We know that big life changes ― layoffs, health events, a new baby ― can cause a lot of stress. However, there are also tiny shifts in our lives (and even our days!) that are often overlooked when it comes to anxiety. Maybe you dread lying down in bed for the night, or maybe the morning rush has you stressed out.
These are called “micro-transitions,” which experts define as smaller moments where something is ending and another event is starting. These can include little points in your day, like the aforementioned bedtime, or slightly bigger events, like a vacation ending.
“Whether it’s called triggers or micro-triggers, we all certainly have things that set us off,” said Jeff Temple, a psychologist at the University of Texas Medical Branch, who adds that sometimes even dreading those transitions can be triggering. “There’s anticipatory anxiety, which is anxiety about being anxious, as opposed to actual things to be anxious about.”
Whether you’ve been officially diagnosed with anxiety or just feel stressed in those moments, there are ways to identify which micro-transitions are toughest for you and strategies for coping.
Here are some micro-transitions to watch out for and what to do to counteract them:
Dark thoughts like to show their ugly faces at night, Temple said, so the sun going down or similar evening-related transitions can trigger anxiety.
There are a few theories on why this happens. One study found that sleep disruption can be caused by an inability to control emotionally negative information at night. Some psychologists blame our caveman-esque brains, which used to scan for danger before bed in hunter-gatherer times. Additionally, our brains’ active “negativity bias” ― where our minds subconsciously focus on bad news over good news ― can be at play. At night, we can reminisce on various negative events that occurred during the day.
The End Of A Fun Event
Maybe you’ve spent weeks preparing for your upcoming vacation with family, only to obsess over your last day as the end of your trip is approaching.
Temple said this can be caused by having a great time and not wanting it to end, or conversely, having high expectations and feeling like whatever happened wasn’t as fun as you wanted it to be.
“So therefore, there’s a sense of dread or let down,” he said. These emotions can materialize as anxiety that you wouldn’t have felt otherwise.
Do you change how you are parenting when your partner leaves the room and your mother-in-law walks in? Maybe you are stricter, or more laid-back.
Either way, Dr. Whitney Casares, a private practice pediatrician and founder and CEO of the Modern Mamas Club, said that an “audience change” can be a micro-transition that causes anxiety. This can also show up as “putting on a good face” at a party when you aren’t up for it, or feeling like you can’t be your true self around certain peers.
If you have a Zoom call coming up, and you know your kid will be waking from a nap at the same time or that a repair person is about to arrive, you might feel pulled in two directions at once. Or maybe it’s a slightly bigger scenario: Say you’ve committed to a distant relative’s wedding and you get an invitation in the mail for your friend’s wedding the same weekend.
Dreading this inability to balance obligations or responsibilities can lead to some anxiety around those micro-transitions, Casares explained. Anticipating or worrying about issues that may come up can cause your body to go into fight-or-flight mode.
How To Deal If You Have Anxiety In These Situations
The first step to handling this type of anxiety is identifying the micro-transitions that are triggering to you, which can be easier said than done, Temple explained.
“Some of the hardest parts are recognizing your negative thoughts, or your anxious thoughts … it’s really difficult. It’s about being ― I really hate this word ― mindful and reflective, and paying attention to your body and your thoughts,” he said, suggesting people write it down when they perceive an “automatic thought” popping up.
These are thoughts that we don’t even notice we are having, like “tonight’s going to suck,” or “I’m not going to be able to sleep tonight because I have to do this tomorrow.” Once we can recognize which thoughts are automatic, we can challenge them, Temple said.
“That’s when you need to back up, and sit down and think about what just happened and what was going on, so then you can figure out what you were thinking,” he said. When you do this, you’ll start to notice a certain time of day, activity or anything in your environment that’s causing your anxiety.
Once you know your micro-transition triggers, you can work to prevent them. Then you can approach those transitions in a relaxed state,Temple said. So if, say, the evening is an anxiety-inducing period of time, practicing sitting down and deep breathing as that time begins can help.
You can also try creating a designated worry time to help compartmentalize your thoughts. This may be especially useful if you feel anxiety before sleep.
“Spend 10 minutes sometime in the mid-morning, not right before you go to bed, and write down every single thing that you are worried or anxious about. Stay seated for 10 minutes,” Temple said.
Later in the day, if something feels worrisome, validate the thought but move it to that worry time. “We’re not saying don’t have that thought, because that’s impossible … we’re saying you’re allowed to think that, you’re allowed to be anxious about that, just not right now. So let’s make a note and we’ll worry about that tomorrow during worry time,” Temple said.
Finally, know you are not alone in your anxieties, Casares said. For example, in scenario of a Zoom call while your child is napping, “you could fill a colosseum full of parents who might feel this exact same way,” she said. By realizing anyone in your situation might be experiencing the same emotions, you give your feelings some permission and some room to breathe.
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I Regret To Inform You That A Desk Treadmill Is Worth The Investment
A hundred lifetimes ago (in other words, before the pandemic), I spent a decent amount of time commuting. Between walks to and from the subway, walking to and from the grocery store or just walking to and from a restaurant or a friend’s apartment, I’d cover at least three miles a day on average, if not more.
