Tag

Mental Health

What Employees Want

Good Mood Dudes founder Dr. Nicholas Chartres, sits down with The Guardian to discuss the new landscape of work/life balance and what employees expect from their workplace.

As featured in:

With the dust starting to settle after almost 3 years of disruption to our way of life due to Covid-19, evidence of what employees expect in the workplace is now becoming clear. 

While the transition to working from home came with its challenges as employees and employers had to conform to Covid-19 restrictions, what’s emerged is a new way to think about work-life balance. People are now seeking flexible work hours, healthier work environments, and autonomy in their roles over less valuable employee ‘perks’. Good Mood Dudes’ Dr Nick Chartres says “In most businesses right now, it’s all about autonomy and flexibility: the autonomy to select how many days in which people are going into the office, as well as the flexibility to adjust that on a week by week basis”.

But autonomy and flexibility are not the only important things people are seeking. “Natural light, fresh air, and end-of-trip facilities – so people can ride into work or go to the gym at lunchtime – are now pretty much mandatory for a lot of companies,” says Chartres. “Being close to public transport, supermarkets, gyms, parks, and green space is also great.” A workplace that makes the commute to work shorter and easier with the physical destination also being a place of comfort is a top request by employees today. 

Experts suggest that many people are now wanting to walk or cycle to work and when they arrive they want the office environment to offer an enjoyable experience that allows them to work effectively in comfort. Whilst psychosocial factors of company culture can impact the comfort of an employee in an office environment, things like having privacy to focus as well as spaces that support collaboration and interaction with teams are crucial.

Whilst the voices of those who prefer a more laissez-faire approach to leadership are being heard, it is important to remember that every employee is different and will have different needs when it comes to being able to work most effectively. 

If you’re looking to support your employees and are not sure where to start, book a strategy call with us today.

Am I a good friend to myself?

On World Mental Health Day on 10/10/2022, the World Health Organisation (WHO) launched a campaign to “make mental health & well-being a global priority for all”, envisioning a world where mental health is “universally valued, promoted and protected”.

We have lived through very serious challenges to mental health during the past three years. The COVID-19 pandemic, major climate events, a war in Europe, and economic uncertainties have all added a series of long-term stresses to our lives. Chronic stress can undermine the mental health of many.

On World Mental Health Day, therefore, it is timely to pause and reflect on what we can do to “value, promote and protect” our own mental health, as well as the mental health of those around us.

In Australia and other economically developed nations, mental health is becoming increasingly accepted as a serious issue that needs discussion. Taboos around mental health struggles have been lifted by those who speak out about it, including famous sportspeople, actors and musicians. The positive contribution of these people to our ability to talk about mental health is immense.

So perhaps the most important thing we can do to protect our mental health is to start talking about it. Much like our physical health, mental health exists on a continuum. Sometimes we only need a little rest and support to get better, and other times we need assistance from a professional. When we feel a little more stressed or anxious than usual, turning to friends and family, someone who can listen and be present for us, can help a lot. But when we struggle with severe challenges, we need a specialist to help us get through.

Once we decide to seek help, the variety of mental health professionals available can be confusing. Where to start?

The best point of contact is your GP. Your GP can provide an initial assessment and a mental health care plan and refer you to a mental health professional supported by Medicare, usually a psychiatrist, a clinical psychologist, or a general psychologist.

What is the difference between these professions?

Psychiatrists are medical doctors who specialise and obtain further training in mental health. As such, they often use medication to treat mental health disorders. They usually see people with complex conditions that respond well to medication, such as schizophrenia or bipolar disorder (also known as manic depression).

Clinical psychologists have at least 6 years of education in psychology followed by a two-year psychology registrar program. They receive specialised training at the Master’s or PhD level in diagnosing and treating mental health conditions using a variety of psychotherapeutic techniques. Importantly, clinical psychology training programs are required to include treatments that are empirically supported: that is, several research studies have shown that the treatment works better than a placebo control condition. Clinical psychologists treat the whole range of mental health problems, but they do not prescribe medication.

General psychologists also have 6 years of education, but they have not completed a formal Master’s or PhD degree in clinical psychology. After studying psychology for 4 or 5 years at university, they usually obtain a Bachelor’s degree and further training through professional placements.

These professions are registered and regulated by the Australian Health Practitioner Regulation Agency (AHPRA), a government organisation that oversees health professionals’ training and professional standards to ensure the quality of care received by the public.

Other options to look after your mental health with the help of a professional include seeing a counsellor or a psychotherapist. In general, counsellors and psychotherapists provide services for people with problems and stresses in everyday living, rather than more serious concerns about mental health. Their services are not regulated by AHPRA, Medicare rebate is not available, and a doctor’s referral is not necessary.

