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Confusion with drug names?

I received a question from a reader about generic drugs… Our generic/brand naming system for medications can be confusing, so I thought I’d try to explain it from a pharmacist’s point of view. All drugs have a generic name (the name of the actual drug) and a brand name (the name given by a particular manufacturer of the drug.) Sometimes the generic name is part of the brand name that the company uses to make it more obvious what the active ingredient is in the product.

Here’s how it works…

The first company to market a drug generally applies for a patent on their new drug to prevent other companies from selling it for a defined number of years. This gives the company time to recover the costs of developing the product by controlling the price and being the only source of the medication. The price of a new drug is not just based on what’s in the pill – it also includes the cost of the experiments and testing that were required to invent the drug, to ensure it was safe and to make sure that it actually worked. Governments generally limit the number of years through legislation because they know the price will drop once the patent expires.

Once the patent expires, other companies can begin to sell their version of the medication. These other companies only need to show that their version contains the right amount of the right drug, and that it’s absorbed and distributed throughout a person’s body in the same way as the original version. This means they have far fewer expenses than the original manufacturer because the drug itself has already been shown to work. We refer to these subsequent brands as “generic equivalents” or “generics”, as these products contain the same drug (known by its identical generic name) and are considered equivalent to the original brand by governments and drug plans.

Of course, this increased competition tends to lower prices. I’ve noticed the price drops some when the first generic version hits the market, but then there’s another (sometimes larger) drop when a third brand becomes available. As a pharmacist, it was a bit of a balancing act to avoid having too much on the shelf at first, knowing its value would decrease soon. The original manufacturer, of course, must ensure they recoup their development costs before other versions are allowed on the market.

Ultra-generics and Authorized generics

There’s another somewhat odd situation that sometimes occurs. In some cases, the original brand name company will make its own generic equivalent and sell it at the lower price, while still making their original brand at its original price. Usually these are a completely identical product (including the non-drug ingredients and how the tablet is made) but sold through a separate branch of the company, under a different brand name and with different markings on the tablet or capsule. We call these “ultra generics” in Canada and I believe they are called “authorized generics” in the US. It seems strange to me that they wouldn’t just lower the price of their original brand to compete – and occasionally they do – but often they must have enough people willing to pay the extra cost of the original brand to make it worthwhile to keep manufacturing both.

Once in a while, a company will decide that it’s not feasible to continue manufacturing the original brand any longer, and it will be discontinued. This is what happened to the original brand of the blood thinner, warfarin, called Coumadin. Most doctors ordered the medication by its generic name, warfarin, so pharmacies could dispense any brand unless the doctor specified the more expensive Coumadin brand. However, when I did some relief work in the north of our province, I was surprised to find that doctors there still ordered it as Coumadin even though the brand had been discontinued years before. I couldn’t help thinking this must make it difficult for patients and new pharmacists – requiring them to learn, not only brand and generic names of drug, but brands that have been discontinued years before and wouldn’t be found in current drug references!

Non-drug examples

A non-drug example of generics might be Kleenex…many people (me included!) refer to our facial tissues as Kleenex, even when they’re a different brand…essentially a generic equivalent. We go “Skidooing” even if it’s on an Artic Cat or Polaris. But we always call other products, like Robin Hood flour for example, by their “generic” name. Interestingly, people are often willing to pay more for Robin Hood brand, though, probably because it’s perceived to be better (more expensive must mean better quality, right?). Whether it is or not, it’s hard to say… my bread and pies seem to turn out the same whatever flour I use!

Occasionally there are problems…

However, this double naming brand/generic system can sometimes create problems in communication between doctors and patients when the different names are used. For example, I once had a patient whose doctor told them to double their dose of Lasix (generic name furosemide). At home, his prescription bottles were labelled as Apo-Furosemide (furosemide) and Lanoxin (digoxin). Remembering the drug the doctor was talking about began with the letter “L”, he increased the dose of Lanoxin by mistake. Not only did he not get the drug action he needed, he developed a toxic reaction to his now overdosed Lanoxin. This is one reason we suggest bringing a list of your medication with you to all appointments, and that all medication changes should be written out by your doctor or nurse practitioner.

