De-Stress With Mindfulness

My last post focused on the pandemic and the actions that my household is taking in response to it. This week, things have gotten more serious. Monday, our governor issued an executive order that calls for home isolation except to secure food and prescription medicine. Workers associated with essential services may go to work; all others must telecommute. It’s a troubling time.

In the midst of all this turmoil, I attended a virtual class on stress management and the immune response courtesy of my local Yoga/Tai Chi studio. Master Brian started the session by reminding us that we cannot control external circumstances. In fact, it creates stress and strain if we try to control them. We’ll get tossed about in waves of thoughts and emotions tied to outside events and information. We’ll lose our ability to stay grounded, to see things clearly, and to take right action. And we’ll weaken our ability to combat infection disease should we be exposed to it.

say no to stressThese observations resonate clearly with a post I wrote two-plus years ago entitled Why Zebras Don’t Get Ulcers. It provided high level findings from Dr. Robert Sapolsky’s book by the same name. In it, he notes that chronic stress gives rise to hypertension, excess fatty acids/glucose/cholesterol, digestive disruption, bone disintegration, immune system suppression, memory decline, and sleep deprivation. In short, it damages vital systems, weakens the body’s defense mechanisms, and elevates the risk of illness and death.

While I’m seeing products that purport to bolster immune response fly off the shelves, I’m not hearing many folks talk about stress management and its role in bolstering immunity. Yet I suspect that managing stress is a far more effective strategy for immune system support than loading up on supplements.

Our exposure to news outlets and social media isn’t helping. It’s all gloom and doom. I get it; the pandemic is frightening. Its global impact has been devastating, and there’s no end in sight. We may need to hear how bad things are to get with the program on making sacrifices to keep ourselves and others safe. And yet a steady diet of that kind of reporting is not good for stress management. If you’ve already got the message, it’s probably best to be a little less informed.

be mindfulWe need to create space between all that external stuff and our conscious awareness. When the gap is small, things that happen outside can hit us and knock us off our feet. They can take over our consciousness and stress us out. When the gap is large, we can simply watch what’s happening and remain unaffected. We can live in a state of total presence. We can let go of expectations tied to the external world and focus on the power and centeredness of our interior life.

Admittedly, I’m not stellar when it comes to practicing presence. I get distracted easily, and unfavorable news can cause me to ruminate and worry. So, I’m making a point of developing habits and practices that run counter to my ingrained tendencies. I’m journaling in the morning to get the noise out of my head, onto paper, and then into the “circular file.” I’m tuning in to my daily Yoga-Tai-Chi (on-line!) class to encourage the practice of presence. And I’m establishing routines that create a sense of normalcy despite living in decidedly abnormal times. It all helps.

I’ve read and written about meditation but haven’t started a practice of it. It’s an auspicious time for me to work on quieting my body and mind. One step at a time. One day at a time.

A Pandemic Hits Home

This past week sent shock waves through our nation once again. I’ve experienced them before. I witnessed the oil crisis of the 1970s with long lines at every gas station. I lived in the SF Bay Area during the Loma Prieta earthquake and its aftermath. We’d moved to Raleigh NC in time to catch Hurricane Fran and the devastation it wreaked on our town. And I joined the nation in mourning the loss of life and sense of security with the terrorist attacks of 2011. I know the anxious feeling that uncertainty brings, and I tell myself that we shall get through it. But I surely do not like it.

covid-19The World Health Organization declared COVID-19 a pandemic one week ago. Federal, state, and local governments have been taking action to restrict travel and establish a measure of social distancing in an attempt to contain the outbreak. As a country, we are scrambling to establish appropriate testing protocols and capacity to identify and (I hope) quarantine affected parties. We have a pressing need to flatten the growth rate of infection so as not to overwhelm our healthcare system. And yet some folks do not take the disease seriously based on the relatively small numbers of confirmed cases reported to date.