‘Counsellor’ and ‘psychotherapist’ are titles that are not legally protected in Australia. This means that anybody can call themselves a counsellor or psychotherapist, irrespective of their background, level of education, or experience. If you decide to see a counsellor or psychotherapist (rather than an AHPRA-registered psychiatrist or psychologist), finding someone who is a member of one of their own accrediting associations, for example, the Psychotherapy and Counselling Federation of Australia (PACFA) would be advisable. These associations require their members to meet certain educational and professional standards. This would help to ensure that you see a person with an accepted level of education and professional experience in counselling and psychotherapy.

It’s worth mentioning that many employers provide Employee Assistance Programs (EAPs), which can include a limited number of sessions with a mental health professional. This may be with a counsellor, psychotherapist or psychologist, so it’s helpful to understand the differences.

Of course, prevention is often better than treatment, regarding both physical and mental health. There are many ways to look after our mental health, from making sure that we eat well, rest well and exercise well to nurturing or seeking out reliable, supportive, healthy social connections. A lack of social support is one of the best predictors of poor mental health in adults.

In general, however, a good way to look after our mental health is to ask ourselves whether we are our own best friend? Perhaps notice when you criticise yourself or berate yourself for a mistake, or when you tell yourself that you need to keep working even though you are running on empty.

Ask yourself: if my best friend, someone I care about and feel responsible for, were in this situation, what would I say? Would I criticise them? Would I berate them, would I push them, would I give them the same advice I am giving myself? Would I do this to my child?

If the answer is ‘no’, it is time to take notice of our self-talk and to develop an inner voice that is kinder and more understanding towards our own struggles. Becoming our own best friend is a great first step towards taking care of our mental health.

 

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.

Everything You Need to Know About Procrastination

“Procrastination is the Thief of Time” (Edward Young, 1683 – 1765)

Procrastination is a common human tendency. We all have, on occasion, postponed tasks despite the negative effects caused by the delay.

When procrastination becomes a habit, it can have serious consequences in life. We don’t only procrastinate at work or in education: we may also avoid obligations such as completing tax returns, delaying making medical appointments, or failing to keep promises towards friends and family. Feelings of guilt, anxiety or depression about the delays can then follow. Unsurprisingly, research has shown that chronic procrastination is associated with lower achievements in education, slower job promotions, and poorer mental and physical health.1

Why do we procrastinate, and how can we overcome this habit?

Procrastination can be caused by a large variety of factors2, which can be grouped into three domains:

1/ task characteristics (e.g., the unpleasantness of the task, unclear instructions or feedback)

2/ environmental factors (e.g., incentives for success, accountability, external distractions)

3/ personality facets (e.g., negative mood, avoidant coping style, poor emotion regulation)

Task characteristics

We often avoid tasks because they are unpleasant (for example, going to the dentist), or they are overwhelmingly large (for example, completing a major project or losing a lot of weight).

Environmental factors

Procrastinators usually do something else instead of the required task. The more available and pleasant that ‘something else’ is compared to the task, the easier it is to procrastinate. This is especially the case if the task does not result in outcomes that are worth the effort (for example, the task seems to have little meaning or value, or you expect that your achievements will not be recognised by others).

Personality facets

Not everybody will procrastinate to the same extent, even if the task is unpleasant. Several personality characteristics make us more likely to procrastinate, given the same task and environmental factors.

Briefly, procrastination can be seen as an attempt at emotion regulation in the face of stress. This attempt is usually successful in the short term but has serious negative consequences in the long-term.

For example, a person may consider the task too overwhelming, boring, or lacking in real value and interest. These perceptions can cause feelings of stress, anxiety, resentment, or other negative emotions. Procrastinators tend to have a lower ability to tolerate and set aside these emotions and concentrate on the task. Instead, the quickest way to reduce these feelings is to walk away from the task, do something else, and even convince ourselves that the other task is just as important.

Unfortunately, the deadline will eventually be so close that avoiding the task is no longer possible, and the procrastinator will finish the job at the last minute, often not having enough time to check for mistakes or create a polished product. If then the feedback is less than positive, the procrastinator may feel guilty (a negative emotion that can lead to more procrastination), or they may be able to maintain self-esteem by telling themselves that they could have done a better job “if only they had more time to do it”. Indeed, this ‘self-handicapping’ behaviour is quite common among people with low confidence in their abilities.

How to reduce procrastination?

Reconsider how you view the task. Procrastinators often focus on the unpleasant or anxiety-provoking aspects of the task. To reduce procrastination, it is important to make sure that all aspects of the task are considered and put into perspective. For that, we need to slow down and think about the task in a different way.

For example, if the task is overwhelming, we may decide to focus on achieving small parts, step by step. Deciding to focus on the time spent working on the task can be helpful. One may set a very rigid schedule: work on the task for exactly 45 minutes, then have a break for exactly 15 minutes and do something to reward yourself. Repeat, rigidly, until you have spent 4 hours working on the task. Have a longer break, then start again.  The most important point is to divert attention from how large and scary the task is and focus on the small achievements. They will add up and the task will be finished.

