Saturday, February 16, 2019

Keep your seasonal allergies in check

Many people do focused brain exercises to help develop their thinking. Some of these exercises work, while others do not. Regardless, the focus network in the brain is not the only network that needs training. The “unfocus” network needs training too.
The “unfocus network” (or default mode network)

Called the default mode network (DMN), we used to think of the unfocus network as the Do Mostly Nothing network. And this network uses more energy than any other network in the brain, consuming 20% of the body’s energy while at rest. In fact, effort requires just 5% more energy. As you can imagine, this network is doing anything but “resting” even though it operates largely under the conscious radar. Instead, when you turn your “focus” brain off, it will retrieve memories, link ideas so that you become more creative, and also help you feel more self-connected too. Somewhat surprisingly, although the DMN is involved in representing and understanding your self, it also helps you read the minds of others. No wonder then, with all these functions on board, this network metaphorically converts your brain into a crystal ball, allowing you to predict things more accurately too. This is the kind of sharpness that you will develop if you train the DMN.

There are many ways to activate the DMN. Below are some that will give you a good start.
Surprising ways to train the default mode network

Some simple interventions could help you engage this network, depending on your goal.

Napping: If, for example, you are dog tired in the midafternoon, and just need your mind to be clear, a 10-minute nap might be all you need for sharper thinking. But if you have a major creative project ahead of you, whether it is an innovative idea at work, or redecorating your house, you will need at least 90-minutes of napping time. This gives your brain enough time to shuttle around ideas to make the associations that it needs to make.

Positive constructive daydreaming (PCD): It’s hard to imagine daydreaming as a type of training, but it is. It has to be the right type of daydreaming. According to Jerome Singer, who has studied this for decades, slipping into a daydream is not of much use; neither is guiltily rehashing everything that makes you feel bad — like the expense you incurred when you bought the shoes you liked, or the one-too-many drinks that you had at a party. But there is a type of daydreaming that will make you more creative and likely re-energize your brain. Called positive constructive daydreaming (PCD), it is best done while you are engaged in a low-key activity, not when you are fading. And as opposed to slipping into a daydream, which is more like falling off a cliff, you must parachute into the recesses of your mind with a playful and wishful image — perhaps one of you lying on a yacht or floating on your back in a pool on vacation. Then comes the swivel of attention — from looking outside, to wandering inside. With this move, you engage your unfocus brain and all the riches that it can bring.

Physical exercise and free-walking: In the brain, thinking supports movement, and movement supports thinking. In fact, exercise improves your DMN function. It normalizes it in obese people (who have too much of it) and increases connectivity in young healthy people. Even a single session can make a difference. Aerobic exercise can help prevent atrophy of key regions within the DMN, and also help the connectivity between different regions too.

Walking does boost creative thinking, but how you walk matters. One year of walking boosts the connections between the different parts of the DMN too. In 2012, psychology professor Angela K. Leung and her colleagues tested three groups of people. One group walked around in rectangles while completing a mental test; one group walked around freely; and the last group sat down while taking the test. The free-walking group outperformed the other two groups. Other studies have shown that free-walking results in improvements in fluency, flexibility, and originality of thinking. So if you want to boost your creativity, go on a meandering hike on a safe path less traveled. Furthermore, walking outdoors may be even more beneficial than puttering around the house (unless you’re using PCD, of course!)
Why you should focus on unfocus

We now know that focus is important in improving how we think, but for optimal brain training, we need both focus and unfocus. So, build unfocus times into your day. Ensure that you’re not in one continuous slog. Your brain is wired for focus and unfocus to work together, so take advantage of both types of intelligence when thinking of training your complex but delightful brain.
Acupuncture is a treatment that dates back to around 100 BC in China. It is based on traditional Chinese concepts such as qi (pronounced “chee” and considered life force energy) and meridians (paths through which qi flows). Multiple studies have failed to demonstrate any scientific evidence supporting such principles. Acupuncture involves the insertion of thin needles into the skin at multiple, varying locations based on the patient’s symptoms. Once inserted, some acupuncturists hand turn the needles for added therapeutic benefit. Although there are many uses for acupuncture in traditional Chinese medicine, in Western medicine it is primarily used for the treatment of pain.
Acupuncture (im)pales in comparison to Western medicine