Here’s why I take it seriously:

  • Confirmed cases are likely grossly underreported given the relatively small numbers of tests performed to date.
  • Many people present mild symptoms and, therefore, do not realize that they are carriers of the disease.
  • The virus appears to have staying power on surfaces that have come into contact with an affected person, thereby increasing its transmission rate.
  • Death rates are disproportionately high, especially for older persons. (My husband and I are older adults!) Those with severe symptoms often require hospitalization to avoid becoming a statistic. They may require a lengthy convalescence and may not recover fully.
  • The growth rate of cases has been exponential; demand for hospital intervention can rapidly outpace capacity.

I had an especially nasty bout with the flu 5 years ago. While it did not rise to the level of hospitalization, I have a keen sense for how “severe symptoms” present and the reality of never quite getting back to “normal” again. I have no desire to experience that again!

We’ve opted to practice social distancing and home isolation. We’ll venture forth to address necessities, e.g., to secure food and prescription medicine. We’ll maintain a discrete distance from others when out and wash our hands thoroughly upon our return. In short, we’ll err on the side of caution to protect ourselves and others.

Meanwhile, we’ll take the opportunity to attend to some long-standing projects that have been on the “to do” list but just never gurgled up to high priority. For example:

  • We’ve reached out to our attorney to update our estate plans. We have been meaning to do it for ages. While I don’t anticipate them having to go into effect, we’ll feel comforted in knowing that we’ve done a yeoman’s job preparing for worst-case scenarios.
  • We’ve updated our emergency suppliers to hold us over if we need to shelter in place for 2-4 weeks.
  • We finished planting all the trees and shrubs for our updated front and back yards. We’ll pay closer attention to them going forward. It’s great exercise!
  • I’ll be catching up on sewing projects that have been nagging at me for weeks (if not months!)
  • We’ll finally get around to going through our closets and garage to identify things that we no longer use or need. I’m not sure when we’ll be able to dispose of them, but at least the hard work of going through everything will be behind us!
  • We’ll both catch up on “office work” that proves time-consuming, mildly tedious, and worth doing.
  • We’ll exercise consistently, eat well, and get plenty of rest.
  • We’ll make the most out of the quality time that we get to spend together.
  • We’ll practice gratitude for all the things that we have and be mindful of others whose predicaments are more precarious than ours.

I’m still unsettled by the uncertainty that surrounds me. But I will do my best to keep this household healthy and upbeat. Fortunately, having a blissfully ignorant, unerringly jubilant Scottish terrier helps!

Daily “Tricks” to Support Weight Loss

hints and tipsIn my final post on Dr. Michael Greger’s How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss, I’ll cover the a few “tweaks” that he recommends to optimize a diet for weight loss. (He advises a consult with your doctor if you have any medical conditions or have difficulty with any of these recommendations.)

At Each Meal:

  1. Drink 1-2 glasses of cool or cold water before eating.
  2. Start each meal with “negative calorie” foods – e.g., an apple or a very light soup of salad
  3. Flavor meals (or a glass of water) with 2 teaspoons vinegar.
  4. Focus on eating, not the TV, notepad, or smartphone.
  5. Decrease bite size and eat slowly to allow for the 20 minutes necessary for your brain to catch up with your stomach.

Every day:

  1. Take in 1/4 teaspoon black cumin powder.
  2. Use 1/4 teaspoon garlic powder.
  3. Use 1 teaspoon ground ginger or 1/2 teaspoon cayenne pepper.
  4. Eat 2 tablespoons nutritional yeast. (When pre-packaged, it’s usually near the spice section. Otherwise, check out the bulk foods section.)
  5. Take 1/2 teaspoon cumin with lunch and dinner.
  6. Drink water, black coffee, or hibiscus tea during meals. Drink 3 cups of green tea daily between meals, waiting at least an hour after you finish eating.
  7. Drink a glass of water hourly, fitting in at least 8 cups throughout the day.
  8. Eat whole (intact) grains to make your microbiome happy. Flour doesn’t count.
  9. Have your largest meals earlier in the day. Eat breakfast like a king, lunch like a prince, and dinner like a pauper.
  10. Confine your meals to a 12 hour window – e.g., 7:00am to 7:00pm.
  11. Exercise 90 minutes daily. (For optimal results, wait 6 hours after your last meal – e.g., first thing in the morning.)
  12. Weigh yourself regularly.
  13. Work on establishing good habits (and breaking old ones) with a set of intentions – e.g., when I sit down to watch TV, I’ll drink a glass of water and work on a Sudoku puzzle to break the habit of snacking mindlessly. Take stock daily on how you’re doing. Adjust your list every 2 months.

