn’t figure prominently in both studies, they showed a protective element in the US study, so they are also worth keeping on your plate. (Beans are also thought to be one of the top foods for longevity.)</p> <h2>Fruit that pack a punch</h2> <p>As for fruit, while some didn’t show as much of a protective effect across the board, berries and apples are two examples of fruit that experts have previously said provide major polyphenol and antioxidant effect.</p> <p>Participants whose brains maintained performance were shown to have eaten three or more servings of vegetables and two or more servings of fruit per day. This is on par with the five servings of vegetables and two servings of fruit recommended we eat every day.</p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/want-to-reduce-your-dementia-risk-eat-these-4-foods-says-new-study" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <h2>The big idea</h2> <p>Social ballroom dancing can improve cognitive functions and reduce brain atrophy in older adults who are at increased risk for Alzheimer’s disease and other forms of dementia. That’s the key finding of my team’s <a href="https://doi.org/10.1123/japa.2022-0176">recently published study</a> in the Journal of Aging and Physical Activity.</p> <p>In our study, we enrolled 25 adults over 65 years of age in either six months of twice-weekly ballroom dancing classes or six months of twice-weekly treadmill walking classes. None of them were engaged in formal dancing or other exercise programs.</p> <p>The overall goal was to see how each experience affected cognitive function and brain health.</p> <p>While none of the study volunteers had a dementia diagnosis, all performed a bit lower than expected on at least one of our dementia screening tests. We found that older adults that completed six months of social dancing and those that completed six months of treadmill walking improved their executive functioning – an umbrella term for planning, reasoning and processing tasks that require attention.</p> <p>Dancing, however, generated significantly greater improvements than treadmill walking on one measure of executive function and on processing speed, which is the time it takes to respond to or process information. Compared with walking, dancing was also associated with reduced brain atrophy in the hippocampus – a brain region that is key to memory functioning and is particularly affected by Alzheimer’s disease. Researchers also know that this part of our brain can undergo neurogenesis – or grow new neurons – <a href="https://doi.org/10.1073/pnas.0611721104">in response to aerobic exercise</a>.</p> <figure><iframe src="https://www.youtube.com/embed/unmbhUvnGow?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Research shows those who regularly dance with a partner have a more positive outlook on life.</span></figcaption></figure> <p>While several previous studies suggest that dancing has beneficial effects <a href="https://doi.org/10.1093/ageing/afaa270">on cognitive function in older adults</a>, only a few studies have compared it directly with traditional exercises. Our study is the first to observe both better cognitive function and improved brain health following dancing than walking in older adults at risk for dementia. We think that social dancing may be more beneficial than walking because it is physically, socially and cognitively demanding – and therefore strengthens a wide network of brain regions.</p> <p>While dancing, you’re not only using brain regions that are important for physical movement. You’re also relying on brain regions that are important for interacting and adapting to the movements of your dancing partner, as well as those necessary for learning new dance steps or remembering those you’ve learned already.</p> <h2>Why it matters</h2> <p>Nearly 6 million older adults in the U.S. and 55 million worldwide <a href="https://doi.org/10.1016/j.jalz.2019.01.010">have Alzheimer’s disease</a> or a <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">related dementia</a>, yet there is no cure. Sadly, the efficacy and ethics surrounding recently developed drug treatments <a href="https://doi.org/10.1080/21507740.2022.2129858">are still under debate</a>.</p> <p>The good news is that older adults can potentially <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">lower their risk for dementia</a> through lifestyle interventions, even later in life. These include reducing social isolation and physical inactivity.</p> <p>Social ballroom dancing targets both isolation and inactivity. In these later stages of the COVID-19 pandemic, a better understanding of the <a href="https://doi.org/10.1177/23337214211005223">indirect effects of COVID-19</a> – particularly those that increase dementia risk, such as social isolation – is urgently needed. In my view, early intervention is critical to prevent dementia from becoming the next pandemic. Social dancing could be a particularly timely way to overcome the adverse cognitive and brain effects associated with isolation and fewer social interactions during the pandemic.</p> <h2>What still isn’t known</h2> <p>Traditional aerobic exercise interventions such as treadmill-walking or running have been shown to lead to modest but reliable improvements in cognition – <a href="https://doi.org/10.1177/1745691617707316">particularly in executive function</a>.</p> <p>My team’s study builds on that research and provides preliminary evidence that not all exercise is equal when it comes to brain health. Yet our sample size was quite small, and larger studies are needed to confirm these initial findings. Additional studies are also needed to determine the optimal length, frequency and intensity of dancing classes that may result in positive changes.</p> <p>Lifestyle interventions like social ballroom dancing are a promising, noninvasive and cost-effective path toward staving off dementia as we – eventually – leave the COVID-19 pandemic behind.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/194969/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, Associate Professor of Medicine and Neurology, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</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/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">original article</a>.</em></p> </div>

