Science Says: What makes something truly addictive

By Lindsey Tanner

THE ASSOCIATED PRESS

CHICAGO _ Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?

The short answer is probably not.

The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviours can cause the same kind of addictive illness as drugs.

The strictest definition of addiction refers to a disease resulting from changes in brain chemistry caused by compulsive use of drugs or alcohol. The definition includes excessive use that damages health, relationships, jobs and other parts of normal life. Brain research supports that definition, and some imaging studies have suggested that excessive gaming might affect the brain in similar ways.

Under a looser definition, addiction is considered “a disease of extreme behaviour. Any behaviour carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.

In its widely used manual for diagnosing mental illness, the American Psychiatric Association calls excessive video gaming a “condition” but not a formal diagnosis or disease, and says more research is needed to determine if it qualifies as an addiction.

DRUGS AND THE BRAIN

Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit. That’s the system that under normal circumstances is activated when people engage in “behaviours conducive to survival” including eating and drinking water when thirsty, explained Dr. Andrew Saxon, chairman of the association’s addiction psychiatry council. The brain chemical dopamine regulates these behaviours, but narcotic drugs can flood the brain with dopamine, encouraging repeated use and making drug use more rewarding that healthy behaviours, Saxon said. Eventually increasing amounts are needed to get the same effect, and brain changes lead to an inability to control use.

WHAT ABOUT OTHER SUBSTANCES?

Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects. Neither substance causes the kinds of life problems found in drug addiction, although some coffee drinkers develop a tolerance to caffeine and need to drink more to get the same “buzz” or sense of alertness.

The World Health Organization recognizes caffeine “dependence” as a disorder; the American Psychiatric Association does not and says more research is needed.

“The term ‘addiction’ is tossed around pretty commonly, like ‘chocoholic’ or saying you’re addicted to reality TV,” said Dr. Ellen Selkie, a University of Michigan physician who studies teens’ use of digital technology. But addiction means an inability to control use “to the point where you’re failing at life,” she said.

WHAT ABOUT Behaviour?

The only behaviour classified as an addiction in the American Psychiatric Association’s diagnostic manual is compulsive gambling. To be diagnosed, gamblers must have several symptoms including repeatedly gambling increasing amounts of money, lying to hide gambling activity, feeling irritable or restless when trying to stop, and losing jobs or relationships because of gambling. Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.

The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behaviour has similar effects on the brain.

Many excessive gamblers, gamers and sex “addicts” have other psychiatric conditions, including anxiety, attention deficit disorder and depression, and some mental health specialists believe their compulsive behaviours are merely symptoms of those diseases rather than separate addictions.

Excessive use of the internet and smartphones is also absent from the psychiatric manual and World Health Organization’s update. Psychiatrists disagree on whether that is a true addiction _ partly because overuse is hard to measure when so many people need to use their smartphones and the internet for their jobs.

DOES THE TERM MATTER?

The World Health Organization’s decision to classify excessive video gaming as an addiction means “gaming disorder” will be added to this year’s update to the organization’s International Classification of Diseases. Doctors worldwide use that document to diagnose physical and mental illnesses. Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.

Find Out If You Are Hard Working or Working Too Hard

Many people confuse hard-working people with workaholics.

What is workaholism?

Workaholism is more than a dedication to your job. It’s a near-obsessive commitment that supersedes most, if not all, other aspects of life. For many, workaholism is a true addiction, inextricably tied to feelings of self worth and identity.

What are some characteristics of workaholics? How could a person tell that he/she is a workaholic?

A workaholic displays symptoms similar to any other addict. He/she works long hours, at the expense of personal relationships and health. When not working, they’re thinking about work. Work dictates their mood: when work is going well, they’re up; when work is going less well, they’re down. Workaholics often go months without seeing friends; put their marriages on cruise control; defend their choice to work as hard as they do (come up with justification after justification); and may use work as a distraction from other problems or aspects of life.

What are some reasons that workaholics work so hard?

Working, or simply being busy, can be a hard habit to break. Busy people are important people. They’re also often pleasantly distracted people. In an op-ed that went viral in the New York Times a few years ago, a cartoonist named Tim Kreider wrote that “Busyness serves as a kind of existential reassurance, a hedge against emptiness.” When workaholics aren’t busy working — or doing something to promote their work — they feel anxious and guilty. For both men and women, this is often a result of recession — they hang onto jobs for dear life and do everything they can to ensure they’re indispensable. For  women in particular, workaholism may stem from the lingering notion that great opportunities for women are still rarer than they are for men, and as such must be strived for with unflagging determination and drive. What’s more, today’s female employees are among the first generation to have been raised by mothers who, as a whole, placed importance not just on a job, but a career. For many of these women, the slide into workaholism seems almost predisposed.