There is a trend, mainly promoted by hospitals who see the results of problems like this, to encourage everyone to use generic drug names all the time. Unfortunately, brand names are often simpler to pronounce and remember, so this can be difficult for many patients. But the more generic names are used, the more familiar they become.

Watch the suffix – the end of the name

The other interesting advantage to generic names, is that they usually have the same ending if they are in the same drug family. For example, beta blocker drugs (used for high blood pressure and to slow the heart rate) end with “-olol”. So, acebutolol, metoprolol, and labetolol are all beta blockers. Examples of other name endings are “-cillin” for antibiotics similar to penicillin, “-profen” for anti-inflammatories, “-vir” for antivirals, “-azepam” for the benzodiazepine tranquilizers (diazepam, oxazepam) and “-mab” for drugs to treat auto-immune diseases like rheumatoid arthritis and multiple sclerosis. You should never be taking 2 “-profens” or 2 “-azepams” as this would be a duplicate therapy that would increase your risk of side effects. There are a few exceptions to this naming rule however – one is triazolam, a benzodiazepine which ends with “-azolam” instead of “-azepam” – but it’s close.

Do generics work as well as the “brand”?

Finally, one question pharmacists are often asked is, are generics as good as the brand? In the vast majority of cases, the answer is yes. They contain the same medication in the same strength and are tested to make sure they are absorbed and circulated in the body the same way before they are approved. Essentially, they are the same thing, just made by a different company, and still a high quality product that has been approved by drug regulators.

Governments do allow a small percentage difference in the amount that is measured in the blood, but generally this difference is too small to make any difference in the overall effect of the treatment. A possible exception is with drugs that have a “narrow therapeutic range”. This means that the difference between a blood level that doesn’t work, and one that is too high and causes problems, is not very large. Two common examples of drugs with narrow therapeutic ranges are warfarin and the thyroid replacement, levothyroxine.

People taking either of these drugs need to have blood tests regularly to make sure the amount of drug is in the correct range. If the brand you are taking is changed, it is advised to have extra tests shortly after the change to make sure the new formulation is still providing the correct amount of medication. Tell your doctor if you have changed brands of warfarin or levothyroxine and ask him/her about verifying your blood level of drug.

Very rarely, people will report a change in how they feel after changing the brand of medication they take. In all my years as a pharmacist, I have only seen this happen once. Doctors have channels to report drug problems and, when a problem is identified, the government acts quickly to investigate and remedy the situation. That company’s product is usually either removed from the market or made non-interchangeable with other brands.

Overall, generic equivalent medications have saved millions of dollars, allowing free market competition to do what it does best!

I hope this helps your understanding of the system of generic drug substitution. Generic equivalent medications are safe and help to keep drug costs under control, even if the system seems confusing sometimes.

Remember that any time you have a question about your medication your pharmacist is always happy to help!

#genericdrugs #brandvsgeneric

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Sunshine, Vitamin D and COVID-19… What’s the connection?

Researchers are working hard to find good treatments for COVID-19 and strategies to prevent it from being as severe. A new study suggests one possibility might already be in many medicine cabinets… Vitamin D3.

Vitamin D is known to play a role in our immune response and to reduce potentially harmful inflammatory responses in the body. We make large amounts of this vitamin when the sun shines on our skin and we can also get it from our food or by taking a supplement. In northern countries, like Canada, a vitamin D supplement is recommended from October until April, when the sun’s rays are not strong enough (and we’re too bundled up due to cold temperatures!) to produce adequate amounts for ideal health. But sunshine is good for us in more than one way.

Benefits of sunshine

We’ve all noticed that viral infections, like colds and the flu, tend to be less common in the summer when the sun’s rays are stronger. There are several mechanisms that have been proposed that could explain this:

  • Vitamin D helps the body to produce more macrophages, immune system cells that destroy invading germs by essentially “eating” them.
  • Ultraviolet rays destroy microbes in the air, so more sunshine means viruses will not live as long outside the body in the air or on surfaces outdoors.
  • Vitamin D helps prevent inflammation from getting out of control, as is noted in severe cases of COVID-19.
  • Skin that is exposed to the sun also releases large amounts of nitric oxide into the bloodstream. Nitric oxide relaxes blood vessels, reduces clotting (a problem associated with COVID-19) and, at least in lab cultures, prevents SARSCoV2 and other similar viruses from reproducing. Interesting side note: drugs like Viagra, used to improve men’s sexual function, work by blocking the breakdown of nitric oxide resulting in increased blood levels and dilation of blood vessels.
  • Vitamin D increases the action of an enzyme called angiotensin-converting enzyme-2, or ACE2, that is associated with improved COVID-19 outcomes.