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Are young people smarter than older adults? My research shows cognitive differences between generations are diminishing

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a></em></p> <p>We often assume young people are smarter, or at least quicker, than older people. For example, we’ve all heard that scientists, and even more so mathematicians, <a href="https://www.forbes.com/sites/nextavenue/2014/08/07/who-says-scientists-peak-by-age-50/">carry out their most important work</a> when they’re comparatively young.</p> <p>But my new research, <a href="https://www.sciencedirect.com/science/article/pii/S027322972400008X#:%7E:text=Highlights&amp;text=Three%20review%20studies%20measure%20secular,%2C%20education%2C%20and%20overall%20health.">published in Developmental Review</a>, suggests that cognitive differences between the old and young are tapering off over time. This is hugely important as stereotypes about the intelligence of people in their sixties or older may be holding them back – in the workplace and beyond.</p> <p>Cognitive ageing is often measured by comparing young adults, aged 18-30, to older adults, aged 65 and over. There are a variety of tasks that older adults do not perform well on compared to young adults, such as memory, spatial ability and speed of processing, which often form the basis of <a href="https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428">IQ tests</a>. That said, there are a few tasks that older people do better at than younger people, such as reading comprehension and vocabulary.</p> <p>Declines in cognition are driven by a process called <a href="https://www.nature.com/collections/cbjacdabdf">cognitive ageing</a>, which happens to everyone. Surprisingly, age-related cognitive deficits start very early in adulthood, and declines in cognition have been measured as dropping in adults as young as just 25.</p> <p>Often, it is only when people reach older age that these effects add up to a noticeable amount. Common complaints consist of walking into a room and forgetting why you entered, as well as difficulty remembering names and struggling to drive in the dark.</p> <h2>The trouble with comparison</h2> <p>Sometimes, comparing young adults to older adults can be misleading though. The two generations were brought up in different times, with different levels of education, healthcare and nutrition. They also lead different daily lives, with some older people having lived though a world war while the youngest generation is growing up with the internet.</p> <p>Most of these factors favour the younger generation, and this can explain a proportion of their advantage in cognitive tasks.</p> <p>Indeed, much existing research shows that <a href="https://theconversation.com/iq-tests-are-humans-getting-smarter-158837">IQ has been improving</a> globally throughout the 20th century. This means that later-born generations are more cognitively able than those born earlier. This is even found when both generations are tested in the same way at the same age.</p> <p>Currently, there is growing evidence that <a href="https://www.pnas.org/doi/10.1073/pnas.1718793115">increases in IQ are levelling off,</a> such that, in the most recent couple of decades, young adults are no more cognitively able than young adults born shortly beforehand.</p> <p>Together, these factors may underlie the current result, namely that cognitive differences between young and older adults are diminishing over time.</p> <h2>New results</h2> <p>My research began when my team started getting strange results in our lab. We found that often the age differences we were getting between young and older adults was smaller or absent, compared to prior research from early 2000s.</p> <p>This prompted me to start looking at trends in age differences across the psychological literature in this area. I uncovered a variety of data that compared young and older adults from the 1960s up to the current day. I plotted this data against year of publication, and found that age deficits have been getting smaller over the last six decades.</p> <p>Next, I assessed if the average increases in cognitive ability over time seen across all individuals was a result that also applied to older adults specifically. Many large databases exist where groups of individuals are recruited every few years to take part in the same tests. I analysed studies using these data sets to look at older adults.</p> <p>I found that, just like younger people, older adults were indeed becoming more cognitively able with each cohort. But if differences are disappearing, does that mean younger people’s improvements in cognitive ability have slowed down or that older people’s have increased?</p> <p>I analysed data from my own laboratory that I had gathered over a seven-year period to find out. Here, I was able to dissociate the performance of the young from the performance of the older. I found that each cohort of young adults was performing to a similar extent across this seven-year period, but that older adults were showing improvements in both processing speed and vocabulary scores.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&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/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=333&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=418&amp;fit=crop&amp;dpr=3 2262w" alt="The figure shows data for a speed-based task where higher scores represent better performance." /><figcaption><span class="caption">The figure shows data for a speed-based task where higher scores represent better performance.</span> <span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <p>I believe the older adults of today are benefiting from many of the factors previously most applicable to young adults. For example, the number of children who went to school <a href="https://education-uk.org/history/chapter12.html">increased significantly</a> in the 1960s – with the system being more similar to what it is today than what it was at the start of the 20th century.</p> <p>This is being reflected in that cohort’s increased scores today, now they are older adults. At the same time, young adults have hit a ceiling and are no longer improving as much with each cohort.</p> <p>It is not entirely clear why the young generations have stopped improving so much. Some research has <a href="https://doi.org/10.1016/j.intell.2016.10.002">explored maternal age, mental health and even evolutionary trends</a>. I favour the opinion that there is just a natural ceiling – a limit to how much factors such as education, nutrition and health can improve cognitive performance.</p> <p>These data have important implications for research into dementia. For example, it is possible that a modern older adult in the early stages of dementia might pass a dementia test that was designed 20 or 30 years ago for the general population at that time.</p> <p>Therefore, as older adults are performing better in general than previous generations, it may be necessary to revise definitions of dementia that depend on an individuals’ expected level of ability.</p> <p>Ultimately, we need to rethink what it means to become older. And there’s finally some good news. Ultimately, we can expect to be more cognitively able than our grandparents were when we reach their age.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229132/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent 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/are-young-people-smarter-than-older-adults-my-research-shows-cognitive-differences-between-generations-are-diminishing-229132">original article</a>.</em></p> </div>