Is there a link between health problems and workaholism?

There is. Just because work itself is a respectable pursuit doesn’t mean that an addiction to it is any less damaging than other sorts of addictions. A number of studies show that workaholism has been associated with a wide range of health problems, such as insomnia, anxiety, and heart disease.

Besides from health problems, does being a workaholic bring negative effects?

Yes. For some people, working serves as a Band-Aid for other issues, a way to numb undesirable feelings or fill certain voids, much in the way that alcohol might do for an alcoholic or sex for a sex addict. What’s more, working too much can lead to lower job satisfaction, as found in a 2008 study published in The Psychologist Manager Journal that compared overworking employees to those who maintained a better work-life balance. Also, the ill effects are contagious: A study published in the International Journal of Stress Management found that workaholics can even make their co-workers stressed.

What about the effects to the families?

A 2001 study published in the American Journal of Family Therapy found that working too much negatively impacted an employee’s marriage. This isn’t surprising, since if you’re married to your work it can be difficult to be married to anything, or anyone, else. There have also been studies looking at the impact of workaholic parents on their children and the news isn’t good. In one study, adult children of workaholic fathers experienced more depression and anxiety and a weaker sense of self. That study appeared in the American Journal of Family Therapy.

What about the positive side?

There are many positive aspects to working hard and to an increasing commitment to career. These days, more and more people, women especially, are embarking on, and staying with, careers that are personally fulfilling, identity making, and lucrative. Hard work can reap great rewards. For many, it’s how they develop feelings of self worth and confidence and purpose. This can be empowering.

Since many workaholics often deny having a problem, what are solutions for them?

It’s difficult to convince a workaholic to change their behavior if they’re not also willing. If you have a workaholic in your life you might point out the things he or she is missing out on while at work, whether it’s a child’s soccer game, a good book, or a yoga class. Seek to understand why the person feels the need to work so much and support them in finding a resolution. Perhaps they feel pressure to earn money, or they feel insecure about their performance. Work together to find ways to handle the dilemma beyond longer hours at the office. For people who wonder if they might be workaholics, I might suggest they resolve to check in every so often and ask themselves: Am I working too hard? And if so, why? What am I getting out of 60 hours that I couldn’t get out of 40? Or 35? Many who work hard are working for reasons beyond the benefits good work provides but it requires really stopping and evaluating the situation to recognize that.

Can the symptoms get better?

They can, but it almost always requires a total overhaul in perspective. The first step is acknowledging and accepting — really accepting — that work isn’t the most important thing in your life. Decide what is. You won’t be able to say “no” to work unless you are saying “yes” to something else. The second step is actually starting to say no — to working late, to extra assignments, to doing a little more ‘for the team.’ Finish one task before taking on another. Third, be firm and vigilant about the time you spend working. Decide in advance that you will work, say, 8 a.m. to 4 p.m., or no more than 40 hours a week. Often, you will find that limiting the time you have to spend on work will make you more efficient during those working hours. You’ll get just as much done — because you have to — and still have time to have dinner with the family.

Excerpted article written by Dr. Peggy Drexler, Huffington Post

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Norovirus outbreak in Canada – here’s what’s triggering the vomiting bug

By  | Global News

Norovirus and gastrointestinal illness cases in Canada have spiked in recent months, and the Public Health Agency of Canada is now working with provincial officials to investigate the rise.

Gastrointestinal illness cases have been linked to raw oysters from B.C. farms, and those facilities have been shut down. But the health agency explained that it’s not clear what, exactly, caused the problem.

What’s especially concerning is that the number of cases are still rising, which indicates that infected oysters are still being sold at grocery stores or restaurants.

Here’s what Canadians should know about the rise, and the raw oysters associated with the illnesses.

Rise in Canada in Canada

While no deaths have been reported, many individuals reported becoming sick between mid-March to early April after eating B.C. oysters.

According to the public health agency, there are currently 126 reported cases of gastrointestinal illnesses in the country directly related to oysters — 92 in B.C., nine in Alberta and 25 in Ontario.

Though not all the cases have been tested, the health agency says that norovirus is the dominant infection.

What exactly is norovirus?

Norovirus is a common gastrointestinal illness in North America that is not known to be deadly, but it does have several uncomfortable symptoms.

The most common are nausea, vomiting, diarrhea and stomach cramps, but others can include a fever, chills and aches. Those with weaker immune systems, such as pregnant women, young children or the elderly, may develop more severe symptoms.

Jason Tetro, a microbiologist and infectious disease expert, told Global News that the symptoms can be very uncomfortable, with uncontrollable vomiting or severe diarrhea.