Of course, that all changed in 2020. Working from home brought a new, more sedentary routine. I was lucky if I even took three steps, let alone three miles (that might be a slight exaggeration, but I think many of you can relate). My lack of movement exacerbated the aches and pains that come with being firmly in my 30s. I also found myself losing mental steam by the time the afternoon rolled around. Simply put, I felt the effects of being under-stimulated.
Then TikTok convinced me to buy a standing desk and ― most key ― a foldable treadmill.
I knew this was going to be an investment, so I spent months doing research and saving money. I had only a few requirements: The desk needed to be tall enough to accommodate my height (I’m 6 feet), and the treadmill had to be quiet and compact since I live in an apartment.
I finally settled on the perfect combination of a FlexiSpot standing desk and a foldable Walking Pad, and don’t regret a single thing. I bought them both on Amazon, where I got them at a discount compared to their list prices.
The slim Walking Pad folds in half and comes with wheels, making storage a breeze. (I keep it under my desk when I’m not using it.) It comes with a remote control, and you can also connect it to via app. It goes up to about 3.7 miles per hour and has two modes: automatic, which allows you to control how fast the belt goes using your feet and your own walking speed, or manual, through which you can set your walking speed using the remote.
Here’s my routine with this so far: I start my morning by putting my desk in the standing position and use the treadmill at a very leisurely pace ― around 1.5 mph. The key is to begin slow so I can get my footing. It’s surprisingly not too cumbersome trying to type while walking; if anything, it’s harder to look down and send a text. Once I feel good at my slow pace, I’ll bump it up to 2 mph or (rarely) higher. I’ll spend most of my morning walking, sit down for lunch and part of the afternoon, then go again around 3 p.m. or so.
“If you’re looking for a way to making working from home better on your body overall, this is it.”
You can’t deny the physical benefits. The first day I used the treadmill, I walked over 12,000 steps. My posture was certainly better than it would be sitting hunched over. Walking is also a low-impact way to gain the benefits of exercise; even just 21 minutes of it a day may reduce the risk of heart disease.
There are mental benefits to walking during the day as well. For one, it spices up my workday. Clearing out my inbox feels more ― interesting? tolerable? ― if I’m walking while doing it. Walking also helps me burn off stress, which I have plenty of thanks to covering COVID on a constant basis. It has also engaged my mind. I had lately found myself spacing out or needing to read the same sentences a few times before I really processed what I was reading, but I’ve noticed that when walking, my focus is heightened and I tend to space out less. I’m in sort of a mental flow.
Now, I won’t ridiculously oversell you on this setup; it isn’t going to be magical cure all for everything that ails you. The privilege of aging means you’ll ache sometimes. There will also be some days when you don’t have the desire to stand on your feet for an extended period of time, and there will be times when the mental fatigue that comes from living through one global crisis after another won’t melt away.
But if you’re looking for a way to making working from home better on your body overall, this is it. Those who are mulling whether to upgrade your home office situation, consider this your sign. Below are the products I personally recommend. I feel they were worth every penny I spent.
Bonus: an adjustable elastic ankle band for your smartwatch
If you’re a data person, beware: Wearing your smartwatch on your wrist while using the desk treadmill won’t accurately count your steps since you’ll be typing and mostly resting your arm. I bought this ankle band for my Apple Watch so I can more accurately track my movement. It’s soft and easy to adjust, making it a breeze to slip on and off. Your watch can still function normally with it on.
Summer Anxiety Is A Real Issue. Here Are The Triggers, And How To Handle It.
At first thought, the summer months are associated with carefree behavior — breezy beach days, shaded hikes and exciting vacations. But, for many people, summer is actually more stressful than exciting because of summer anxiety.
According to Dr. Crystal Burwell, a psychotherapist and owner of Dr. Burwell Speaks in Atlanta, anxiety occurs any time there is a transition, whether it’s the change of seasons or another kind of change.
And, summer, in particular, is full of changes that could cause anxiety: warmer weather, different outfits, summer vacations, longer days and more.
Here, experts share why you may notice that you’re more anxious during the summer months.
Summer seasonal affective disorder could be at play.
While seasonal anxiety is usually associated with winter, you can still experience a version of seasonal affective disorder in the summer, Burwell said. “It’s often called summer SAD,” she said. “What happens is it throws off our circadian rhythm,” which are 24-hour cycles that help control when we fall asleep and when we wake up.
In the winter, too little sunlight causes seasonal affective issues, and in the summer, there’s too much sunlight, which also causes similar issues, she said.
“We need the Vitamin D [from] the sun, however, when there’s too much sunlight our natural sleep cycle is thrown off,” she said.
Our bodies associate daylight with being awake. So, that late-night sunset may be pretty, but it’s not actually good for your night’s rest.
What’s more, Burwell added, is that in the summer months many of us have a dip in our body’s ability to create melatonin, which is the hormone the body needs for sleep.
Dr. Rachel Cavallaro, a psychologist with Thriveworks in Boston, stated that “with the longer days, our minds and our bodies are just more awake,” and, because of this, many people may have a harder time falling asleep.
And sleeping less creates more problems in general, including heightened anxiety.
The heat itself can even make some people anxious.
According to Cavallaro, the hallmark symptoms of anxiety include a higher body temperature, sweating and shallow breathing. And what else is associated with these symptoms? Hot days.
“Anxiety breeds anxiety,” she said. “The anxious person over focuses on what’s going on in their body on any given day.”