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Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?

<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/diny-thomson-1519736">Diny Thomson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.</p> <p>Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.</p> <p>Since as early as the <a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">19th century</a>, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.</p> <p>It is estimated <a href="https://pubmed.ncbi.nlm.nih.gov/20010032/">43% of people</a> who experience this brief lucidity die within 24 hours, and 84% within a week.</p> <p>Why does this happen?</p> <h2>Terminal lucidity or paradoxical lucidity?</h2> <p>In 2009, researchers Michael Nahm and Bruce Greyson coined the term “<a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">terminal lucidity</a>”, since these lucid episodes often occurred shortly before death.</p> <p>But not all lucid episodes indicate death is imminent. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13667">One study</a> found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.</p> <p>Lucidity has also been <a href="https://www.sciencedirect.com/science/article/pii/S0167494311001865?via%3Dihub">reported</a> in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.</p> <p>Moments of lucidity that do not necessarily indicate death are sometimes called <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12579">paradoxical lucidity</a>. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.</p> <p>But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.</p> <h2>Why does terminal lucidity happen?</h2> <p>Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that <a href="https://psywb.springeropen.com/articles/10.1186/s13612-014-0024-5">music can sometimes improve lucidity</a>. But many episodes of lucidity do not have a distinct trigger.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0300957223002162">A research team from New York University</a> speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.</p> <p>Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.</p> <p>And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.</p> <p>Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.</p> <h2>Why is it important to know about terminal lucidity?</h2> <p>People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.</p> <p>Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.</p> <p>For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.<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/202342/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/diny-thomson-1519736">Diny Thomson</a>, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, <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/terminal-lucidity-why-do-loved-ones-with-dementia-sometimes-come-back-before-death-202342">original article</a>.</em></p>