“You literally turn into an explosion,” Tetro said.

The virus typically begins 24 to 48 hours after exposure and generally lasts about two days.

How does it spread?

The health agency warns that the virus is very contagious.

People can become infected with it through human contact, things like sharing food or utensils, or changing the diaper of a sick child. It can also be spread through infected surfaces, such as door handles or counter-tops.

In this outbreak’s case, it was spread through the consumption of contaminated food.

Unlike other bacteria, norovirus can live on surfaces for months, Tetro explained.

WATCH: Over 200 sick after norovirus outbreak on two cruise ships

How to safely handle and eat oysters

The health agency warns that oysters should be fully cooked in order to kill norovirus — partially cooking will not solve the problem. That means they should be cooked to an internal temperature of 90 C, or 194 F.

Oysters that don’t open while cooking should be thrown away, and any leftovers should be refrigerated immediately.

Surfaces that the oysters touch, as well as hands, should be cleaned and properly disinfected.

Quebec’s health insurance board has the power to investigate clinics

CBC News

Over the course of two years, the number of inspections Quebec’s health insurance board (RAMQ) has done at medical clinics dropped by half, according to documents obtained by Radio-Canada.

The check-ups help uncover whether private clinics are charging illegal fees to patients, among other things.

In 2015, the RAMQ did 298 inspections and found that 35 clinics were charging patients for services that are covered by the public health insurance plan. In 2017, only 150 inspections were done; 12 clinics were found to be charging illegal fees.

A law passed in 2016 gave teeth to the RAMQ’s inspectors — before, inspections were more preventive in nature. Inspectors weren’t able to invoke laws and dole out fines.

In an email, a spokesperson for the RAMQ explained that the new powers bestowed upon the board’s 25 inspectors makes the inspection process more complicated, notably because they increased the standard of proof needed to write up lawbreakers.

The spokesperson also said the inspectors’ work was delayed last year due to the passing of a new law that forbids doctors from charging certain fees to patients. Staff had to undergo training in order to be able to apply it properly.

Worrisome drop, says watchdog

Dr. Isabelle Leblanc heads a group of Quebec doctors and medical students who work to preserve the universal nature of Quebec’s health care system.

She says the drop in inspections is cause for concern because it’s up to the RAMQ to make sure that doctors are following the rules.

“Inspections that aren’t based on complaints, just going to check out what’s going on in the clinics, are important because we know that due to the power imbalance, there are many patients who don’t want to file a complaint against their doctors,” she said.
Leblanc questioned whether the government made sure the RAMQ had the necessary resources to carry out inspections and investigations when it decided to increase their powers.
A Daily Journal Could Change Your Life: The 10-minute routine

A Daily Journal Could Change Your Life: The 10-minute routine

“Never go to sleep without a request to your subconscious.”  — Thomas Edison

Excerpted article was written by Benjamin P. Hardy

Here’s why.

10 minutes before going to sleep:

It’s common practice for many of the world’s most successful people to intentionally direct the workings of their subconscious mind while they’re sleeping.

How?

Take a few moments before you go to bed to meditate on and write down the things you’re trying to accomplish.

Ask yourself loads of questions related to that thing. In Edison’s words, make some “requests.” Write those questions and thoughts down on paper. The more specific the questions, the clearer your answers will be.

While you’re sleeping, your subconscious mind will get to work on those things.

10 minutes after waking up:

Research confirms the brain, specifically the prefrontal cortex, is most active and readily creative immediately following sleep. Your subconscious mind has been loosely mind-wandering while you slept, making contextual and temporal connections. Creativity, after all, is making connections between different parts of the brain.

In a recent interview with Tim Ferriss, Josh Waitzkin, former chess prodigy and tai chi world champion, explains his morning routine to tap into the subconscious breakthroughs and connections experienced while he was sleeping.

Unlike 80 percent of people between the ages of 18 and 44 who check their smartphones within 15 minutes of waking up, Waitzkin goes to a quiet place, does some meditation and grabs his journal.

In his journal, he thought-dumps for several minutes. Thus, rather than focusing on input like most people who check their notifications, Waitzkin’s focus is on output. This is how he taps into his higher realms of clarity, learning and creativity—what he calls, “crystallized intelligence.”

If you’re not an experienced journal writer, the idea of thought-dumping might be hard to implement. In my experience, it’s good to loosely direct your thought-dumping toward your goals.

Consider the requests you made of your subconscious just before going to bed. You asked yourself loads of questions. You thought about and wrote down the things you’re trying to accomplish.