If starting is particularly difficult, again, take tiny steps. Make it easier on yourself.  Tell yourself: “I’m just going to open the document and read one page. That’s all.” Or, “I’m just going to put on my running shoes and take a walk around the block.” Or, “I’m going to find my tax expense receipts for just one month”. While it may sound like doing such small tasks is ‘not worth it’, they are a whole lot better than not doing anything! Most importantly, they will help you refocus your attention from your perception of how unattainable the task is. This may allow you to reduce your negative emotions about the task and make a start.

Change the task environment. We all know that limiting intrusions and distractions is important to stay focused. Turn off social media reminders.  If needed, put on an email notification saying that you are away from email for a couple of hours.

However, distractions are only a part of the total work environment. The positive and negative consequences associated with the task itself are very important. Were the expectations for the task clearly communicated to you? Do you feel supported, can you turn to someone for advice? Are your achievements recognised by your workplace? If you feel alone, unsupported, and unsure of what it is you need to do, procrastination is more likely.  A conversation with your supervisor may help if your workplace is open to feedback.

Consider your personality and coping style. Empirically supported treatments for chronic procrastination tend to emphasise the development of more effective emotion regulation skills3. People can learn a variety of emotion regulation techniques, such as deep breathing, positive self-talk, or setting up positive experiences as rewards for achieving small steps. Observing and changing one’s own thinking habits and emotion regulation styles is difficult, though. Procrastination is often associated with long-held beliefs (for example, a deep-seated feeling of not being good enough despite evidence for the contrary; or a belief that one needs to cope with everything without asking for help) that are so automatic that we are rarely aware of them. Reading a self-help book about procrastination or seeking professional assistance may be helpful in these cases4.

References

1Steinert, C., Heim, N., Leichsenring, F. (2021). Procrastination, perfectionism, and other work-related mental problems: prevalence, types, assessment, and treatment. Frontiers in Psychiatry, 12. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.736776

2Steel, P. (2007). The nature of procrastination: a meta-analytic and theoretical review of quintessential self-regulatory failure. Psychology Bulletin, 133, 65–94. doi: 10.1037/0033-2909.133.1.65

3Malouff, J.M., Schutte, N.S. (2019). The efficacy of interventions aimed at reducing procrastination: a meta-analysis of randomized controlled trials. Journal of Counseling and Development, 97, 117–127. doi: 10.1002/jcad.12243

4Steel, P. (2010). The procrastination equation: how to stop putting things off and start getting stuff done. Random House Canada.

 

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.

 

 

These harrowing cancer statistics can actually be good news. Wait, what?

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: These harrowing cancer statistics can actually be good news

 

When I first read this headline, I assumed that this article was going to discuss new government regulations on industry (alcohol in this instance), spurred by more unequivocal evidence on the already established health effects caused by harmful products like alcohol.

Instead, the story focused on what the individual can do to change their behaviour, with education being a key component of that behaviour change.

Seems reasonable, I hear you say.

Let me explain the shortcomings of this approach and why it is the narrative that the industries that produce these harmful products love to see published.

While the story points to the fact that smoking rates in Australia have dropped from 24% in 1995 to 11% in 2021, this was not done through education campaigns alone. It took an aggressive suite of regulatory measures for this to occur. These included an increase in sales taxes, a complete ban on advertising and marketing (sports advertising was one of the first to go), and the introduction of plain packaging, coupled with aggressive graphic health warnings by the Australian government.

Government action must be part of the solution.

I study the commercial determinants of health. This includes the strategies that industries like tobacco, alcohol, packaged food, and fossil fuels use to sell their products, as well as the political and economic systems that they operate within.

As economic globalization has intensified over the last two decades, these determinants of health have not only become the leading cause of disease but have also created health inequities within and across countries. For example, communities of color and low-income communities have experienced disproportionate consequences and impacts on their health due to either higher consumption rates of alcohol, tobacco, and ultra-processed foods or higher rates of exposure to toxic air pollution (due to the combustion of fossil fuels) and chemicals.

These industries use a suite of tactics aimed at preventing government regulation, which includes distorting the science on the human and planetary health effects of their products, undermining the policy process via lobbying, and shaping the narrative on their brands and products through evocative marketing and corporate social responsibility campaigns.

Now I love a beer and a pie at the footy. However, it’s vital that stories covering chronic health statistics should not be presented as a “really good news story” without being accompanied by perspectives addressing the need for government regulation to implement strategies like those mentioned above which have proven successful in tobacco control.

Without strong government action, these statistics will continue to increase, and I cannot see the silver lining in that.

 

Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

Understanding Burnout

After nearly three years of living with the COVID-19 pandemic and other worrying developments in the world, more and more of us feel ‘burnt out’.

But what is burnout? How is it different from being generally stressed or tired? What causes it, and how can we prevent it?

What is burnout?
The World Health Organisation defines burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. It refers specifically to experiences in the occupational context, rather than in other areas of life. Of course, if chronic stress is present in other areas of life, workplace stress will be more difficult to manage, and vice versa.

Burnout was first described by psychologist Christina Maslach and her colleagues in the 1970s. They identified this issue among professionals working in human services, such as doctors, nurses, or counsellors. Their research suggested that burnout has three distinct aspects: emotional exhaustion, depersonalization and a reduced sense of personal accomplishment.