Every night:

  1. Fast after 7:00pm.
  2. Get a good night’s sleep!

If any of these recommendations seems peculiar, I have a suggestion for you. Get a copy of Dr. Greger’s book and read it cover to cover! As I’d mentioned in the introductory post to this series, he provides nearly 5,000 citations of credible (vetted) scientific evidence for each one of his recommendations. And by investing the time to read this amazing book, it’ll hep you reinforce your commitment to a healthier you!

Weight Loss Boosters

In my third installment of findings from Dr. Michael Greger’s How Not To Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss, I’ll briefly summarize his weight loss boosters to help win the battle of the bulge.

diet boostersAccountability: Group therapy, health coaches, and social support produce better results than going it alone. At a bare minimum, weigh yourself regularly to stay focused on your weight loss goals.

Amping AMPK: An AMP-activated protein kinase causes the body to switch from storing to burning fat. It also stimulates production of mitochondria, the energy engines inside our cells. Eat nightshade vegetables (bell peppers, eggplant, tomatoes), barberries, and up to 2 tablespoons vinegar daily.

Appetite Suppression: Ground flaxseed, cumin, and black cumin naturally tamp down our appetites.

Chronobiology: Take advantage of our body’s circadian rhythms by eating when we’re most likely to process food efficiently. The rule of thumb is: Eat breakfast like a king, lunch like a prince, and dinner like a pauper. And don’t snack at night!

Eating Rate: It takes ~20 minutes after we start eating for the brain to put the brakes on our appetites. Eat slowly. Opt for solid foods that require chewing. Even the sensations in the mouth can translate into the sensation of physical fullness. Ergo, nibble and savor rather than chomp and gulp!

Exercise Tweaks: As noted in a prior post, adjusting one’s diet is a far more effective strategy for weight loss than relying on exercise (although exercise confers many other benefits). Choose activities that you genuinely enjoy so that you will be less tempted to reward yourself with culinary treats for doing it.

Fat Blockers: Thylakoids in greens delay fat absorption and decrease ghrelin, the hunger hormone. Superstars include kale, collards, and arugula.

Habit Formation: Build healthy habits so that good food choices (not bad ones!) become automatic. Be intentional every time you put food in your mouth. Don’t eat on autopilot.

Hydration: Substitute water for sugary beverages. Drink filtered water to avoid impurities.

Inflammation Quenchers: Adopt a whole food plant-based diet to maximize anti-inflammatory food substances. Try goji berries (wolf berries); they have four times the antioxidants as other dried fruits. Add turmeric and nutritional yeast to your diet.

Intermittent Fasting: Front-end load calories every day; “fast” every evening after an early dinner. This practice has been associated with lower inflammation, better blood sugar, and improved weight maintenance.

Meal Frequency: The more frequently people eat, the more weight they tend to gain. Break the snacking habit and/or make it really inconvenient to do so.

Metabolic Boosters: Drinking 2 cups of (plain) water boosts the metabolism; doing so four times daily can wipe out 100 calories! Cold water takes more energy to process than warm water. Limit consumption to no more than 3 cups per hour to avoid overload on the liver.

Mild Trendelenburg: Drinking extra water also causes our blood capacity to expand which induces the heart to release atrial natriuretic factor (ATF), a fat burning hormone.

Negative Calorie Preloading: If you drink 2 cups of water or 1 cup of water-rich vegetables before a meal, you tend to eat less during the meal. Apples and grapefruits can produce the same effect, but other fruits did not pass muster. (The sweetness may be an appetite stimulant.)

Sleep Enhancement: When we sleep too little, we tend to crave unhealthy foods and gain weight. Excess weight can be a deterrent to a good night’s sleep due to indigestion, sleep apnea, or physical discomfort. Aim for 7 hours per night of sleep.