In the summer, this is particularly problematic since the hot weather creates symptoms that are very similar to anxiety symptoms.
“Then, it starts to spiral,” she said, with thoughts like, “Oh, no, I’m getting anxious,” creeping in and, ultimately, causing anxiety.
Anxiety can be triggered through thoughts, environment, or, in the case of summer heat, through a physiological false alarm.
For people with social anxiety, more social obligations may feed into anxiety, too.
From barbecues to pool parties to family reunions, summer’s social gatherings can be a reason people deal with anxiety this season, Cavallaro noted.
This is especially true for people who have either general worry or social anxiety, she said.
But even for those who don’t struggle with social anxiety, a full calendar with not too many breaks is also a reason for stress.
The routine-less days of summer can cause anxiety.
“When you’re on vacation or you’re not in school, people have [fewer] activities” and less of a daily routine, Cavallaro said. “That can create a lot of opportunities for anxious thoughts to come in because your mind is not occupied.”
Think about it: When you’re on a beach vacation, you’re probably lounging on a beach chair with none of your usual work or to-do list distractions to fill your mind.
“Boredom can be a trigger for anxiety — your mind needs something to do,” she said.
It’s important that you take time to relax and destress, but it’s about having a balance. “This is where structure and routine really help,” Cavallaro noted, “in the summer, people’s structure goes out the window, which then creates a whole host of other problems” because your daily balance is missing.
Cavallaro stated that one of the biggest underlying factors of anxiety is intolerance of uncertainty. This is why vacations can make people anxious; they’re uncertain about what can happen on their trip, whether that has to do with the weather or their flight.
Being less covered could trigger you, too.
When it’s 90 degrees and humid, you’re probably reaching for shorts, short-sleeved shirts, or sleeveless dresses. And while this may help you keep cool, many people may also feel anxiety when they go out in less clothes than they’re used to, Cavallaro stated.
“Less clothing can create a lot of insecurity,” she said, adding that people may have negative thoughts, like ‘What if people make negative comments about my body?’ or ‘What if people see me like this?’
The pressure of expectations can lead to anxiety.
Burwell noted that many of her patients feel an added pressure to “keep up with the Joneses” during the summer, particularly as they’re faced with questions about summer plans.
According to Burwell, when you see friends traveling to exciting places, you’re faced with both socioeconomic anxiety (Questions like: Why can’t I afford a vacation?) and worries about not having interesting stories to share with coworkers or peers (Thoughts like: How will my summer stories live up to the excitement of an Italian vacation?).
When faced with the question, “What did you do over the summer?” you may have feelings of being left out of the fun, she said.
If you are dealing with summer anxiety, create a routine for yourself.
“I’m a big believer in clients having a plan, because when we have a plan, we feel more empowered,” Burwell said. Even if Plan A doesn’t work out, just focusing on the solution instead of the problem can help combat anxiety.
Burwell encouraged those struggling with summer anxiety to anticipate their anxiety trigger ahead of time and make a plan to lessen its effects.
For example, if you feel anxious around a certain day, try distraction techniques like going for a run, cleaning up your house or making plans with supportive friends.
“Having a plan for how you’re going to combat this is a way of being proactive as opposed to reactive,” she said.
And make sure you’re getting enough sleep.
“Sleep is so important for our physical and mental health,” Cavallaro said.
She added that if you’re not getting enough sleep, you’re going to have a hard time managing your emotions and any issues that may come up throughout the summer.
Sleep goes back to the importance of schedule and routine, too. According to Cavallaro, “It’s better to have a consistent wake-up time than a consistent bedtime.”
Ideally, you want to wait until you’re tired to go to bed, but should maintain your morning alarm time to help you set up a summer (and all-year) routine.
Lastly, don’t be afraid to reach out to a professional.
Anxiety can be debilitating, stressful and can take all of the fun out of the summer months.
If you feel that you’re struggling, talk to a mental health professional. They can help you manage your anxiety and get ahead of it before the next season change.
Do Waist Trainers Work Or Are They Total B.S.?
Welcome to Beneficial Or B.S.?, where we investigate the health and fitness trends that are all over social media to determine whether they’re actually worth trying.
Between the world’s history of corsets and girdles, wanting a slim waist is certainly nothing new.
What is new, though, is using waist trainers in a workout to achieve it ― a phenomenon largely made famous by trending social media posts and fitness influencers. The claim from people who use waist trainers? It helps you lose weight around your midsection. But is that true?
Below, experts share their thoughts on waist trainers and give you the lowdown on whether it really slims your waist.
First, what is a waist trainer and why do people wear it?
Waist trainers are a form-fitting structure that wraps around the waist to compress the area — kind of like an old-school girdle or a corset, according to Dr. Jason Womack, chief of the department of sports medicine at Rutgers University’s Robert Wood Johnson Medical School in New Jersey.
Some waist trainers are all elastic, while others have hooks, zippers or velcro but all have the same goal of cinching the waist to create a specific, hourglass form of the body.
“It seems to have a more aesthetic purpose as opposed to a true medical purpose,” Womack said. He added that beyond creating a specific form, the goal of the waist trainer also involves training the core and losing weight.
Do waist trainers slim your waist or build your core?