Emotional exhaustion refers to a state of feeling overextended, constantly tired, and having a sense of depleted energy, or ‘running on empty’.

Depersonalization, which is sometimes also referred to as cynicism, is the interpersonal dimension of burnout. It is a negative, detached, insensitive, uncaring attitude to work and especially towards one’s clients.

Low personal accomplishment refers to a diminished sense of professional competence, and reduced productivity at work. The Maslach Burnout Inventory is a widely used questionnaire to assess these three aspects of burnout.

Burnout itself is not classified as a medical condition or psychological disorder. There is no ‘cut-off’ point on the questionnaire above which one can be called ‘burnt out’. Instead, high scores on a burnout questionnaire indicate that all is not well: you are exhausted, you don’t care about your clients, and you constantly feel that you are not doing a good enough job.

Burnout is associated with serious physical and psychological health conditions, such as depression, insomnia, chronic pain,
increased susceptibility to respiratory infections, gastrointestinal problems, and cardiovascular diseases.

So, if you do feel burnt out, it is time to look at the causes and to begin doing something to improve the situation.

What causes burnout?
Christina Maslach’s original research showed that burnout was most likely to develop in people who had been suffering from chronic work stress. When a stressful event occurs, the body responds with the activation of a characteristic stress response, called the fight or flight response.

During evolution, the threats we faced were usually physical. We needed to run away or face a potential predator (flight or fight). Even though nowadays we are rarely in such physical danger, our biological system still reacts with the same flight or fight response to social stress, such as an unpleasant encounter at work.

When this response is activated, both body and mind increase preparedness to deal with a potential threat. For example, blood pressure increases, breathing patterns change, blood flow increases towards the large skeletal muscles and away from the guts.

This activation reduces processes needed for rest and recuperation, such as digestion or sleep. Importantly, these bodily changes are accompanied by changes in the mind: you become more vigilant for negative information, and it becomes more likely that you interpret ambiguous information as threatening. In other words, your thinking becomes more negative.

Humans evolved to deal with short term (acute) stress very well. When the stressful event ends, the body returns to its normal state, and it can rest and recuperate. However, if stress is ongoing (chronic), that rest and recuperation can not happen. The constant activation of the stress response can eventually cause physical and psychological health problems, including burnout.

We know that several work circumstances can increase employee stress. These include:

  • unreasonable time pressure
  • an unmanageable workload
  • a lack of role clarity
  • a lack of control and autonomy
  • a lack of communication and support from managers
  • unfair treatment from managers, clients, or co-workers.

However, not everybody reacts to stressful situations the same way.

Personality traits, strongly held beliefs and values, and certain thinking patterns can contribute as well. For example, people who are highly perfectionistic tend to experience more stress, which can then lead to burnout. Strong individual values placed on achievement can also cost personal wellbeing if they are not balanced with a sense of self-care and compassion. Sometimes underlying such tendencies for perfectionism and high achievement orientation is a deep-seated feeling that something is about to go wrong, and one needs to be constantly in control to stave off disaster – even if the nature of that disaster is not always clear in your mind.

What can we do about it?
As most of us are already aware, to avoid burnout, we must reduce chronic stress or manage stressful situations better. If the workplace is open to creating a healthier work environment, talking to a supervisor may solve the problem. Simple self-care strategies, like eating a healthy diet, getting enough exercise, social support, improving your sleep quality, and regular breaks from work may also help to fend off the effects of high-stress jobs. Sometimes a change of position or job is an option.

However, such strategies are often ineffective if one’s personality, beliefs or thinking are at least partially responsible for a tendency towards experiencing chronic stress. No amount of fresh green vegetables and lavender oil will solve the problem for a person whose thinking is habitually negative or self-critical, who keeps putting others’ needs ahead of their own, or who has difficulty relaxing control over minor aspects of life.

If you are that kind of person, start watching your thinking and asking yourself whether a healthier thinking pattern would also be helpful. It is hard work, but it is possible to change our thinking.

If you are experiencing chronic stress or burnout and you’re having difficulty finding your way out, it may be a good idea to seek professional support. Talking to a mental health professional can help clarify the problem and identify strategies to solve it. You deserve to feel your best.

References and further reading

  1. World Health Organization. (2019). ICD-11: International classification of diseases (11th revision).
  2. Maslach, C. and Jackson, S.E. (1981), The measurement of experienced burnout. Journal of Organizational Behavior, 2, 99-113. (full text)
  3. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. (2017) Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 12(10):e0185781. doi: 10.1371/journal.pone.0185781. (full text)
  4. Renzo B, Guadalupe MG, Jean-Pierre R. (2021). Is burnout primarily linked to work-situated factors? a relative weight analytic study. Frontiers in Psychology, 11. (full text)

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.  

Do I have adult ADHD?