Stress Hormone Relief: Much like sleep deprivation, stress is associated with weight gain. (They don’t call it “comfort food” for nothing!) Stress-induced weight gain tends to lodge in the belly – the worst place for it! Remedies include exercise, laughter, yoga, massage, and mindfulness-based stress relief (MBSR).

Wall Off Your Calories: When eating whole foods and whole grains, calories get trapped in their cell walls. It passes through our elimination channel and never makes it inside us. So, that’s an easy way to limit caloric intake. So, for example, choose raw, unprocessed almonds instead of almond butter, or whole grains instead of a slice of whole wheat bread!

17 Characteristics of a Great Diet

As promised in my last post, I’m going to cover 17 characteristics of a great diet according to Dr. Michael Greger in his latest book, How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss.

Anti-Inflammatory: Inflammation is our immune system’s response to unhealthy elements that invade our bodies. Processed foods and animal products are pro-inflammatory; whole plant foods, fiber, and phytonutrients are anti-inflammatory. Anti-inflammatory superstars include turmeric, ginger, raw garlic, green or black tea, and fiber.

Clean: Research connects chemical pollutants with obesity. The meat, poultry, and seafood industries have been plagued by obesogenic pollutants. Harmful substances can be present in canned goods and certain plastic containers. Pesticides also affect the obesity rate. The solution? Go organic, get to know the people who make your food, and learn to cook from scratch.

High in Fiber-Rich Foods: High fiber diets make us feel full by distending our bellies and delaying emptying into the intestines. Upon reaching the intestine, they block absorption of carbs and fats into the bloodstream and help curb our appetites. And, to top it off, the good bacteria in our gut biome love to feast on fiber!

High in Water-Rich Foods: Water adds bulk to what we eat without adding calories. Water-rich foods take more chewing action and have a dampening effect on stomach emptying. These built-in delays provide much needed time for our body to signal to our brain that we should stop eating!

Low Glycemic Load: These foods avoid sugar spikes in our bloodstream and the associated activation of the reward/craving centers in our brains. They help us burn more fat and result in less of a metabolic slowdown as we lose weight.

Low in Added Fat: Naturally low-fat foods encourage a higher burn rate in resting calories, and a higher percentage of their intake gets flushed down the toilet. Don’t be fooled by processed foods claiming “low fat” as they frequently contain extra sugar!

Low in Added Sugar: Sugar amps up our caloric intake, triggers an addictive response, and delivers no material nutritional value. What’s the number one strategy to avoid added sugar? Stop eating processed foods!

Low in Addictive Foods: The combination of sugar, fat, and salt revs up our craving engines and compels us to overeat nutritionally vacuous foods. Better to train our brains to enjoy healthy foods.

Low in Calorie Density: We’re designed to eat about 4-5 pounds of food per day. The body principally registers satiety by volume, not calories. So, it may be that obese individuals eat the same relative weight of food but simply ingest substantially more calories per mouthful.

Low in Meat: According to Dr. Greger, the odds of being obese increase by 18% for each 1% intake of calories by meat. This weight gain tends to settle in the abdomen.

Low in Refined Grains: Ultraprocessed food account for 58% of our daily intake. These refined grains contribute to weight gain far more than any other dietary and lifestyle factors. By contrast, whole grains increase satiety, increase our metabolic rate, and increase caloric loss via stool.

Low in Salt: Like sugar and fat, salt has an addictive quality that stimulates appetite and may encourage ingestion of sugary drinks.

Low Insulin Load: Sugar and meat protein cause insulin surges which, over time, result in cellular insulin resistance. High fat meals also diminish insulin sensitivity.

Microbiome Friendly: Our microbiome regulates our immune system, balances hormones, improves digestion, and makes life-sustaining vitamins. Every food choice affects our gut flora. A diverse gut flora supports lower body fat. Eat fiber-rich food (the real stuff, not fiber supplements).