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7 things you need to know about fear

<p>Fear is an emotion that can be debilitating and unsettling. But it is a natural part of life and we are hardwired to experience it.</p> <p><strong>1. Fear can protect you</strong></p> <p>Experiencing fear elicits responses from your brain to your limbs. It is the body’s natural way of protecting itself. For our ancestors the fear was often more physical – such as being chased by a lion. Modern fear can range from physical danger (such as a spider or an intruder) or even from perceived danger (such as the worry that something will happen to our partner or child). Feeling fear doesn’t make you a weak person. In fact, not feeling any fear could mean that there are neurological issues present.</p> <p><strong>2. There are many levels of fear</strong></p> <p>Not everything that we fear is intense and paralysing. It can range from low levels of fear (such as worry about being robbed), to medium levels of fear (say if a loved one is in hospital) to high levels of fear (you are being chased by an attacker). Fear can also become stronger when we hear about events such as a terrorist attack or a natural disaster. It all relates back to how much the scary event will impact our lives.</p> <p><strong>3. Fear is not just instinctive</strong></p> <p>We become fearful due to three main factors: instinct, learning, and teaching. An example of instinctual fear is pain – we learn to be fearful of things that hurt us. Learned fear comes from being exposed to unpleasant or uncomfortable things and wanting to avoid them in the future. For instance, having a relative die in a car crash could make you fearful of driving in the future. Other fears are taught to us by our family, friends and even society. For example, some religions teach us to be fearful of other religions or customs.</p> <p><strong>4. Fear can arise without a real threat of danger</strong></p> <p>Fear can also be imagined, so it can be felt even when there is no danger present. If we feel this all the time it can lead to anxiety and depression. It’s important to think about whether the thing you are fearful of is real or likely to happen before you give it too much airtime.</p> <p><strong>5. Fear produces fear</strong></p> <p>If you are already in a state of fear, your response to more fear is heightened. For instance if you are watching a scary movie, a small noise from the next room could make you jump and scream. Your senses are on red alert, primed to act if the need arises.</p> <p><strong>6. Fear leads to action</strong></p> <p>Depending on the individual and the level of fear they are experiencing, there tend to be four main types of action as a result of fear: freeze, </p> <p>fight, flight, or fright. </p> <p>When you freeze it means you don’t move while you decide what to do (for instance you see a snake in your garden). From there you choose either fight (grab a shovel) or flight mode (walk away). If the fear is too much you might experience fright, where you do nothing and take no action (stand there screaming or worrying).</p> <p><strong>7. Real threats can lead to heroic actions</strong></p> <p>Imagined threats can cause us to live in a permanent state of fear and stress. But often we will do nothing about it (for instance being worried about sharks attacking us in the ocean). Compare this to the threat from a real and identifiable source, which will make you spring into action almost immediately. Often we don’t even make the decision to act, it just happens automatically (such as moving a child out of the way of an approaching car). </p> <p><em>Image credits: Getty Images</em> </p>

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What is childhood dementia? And how could new research help?

<p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>“Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia.</p> <p>Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>.</p> <p>Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure.</p> <h2>More about the causes</h2> <p>Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail.</p> <p>As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs.</p> <h2>What happens to children with childhood dementia?</h2> <p>Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning.</p> <p>Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures.</p> <p>The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage.</p> <h2>Are there any treatments available?</h2> <p>Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results.</p> <p>Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain.</p> <h2>Research attention is lacking</h2> <p>Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia.</p> <p>In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer.</p> <p>The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes.</p> <p>Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia.</p> <p>Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves.</p> <p>That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years.</p> <p>In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families.</p> <h2>New research</h2> <p>Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments.</p> <p>More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions.</p> <p><em>Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, contributed to this article.</em><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/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, 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/what-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>.</em></p>

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What’s the difference between ADD and ADHD?