Until recently, Attention Deficit Hyperactivity Disorder (ADHD) has been considered primarily a childhood disorder, with only a minority of children continuing to have symptoms in adulthood. A surge in adult ADHD diagnoses occurred in recent years after changes to the diagnostic system made it easier to detect ADHD in adults. This increase has been accompanied by a lot of media
interest, with #ADHD trending on TikTok and other social media platforms as well.

Many people may have now encountered messages such as this:

  • Are you someone who can focus on some projects or activities so intensely that you completely lose touch with time?
  • At the same time, are you also a person who keeps forgetting appointments, can’t pay bills on time, is always late, can’t get organized, and can’t concentrate on unexciting projects, despite your best efforts?
  • Have you often wondered why you find “adulting” so difficult?

If you answered yes to these questions, you may have adult ADHD.

As usual, however, the story is more complicated.

How is ADHD diagnosed in adults?

What are the symptoms?

The diagnostic criteria for ADHD are essentially the same for adults and children. The current diagnostic manual lists 9 symptoms of inattention and 9 symptoms of hyperactivity. Children need to report 6 out of the 9 symptoms of either inattention or hyperactivity to receive a diagnosis of ADHD. Adults need to report only 5 out of the 9 symptoms in either group.

An example of an inattention symptom is “Often fails to give close attention to details or makes careless mistakes at school, work, or during other activities (e.g., overlooks or misses details, work is inaccurate”.

An example of a hyperactivity symptom is “Often blurts out an answer before a question has been completed (e.g., completes people’s sentences, can not wait for turn in conversation).” (DSM-5, APA, 2013)

Adults and females of all ages are more likely to have inattention, rather than hyperactivity symptoms.

However, saying ‘yes’ to 5 or more symptoms is not enough for a diagnosis. To have a clear picture, we need to ask further questions.

Do these symptoms interfere with important life functions?

We all become inattentive, unfocused, forgetful, or impatient sometimes. To receive a diagnosis of ADHD, the symptoms need to directly cause serious problems in the person’s life. For example, do these symptoms result in lower achievements at work or in education? Do they increase social and family problems? Could they be responsible for accident proneness, legal difficulties, or substance misuse in the person’s life?

Do the symptoms occur in several different situations?

If a person is hyperactive or inattentive in some situations (e.g., at work) but not in others (e.g. with friends or family), it is possible that the situation itself is responsible for the problem, not the person.

However, people are not always aware of the problems that their symptoms cause. It can be helpful to consult others in different settings (e.g., friends, spouses, co-workers) to find out whether they see any substantial, ongoing signs of inattention or hyperactivity in those settings.

Have the symptoms been present before age 12?

ADHD is a neurodevelopmental disorder. Therefore, it must have already been present in childhood. Because recall of childhood memories tends to be unreliable, it is important to consider family history very carefully and to find informants or school records to confirm that ADHD caused problems in several different settings (school, home, social situations) before age 12.

Is there an alternative explanation for these symptoms?

This question is perhaps the most important, but also the most difficult to answer.

Sometimes apparent symptoms of ADHD are better explained by another psychological condition or disorder. This other condition may have been with you since childhood. For example, anxiety, stress, depression, and adverse childhood experiences (i.e., family discord, mental health or substance use problems in the family, emotional or physical abuse or neglect of a child) can all cause attention and concentration problems, forgetfulness, impatience and impulsivity both in adults and in children. In those cases, a diagnosis of ADHD would not be helpful, and could in fact be harmful.

Only a very careful clinical assessment can disentangle the cause-and-effect relationships among these symptoms and disorders.

In summary

Symptoms need to be understood in the wider context of the person’s life, rather than just being a shopping list of items to be ticked off. Mental health professionals following best practice guidelines take a very thorough family history and, if possible, seek information from family, friends, significant others, and previous written records (with the client’s informed consent, of course). Therefore, establishing a diagnosis of ADHD with some certainty can be a lengthy and difficult process.

If you think that you have symptoms of ADHD

Don’t jump to conclusions. You may want to start with a well-validated screening questionnaire, such as this. Consider if your symptoms have been present since childhood and whether they are possibly better explained by other problems, such as anxiety, depression, stress, or adverse childhood experiences.

If you think that your experiences fit the diagnosis of ADHD, seek a full assessment from a clinical psychologist or a psychiatrist. Ideally, your mental health professional will follow best practice guidelines to make sure that they do not miss a diagnosis of ADHD, but also that they do not diagnose ADHD when the problems stem from alternative causes, such as anxiety, depression, stress, or early trauma.

Because the most effective treatment for ADHD is stimulant medication, we need to exercise extra caution about potential misdiagnoses. The prescription of stimulants for adults who do not in fact have ADHD can have many far-reaching consequences for the person and society.

 

References and further reading

 

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.  

The US supreme court has declared war on the Earth’s future

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: The US supreme court has declared war on the Earth’s future 

 

As an academic working in US environmental science policy, and a father of three children, I was deeply concerned by the Supreme Court of the United States (SCOTUS) opinion in West Virginia vs. EPA that will significantly weaken the US Environmental Protection Agency’s (US EPA) authority to regulate carbon dioxide emissions from power plants (the second-largest source of planet-warming pollution). Let me explain why.