Rich in Fruits and Vegetables: Such diets yield 17% lower odds of weight gain or abdominal obesity. Plant cells also affect gene expression in a way that promotes weight loss.

Rich in Legumes: The more beans you eat, the lower your body weight, waist size, saturated fat, and cholesterol intake. Beans also slow digestion and delay the return of hunger. And beans are packed with protein and fiber.

Satiating: We are built for gluttony. Our survival mechanisms were fine-tuned through thousands of years of scarcity. To keep our brains and hormones appropriately regulated, opt for fiber-rich, water-rich whole foods that suppress appetite. Make sure there’s ample variety in food selection to keep the mind and body happy.

Diet Beats Exercise for Weight Loss

I’ve been watching videos from Dr. Michael Greger’s website for the past two-and-a-half years. As noted in an earlier post, I’m impressed by Dr. Greger’s passion and integrity as well as the rigor with which he tackles nutrition research. So, I purchased his latest book – How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss – as soon as it was published.

Given scads of diet books on the market, Dr. Greger set out to produce something unique – an evidence-based diet book for which the author had no personal financial incentive. (He donates all of the proceeds to charity.) It’s a 570-page tome jammed-packed with all kinds of valuable information and backed up by nearly 5,000 citations of scientific articles. (The team actually reviewed 500,000 peer-reviewed scientific publications to support this book!)

Here are a few of the attention-getting statistics that introduce the core of his content:

  • obesity pandemicWhile the diet industry rakes in $50 billion per year in revenue, it’s plagued by a gaggle of “fake news.” All too often, the profit motive supersedes well-researched, unbiased academic scholarship.
  • Seventy-one percent of Americans are overweight; 40% are classified as obese. Perhaps even more startling, 90% of Americans are overfat. (That is, a lot of thin people have too little lean muscle mass!)
  • The rise in daily caloric intake more than accounts for our obesity epidemic. The U.S. produces 3,900 calories of food per person per day – far more than we need to sustain normal body weight.
  • Taste engineers in food processing companies strive to make their foods irresistibly desirable by tapping into the addictive properties of sugar, fat, and salt. Dr. Greger refers to their products as C.R.A.P. – i.e., Calorie Rich And Processed food.
  • The average child may watch upwards of 10,000 ads for C.R.A.P. foods in the course of a year.
  • Failure to turn the tide of obesity isn’t a matter of personal willpower. It also reflects a lack of political will. Food lobbyists influence government policy and work to suppress the stark truths about their products. Moreover, the sugar, fat, and meat industries receive substantial governmental subsidies.
  • The per capita lifetime cost of obesity (including lost productivity) equals ~$200,000.
  • Four million deaths annually can be traced to excess body fat.

The foregoing may not surprise you. But here’s a fact that probably will: Caloric intake, not physical activity, predicts weight gain. Moreover, the power of your genes is nothing compared to the power of your fork. Say what?

Body fat accumulates when Calories IN consistently tops Calories OUT. So how do we burn calories?

calories out

  • Our resting metabolic rate consumes 60% of our calories. It’s what we need to feed all of our cells and manage all of our bodily functions.
  • Twenty-five percent of our calories get used up supporting non-exercise physical activity – e.g., walking, hoofing up and down stairs, gardening, housework, cooking, etc.
  • Another 10% of our calories get used for thermogenesis, which is just a fancy word for the effort it takes to process food into usable substances (and eliminate the rest).
  • The remaining 5% gets burned off during exercise.

But wait – what about all those elite athletes who burn thousands of calories during their workouts? Sure – their Calories OUT equation looks a whole lot different from the Average Joe. But here are all the ways the Average Joe thwarts the benefits reaped by exercise:

  • Rewards self with a sugary protein bar immediately after working out
  • Adds more calories to daily consumption than gets burned off by exercise under the guise of increased appetite
  • Spends more time as a couch potato, thereby dialing down the burn available through non-exercise physical activity

Exercise most assuredly adds years to our lives and life to our years by stimulating our cardiovascular system, building strong bones and muscles, and increasing our flexibility and agility. But we can’t hang our weight loss hats on this strategy alone. We must watch what we eat AND make sure we’re getting sufficient non-exercise activity. (Just move!)