Now first thing in the morning, when your creative brain is most attuned after its subconscious workout, start writing down whatever comes to mind about those things.

I often get ideas for articles I’m going to write while doing these thought-dumps. I get ideas about how I can be a better husband and father to my three foster children. I get clarity about the goals I believe I should be pursuing. I get insight about people I need to connect with, or how I can improve my current relationships.

To be sure, you’ll need to practice this skill. It might take several attempts before you become proficient. But with consistency, you can become fluent and automatic at achieving creative and intuitive bursts.

2. Journaling accelerates your ability to manifest your goals.

As part of your morning creative burst, use your journal to review and hone your daily to-do list. Review and hone your life vision and big-picture goals.

As you read and rewrite your goals daily, they’ll become forged into your subconscious mind. Eventually, your dreams and vision will consume your inner world and quickly become your physical reality.

3. Journaling creates a springboard for daily recovery.

People struggle drastically to detach from work. More now than ever, we fail to live presently. Our loved ones are lucky to experience a small percentage of our attention while they’re with us.

But utilizing your journal can curb this mismanagement. At the end of your workday, reopen your journal and review your to-do list from that day. If your morning journal session was excellent, you’ll have likely gotten everything done you intended to do. Private victories always precede public victories.

Journal sessions are your post-work reflection time. Account to yourself what you got done that day and what needs to be moved to tomorrow. Write the things you learned and experienced.

Lastly, direct your subconscious by writing about things you want to focus on tomorrow. As you put work behind you for the evening, your subconscious will be preparing a feast for you to consume during your next morning’s creative and planning session.

This end-of-day journal session doesn’t need to be as long as the morning session. Greg McKeown, author of Essentialism, recommends writing far less than you want to—only a few sentences or paragraphs at most. This will help you avoid burnout.

A primary objective of this session is to mentally turn off work mode. Just as in physical training, you need to rest and recover between workdays to get stronger.

Use this session to completely unplug and detach from work. This is your time to recover and be present with your loved ones—because there is more to life than work. The higher quality your recovery, the more potent and powerful your creative sessions will be.

4. Journaling generates clarity and congruence.

This keystone habit has so much power. By journaling in the morning and evening, you’ll quickly see what is incongruent in your life.

You’ll clearly see what needs to be removed and what should be included in your life. Journaling is a beautiful and powerful facilitator of self-discovery. My own journaling is how I’ve come to form my sense of identity and path in life.

Not only will you have more clarity about your path in life, but journaling improves your ability to make small and large decisions along the way.

On the pages of your journal will be the future world you are creating for yourself. You are the author of your life’s story. You deserve to be happy. You have the power to create whatever life you want. As the designer of your world, get as detailed as you desire.

5. Journaling clears your emotions.

Several research studies found that writing in your journal reduces stress. These benefits include:

  • Reducing scatter in your life
  • Increased focus
  • Greater stability
  • Deeper level of learning, order, action and release
  • Holding thoughts still so they can be changed and integrated
  • Releasing pent-up thoughts and emotions
  • Empowerment
  • Bridging inner thinking with outer events
  • Detaching and letting go of the past
  • Allowing you to re-experience the past with today’s adult mind

When you are in an intensely emotional mood, journaling can help you more fully experience and understand those emotions.

After you’ve vented on the pages of your journal, you’ll quickly find a release. Objectivity will return and you’ll be able to move forward.

Without a journal, intense emotional experiences can be crippling for hours, days and even years. But an honest and inspired journal session can be the best form of therapy—quickly returning you better and smarter than you were before.

6. Journaling ingrains your learning.

Humans are bad at retaining information. We forget most of what we read and hear. However, when you write down the things you’ve learned, you retain them far better. Even if you never reread what you’ve written, the simple act of writing something down increases brain development and memory.

Neurologically, when you listen to something, a different part of your brain is engaged than when you write it down. Memory recorded by listening does not discriminate important from unimportant information. Writing creates spatial regions between important and unimportant pieces of information, which allows your memory to target and engrain the important stuff you want to remember.

Furthermore, the act of writing allows your subconscious mind to work out problems in unique ways, intensifying the learning process. You’ll be able to work out problems and get insight while you ponder and write about the things you’re learning.

7. Journaling increases your gratitude.

Even if you start a journal session in a bad mood, the insight writing brings has a subtle way of shifting your mind toward gratitude.

When you start writing what you’re grateful for, new chambers of thought open in the palace of your mind. You’ll often need to put your pen down and take a few breaths. You’ll be captivated not only by the amazing things in your life, but by the awe and brilliance of life in general.

As part of your morning and post-work journaling sessions, be sure to include some gratitude in your writing. It will change your life orientation from scarcity to abundance. The world will increasingly “become your oyster.”