The Case

The original case is about the Clean Power Plan that sought to combat climate change by capping carbon pollution from power plants, a rule developed during the Obama administration. That would have allowed US EPA to use the most effective regulatory tools to address greenhouse gas emissions from power plants – a shift from coal to energy sources that produce fewer emissions. However, in an unprecedented action, the plan was put on hold in 2016 due to pressure from the coal industry.

Congress granted US EPA authority to regulate toxic pollutants through laws like the Clean Air Act (CAA) and Clean Water Act (CWA), which have led to vast improvements in the air and water quality in the US. Such authorities granted by Congress are critical as it gives an expert agency like US EPA the power to address significant and quickly evolving environmental health issues, as and when they arise.

SCOTUS was called to rule on whether the CAA allows US EPA to issue nationwide regulations over the power sector or if the Agency should be limited to regulating changes at individual power plants.

The Court Ruling

In a 6-3 opinion, consisting of the recent conservative Justice appointments made under the Trump Administration, SCOTUS sided with West Virginia and the coal industry in adopting a narrow interpretation of the CAA and rejected the idea that US EPA has the authority to regulate greenhouse gas (GHG) emissions.

SCOTUS ruled that if Congress wanted to give an administrative agency (like EPA) the power to make “decisions of vast economic and political significance,” it must explicitly state this. It did so by applying a doctrine it enshrined into the case law, the “major questions doctrine”. So if the court thinks an agency is overreaching in future cases it can strike down any manner of policies. This reasoning is a concerning departure from traditionally held deference to federal agencies to regulate and develop rules based on their expertise.

In the dissent, Justice Elena Kagan writes “Whatever else this Court may know about, it does not have a clue about how to address climate change…The Court appoints itself—instead of Congress or the expert agency—the decision-maker on climate policy. I cannot think of many things more frightening.”

Why I am so concerned

The precedence this ruling sets is deeply concerning as certain rulemakings across federal agencies like US EPA (along with the financial sector, health care and others) will now need to rely on clear legislative authority to withstand legal challenges, but with a narrowly divided House and Senate, which is in gridlock, these actions seem unlikely.

The most troubling thing for my children and others is that to cut GHG emissions by 50% by 2030 to prevent the catastrophic effects of climate change, we need the US government to have every policy tool at its disposal. Historically they have been the largest contributor to GHG in our atmosphere, and they are now number two only to China. So what they do really matters. This SCOTUS decision now takes one of the most important tools away and has the potential to undermine all federal authority and agency power.

Finally, this damaging court decision once again makes clear the importance of efforts to expose industry tactics and influence on the judicial, executive, and legislative branches of government.

 

Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

When Did Eating A Healthy Diet Become So Hard?

According to the Australian Bureau of Statistics, only 1 in every 20 Australians consumes the minimum serving of vegetables per day. While over a third of our diet comes from packaged junk food. Nutrition based public education campaigns don’t work. Sure, most of us know what we are supposed to be doing – 5 serves of vegetables, 2 serves of fruit, some protein but not too much, and go easy on the fats – and so to some extent, the message has got through. But they haven’t worked in affecting change or establishing good routine behaviours.

What does the Government have to say?

Governments, past and present, say it is the individuals’ fault for ignoring some 40 years of public awareness campaigns. More than one former Prime Minister and/or Federal Health Minister have proudly proclaimed that the only person that should tell them what to eat is themselves and Governments have no place in restricting food choices. But it is not the fault of the individual. It is a consequence of the food environment in which education must compete against marketing practices that overwhelm the senses and fatigue even the most committed shopper. Messaging in both public health campaigns and marketing practices seem to be widely varied and misinforming in many cases. With some 2 in every 3 Australians overweight or obese, we need a more authorative and thorough approach to public health messaging than just being told what is good for us.

Why are we all so confused on what to eat?

Over the past 40 years there has been and continues to be a fundamental shift in our understanding of nutritional science. In the early days, a reductionist approach was embraced in which foods were identified by their individual nutrients. Such as, did they contain saturated fat or unsaturated fat? Are they high protein or low protein? The result of this approach was a re-conceptualising of food, not as food. But rather as a vehicle of specific nutrients resulting in what is termed nutrient based criteria. Foods were quickly classified good or bad for you on the basis of perhaps only one ingredient. With the most consumed products being made up of three or more ingredients today, this approach can skew the validity of what is healthy and what is not.

The Health Star Rating System

The popular Health Star Rating System (HSR) is derived from this more reductionist approach. Where the apparent health of a food is determined by an algorithm incorporating component ratios of certain ingredients and correction factors for different food categories. While this system relies on science and a few calculations, in no living system, has the accuracy of the star ratings been tested, examined and shown to be true. Controversially, in some studies where interventions were supposed to improve the health of participants, incidence of disease increased. There are many examples of where the HSR fails to meet its lofty advocacy as a universal indicator for healthy choices. Not least the automatic allocation of 5 stars to fruit juice which the World Health Organisation arguably classifies as a sugar sweetened beverage and recommends we avoid. However, if adequately explained, consumers may still be able to find some use in the HSR.