In my next post, I’ll cover Dr. Greger’s 17 key ingredients for a successful weight loss program.

Death and Diet

In 2013, the National Institute of Health published a research paper entitled “The state of US health, 1990-2010: burden of diseases, injuries, and risk factors.” Its analysis and comparison with 34 other industrialized nations provided valuable input for national health policy. Here are some interesting facts:

  • The US spends the most per capita on health care.
  • US life expectancy increased from 75.2 years in 1990 to 78.2 years in 2010.
  • Healthy Life Expectancy increased from 65.8 years in 1990 to 68.1 years in 2010.
  • Among the 34 countries, the US rank for age-standardized death rate went from 18th in 1990 to 27th in 2010.

To summarize: We spend a disproportionate amount of money on healthcare. While life expectancy has increased, the average person still experiences 10 years of disability. And the US is falling behind other countries in its mortality rate. Not such great news!

Roughly three-quarters of all US deaths can be attributed to one of 10 causes. Here are the statistics gathered by the Center for Disease Control:

leading causes of death in the usa

I know a lot of people who think that we do not have much control over when and how we die. They think that maladies come with old age and that something is bound to get us. But when you look at the data, it turns out that we have much more control than you might think. According to the aforementioned State of US Health report, here are the top 10 primary risk factors that lead to premature death:

risk factors for death

What’s the number one risk factor? Diet! And if you’ve read my other posts, you’ll see how diet impacts blood pressure, body mass index, plasma glucose, and cholesterol. So, in reality, diet is responsible for the 1st, 3rd, 4th, 6th, and 7th leading risk factors for premature death. And Dr. T. Colin Campbell makes the connection between diet and cancer in his book, The China Study.

Bottom Line: Change your diet and you just might save your life!

A Year of YES

I discovered Grey’s Anatomy a few years ago. Binged watched it to get caught up. Then went on to enjoy two of Shonda Rhimes’ other series – Scandal and How To Get Away With Murder. They’re well-crafted TV dramas with compelling story lines, sharp dialog, and strong, capable women. No surprise given the powerhouse of a woman who stands behind these series. Yet even this highly successful woman had to go on a journey of discovery to find her best self.

I’ll share a few tidbits from Shonda’s book, Year of Yes: How to Dance It Out, Stand in the Sun, and Be Your Own Person. My heartfelt recommendation is that you get your hands on the book and read it for yourself. Quite a lot gets lost in the “highlight reel,” and you’ll miss the experience of reveling in her distinctive voice. But here goes anyway.

yesThe year of YES began after a family Thanksgiving gathering during which Shonda rattled off a list of A List engagements to which she was invited. Her older sister was unimpressed and knew that Shonda would turn them all down. As she said, “You never say yes to anything.” Indeed, Shonda had become quite comfortable living life as a busy TV executive and mother of three (which assuredly left her plenty occupied!) But she wasn’t breaking out of her shell and trying new things. So, she resolved to make the ensuring year one that included a lot more YES.

Initially, I thought, “That’ll never be an aspiration of mine. I’m the girl who can’t say ‘no’ and winds up spent and exhausted. I need a year of NO!” But as I went along on Shonda’s journey, I found myself wanting to get on the YES train.

Here are things to which Shonda said YES:

  • To anything and everything that scared here – e.g., a commencement speech at her alma mater, TV appearances, charity events, interesting parties

“Every yes changes something in me. Every yes is a bit more transformative. Every yes sparks a new phase of evolution.”

  • To her children when they said, “Wanna play?”

“The more I play, the happier I am at work. The happier I am at work, the more relaxed I become. The more relaxed I become, the happier I am at home. And the better I get at the playtime I have with the kids..”

  • To feeling unpleasant feelings rather than burying them under food

“Food feels so good when you put it on top of all the stuff you don’t want to deal with… It numbs you… [but] numb feels not just dead but rotting.”