At a time when people are increasingly concerned about drug side effects, some consider acupuncture an attractive non-medication option. Unfortunately, many studies show that the potential benefits of acupuncture are short-lived. In my experience, I put acupuncture, massage, and chiropractic interventions in the same bucket. You may feel better for a day or two, but there is limited lasting improvement.

In one study, 249 people with migraines occurring two to eight times per month received either acupuncture, sham (fake/placebo) acupuncture, or were put on an acupuncture waiting list. The two treatment groups received treatment five days per week for four weeks. Twelve weeks after treatment, the acupuncture group had on average 3.2 fewer attacks per month, the sham acupuncture group had 2.1 fewer attacks per month, and the wait-list group had 1.4 fewer attacks per month. These results are modest at best, and carry an approximate treatment cost of $2,000 per month (estimating $100/session x 20 sessions). This figure does not include lost income from time away from work to attend appointments, travel costs, pain from the procedure, and recovery time.

In general, the effectiveness of standard treatment (medication and injectable therapies) is supported by much stronger scientific evidence than acupuncture, including large clinical trials with thousands of subjects. For those averse to medications, physical therapy is a great alternative — one based on actual human anatomy and scientific principles. My patients often complain that they do not feel significantly better after the five to 10 sessions of physical therapy that insurance companies typically approve. I advise them that the true benefit of physical therapy comes when the stretching and strengthening routines taught by the therapist are continued at home on a long-term basis. Expecting an instant and permanent cure from physical therapy is like going to the gym for a week, and expecting to lose 20 pounds — without any chance of regaining the weight. (If any readers find a gym like that, please let me know….)
Stuck with needles, then stuck with a bill

At a cost of around $100 per treatment, and with sessions that can last over an hour, acupuncture treatments can be limited by both time and cost. Some patients may confidently argue that they do not mind the cost, because their insurance plan covers acupuncture. I would caution those same patients that money does not grow on trees, especially in the health insurance forest. If money is spent on one expense, it cannot be spent on something else. A plan that covers acupuncture may include fine print about excessive co-pays or limited coverage for basic medications. In some cases, covering acupuncture or massage may affect other patients in the same pool. Imagine if everybody received free massages, but in turn a cancer patient’s lifesaving chemotherapy becomes unaffordable. Although this is an exaggerated example, it does demonstrate the economics of health insurance.
Skewer side effects?

Side effects are not just limited to medications; procedures can also have negative effects. Acupuncture is relatively safe when the practitioner uses single-use, sterile needles with a clean technique. Side effects can include skin infections, bleeding, and pneumothorax (collapsed lung) if the needles are inserted too deep in the chest. Physicians sometimes perform acupuncture, but medical training is not required, and the qualifications to secure a license to practice acupuncture vary by state. It is probably worth the added expense to have a more experienced and/or highly credentialed acupuncturist.
Needle-less to say, the procedure went well

I fondly recall meeting an elderly lady who had a good experience with acupuncture for the treatment of her migraines, but the benefit only lasted one to two days after each session. After failing multiple treatments, she tried Botox injections with physicians not named Dr. Mathew, which she found effective. Due to scheduling issues, she ended up seeing me for injections. After I explained the risks and benefits of the procedure, she asked, “Dr. Mathew, are you experienced?” I replied, “Well, I trained the other two doctors who performed your previous injections.” She replied, “Well, I guess that makes you experienced. Are you gentle?” I paused and then replied in a stern tone, “Well, I am known as the Butcher of New England.” The woman was mortified, and she actually turned a little pale. I then advised her that I was just kidding, and that I am one of the gentler injectors in the practice. We then proceeded with her treatment. After we were done, she said, “That was the gentlest set of injections I ever received, and my pain is actually better.” I then said, “Please don’t say that… you will ruin my horrible reputation as the Butcher of New England.” Teens are affected by what their peers do and say — and by what they see in the media. We all know this. Most of the time, it isn’t a serious problem. But when it comes to suicide, it can be a serious problem.