Gratitude journaling is a scientifically proven way to overcome several psychological challenges. The benefits are seemingly endless. Here are just a few:

8. Journaling unfolds the writer in you.

I became a writer through journaling. While I was on a mission-trip, I wrote in my journal for one to two hours per day. I got lost in flow and fell in love with the writing process.

If you want to become a writer one day, start by journaling. Journaling can help you:

  • Develop strong writing habits.
  • Help you discover your voice.
  • Clear your mind and crystalizes your ideas.
  • Get closer to the 10,000 hours Malcom Gladwell says are required to become world-class at what you do.
  • Produce gems you could use in your other writing.

9. Journaling records your life history.

I started journaling in 2008 after reading an article about the importance of journal writing. In the article, the author described how much journaling had changed her life. She said after all these years, she now has 38 recorded volumes of personal and family history.

After finishing that article, I have never stopped writing in my journal. In my family room on a bookshelf are 20-plus journals filled with my thoughts and experiences. I’m certain they will be cherished by my ancestors as I’ve cherished the writing of my loved ones who have passed on.

This post originally appeared on BenjaminHardy.com.

 

New way of defining Alzheimer’s aims to find disease sooner

By Marilynn Marchione

THE ASSOCIATED PRESS

Government and other scientists are proposing a new way to define Alzheimer’s disease _ basing it on biological signs, such as brain changes, rather than memory loss and other symptoms of dementia that are used today.

The move is aimed at improving research, by using more objective criteria like brain scans to pick patients for studies and enrol them sooner in the course of their illness, when treatments may have more chance to help.

But it’s too soon to use these scans and other tests in routine care, because they haven’t been validated for that yet, experts stress. For now, doctors will still rely on the tools they’ve long used to evaluate thinking skills to diagnose most cases.

Regardless of what tests are used to make the diagnosis, the new definition will have a startling effect: Many more people will be considered to have Alzheimer’s, because the biological signs can show up 15 to 20 years before symptoms do.

“The numbers will increase dramatically,” said Dr. Clifford R. Jack Jr., a Mayo Clinic brain imaging specialist. “There are a lot more cognitively normal people who have the pathology in the brain who will now be counted as having Alzheimer’s disease.”

He led a panel of experts, working with the Alzheimer’s Association and the National Institute on Aging, that updated guidelines on the disease, published Tuesday in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

ABOUT ALZHEIMER’S

About 50 million people worldwide have dementia, and Alzheimer’s is the most common form. In the U.S., about 5.7 million have Alzheimer’s under its current definition, which is based on memory problems and other symptoms. About one-third of people over 70 who show no thinking problems actually have brain signs that suggest Alzheimer’s, Jack said.

There is no cure current medicines such as Aricept and Namenda just temporarily ease symptoms. Dozens of hoped-for treatments have failed, and doctors think one reason may be that the studies enrolled patients after too much brain damage had already occurred.

“By the time that you have the diagnosis of the disease, it’s very late,” said Dr. Eliezer Masliah, neuroscience chief at the Institute on Aging.

“What we’ve realized is that you have to go earlier and earlier and earlier,” just as doctors found with treating cancer, he said.

Another problem: as many as 30 per cent of people enrolled in Alzheimer’s studies based on symptoms didn’t actually have the disease they had other forms of dementia or even other medical conditions. That doesn’t give an accurate picture of whether a potential treatment might help, and the new definition aims to improve patient selection by using brain scans and other tests.

BETTER TESTS

Many other diseases, such as diabetes, already are defined by measuring a biomarker, an objective indicator such as blood sugar. That wasn’t possible for Alzheimer’s disease until a few years ago, when brain scans and spinal fluid tests were developed to do this.

They measure certain forms of two proteins amyloid and tau that form plaques and tangles in the brain _ and signs of nerve injury, degeneration and brain shrinkage.

The guidelines spell out use of these biomarkers over a spectrum of mental decline, starting with early brain changes, through mild impairment and Alzheimer’s dementia.

WHAT TO DO?

People may be worried and want these tests for themselves or a family member now, but Jack advises: “Don’t bother. There’s no proven treatment yet.”

You might find a doctor willing to order them, but spinal fluid tests are somewhat invasive, and brain scans can cost up to $6,000. Insurance usually does not pay because they’re considered experimental outside of research. A large study is underway now to see whether Medicare should cover them and when.

Anyone with symptoms or family history of dementia, or even healthy people concerned about the risk can consider enrolling in one of the many studies underway.

“We need more people in this pre-symptomatic stage” to see if treatments can help stave off decline, Masliah said.

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