  • To accepting any and all compliments with a clear, calm “Thank you”

“No one who succeeds is merely lucky… I am not lucky. You know what I am? I am smart, I am talented, I take advantage of the opportunities that come my way, and I work really, really hard. Don’t call me lucky. Call me badass.”

  • To saying NO without explanation

“I come up with three different clear ways of saying no: ’I am going to be unable to do that.’ ‘That is not going to work for me.’ ‘No.’’’

  • To having the difficult conversations

“No matter how hard a conversation is, I know that on the other side of that conversation lies peace. Knowledge. An answer is delivered. Character is revealed. Truces are formed. Misunderstandings are resolved. Freedom lies across the field of the difficult conversation.”

  • To surrounding herself with friends and colleagues who are the real deal

“The upside to culling people from my life is that my focus has become crystal clear… I now work to see people, not as I’d rewrite them, but as they have written themselves… people whose self-worth, self-respect, and values inspire me to elevate my own behavior.”

  • To telling her truth

“Happiness comes from living as you need to, as you want to. As your inner voice tells you. Happiness comes from being who you actually are instead of who you think you are supposed to be.”

At the finish line, Shonda described herself as being: “One hundred twenty-seven pounds thinner. Several toxic people lighter. Closer to my family. A better mother. A better friend. A happier boss. A stronger leader. A more creative writer. A more honest person… More adventurous. More open. Braver. And kinder. To others. But also to myself.”

Those are things to which I can say YES!

Alzheimer’s Disease

With last week’s focus on mental health, I thought I’d zero in on a particularly challenging form of mental disorder, Alzheimer’s disease. The Mayo Clinic characterizes the condition as “a progressive disorder that causes brain cells to waste away and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral, and social skills that disrupts a person’s ability to function independently.”

alzheimer's diseaseThe Alzheimer’s Association has published a rather alarming set of statistics regarding the prevalence of this disease:

  • 8 million Americans live with Alzheimer’s disease, with estimated growth to 14 million by 2050
  • 16 million Americans provide 18.5 billion hours of unpaid care for people with Alzheimer’s disease and other forms of dementia, valued at nearly $235 billion
  • 1 in 3 seniors dies with Alzheimer’s disease or senior dementia

There is no treatment that cures Alzheimer’s disease or alters the disease process in the brain. However, as documented elsewhere in this blog, healthy lifestyle habits appear to be protective of brain circuitry and forestall its development.

I have some experience in this area. My father had geriatric dementia in his later years. While his cognitive functioning was impaired, he was still able to carry on an animated conversation until the last couple of months before his death at 96. My mother has fill-blown Alzheimer’s disease and has been substantively impaired for quite some time.

It turns out that while most seniors think it’s important to have their cognitive abilities checked regularly, only 16% of them actually follow through with testing. I can understand why. Of the many things that fall away with old age, the loss of one’s cognitive capacity and memory just might be the most frightening. It’s a clear marker of infirmity that foretells the loss of independence. And, as noted in last week’s post, any condition identified as detrimental to mental health tends to be stigmatized.

My mother was among the smartest people I’ve ever known, and she viewed her intelligence as one of her primary assets. So, I imagine that it was really bothersome for her to experience a decline in her analytical capacity and  stellar memory. Early indications came 5+ years ago when she asked me to take over their finances when Dad went into skilled nursing. The cover story was that it would be easier for me to navigate all the administrative details that accompanied payment of fees and reimbursement by their long-term care insurance provider. But a quick glance at their books revealed that Mom’s accounting skills had really fallen by the wayside.

Mom was once our chief purveyor of family stories, providing extraordinary detail on names, relations, conversations, events, etc. In the last few years, she spent more time listening to the stories and acting as if she were following the conversation (but may not have been). A little over a year ago, she stopped being able to watch movies or TV shows – even familiar ones or those with really simple story lines. She just couldn’t follow the action and would say over and over, “What’s going on?” Within the past couple of weeks, she seems to have forgotten who I am.

As caregivers go, I am really, really lucky. My parents acquired long-term care insurance 25 years ago. As such, Mom can afford to live in one of the nicest Memory Care facilities in the area. Her room and the common areas are beautifully appointed. The organization attracts competent, caring staff. They do the “heavy lifting” (literally and figuratively) so that I can focus on being a daughter. Even so, it is still really difficult to watch my Mom struggle with everyday living. And there’s very little I can do these days other than sit with her.