Pigment in the skin filters the sun, providing protection from harmful rays, but it also reduces the amount of vitamin D formed in the skin. This has been suggested as one possible factor contributing to higher rates of vitamin D deficiency as well as increased rates of severe cases of COVID-19 among people of colour. Social and economic issues are also believed to be contributing to these excess cases.

Our general health affects how much active vitamin D we have in our bodies. The healthier you are, the more your vitamin D levels will rise naturally. Eating right, exercising, not smoking, spending time outside in the sun and keeping a healthy weight all help.

Of course, a vitamin D supplement won’t raise nitric oxide levels as sunshine does, but researchers are testing medications that can raise nitric oxide blood levels as well as whether inhaling nitric oxide gas can raise blood levels in a similar fashion. A preliminary study, done on cells from monkeys, showed that nitric oxide has antiviral action against SARSCoV2 and reduced blood clotting as well as dilating blood vessels.

There are those who point out that we don’t yet have concrete evidence that higher levels of vitamin D will protect us from severe forms of COVID. Like so much else with this new coronavirus, we will need to wait for the results of studies to know for sure whether this approach will save lives.

But this makes me think of the discussion about masks, where we were discouraged from wearing them at first because they weren’t “proven” to help (I think they actually said “there was no evidence they helped”…). Vitamin D supplements are considered safe in doses up to a maximum of 4000 units daily in adults and taking a supplement in the winter, when the sun’s rays are too weak to form vitamin D in our skin, has been encouraged for health reasons for as long as I can remember. A common dose is 1000 units daily and it’s readily available and inexpensive in pharmacies and many grocery stores.

Coronavirus spikes may be a pain reliever…

The other interesting COVID-related news I read this week, was that the coronavirus appears to have a pain-numbing effect. The Centers for Disease Control and Prevention (CDC) in the US estimate that about 40% of people with the virus do not have any symptoms. Scientists suggest that this could be because the coronavirus can block a pain signalling pathway, resulting in some of those infected being unable to feel the discomfort the virus infection. This would explain the asymptomatic cases and lack of symptoms early in the course of the infection, allowing increased spread of the virus as people don’t realize they are sick.

The spikes on the coronavirus attach to the ACE2 receptor on the surface of our body’s cells, like a key fitting into a lock. This is how they get into cells to infect them. But the spike proteins can also attach to another receptor on the cell surface called neuropilin and block it. Since this receptor is part of a pain pathway, the virus (or just its spikes, as was used in an experiment done on rats) blocks the pain signals that would otherwise be sent to the brain through this pain system.

So, besides providing a possible explanation for why people with milder forms or in the early stages of the infection don’t feel sick, these scientists may have found a new way to relieve pain in the future. If they could create a drug that mimics this action of these spike proteins, without the rest of the virus, we might have a new class of pain medications. Of course, this would be far off some time in the future, but it’s interesting to see how science works – often by observing an action in nature, analyzing how it occurs, then using this information for our benefit.

Can you catch the virus through your eyes?

Another article I read this week was about the potential to catch COVID through the eyes. It is thought that very few cases of the disease are caused by virus entering the body through the eyes, although they do tell us it’s a possibility. However, someone thought to assess what percentage of a group of hospitalized patients in China wore glasses daily, as compared to the local population. They noted that, although 31.5% of the population wore glasses at least 8 hours a day, only 5.8% of those in hospital at that time for severe COVID did so.

Of course, this is just an “observational” study that doesn’t prove anything, but it does suggest that the eyes could be a more important route of entry for viruses than we currently believe. It suggests that we should take another look at this issue. Meanwhile, I think I might wear my glasses instead of my contacts when I go out… just in case it does make a difference, Besides, I really like my new glasses!