That’s why many parents and professionals are worried about the Netflix series 13 Reasons Why. Based on the book by Jay Asher, it tells the story of Hannah, who kills herself and leaves behind 13 tapes for the people who played a role in her decision. The worry is that the series could make some vulnerable teens consider or try suicide.
How worrisome is this?

It’s a reasonable concern. Suicide is the second leading cause of death in youth ages 15 to 19, just behind accidents — some of which might actually be suicides. According to the 2015 Youth Risk Behavior Survey (YRBS), 17.7% of high school students said they considered suicide in the previous year, 14.6% made a plan, and 8.6% tried to kill themselves.

That’s a lot of kids. And given that there are studies that show that teens are more likely to commit suicide when they hear or read about another suicide, or when a schoolmate commits suicide, it’s understandable why the Netflix series has raised alarm. Trying to stop teens from watching it is a natural response. But besides the fact that it’s hard to do that for a show mostly watched online, the better response may be to use the show to start conversations, and get educated, about suicide.

Some teens are definitely at higher risk of suicide, such as those with mental health problems, a history of abuse, a history of a previous suicide attempt, or a family history of suicide. Teens who are LGBTQ (lesbian, gay, bisexual, transgender, or questioning) are also at higher risk. But given that the YRBS data shows that nearly one in five high school students thinks about suicide, there’s more that comes into play. Bullying, social isolation, and stressful life events, all of which happen to Hannah in the show, can make a teen think about dying — and, as also happens in the show, parents, friends, teachers, and others can be completely unaware of how sad and desperate a teen is feeling.

It’s certainly true that adolescence is almost by definition full of angst. But it’s important to be alert to anything that increases a teen’s risk of feeling suicidal, and to any signs that a teen is very sad, angry, or isolated. Too often, we are reluctant to even to talk about suicide, when talking is exactly what we need to do.
5 points to discuss with your child

Ideally, parents should watch 13 Reasons Why with their teens, and talk about it. But if that’s not possible (or if their teens have already watched it), here are some points worth discussing:

    The struggles and feelings Hannah has are common. So very many teens have trouble fitting in, or experience bullying, or have relationship problems, for example. Sometimes teens can feel like they are the only ones for whom life isn’t working out. Talking about this can put it in perspective, and allow you to point out that…
    There are other and better solutions than suicide. As horrible as a situation might feel in the moment, there is always something that can be done, and there is always someone who can help. Things can get better — unless you are dead, in which case they can’t. However, in order to get help, you have to let someone know you need it. So…
    If you ever start thinking about suicide, at all, tell someone. The best “someone” is someone who can help, or help you get help, like a parent, a teacher, or your doctor. But the most important thing is to tell someone. If you don’t feel comfortable telling someone you know, there are hotlines you can call, like the National Suicide Prevention Hotline: 800-273-8255. And, of course…
    If someone ever says that they are thinking about suicide, take it seriously. Don’t brush it off as a joke, don’t act like it’s no big deal or just a bad day. Act like they mean it, and get them help. You should also react and get help when someone is acting sadder than usual, is isolating herself or himself more, or is otherwise acting different in a way that is worrisome. If it turns out to be nothing, they will at least know how much you care about them. Which leads to another important message…
    We all have the power to help — or hurt — people every day. The people around Hannah didn’t realize how much they were hurting her, or how they could have helped her. Comments and actions that seem small can be devastating; kindnesses that seem small can make all the difference. If we use this Netflix series to talk about how we are responsible for each other, and how we need to take better care of each other, it could not only help us be better people, it could save lives.

No comments:

Leave a comment