People certainly look different when they’re wearing a waist trainer in the short run, said Dr. David Creel, a registered dietitian in the Bariatric & Metabolic Institute at Cleveland Clinic. But, this change is very temporary, Creel stressed.
“There’s no evidence that these [result in] permanent changes in your shape,” he said. Fat cells may move around temporarily but they’ll go back in place after the waist trainer comes off.
And when it comes to weight loss, Creel stated that there is no mechanism to support that waist trainers help you lose weight just by wearing them.
To put it frankly, “in my professional opinion, waist trainers are a gimmick,” said Dr. Alex McDonald, a family physician who specializes in sports medicine at Kaiser Permanente in California.
Are there any practical uses for it?
No, probably not, but, if someone you know is instructed to wear something that looks like a waist trainer, there is a reason.
“There are some situations where people wear abdominal binders, which look similar to waist trainers,” Womack said, but the two couldn’t be more different. Abdominal binders are intended for people who had recent stomach surgery or a C-section.
Studies show that when people wear abdominal binders, it helps them regain some of their muscle strength sooner. But, this goes for people who had a significant injury or surgery to their abdominals, not the everyday person who is just trying to increase their strength, he noted.
What are the dangers of wearing a waist trainer?
Beyond being uncomfortable, McDonald said, waist trainers “may also impair diaphragm motion and reduce athletic performance.”
In other words, they make it harder to breathe, and catching your breath is pretty crucial when doing a tough workout.
Even more, it could put stress on other parts of your body and work your core less.
Some people claim that waist trainers help with core strengthening or losing weight when you work out, Womack stated. But, he added, that is probably not the case.
The waist trainer could actually “modify the way that your core muscles are activating during activity,” he said. “You’re not actually activating those muscles in the most effective way.”
Similarly, he said, heavy weightlifters may wear waist belts, which help spread pressure across a wider area so they experience less strain. If anything, waist trainers could create stress on different areas of the body and put unexpected pressure on a different muscle group.
Because of this comparison, Womack noted that he is “not sure why waist trainers would be considered something [that] makes a workout better or more effective.”
And it doesn’t promote a healthy way to get fit.
Beyond this, Creel said that the biggest concern he has is that waist trainers “take the focus off of what is important and effective” when it comes to physical health. He explained that waist trainers make people chase a certain look instead of focusing on their well-being.
And since waist trainers aren’t an effective tool for weight loss or muscle building, Creel emphasized that people should turn to the fitness and healthy-eating methods that are proven with decades of research.
“Studies say we can’t spot reduce our weight — so I can’t do crunches and then get rid of fat around my waist,” he said.
He added that “when we lose weight, we have the same shape but it’s smaller, so if you’re apple-shaped you’re a smaller apple.” A waist trainer isn’t going to change your genetic build.
Focusing more on the health benefits of working out, and not just the appearance, is crucial, Creel noted. If people solely focus on appearance, they’ll be chasing the ever-changing “in” body trends and may never be satisfied
“When we focus on health and a healthy body,” he said, “there’s more acceptance with how that body looks versus just chasing a certain look, which, sometimes genetically, we’re not predisposed to look that way.”
Fertility Treatment Puts Many Families In Debt. Here’s How To Manage It.
The scientific community has come a long way when it comes to fertility treatments. Year after year, countless families turn to specialists and assisted reproductive technology to have children, and people are much more increasingly open to discussing their experiences with the process.
But despite how advanced and normalized these options have become, there remains a serious barrier to entry: the cost.
“Fertility treatment can be terrifyingly expensive,” Matt Schulz, chief credit analyst with LendingTree, told HuffPost. He cited a 2020 report from The Center for Reproductive Rights that found the median cost of a single IVF cycle in the United States is $19,200.
“That’s a staggeringly high total, especially when you consider that many women require multiple cycles to become pregnant and that there is no guarantee of success no matter how many cycles you go through,” Schulz added. “Given those costs, it is no wonder that many people say they just can’t afford to do fertility treatments. It’s really nothing short of heartbreaking.”
Of course, the range of costs can vary based on where you live and your individual needs when it comes to bloodwork, injections, egg retrieval, continued monitoring and more. But each step adds up, and it’s not uncommon for patients to accumulate thousands ― if not tens of thousands ― of dollars in debt to cover the out-of-pocket costs.
Still, is it possible to pursue fertility treatment without incurring serious financial setbacks? Below, Schulz and other experts share their advice for avoiding or minimizing the burden.
Map out your budget.
The first step to managing any financial decision is determining your budget. Calculate your income and expenses each month to figure out what you’re currently able to spend and any changes you might make to accommodate fertility treatment payments.
“It may sound simple, but a budget is where you have to start,” Schulz said. “You can’t make a meaningful plan to attack debt unless you know exactly how much money is coming in and going out of your household each month. Once you know that, you can start to prioritize where your money goes, whether that is saving for a potential treatment, carving out more money to pay down debt or any other reason.”
Check your benefits.
“It sucks that it has to be this way, but the truth is that it is pretty much up to the people seeking treatment to turn over every stone and exhaust every option in looking for safe, reliable and less expensive treatment,” Schulz said. “Check to see if your employer’s benefits cover these treatments. It’s more common than you might guess. Look into your insurance coverage.”
While full IVF coverage might be hard to find, some insurance carriers cover other parts of the fertility treatment process ― like diagnostic testing and other assessments. There’s also been recent progress on the side of employer-provided benefits.