And I always take a vitamin D 1000iu supplement in the winter unless I go somewhere warm and sunny. I guess I’ll be taking one all winter this year while I look at photos of Florida and Spain to lift my spirits when it’s too stormy to go outside…

#COVID #vitaminD

References:

Vitamin D for Covind-19: New Research Shows Promise – Medium elemental

How Sunlight, the Immune System, and Covid-19 Interact – Medium elemental

COVID-19: Nitric oxide shows promise as antiviral treatment – Medical News Today

Association of Daily Wear of Eyeglasses With Susceptibility to Coronavirus Disease 2019 Infection – JAMA Network

COVID-19: What role does vitamin D play? – Medical News Today

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The key to COVID-19

Researchers have been trying to figure out why large numbers of COVID-19 cases occur in some areas but only a few cases in others. Here in New Brunswick, we are getting about 1 new case a week (almost all travel related) while, next door in Quebec, there are over a thousand new cases daily. COVID-19 sometimes spreads to many people all at once and other times it is only passed to 1 or 2 people…or none at all. This is different than the flu, where it usually spreads evenly through a community and you’re almost guaranteed to catch it if you get too close to someone who has it (barring having been vaccinated, of course…got mine this week!). Researchers think this difference may be an important key to what we need to do to control this novel coronavirus.

You may have heard references to the “R0” measurement (pronounced “R-zero” or “R-naught”), sometimes also called the basic reproduction rate. This number indicates the average number of people who are infected by each new case of an infection. If each sick person infects 1 other person, the R value would be 1 and the number of cases would remain constant, with each case replacing itself. If less than 1 is infected on average, the number of cases will reduce over time; if more than 1, the number of cases will grow.

The R0 factor has been called a key factor in understanding what is happening with the pandemic, whether it is getting better or worse. But the problem with the R0 system, is that it is based on averages, while COVID-19 spreads mostly in batches at “super spreading” events, so it doesn’t show the true picture of what is happening.

But there is another type of measurement for disease spread that you may not have heard about: the “k” value, a measure of dispersion or how a disease spreads. Does it spread in a steady manner or in big bursts? The k factor, although complicated, captures viral behaviour that alternates between super infectious and noninfectious. Data collected in the first 9 months of the pandemic suggest that COVID-19 is an “overdispersed” pathogen, one that spreads in clusters. We need to take this into consideration when we assess the risk we will encounter from any given activity we are thinking of attending.

A study done in New Zealand found that only 19% of 277 separate introductions of virus resulted in more than one new case, while analysis of outbreaks in other countries have shown a single person to have infected as many as 5,000 known cases – that one occurred at a megachurch service in South Korea. The scientific term for this type of disease spread is “stochastic” – dominated by a small number of individuals and driven by super-spreading events. Even if the virus spread in a population is relatively under control, just a few super-spread events can turn that around quickly, as we are seeing in Quebec and Ontario right now.

The key to controlling spread

Multiple studies have suggested that as few as 10 to 20% of infected people may be responsible for 80 to 90% of transmission of COVID-19 through super spreading events. These include long-term care facilities, meat-packing plants, fish factories, cruise ships, family gatherings, house parties and night clubs. Researchers have realized that, if they want to get the pandemic under control, they need to prevent these super-spreading events that are driving the increase in cases. This is now believed to be the key to controlling the coronavirus.

This concept of unevenness is sometimes referred to as the 80/20 Rule or the Pareto Principle (named after economist, Vilfredo Pareto, who first noticed the phenomenon) , where approximately 80% of effects are often generated by about 20% of the causes. In addition to occurring in nature, we also see it in various human activities like 80% of business coming from 20% of customers or 80% of taxes being paid by 20% of citizens. If you’re interested in reading more about the 80/20 Rule, Wikipedia has a good explanation.

The three C’s of superspreading events…

So, what made events that resulted in many cases, different from similar gatherings that resulted in no new cases? Researchers found 3 factors in common, referred to as the 3 C’s:

  • Crowd – Many people at an event increase the chance that one will be carrying the virus. Holding an event in a community where the virus is less controlled also increases the chance someone who is highly infectious will be included in the group.
  • Close – Not being able to maintain a distance 2 meters or 6 feet from others increases the chance of viral spread, as we all know now. Prolonged contact is also known to increase the chance of the virus passing from person to person. It is believed that a contact time of 15 minutes or longer of contact increases the chance of passing on the virus.
  • Closed space – An indoor venue with poor ventilation allows tiny droplets containing viruses to hang in the air as an aerosol for much longer. Singing and loud talking (for example, talking over loud music in a bar) readily generate these aerosols, but normal talking and even just breathing also generate droplets. A mask of any kind, even a homemade cloth one, will trap these particles and reduce the chance of viral spread. Masks generally were not being worn at super-spreading events.