<p><em><a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.</p> <p>ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.</p> <p>Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?</p> <p>In short, what was previously called ADD is now known as ADHD. So how did we get here?</p> <h2>Let’s start with some history</h2> <p>The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.</p> <p>Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.</p> <p>The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.</p> <p>In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder <em>with</em> hyperactivity (ADDH) and attention deficit disorder as the subtype <em>without</em> the hyperactivity.</p> <p>However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:</p> <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> <p>ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.</p> <p>First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types.</p> <p>The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?</p> <p>Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers.</p> <h2>Why do some people use the term ADD?</h2> <p>There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD.</p> <p>Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.</p> <p>Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.</p> <h2>How is ADHD currently diagnosed?</h2> <p>The three sub-types of ADHD, outlined in the DSM-5 are:</p> <ul> <li> <p>predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions</p> </li> <li> <p>predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control</p> </li> <li> <p>combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.</p> </li> </ul> <p>ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.</p> <p>However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.</p> <p>Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<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/225162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith 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/whats-the-difference-between-add-and-adhd-225162">original article</a>.</em></p>

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Better sleep is a protective factor against dementia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, <a href="https://theconversation.com/institutions/monash-university-1065"><em>Monash University</em></a></em></p> <p>Dementia is a progressive loss of cognitive abilities, such as memory, that is significant enough to have an impact on a person’s daily activities.</p> <p>It can be caused by a number of different diseases, including <a href="https://alzheimer.ca/en/about-dementia/what-alzheimers-disease">Alzheimer’s</a>, which is the most common form. Dementia is caused by a loss of neurons over a long period of time. Since, by the time symptoms appear, many changes in the brain have already occurred, many scientists are focusing on studying the risk and protective factors for dementia.</p> <p>A risk factor, or conversely, a protective factor, is a condition or behaviour that increases or reduces the risk of developing a disease, but does not guarantee either outcome. Some risk factors for Alzheimer’s disease and dementia, such as age or genetics, are not modifiable, but there are several other factors we can influence, <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">specifically lifestyle habits and their impact on our overall health</a>.</p> <p>These risk factors include depression, lack of physical activity, social isolation, high blood pressure, obesity, diabetes, excessive alcohol consumption and smoking, as well as poor sleep.</p> <p>We have been focusing our research on the question of sleep for over 10 years, particularly in the context of the <a href="https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs">Framingham Heart Study</a>. In this large community-based cohort study, ongoing since the 1940s, the health of surviving participants has been monitored to the present day. As researchers in sleep medicine and epidemiology, we have expertise in researching the role of sleep and sleep disorders in cognitive and psychiatric brain aging.</p> <p>As part of our research, we monitored and analyzed the sleep of people aged 60 and over to see who did — or did not — develop dementia.</p> <h2>Sleep as a risk or protective factor against dementia</h2> <p>Sleep appears to play an essential role in a number of brain functions, such as memory. Good quality sleep <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2793873">could therefore play a vital role in preventing dementia</a>.