“According to Fertility IQ, there is a 8% year-over-year increase in large employers providing additional coverage for family planning including IVF treatments, egg freezing and adoption,” said Nicole Carson, a financial planner with Brunch & Budget. “This is becoming increasingly popular in employee benefits packages as employers are looking to attract and retain top diverse talent.”
She believes more employers will add family planning benefits to their packages as the job market remains competitive.
Look for government programs.
“There are some ways to save money on IVF treatments,” Carson said. “Because pricing depends on the state you live in, some states like New York, California and Texas offer government programs to subsidize the costs of IVF treatments. There are also income-based grants and scholarships at the national level.”
Indeed, a number of organizations have programs to help families pay the out-of-pocket expenses of fertility treatments. Some are geared toward specific types of patients, like veterans, cancer survivors or Jewish families.
Find the right doctor.
After you get a sense of your coverage, find the right doctor for you. Your employee benefits might only apply to a specific provider, or you might have options.
Some clinics also offer discounts for multiple rounds of treatment, so it’s best to familiarize yourself with all possibilities. Once you know where you’ll be receiving treatment, then you can make more meaningful calculations to determine the total cost of the endeavor.
“Shop around to different clinics,” Schulz advised. “Research different loan options. You can even consider leaving the country to receive treatment, though that’s something that would require significant research and should not be entered into lightly.”
Traveling out of the country would also mean additional costs to take into consideration.
Ask yourself tough questions.
“How we spend is a direct reflection of our priorities,” Schulz said. “For some, the idea of spending $20,000 for a treatment that might not even work doesn’t make sense. Others wouldn’t even hesitate to spend that much or more for as long as it takes. Whether you agree with the former, the latter or something in between, make sure that you do your due diligence and ask yourself some tough questions before you make the call.”
For many families, the stakes involved in the choice to pursue expensive fertility treatment are too high to justify it.
“Unfortunately, you may have to ultimately decide that it just isn’t financially feasible,” Schulz said. “Our absurdly high-priced health care in this country forces people to make heartbreaking decisions about their health and their family’s wellbeing every single day. That’s true whether you’re talking about cancer medications, fertility treatments or countless other things facing Americans today. It’s an absolute tragedy, but it is where we are right now.”
Set aside whatever money you can.
“If you want to avoid debt to pay for fertility treatment, set a goal to set money aside over the next X months,” recommended finance coach Tatiana Tsoir. “Maybe skip a latte, or the next phone upgrade, or a vacation next time. All of those things add up really quickly and can break the bank.”
Even if you can’t fully avoid incurring debt, starting a fund can reduce the amount you’ll end up having to take out in loans. Think about it sooner rather than later, Tsoir advised.
“I say ‘start saving now,’” she urged. “It’s a good idea to save ‘just because’ for all adults, and a rainy day fund can come in handy in a situation when you want to start a family.”
Prepare for the hidden costs.
“Fertility has a lot of hidden costs, including mental health and physical health,” Tsoir said. “The drugs you take affect your skin and your overall health and can affect your self esteem and, in turn, affect your mental health.”
Think about the time you might need to take off work to deal with potential issues. She recommended reading other people’s accounts of the fertility treatment experience to give yourself a sense of things that could happen.
“Gabby Bernstein, in her book ‘Super Attractor,’ talks about her own journey and addresses the mental health behind it,” Tsoir noted. “I think it’s worth exploring.”
Choose loan options wisely.
Avoiding any debt might not be possible for your family, but you can set yourself up to take out less money in loans and manage it well.
“It is critical to understand what you’re getting into before you apply for any of these loans,” Schulz emphasized. “Fertility treatments are so expensive, so making a rushed or ill-informed choice on how to finance them can end up being very costly.”
He suggested looking into credit cards with a 0% introductory interest rate, but ensuring you know what the post-introductory interest rate is in case you can’t pay off the entire amount in that initial period. A personal loan is another option to help you manage your out-of-pocket costs.
“You won’t find 0% offers with these loans, but if you have good credit, they can often come with lower interest rates than you’d find with credit cards,” Schulz explained. “There are also IVF loans available from fertility clinics specifically for the needs of folks receiving these treatments.”
Carson noted that the more favorable your credit score is, the less interest you’ll have to pay.
“Consider a fixed-rate loan over a credit card where your payments are variable,” she said. This will help to keep your payments consistent and often offer a lower rate to borrow. And consider the length of time it will take you to pay the debt back ― choose a length of time that is going to fit within your budget.”
Study Finds Gout Flare-Ups May Increase Risk Of Heart Attack And Stroke
In America, heart disease is the leading cause of death among adults, and strokes (another cardiovascular disease) are one of the top five causes of death.
While certain lifestyle changes can reduce your risk of cardiovascular events, genetics also plays a large role in determining your risk for heart attacks, heart disease and stroke. This also holds true with certain health conditions. A new study shows gout, a common form of arthritis, may be associated with a higher risk of both stroke and heart attack.
Gout flare-ups are linked to an increased risk of heart attack and stroke for some time after the flare-up happens, according to U.K.-based research published in the American Medical Association’s JAMA journal.