Backward contact tracing

Since this coronavirus spreads differently, we should be looking at contact tracing and testing differently, too, researchers say. Because only 20% of cases or less are responsible for most of the spread, it is important to identify those 20%. Statistically, It’s more likely that the person who gave the virus to a new case will be a super-spreader than the case at hand.

This suggests, especially if tests are limited, that it would be most efficient to trace the source of an infection and then test the source’s contacts, rather than try to test everyone’s contacts and not be able to keep up. If more than 1 or 2 cases are found amongst the contacts of a source, then there’s a good chance that a super-spreader may have been found. In lieu of testing all of the source’s contacts, isolation can simply be recommended when sufficient tests are not available. Tracing back to the source then checking their contacts is called “backward contact tracing”.

Using this information

This weekend is Thanksgiving in Canada, and many families will want to celebrate together. In some provinces, where the virus is spreading quickly and many new cases are being reported daily, governments are telling people to stay at home… and instead to share the holiday remotely, by video chat or phone call, instead.

But what about our “Atlantic bubble” where we have had very few new cases daily here in Atlantic Canada and no community spread for months? This week, we had an outbreak in a nursing home in a nearby city…15 cases there plus 2 family members who work at Costco and St. Hubert’s restaurant, plus 3 other separate cases that were travel related and already in quarantine. They are still trying to identify the source of the nursing home outbreak (backward contact tracing!) and the extent of the spread, and have finally mandated that masks be worn in all public places in our province.

So, although it might seem to be fairly safe to gather in small groups, we can’t let our guard down. The pandemic is still at our doorstep and it’s looking like the second wave is beginning its spread around the globe. We can’t forget that the virus is potentially everywhere…and we need to continually improve our systems and practices until we stop the spread and protect the most vulnerable.

References:

This Overlooked Variable Is the Key to the Pandemic – Medium.com

Stochasticity and heterogeneity in the transmission dynamics of SARS-CoV-2 – B.M.Althouse, et al, Institute for Disease Modeling

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Motion sickness… Many ways to treat it

I’ve suffered from motion sickness ever since I was a kid… I still remember trips to the cottage (over rough dirt roads!) that left me sick all afternoon. And I’ve tried plenty of different strategies to overcome it. Some worked better than others…

One of the first things I noticed, is that I’m more likely to get carsick in the back seat than in the front. Of course, I only discovered this once I was an adult. But I’ve used this strategy in recent years on the rare occasion when I end up in the back of a car. If I avoid looking out the side window at the landscape rushing by, I can usually avoid getting queasy. I often volunteer to ride in the middle (the least desirable seat!) so I can look out the front window. Or I simply try to look at my lap or the floor (boring but it helps!).

I’ve also learned that reading makes me nauseous in a car very quickly, even in the front seat. I can notice it starting even if I try to read the mail on the ride home from the community mailbox at the top of our road! So I avoid any activity in a car that requires close concentration, like reading or a complicated knitting project (although I can usually handle simple knitting). Fortunately, I can concentrate on driving without getting ill!

What causes it?

Motion sickness is thought to be caused by a conflict between the movement detected by the balance mechanism in the ear (the vestibular system) and the motion the eyes are seeing. For me, the worst conflict is scenery rushing past while my vestibular system is telling me I’m just bumping around a little from the vehicle vibrations. Luckily air travel doesn’t bother me, and only once did I have a problem on a boat, and that was caused by strong winds the last day of a cruise we took. I managed that by pretending I was being rocked to sleep…mind over matter!

Strong smells, like cigarette smoke or spicy/greasy foods, can make the nausea worse, too. I once “lost my lunch” when we pulled into the parking lot of a fast food joint, just at the thought of a greasy burger and fries…

Treatments

Of course, anti-nausea medications, such as Gravol (dimenhydrinate), Dramamine (meclizine) or Transderm-V (scopolamine) patches can help prevent the problem, but they cause side effects, like drowsiness and dry mouth. And they take a while to kick in, so are really most useful for a planned trip. Unfortunately, non-drowsy antihistamines and ginger are not considered as effective in preventing or treating motion sickness, although some references suggest ginger can be tried.