</p> <p>Sleep is important for maintaining <a href="https://www.science.org/doi/10.1126/science.1241224">good connections in the brain</a>. Recently, research has revealed that sleep seems to have a function similar to that of a garbage truck for the brain: <a href="https://doi.org/10.1016/j.mad.2023.111899">deep sleep could be crucial for eliminating metabolic waste from the brain</a>, including clearing certain proteins, such as those known to accumulate in the brains of people with Alzheimer’s disease.</p> <p>However, the links between deep sleep and dementia still have to be clarified.</p> <h2>What is deep sleep?</h2> <p>During a night’s sleep, we go through several <a href="http://ceams-carsm.ca/en/a-propos-du-sommeil/">sleep stages</a> that succeed one another and are repeated.</p> <p>NREM sleep (non-rapid eye movement sleep) is divided into light NREM sleep (NREM1 stage), NREM sleep (NREM2 stage) and deep NREM sleep, also called slow-wave sleep (NREM3 stage). The latter is associated with several restorative functions. Next, REM sleep (rapid eye movement sleep) is the stage generally associated with the most vivid dreams. An adult generally spends around 15 to 20 per cent of each night in deep sleep, if we add up all the periods of NREM3 sleep.</p> <p>Several sleep changes are common in adults, such as going to bed and waking up earlier, sleeping for shorter periods of time and less deeply, and waking up more frequently during the night.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&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/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Sleep stages, and the role of deep sleep for brain health.</span> <span class="attribution"><span class="source">(Andrée-Ann Baril)</span></span></figcaption></figure> <h2>Loss of deep sleep linked to dementia</h2> <p>Participants in the <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2810957">Framingham Heart Study</a> were assessed using a sleep recording — known as polysomnography — on two occasions, approximately five years apart, in 1995-1998 and again in 2001-2003.</p> <p>Many people showed a reduction in their deep slow-wave sleep over the years, as is to be expected with aging. Conversely, the amount of deep sleep in some people remained stable or even increased.</p> <p>Our team of researchers from the Framingham Heart Study followed 346 participants aged 60 and over for a further 17 years to observe who developed dementia and who did not.</p> <p>Progressive loss of deep sleep over time was associated with an increased risk of dementia, whatever the cause, and particularly Alzheimer’s type dementia. These results were independent of many other risk factors for dementia.</p> <p>Although our results do not prove that loss of deep sleep causes dementia, they do suggest that it could be a risk factor in the elderly. Other aspects of sleep may also be important, such as its duration and quality.</p> <h2>Strategies to improve deep sleep</h2> <p>Knowing the impact of a lack of deep sleep on cognitive health, what strategies can be used to improve it?</p> <p>First and foremost, if you’re experiencing sleep problems, it’s worth talking to your doctor. Many sleep disorders are underdiagnosed and treatable, particularly through behavioural (i.e. non-medicinal) approaches.</p> <p>Adopting good sleep habits can help, such as going to bed and getting up at consistent times or avoiding bright or blue light in bed, like that of screens.</p> <p>You can also avoid caffeine, limit your alcohol intake, maintain a healthy weight, be physically active during the day, and sleep in a comfortable, dark and quiet environment.</p> <p>The role of deep sleep in preventing dementia remains to be explored and studied. Encouraging sleep with good lifestyle habits could have the potential to help us age in a healthier way.<!-- Below is The Conversation's page counter tag. 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More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, Professeure-chercheure adjointe au Département de médecine, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, Associate Professor of Neurology and Epidemiology, <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/better-sleep-is-a-protective-factor-against-dementia-222854">original article</a>.</em></p> </div>

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

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

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How music is changing the way dementia patients think