The study followed 62,574 people with gout and found that “patients who suffered a heart attack or stroke were twice as likely to have had a gout flare in the 60 days prior to the [cardiovascular] event, and one and a half times more likely to have a gout flare in the preceding 61-120 days.”
This means if you experience a gout flare-up, there’s an increased risk of cardiovascular events in the four months following the occurrence.
“People with gout tend to have more cardiovascular risk factors,” according to the research. Additionally, the study stated gout ultimately leads to severe inflammation that manifests “as joint pain, swelling, redness, and tenderness that often lasts for one to two weeks. These episodes, called gout flares, often recur. Inflammation is also a risk factor for heart attack and stroke.”
Currently, about 8.3 million Americans have gout, and that number is only expected to grow in the coming years as rates of obesity rise and Baby Boomers get older. In other words, many Americans now have even more reason to monitor their heart health.
So, what can you do to protect your heart health if you have gout? And how can you reduce your risk of developing the condition? An expert shared below a few tips to help.
What is gout and who is prone to it?
Gout is “a disease that causes inflammation of the joints [and] it is the most common [type of] inflammatory arthritis,” according to Dr. Ethan Craig, an assistant professor of rheumatology at the Perelman School of Medicine at the University of Pennsylvania.
At its core, “gout is caused by an immune reaction to monosodium urate crystals in the joints,” he said. These crystals occur when you have elevated levels of uric acid in the blood.
Gout flare-ups (which are when the joints become painful, red or swollen commonly in the big toe, knee and ankle) happen when something occasionally triggers the immune system to notice the crystals in the joints, Craig noted. Flare-ups vary in severity but can become chronic and even lead to the destruction of the joints.
Can you reduce your risk of developing gout?
Unfortunately, a large component of gout risk is genetic, Craig said. “I emphasize this because there is this misconception that gout happens entirely because of dietary choices or lifestyle choices, but in most cases, this is not true,” he added.
There are a few things you can do to help reduce your risk of developing gout. Craig noted that weight loss, moderating alcohol consumption and following a Mediterranean diet are all ways to lower uric acid levels. It’s important to note that whether these lifestyle choices prevent gout altogether is unclear.
If you have gout, there are ways to manage it
This all may feel a little grim, but there is good news: Gout is highly treatable, Craig said.
Acute flare-ups are treated with an anti-inflammatory drug or steroid, he explained. And with long-term treatment, doctors address the underlying cause — which is high uric acid levels — through lifestyle changes or medication.
If you have gout, you must stay up to date with your treatments. Gout is a lifelong condition that requires ongoing and constant management; it can also become dangerous and even more painful when left untreated.
Additionally, there are methods to reduce your risk of heart attack and stroke
If you suffer from gout and are nervous about the heightened risk of cardiovascular events, you can make a few simple lifestyle changes to improve your heart health while continuing to manage your gout.
Maintaining a healthy weight, eating a diet with lots of fruit, veggies and lean protein, not smoking and regular exercise are all ways to reduce your risk of heart attack and stroke, according to the American Heart Association.
Walking for 21-minutes a day also cuts your risk of heart disease by 30%, according to Harvard Health. And Dr. Tamanna Singh, co-director of the sports cardiology center at Cleveland Clinic, previously told HuffPost that walking can benefit everyone whether they have increased cardiovascular risk or not.
Taking a walk can help control things like high blood pressure and high cholesterol. The activity can also prevent heart attacks and strokes, Singh said.
While gout flare-ups may mean an increased risk of heart attack and stroke, there are ways to manage both your gout and heart health to help prevent these cardiovascular events from happening.
How A COVID-19 Infection May Affect Your Period
Earlier this year, a large study of about 16,000 people found that the COVID-19 vaccine did, in fact, alter menstruation among 42% of participants. After vaccination, cycle length changed temporarily and heavier periods were reported, too.
Now, some experts (and many people who menstruate) are wondering how a COVID infection may have the same impact. Anecdotally, people have reported changes. Is this really the case? Here’s what experts currently know about the phenomenon:
In a recent study, participants reported period changes after being sick with COVID.
Recently, Dr. Leslie Farland, an assistant professor at the University of Arizona’s Mel and Enid Zuckerman College of Public Health, and a team of her colleagues studied menstruation changes after COVID infections. The research was conducted in 127 people ranging from ages 18 to 45 beginning in May 2020. All participants tested positive for COVID at some point between the beginning of the pandemic and now; the study is still ongoing.
“Approximately 16% of menstruating participants who had COVID-19 reported changes to their menstrual cycle following infection,” Farland told HuffPost.
Participants most commonly reported irregular menstruation, an increase in premenstrual syndrome symptoms like mood swings and tiredness, and infrequent menstruation.
Outside of the study, other period changes have been reported, too.
“Anecdotally, I’ve heard reports of periods changing in regularity, flow, duration, pain level and intensity,” said Dr. Staci Tanouye, a gynecologist at Women’s Care Florida.
The topic of period changes is also rampant on Reddit threads, where users of the platform corroborated on issues like late periods and spotting after being infected with COVID.
Tanouye noted that “the normal menstrual cycle is immune-mediated, so we know that any type of major infection or challenge to the body’s immune system could alter menstrual cycles and symptoms.”
Delayed cycles, heavier periods or more painful periods can also occur when people have infections like HIV, hepatitis B and hepatitis C, she added.
People with more severe COVID infections were more likely to report menstruation changes.