Fresh air can also be helpful. Opening the car window (or putting the top down!), using a fan or directing the air vent in a plane toward your face can sometimes be enough to reduce nausea, especially if you do this at the first sign of the problem and also stop any aggravating activity. Although not often available to you when travelling, peppermint and chamomile teas relax the digestive system and can reduce nausea as well.

Another strategy, is an accupressure device called “Sea Bands”. These are small elastic bands with a knob on the inside. The idea is to place the knob so it puts pressure on an accupressure point on the inside of the wrist. These have been clinically shown to reduce nausea. The point is located about 6-7 cm (2-2.5 inches) or 3 finger-widths above the inside fold of the wrist (palm up), between the two large tendons in the center of the arm. You can also just massage this accupressure point with the tip of your finger if you don’t have the bands.

A new preventive strategy…

This week I read about a small experiment where researchers found “visuospatial training”, manipulating 3D objects in one’s imagination for 15 minutes a day for 14 days, helped reduce motion sickness by over 50%. This involved identifying which 3D shapes matched when rotated, paper folding, and analyzing patterns.

The researchers got the idea for the study from previous research that had noted a link between visuospatial abilities and motion sickness. This research also found that males are less likely to have motion sickness than females and, correspondingly, also tend to have better visuospatial abilities than women.

My 3D talents are close to zero… I was hopeless at trying to solve the Rubic’s Cube puzzle, and I remember being totally frustrated by trying to print and assemble a multi-page folded pamphlet that my pharmacy student was able to whip up in no time! So, this connection makes sense to me…

I also like the possibility that this might permanently reduce the risk of nausea when travelling, as you never know when motion sickness can strike. With the development of self-driving cars, researchers suggest the technique may become more useful in the future. They envision it being used before test-driving a new autonomous vehicle, or by the navy or cruise passengers.

Brain training games are available on Google Play or Apple App stores. I’ve decided to try out one called Train your Brain—Visuospatial Games and another called Mental Rotation looks good too. I’ll be interested to see if playing the games helps to make my next road trip more pleasant!

Surprisingly, my first game session left me feeling a little disoriented, almost queasy. It seems likely to me that 3D games and motion sickness must use the same area of the brain. Exercising this area by playing a video game probably helps to develop improved function, resulting in less chance of motion sickness. Cool. Isn’t the brain fascinating?

Let me know in the comments if you try this technique or any of the above ones… and whether any of them work for you…

#motionsickness #nausea

References:

Prevention and Treatment of Motion Sickness – American Family Physician

Motion sickness: First aid – Mayo Clinic

Top 16 Ways to Get Rid of Nausea – Healthline

Sea-Band

Can we ease motion sickness through mental training? – Medical News Today

Worksheet packet – Cognitive Therapy Worksheets for Visual & Spatial skills

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A “non-blog” this week…

What a week I’m having! Seems there’s no room on my schedule (or in my head!) for thinking about a blog. But rather than ignore all of you (my faithful readers!) perhaps I’ll tell you what I’m up to…

A visit from “Teddy”…

First, it’s another hurricane week – Teddy, this time. With memories of the damage from Dorian this time last year still fresh, we spent time putting outdoor things away and battening down the hatches. My hubby even put fresh caulking on the front windows that face the ocean. The storm has subsided now, and it all seems to have worked, except for damage to our poor flag…should have remembered to take it down. Thankfully, this storm wasn’t nearly as strong as last year’s…

Family too…

Next, a couple of my sisters-in-law who live up north are here for their annual shopping trip to Moncton… never too early to start Christmas shopping, and best to do it before the snow flies (and things ice up much earlier in northern New Brunswick than they do here). Of course, having visitors means doing some extra house cleaning so the place will look its best…and lots of chatting and laughter while we catch up!

And a new project!

But my big news is my new project… I’ve started working on the audiobook version of my book “Can I Speak to the Hormone Lady?” Some of you may have noticed that I made an audio version of my blog for a few weeks…that was to practice and learn now to read, record and edit audio files!