The Glycemic Index or GI

An alternative approach to understanding the healthfulness of some foods has been to focus on the carbohydrate content, both the quantity and quality. The early steps in this approach saw the creation and development of the glycemic index. In brief, members of the community would be asked to eat small portions of a test food and their blood glucose response would be monitored. On another day an equivalent portion of white bread or some other comparative food would be consumed and the relative difference in blood glucose response would be used to calculate the GI. The general belief being – the lower the GI the healthier it is for you.

Over the past 20 or so years, millions of dollars and hours of effort have gone into validating this tool as an indicator of the healthfulness of a product. At the same time however, shortcomings in the methodology and high variability between individuals has chipped away at confidence in this commonly advocated front of pack label.

What do we do now?

If the two most immediately recognisable and advocated front of pack labels for helping consumers make informed choices are of limited use – where does that leave us? Well one of the first things we need to recognise with approaches such as the HSR and the GI, is that they focus only on some of the components in a product. And not necessarily the food, in the context of our daily lives and how we eat. Food is greater than the sum of its individual parts.

When we look beyond our borders we see a vastly different approach to “dietary guidelines”. For example in Brazil, there is no singling out of saturated fat, carbohydrates or even alcohol. Rather there are steps towards a healthy diet focussing on the avoidance of ultra-processed foods. They encourage planning, developing and sharing cooking skills and eating in social contexts. It is out of Brazil that the NOVA food classification was borne. A system that has both excited nutritional science in providing a whole new scope of data to play with but more importantly has provided community members and public health advocates with a simple enough guide to improving diets – focussing on food processing.

The systems and messaging in place in our modern society that were designed to aid in making healthy lifestyle changes when it comes to our diet are confusing and outdated. The government needs to take a new approach in advocating healthy lifestyle changes, like Brazil’s NOVA classification, where emphasis is put onto advocating for healthy food choices according to food proccessing standards without isolating a particular food group.

Further reading:

The NOVA Food Classification System Explained

 

Dr. Kieron Rooney completed his PhD in the Department of Biochemistry, within the Faculty of Science at the University of Sydney. Kieron’s primary interest focuses on conducting research and using this research to educate others on how what we eat, influences our metabolism.

Research Review: Can We Sleep To Much?

In this article, our expert Dr. Yu Sun Bin reviews: Can People Sleep Too Much? Effects of Extended Sleep Opportunity on Sleep Duration and Timing by Klerman EB, Barbato G, Czeisler CA, Wehr TA. 

 

1) What was the high-level summary of the research? 

People cannot sleep ‘too much’. The amount of sleep we get is regulated by the homeostatic and circadian systems which drive us towards a stable amount of sleep, provided we allow enough time for it. 

While we cannot sleep too much, we can spend excess time in bed. When given 12-14 hours of opportunity to sleep, healthy people can develop patterns similar to those with insomnia and take longer to fall asleep, wake more often in the middle of the night, and wake too early and be unable to go back to sleep. 

 

2) What did the study try to measure? 

The study measured objective sleep using sleep studies. The study assessed whether, when given long periods of time in which to sleep, people could sleep to excess, or if they would reach a stable point with a roughly consistent amount of sleep every night. 

 

3) How was the study undertaken? 

The authors of this study analysed data from two of their previous studies. 

In Study 1, healthy volunteers were given the opportunity to spend 14-hours in bed per night for 28 days; In Study 2, volunteers were given the opportunity to spend 12-hours in bed for 8 nights, with the addition of a 4-hour window for napping during the day. 

Neither study interfered with the sleep of the volunteers, apart from giving instructions that they should try to sleep during those windows of time. Both studies involved volunteers sleeping in research labs so that factors such as work and socialising did not influence how much volunteers slept and when they went to sleep and woke up. 

 

4) What did the study find? 

In both studies, volunteers slept more during their first week in the lab – on average, sleeping 2 hours longer than they did at home. However, the differences between volunteers were marked: some did not sleep more at all when given the opportunity, whilst others slept almost 6 hours longer! 

After the first week of extended opportunity for sleep, the total sleep time of the volunteers stabilised: on average, people in Study 1 slept 8.6 hours nightly, whilst those in Study 2 slept 8.9 hours on average. However, individual needs for sleep were very different: at one extreme, one volunteer stabilised at 5.2 hours of nightly sleep, whilst at the other extreme, another stabilised at 11.0 hours. These results show that during the first week in the lab, having protected sleep time was important for many of the volunteers to catch up on sleep. However, once they had caught up, their sleep stabilised and they tended to have roughly the same amount of sleep every night. This amount of sleep was unique to them.