In the University of Arizona study, “individuals who reported changes to their menstrual cycle following COVID-19 were more likely to experience a greater number of COVID-19 symptoms,” Farland said.
But, there is room for error: Study participants self-reported the severity of their COVID symptoms and their menstruation changes.
Stress could also be a factor.
It’s no secret that stress can impact your period, even causing it to disappear for months on end. And the pandemic has been extraordinarily stressful, Tanouye explained.
“With COVID infection, there are multiple stressors to the body including the physical and emotional stress of both pandemic changes as well as COVID infection,” she said.
Farland added that study participants who reported period changes also did report higher stress levels. But, she emphasized that her study did not focus on stress’ relationship to menstruation changes during a COVID infection.
Overall, the reason behind period changes after a COVID infection is still unclear.
“We are not entirely sure [of] the mechanism behind these changes to the menstrual cycle,” Farland said.
She noted that while higher stress levels were witnessed in some study participants, factors like long COVID should not be ruled out until they’re studied.
“A consequence of this work is the importance of including gynecologic and menstrual health into the discussion of long COVID symptoms,” she said.
It’s well-known that long COVID manifests in a range of systemic changes that last for weeks to months, Farland added. And these changes vary greatly from person to person.
More research is needed on the impact that a COVID infection has on periods.
“There is a paucity of scientific research on these topics,” Farland and her team write in the study. This can be attributed to many factors that for years have driven the lack of research on gynecologic health.
“Historically, these topics may have appeared less important and therefore received less research funding,” Farland told HuffPost.
Farland believes this is slowly changing as correlations are drawn between gynecologic health, quality of life and long-term chronic disease outcomes.
As more and more people notice period changes after having COVID, they’re turning to online forums or tips from friends for help. The impact a COVID infection has on periods may not be fully known, but, anecdotally, there seems to be one.
More research and funding would help address the topic and put many people’s worries at bay. Because don’t we have enough to worry about already?
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
‘Fake It Till You Make It’ Isn’t Just A Cliché. It’s Backed By Science.
The phrase “fake it till you make it” can feel like a cliché, but there’s some value to this idea in the mental health field.
The expression is often evoked in describing the concept of behavioral activation ― a useful tool in managing conditions like depression and anxiety. But what exactly is this approach, and how does it compare to the idea of “faking” confidence, competence or positive emotions in order to achieve results?
Below, mental health professionals break down the meaning and effects of behavioral activation, as well as the best ways to apply this technique in your everyday life.
What is behavioral activation?
“Behavioral activation is a concept and intervention frequently used in cognitive behavioral therapy that utilizes behaviors to influence emotions, thoughts and mood,” said Rachel Thomasian, a licensed therapist and owner of Playa Vista Counseling in Los Angeles. “In other words, a therapist will often prescribe behaviors for their client to take part in, with the expectation that it will modify or ease some painful emotion they might be experiencing, such as anxiety or depression.”
A common symptom of depression is the inability to engage in behaviors that used to bring a person joy ― even though those behaviors would likely help alleviate their depression. Examples include socializing, exercising, cooking nice meals, self-pampering with showers and skin care routines, trying new activities and more.
“Instead, people who are feeling sad or lonely may seek out situations or fall into patterns that confirm their feelings of isolation and sadness,” said Meg Gitlin, a New York-based psychotherapist who runs the Instagram account @citytherapist. “This can be seen as somewhat of a self-fulfilling prophecy or a downward spiral. Behavioral activation requires you to consider the alternate ― that is, that by planning out activities and rewards that once brought you pleasure, it’s likely that you will experience those same good feelings once completed.”
How does it work?
“Our mental health and emotional state is so tied to the behaviors we engage in,” Thomasian said. “Deciding to stay in bed and going on a morning walk release very different chemicals in our brain, create starkly varying thoughts in our mind that then reinforce or break our emotional state.”
Engaging in behaviors that foster a healthy mental state can create a positive ripple effect that in turn encourages you to continue participating in those activities. This concept is at the root of the popularization of self-care.
“Behavioral activation therapies help reduce depression and anxiety symptoms by activating a reward system, and have been shown to be very effective,” said Bisma Anwar, a licensed therapist with Talkspace. “For example, replacing avoidant behaviors, like staying at home, with more rewarding behaviors, such as meeting up with friends for a walk, can increase a person’s motivation to continue this positive behavior.”
Initially, these actions might feel daunting and require a lot of effort. But if you commit to just giving it a try, you activate the positive reinforcement system.
“When you put one foot in front of the other, voila! You start walking,” said Sue Varma, a clinical assistant professor of psychiatry at NYU Langone Health. “Just like exercising, you may not initially be in the mood, but you end up feeling good afterwards and are glad you did it.”
Another way that behavioral activation can improve mental health is by helping people become more aware of which activities give rise to positive emotions, and which have the opposite effect. A person using this approach might also be reminded that they have the ability to experience joy, and remember how it feels.
“Through intentional tracking, the client improves their ability to recognize positive experiences throughout their day and increases their awareness of cause and effect,” said Marianela Dornhecker, a licensed psychologist practicing in Missouri and Texas. “With this increased awareness, clients typically feel more motivated to engage in those activities, and mindful of avoiding activities that aren’t helpful to them.”
Is it the same as “fake it till you make it”?