<p dir="ltr">New research has proven that music truly is the universal language, with experts discovering how the power of music is helping those suffering with dementia. </p> <p dir="ltr">Music therapists have shown that music brings dementia patients back to the present, with some even finding their voice thanks to the nostalgic memories of the past. </p> <p dir="ltr">According to Registered Music Therapist and Managing Director of music therapy company Music Beat, Dr Vicky Abad, the power of music is not to be overlooked when it comes to degenerative diseases.</p> <p dir="ltr">“Music is a window into people’s pasts,” she said. “It builds on strengths and abilities against a disease that can strip a person of their dignity, abilities and quality of life.”</p> <p dir="ltr">The team at <a href="https://www.tricare.com.au/">TriCare Aged Care and Retirement</a>, who see the devastating impact of dementia each and every day,  also experience first-hand the impact music has on residents, with many noticing “unrecognisable” changes in personality when a nostalgic tune is played.</p> <p dir="ltr">Louis Rose, an 80-year-old dementia patient and TriCare resident, was diagnosed with dementia six years ago, and requires assistance with many aspects of day to day life. </p> <p dir="ltr">However, listening to music is one thing he can enjoy on his own.</p> <p dir="ltr">“I grew up in Mauritius and while we didn’t have a lot, we certainly had music. Listening to music has always been an escape for me and a way to relax,” Mr Rose said.</p> <p dir="ltr">“When your brain starts to slow down and you find yourself forgetting things, it can be quite frustrating and confusing. Listening to music has been a way to distract myself from what’s going on in my head, it has helped me so much.”</p> <p dir="ltr">Tamsin Sutherland is a regular live music performer at TriCare facilities across Queensland, and has been able to witness incredible moments with the residents as they come alive as soon as she starts to play. </p> <p dir="ltr">“Watching residents who are often non-verbal sing along to the words is incredible,” she said “It really is like they are coming back to life and reconnecting with who they once were. To be part of that is quite emotional for me.”</p> <p dir="ltr">According to Dr Abad, music can help prevent the restless behaviour that often leads to pacing and wandering, especially in the evenings, which are often difficult times for those battling the disease. </p> <p dir="ltr">“Sundowning usually occurs in the late afternoon as dusk approaches, a time that is also associated with what used to be a busy time period in people’s lives,” she noted. </p> <p dir="ltr">“Personalised music is a simple and effective tool to help residents feel validated in their emotions during this time and provides them an opportunity to experience a calmer state of mind”.</p> <p dir="ltr"><em>Image credits: Getty Images </em></p>

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How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">La<em>wson R. Wulsin</em></a><em>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a></em></p> <p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others.</p> <p>So how much stress is too much, and what can you do about it?</p> <p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p> <p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.”</p> <p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging.</p> <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> <p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit.</p> <p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.”</p> <p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface.</p> <p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p> <p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors.</p> <h2>‘Treating’ stress</h2> <p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan.</p> <p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure.</p> <p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>.</p> <p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress.</p> <p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses.</p> <h2>Suffering from toxic stress</h2> <p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p> <p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be.</p> <p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all.</p> <p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p> <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> <p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>.</p> <p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p> <p>Adopting these lifestyle changes is not quick or easy, but it works.</p> <p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p> <p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655"><em>Lawson R. Wulsin</em></a><em>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</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-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.</em></p>

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What’s the difference between autism and Asperger’s disorder?

<p><em><a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference?</p> <p>Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.</p> <p>Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.</p> <p>When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made.</p> <h2>Where do the definitions come from?</h2> <p>The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.</p> <p>Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.</p> <p>In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>.</p> <h2>How did we used to think about autism?</h2> <p>The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.</p> <p>Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.</p> <p>Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.</p> <p>The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.</p> <p>Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.</p> <h2>What changed with ‘autism spectrum disorder’?</h2> <p>The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.</p> <p>It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.</p> <p>The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.</p> <p>The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.</p> <h2>Why do some people prefer the old terminology?</h2> <p>Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.</p> <p>The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.</p> <h2>What about identity-based language?</h2> <p>A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.</p> <p>The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.</p> <p>The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.</p> <p>However the social model contrasts itself against a very outdated medical or clinical model.</p> <p>Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.</p> <p>A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<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/223643/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.</em></p>

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World's oldest woman turns 117