Also important to note is that sleep quality decreased for many of the volunteers in these studies – that is, even though the same amount of sleep was achieved, it took them longer to fall asleep, they woke up more often or too early on some nights. However, unlike people with chronic insomnia, these healthy volunteers then made up for this slight sleep loss the next night. This is exactly how sleep is supposed to work as dictated by the sleep homeostatic process which maintains an equilibrium in our sleep/wake cycles. 

 

5) Is there any other research out there that supports these findings or contradicts it? 

There is plenty to support it! For example, in large scale epidemiological studies that link long sleep durations (>9 hours) to poor health, the association is no longer seen when existing health conditions are taken into account. This suggests that it is time in bed and poor sleep quality that contributes to poor health, or that poor health contributes to excess time in bed and poor sleep quality.

Similarly, in terms of performance, it is not possible to sleep more to ‘bank’ sleep, but it is possible to reduce existing sleep debt so that you are better protected from any effects of future sleep deprivation. 

 

6) How much weight should we give this research?

This research is highly credible given the supporting evidence. The only thing to keep in mind is that the studies were limited to young people, aged 18 to 36 years, without any health conditions so the expectation of ~8 hours of sleep being average may not be applicable to other age groups and people with existing health conditions.

 

7) What does this mean for your work/research/industry? 

There is often a disconnect and conflict in the sleep field about what advice we give to people with clinically significant insomnia and to the general public at large. The message we try to give to the general public is that typically, people should sleep more to get enough sleep. However, the clinicians who work with insomnia sufferers are unhappy with this message, because spending more time in bed can make insomnia worse. 

This study shows that there is a direct connection between those two messages and that they are actually not in conflict. That is, we should all try to sleep enough, for us to be individually well-rested, but avoid spending more time in bed beyond that point, because it only creates poor sleep quality that’s similar to symptoms of insomnia. 

 

8) What’s the key takeaway for us to take from this research?

It isn’t possible to sleep ‘too much’ but it is possible to spend too long in bed. If you spend too long in bed, the quality of your sleep can suffer. 

 

9) Will you be doing anything differently because of this research? 

I think this study highlights we should give ourselves the opportunity for enough sleep every night and try to figure out where our equilibrium point of ‘enough sleep’ is. We should then try to protect our sleep time to achieve our required amount of sleep as much as possible.

 

Dr Yu Sun Bin is an epidemiologist and public health researcher. Her particular research interests are on sleep and circadian rhythms and how these biological systems are reflected in behaviour, health, and disease.

Goal Setting for the New Year and Beyond

Goal Setting for 2022

As the year ends, many of us begin to think about our goals for the new year and beyond. Many of us will also fail to keep some of our resolutions and achieve our goals. 

Do not fear, this is perfectly normal. Psychologists use several approaches to help you in changing and sustaining a new behaviour. One such approach is the use of SMART goals. SMART goals are said to be achievable because they are 

  • S – Specific 
  • M – Measurable 
  • A – Achievable 
  • R – Relevant 
  • T – Time-bound (or Trackable).

For example, if you don’t get any exercise and would like to improve your fitness, instead of setting “become more fit” as a goal, try to use the SMART goal of “walk 7000 steps at least 3 times a week” as your initial aim – of course it needs to be achievable considering your current level of fitness, and you can adjust it as your fitness improves. 

However, no matter how SMART our goals are, some of us fail to achieve them. Part of the problem may be that we have too many different goals that end up overwhelming us, so we soon give up. Another, deeper problem may be that the goals we set do not align with our authentic values; we pursue them without questioning whether this is really what we want to do with our lives.

Indeed, one important (and sometimes ignored) aspect of SMART goal setting is “Relevance”. 

Is this goal relevant to how I want to live my life? Is it aligned with my authentic values?  Considering our values are also important when we have many different goals, and we need to prioritise and direct our attention to the most important ones. 

How do we know if our goals are aligned with our authentic values? 

Psychology Professor Steven Hayes, the creator of Acceptance and Commitment Therapy (ACT) suggests that there is an important difference between goals and values. Goals are things we want to achieve. We may want to run a marathon, get married by a certain age, have 3 children, earn a certain amount of money, have a house in a certain suburb, etc. 

Goals can be seen as signposts on a certain path we travel in life. 

However, what is the direction of that path? The direction is given by our values. When we set goals that are consistent with our values, their purpose is meaningful to us. 

Keeping our values in mind helps even when, for whatever reason, we do not achieve our goals. For example, we might say that having loving, loyal, kind relationships is an important value to us. Our goals may never materialise: maybe we won’t get married, maybe we won’t have children, either by choice or because of reasons outside of our control. But we can still have loving relationships in our lives. We can choose to act in a loving way right now with our friends or with our family of origin. We can choose to be patient and kind to the stranger who slows us down in traffic. We can live consistent with our values, irrespective of whether we meet our set goals or not.  

Keeping our values in mind helps us travel the path we chose without the pressure and stress that sometimes can result from living our lives from one goal to another. It frees us from defining our lives in terms of a series of successes and failures and helps us keep the ‘big picture’ of who we want to be in mind. 

 

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.