My book is aimed at women in their 40s and early 50s…those who are seeing menopause looming in their future, and who may already be noticing some changes in their cycles and want to be prepared.

When I was 40, I bought my first book on menopause because I didn’t want to be caught off-guard. I find that knowing about a subject makes it much less frightening. And knowledge gives you control.

Unfortunately, the first book I bought didn’t give me all the information I needed. Over the following 10 years I read many books about menopause and hormone imbalances. I realized that many women needed information and options, especially in the early 2000s when studies were finding problems with standard menopause therapies.

Many women had questions, and I researched to find answers and options for them. Eventually, I realized that if I met with them to gather information and learn their preferences, I could do a better job at making recommendations. I also realized that, if I wrote a concise report that summarized the information I gathered, we could share what I’d learned with the woman’s doctor. Almost all the doctors I did this for, appreciated the insight. They could never make enough time during a regular appointment to ask about all of a woman’s symptoms to form a complete picture of what she needed and how she wanted to approach therapy to get in control.

I constantly read studies and books, did online courses and attended live conferences in Toronto and Houston, Texas. I wanted to learn all I could so I could solve women’s hormone imbalance problems throughout her reproductive life. It was very gratifying to be able to make a difference in many women’s lives.

When I retired, I wanted to capture all I’d learned so I could continue to help women, so I wrote it all down in book form. I wanted it to have all the information women needed… I wanted it to be the book I was looking for when I turned 40.

Recently, I realized that younger women, the ones who could really benefit from my book, often prefer to listen to books while they’re doing other activities, like working out, driving to work or walking the dog. Being an avid reader since I was a child, I’d never really listened to audiobooks or podcasts and preferred books and blogs, written words.

But, since I want to be able to help as many women as possible, I decided to learn how to create an audio form of my book. I love learning new skills! I took an online course on how to create and edit an audiobook, tested out my skill by recording a few of my blogs, and got to work.

Meanwhile, I’ve been learning about how to market books… how to let people know that the information they’ve been looking for is available in a book I’ve written. The world of book marketing, whether a writer has published traditionally or self-published, is complex and constantly changing. So much to learn! But I keep studying ways to let people know about information I have to share, without being annoying or “salesy”.

Building a “Launch Team”

I realize that many or you who receive my emails are not interested in learning about the world of hormones. But I’d like to invite those who are, to join a separate group that will help me develop and launch my audiobook of hormone information. If you know any women in their 40s or early 50s that you think might also be interested, please pass my request on. I’m especially looking for volunteers who are keen to learn more about hormones, like to listen to audio, and will tell me what works and what doesn’t. It’s turning out to be a challenge to read the chapters that contain charts and summaries…and I could really use some feedback! Here is the link to sign up for the Launch Team list: https://mailchi.mp/a79fd38aac73/launch-team

I’m a little over half finished the recording now, and will have editing to do afterward, so it will be a few weeks until I have it ready to go. I’m planning to do a relaunch of my book at the same time and, hopefully, do a better job of it this time around!

Then I’ll be moving on to my next book – about another of my passions, the environment. No title yet!… I’m working on the outline currently…

#audiobooks #hormoneinformation

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Why facts don’t always change our minds…

Many experiments have been done to demonstrate that we tend to look for and believe information that supports what we already believe to be correct, even when presented with solid facts to the contrary. In science this is called Confirmation Bias, and research methods are designed to prevent this from happening. In everyday life, some refer to this tendency as “myside” bias… we believe information from those who have the same opinion as we do.

And, when presented with contrary information, too often it is more important to win the argument or discussion than is it to listen to facts different from what we believe, to see if we can learn something new. Economist, J.K. Galbraith expressed it as: “Faced with a choice between changing one’s mind and proving there is no need to do so, almost everyone gets busy with the proof.”

Evolution

So, why do we cling to our beliefs, even when overwhelming evidence suggests we are not right? Psychologists explain it’s at least partly due to evolution. In the distant past, being part of a group or community meant a better chance of survival. It was better to be included in the tribe, even if they weren’t making the best choices, because it was almost impossible to survive alone. Agreeing with the other members of the tribe meant you would be accepted and kept safe.