“This technique is often accompanied by the idea of ‘fake it till you make it’ because at the time, you may not feel like doing the things that are part of the behavioral activation, such as going for a walk or planning a nice meal with a friend,” Gitlin said. “The technique asks that you not think too hard about whether or not you genuinely feel like doing something ― i.e. fake it ― and instead focus on completing the task itself.”
In a sense, behavioral activation is like pretending that you feel better. But in doing this positive behavior, you’ll likely develop some positive feelings that can lead to “an upward spiral of motivation,” Gitlin said.
Still, some experts say there are crucial differences.
“There is an aspect of ‘fake it till you make it’ because you’re activating behaviors that don’t necessarily align with your current emotional state or idea of your sense of self,” Thomasian said. “However, I think the difference comes from the intent of the behavior.”
She offered running as an example. Following a pure “fake it till you make it approach,” you would fake being a runner even though you’re a beginner, until you eventually get good at running.
“In behavioral activation, there is a different end to the means,” Thomasian said ― it’s more like “I’m going to start running even though it’s the last thing I want to do, because doing so will help my emotional state.”
Besides, if you think of behavioral activation as “faking” your motivation to do an activity, it could affect your intentions and make the technique less likely to work.
“‘Faking it’ implies forced action, a lack of authenticity, connection and a cynicism around an experience,” said Monica Vermani, a Toronto-based clinical psychologist and author of “A Deeper Wellness: Conquering Stress, Mood, Anxiety, and Traumas.” “Framing it as a route or path to betterment, self-improvement, healing, overcoming anxiety and fears, and self-actualization creates a more positive and enjoyable process and experience ― which can help conquer maladaptive patterns.”
Dornhecker believes a better way to think about the mechanism of behavioral activation is the idea that “energy begets energy.”
“When someone is experiencing depression, their brain can feel like it is in a fog, or everything feels ‘underwater’ or dulled out, which can lead to low activity,” she explained. “This low activity actually has the effect of creating even lower energy and decreasing motivation. However, when someone makes the decision to do an activity that requires energy (even if they don’t feel like it), this actually has the effect of creating more energy in the body and thus increasing motivation and mood.”
How can you implement it?
Behavioral activation can take many forms, but here are some general steps for using this technique.
1. Monitor your actions and feelings.
“The first step of behavioral activation is actively monitoring,” said Shagoon Maurya, a psychotherapist based in Australia. “It is critical to be fully aware of our daily activities and how they affect our mood.”
You can keep a journal or download an app to take notes about what you’re doing and how you’re feeling. As you track your actions and the emotions they evoke, make a list of the behaviors that make you feel good and commit to implementing them in your everyday life.
“If you’re unsure what behaviors to focus on, it can be helpful to consider one’s values,” said Sanam Hafeez, a neuropsychologist in New York. “Your values are what matter most to you, and can guide how you live or how you’d like to live. You can ask yourself: ‘What would my life be like if I had no obstacles?’ ‘What matters most to me?’ ‘Who do I look up to? What qualities do they encompass?’”
Once you’ve determined which activities improve your mood and give you a sense of purpose, challenge yourself to do them more, even if you can’t always find the motivation.
“Repetition is key,” Vermani said. “You want to become bored by what makes you anxious, apprehensive and uncomfortable. The more you do something, the less intimidating and threatening that activity feels. The less threatening an activity becomes, the less power cognitive distortions and maladaptive thoughts [have].”
2. Set achievable goals for positive behaviors.
Vermani recommends setting achievable goals by focusing on one or two behaviors at a time and practicing them on a regular basis.
“For example, a person who has difficulty getting out of bed could commit to putting on an outfit that makes them feel good every morning, even if they do not go out anywhere, or commit to setting their alarm to play their favorite music to motivate them to get out of bed,” she said. “The goal here is to create something that elevates and improves your mood, lowers your sense of dread and sadness, and limits potential stressors.”
Eventually, you can build up to bigger activities like organizing a social gathering or pursuing a major project at work.
3. Minimize the negative behaviors.
As you identify and implement the behaviors that positively impact your mood, you should also take note of which ones don’t bring you joy or fulfillment.
“Reduce behaviors that make you feel bad,” Vermani said. “For example, someone may choose to limit the amount of time they spend on social media, and replace this with connecting one-on-one with friends. By getting rid of unneeded and unhelpful behaviors, you can increase self-esteem and self-confidence.”
4. Don’t confuse behavioral activation with busyness.
“Behavioral activation can sometimes be misunderstood to mean that being busy is the way to combat depression,” Dornhecker said. “Busyness for busyness’ sake is not what helps someone feel motivated ― in fact, this can lead to burnout.”
She noted that some of the activities that are valuable in combating mental health symptoms involve being busy ― for instance, learning a new skill. But other helpful activities can be slow and relaxing, like spending time outside or sipping coffee as you listen to music.
5. Use the technique in combination with other coping strategies.
Remember that behavioral activation is just one of many tools involved in cognitive behavioral therapy. It doesn’t necessarily work for everyone, and that’s OK.
“Although some people may respond well to behavioral changes alone, others may need a mixture of therapies to help,” Vermani said. “When behavioral activation alone does not help with a person’s symptoms, a mental health professional may be able to treat the condition more holistically in partnership with their medical team.”
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