<p>One of the world's oldest living person has turned 117. </p> <p>Maria Branyas Morera born on March 4, 1907 in San Francisco, lived through the 1918 pandemic, the two World Wars, Spain’s civil war and fully recovered after contracting Covid just days before her 113th birthday. </p> <p>She was one of the world's oldest Covid survivor's in 2020 and is now the 12th oldest verified person in history. </p> <p>Maria, who moved to Catalonia, Spain when she was eight, proudly announced her age on X, formerly known as Twitter in a post that read:  “Good morning, world. Today I turn 117 years old. I’ve come this far.”</p> <p>Maria, who has lived in a nursing home for the past 23 years, is healthier than ever aside from hearing difficulties and mobility issues, and scientists are studying her to find out the secrets to a long life. </p> <p>“She remembers with impressive clarity events from when she was only four years old, and she does not present any cardiovascular disease, common in elderly people," Scientist Manel Esteller told Spanish outlet <em>ABC</em>.</p> <p>“It is clear that there is a genetic component because there are several members of her family who are over 90 years old.”</p> <p>Scientists and Maria are working together to gain further insights into living longer, and researchers hope that studying Maria’s genes will help with the development of drugs which could combat diseases associated with ageing.</p> <p>Maria had three children with her husband  a Catalan doctor named Joan Moret.</p> <p>Her husband passed away 1976, and Maria also outlived her only son, August who tragically passed away in a tractor accident when he was 86. </p> <p>Maria now has two daughters, 11 grandchildren and 11 great-grandchildren.</p> <p>The oldest person ever established was a Frenchwoman named Jeanne Calment, who lived to the age of 122 years and 164 days.</p> <p><em>Image: news.com.au/ Guiness Book of Records</em></p>

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How can I stop overthinking everything? A clinical psychologist offers solutions

<p><em><a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a></em></p> <p>As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage.</p> <p>While rumination and overthinking are often considered the same thing, they are slightly different (though linked). <a href="https://www.apa.org/monitor/nov05/cycle">Rumination</a> is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem.</p> <p>It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated.</p> <h2>We’re on the lookout for threats</h2> <p>Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future.</p> <p>Our “what ifs” are usually negative outcomes. These are what we call “<a href="https://ccbhc.org/hot-thoughts-what-are-they-and-how-can-you-handle-them/">hot thoughts</a>” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them.</p> <p>However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts.</p> <h2>Who overthinks?</h2> <p>Most people find themselves in situations at one time or another when they overthink.</p> <p>Some people are <a href="https://www.apa.org/monitor/nov05/cycle">more likely</a> to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities.</p> <p>Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink.</p> <p>Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually.</p> <p>Being run down or physically unwell can also mean our thoughts are <a href="https://healthify.nz/hauora-wellbeing/m/mental-health-and-your-body/">harder to tackle</a> and manage.</p> <h2>Acknowledge your feelings</h2> <p>When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused <a href="https://link.springer.com/referencework/10.1007/978-1-4419-1005-9">strategies</a>.</p> <p>Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen.</p> <p>Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful.</p> <p>The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising.</p> <p>But it is difficult to plan for all eventualities, so this strategy has limited usefulness.</p> <p>What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of.</p> <h2>Think about why these thoughts are showing up</h2> <p>Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now.</p> <p>For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person.</p> <p>Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful.</p> <p>But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others.</p> <h2>Let the thoughts go</h2> <p>A useful way to manage rumination or overthinking is “<a href="https://www.getselfhelp.co.uk/docs/Options.pdf">change, accept, and let go</a>”.</p> <p>Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely.</p> <p>You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services.</p> <p>Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought.</p> <p>Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours.</p> <p>Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through.</p> <p>So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope.</p> <h2>What else can you do?</h2> <p>A stressed out and tired brain will be <a href="https://mentalhealth.org.nz/resources/resource/stress-and-how-to-manage-it">more likely</a> to overthink, leading to more stress and creating a cycle that can affect your wellbeing.</p> <p>So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit.</p> <p>Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat.</p> <p>If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage.</p> <p>When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety">here</a>.</p> <p>When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. <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/223973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/kirsty-ross-1513078"><em>Kirsty Ross</em></a><em>, Associate Professor and Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/massey-university-806">Massey 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-can-i-stop-overthinking-everything-a-clinical-psychologist-offers-solutions-223973">original article</a>.</em></p>

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