As noted above, 1 in 3 older adults passes on with some form of dementia or Alzheimer’s disease. The sad reality is that the person you knew leaves long before his or her body finishes its earthly existence. I miss the mother who knew me. I miss the mother who shared my memories. I pray that she is as safe, comfortable, and peaceful as we can make her in these final days.

Mental Health

Ten years ago, a former colleague published an evocative memoir about her struggle with depression, her road to recovery, and her ongoing management of the condition. I was floored by her revelation. When we worked together, she was an “it” girl – intelligent, witty, beautiful, athletic, and seemingly successful in all aspects of her life. And yet her struggles were very real, very painful, and very nearly fatal.

She is not alone.

mental healthTIME magazine’s special issue on mental health tells us that 450 million people worldwide struggle with mental health issues. In the United States alone, one in five people experience some form of mental illness each year. Those afflicted increase their mortality risk by 26% and are decidedly more susceptible to metabolic syndrome, chronic stress (and the attendant physiological distress), and altered immune function. TIME estimates the worldwide annual cost of mental illness to be $2.5 trillion and projects growth to $6 trillion by 2030. Suffice it to say, it’s an emerging health crisis.

The stigma attached to mental illness creates an impediment to effective treatment. It takes courage to seek help in a society that often deems mental disorder as a sign of weakness. Yet the emerging science tells us that these brain disorders have their basis in biology and require intervention. We need to change the public discourse to create a safe space for people to get the help they need.

For the past 60 years, antidepressants have been a bedrock of psychiatric treatment. However, 30% of the target population do not respond well to them. Of the remainder, it could take a process of trial-and-error to find the right medication and dosage to produce a workable result. Unfortunately, the longer one stays in a state of depression, the harder it becomes to set things right.

While depression can affect every one of us at any age, we are at increased risk in our 60s and beyond. There’s an increased incidence of seniors living without family members nearby. Upwards of 20-25% of Baby Boomers do not have children. That combined with a plethora of solitary entertainment can result in a downward spiral of loneliness.

So, what can we do to maximize our own mental health?

  1. Get a good night’s sleep every night. Try to go to bed at the same time every night and arise at the same time every morning. Have a calming ritual at night that helps you prepare for sleep.
  2. Eat a healthy diet. The same dietary risk factors that give rise to heart disease also affect brain health.
  3. Exercise! It’s not just good for the body; it’s good for the brain! Physical activity elevates mood, bolsters energy, and stimulates the production of endorphins. It also desensitizes the body to certain kinds of emotional distress.
  4. Prioritize spending time with people. Socialization is one of the best things you can do to sustain a healthy brain and ward off depression. Stay in the workforce. Volunteer. Join clubs. Put the welcome mat out and invite friends over.
  5. Consider living in an intentional community. The younger generation has embraced this lifestyle, often as a function of economic necessity. The fifty-five-and-over crowd has access to a broad range of planned communities all across the country, primarily in warmer climates. A handful of multi-generational communities are sprouting up as well. Or simply forge connection within your neighborhood.
  6. Engage in mindfulness training. It helps you focus on the present rather than ruminate on the past, among other benefits. For those of us who have trouble sitting still, try floating on water. Early evidence suggests that it lowers anxiety, relieves muscle tension, and engenders a relaxed state of mind.
  7. Seek professional help. As a case in point, cognitive behavioral therapy focuses on changing negative thought patterns and finding new approaches to problems.
  8. Get a pet. Research has shown that pet ownership lowers blood pressure, heart rates, and heart disease risk. And pets are a proven antidote to anxiety and loneliness.
  9. Use light therapy if affected by Seasonal Affective Disorder. It can be a mood and energy booster first thing in the morning.
  10. Focus on all the things about which you can be grateful and let go of grievances and disappointments. Make a habit of forgiving yourself and others. Pay attention to the blessings that each day brings.