But even today, socializing is still important to humans. We know that people live longer when they have community support. Accepting the ideas and beliefs of your group is often necessary to remain in the group. Being rejected and trying to create or join another social group is difficult.

We see this clearly in teenagers, where some will commit acts they know are wrong (like stealing, for example) or submit to dangerous hazing rites to be part of a group. As adults, peer influence is more subtle but still there. Researchers say we are more likely to change an opinion based on the influence of a less knowledgeable friend, with whom we agree on other topics, than we are based on solid information from an established expert.

Politics and social media

This is prevalent in politics and in any controversy that becomes politicized. Backing down or changing one’s mind when presented with facts can be seen as a weakness, a “flip-flop”, rather than as having the courage to admit when one is wrong and improve when presented with facts. In public discussions, such as on social media, a typical “troll” response, when presented with irrefutable evidence that they are wrong, is to switch to a personal attack rather than back down.

I had that happen to me once on social media… Although the comment was a bit rude, I just kept being nice and politely pointed out the links to studies that supported each statement. My blogs are based on science and rarely on anecdotes (and I tell you when anything is just my “opinion”). It turned out that we did similar work reviewing scientific articles but eventually he resorted to pointing out a typo on my website. I thanked him for his sharp eye and suggested he would make a great editor!

Personal experience

We can also tend to place more weight on personal experiences than on facts from experts we don’t know personally. An example is with vaccines. It’s easy to understand parents being suspicious about the safety of all vaccines if their child has had a reaction to one, even though science and experts overwhelmingly agree that vaccines save many, many lives overall. Of course, once a person has had a reaction to any vaccine extra caution needs to be exercised for future injections, but one rare case doesn’t negate years of evidence of the overall benefit of vaccines for the vast majority. Unfortunately, reports of these statistically rare cases are sometimes used to influence others who are not at risk to be skeptical about all vaccines too.

Communicating with your adversaries

Winston Churchill quite famously would sometimes preface a statement with “I may be wrong but…”, allowing the others more freedom to state their opinion, and himself greater freedom to change his mind. Since none of us can know everything, we all can have wrong opinions from time to time due to lack of information. To help you to learn the truth and make the best decisions, keep an open mind and try, always, to look at the facts and the sources of those facts. Always keep the potential for bias in mind, both yours and that of your information source.

But, since people tend to agree more often with friends, one way to influence the opinions of others is to get to know them. Even the simple act of sharing a meal can help you get to know each other enough to be more understanding and accepting of the others’ opinions.

Effect on the pandemic

Lastly, when it comes to COVID-19, we all need to realize that we still have a lot to learn about this disease and the virus that causes it. While some people feel confused and don’t know what to believe, we all need to realize that statements and decisions are being made with limited knowledge. As our knowledge evolves, decisions change and will continue to change. That should be expected. It’s too bad the experts didn’t preface early statements with “This may change in the future after more research but, for now, we recommend…”

Fortunately, the scientific method, which continually questions and re-evaluates previously held “facts” makes it easier to admit wrongness, based on newly-discovered evidence. But changes in policies and recommendations have created confusion for many who don’t understand the process. Unfortunately, refusing to accept the facts these days as our knowledge evolves can be risky to your health or that of others around you, including your “tribe”!

We are just starting to learn about the long-term consequences of COVID-19 because it’s only been around for a few months. New reports are surfacing about “long COVID”, those who continue to have disease symptoms for months after recovery, and about possible organ damage. Many experts predict a second wave of illness but it’s easy to think it will happen somewhere else or to someone else. The best strategy right now, is to be as careful as possible to avoid exposure to the novel coronavirus and find safe ways to satisfy our “tribal” social needs. Video chat, anyone?

P.S. …

We’ve been using a great video chat program called Whereby, noted for its security. Once you create a “chat room” (simple to do…) you can just send a link to your “room” to those you want to chat with – no need for others to download the program to chat with you. It works on a computer, phone or tablet and is free for up to 4 people/devices at a time. The link is just whereby.com/whatever-you-named-your-room then you “knock” for permission to be let in (prevents hackers from butting in to your call!). Seems like a great way to stay in touch with those you can’t safely visit…

References:

Why Facts Don’t Change Our Minds – James Clear

Why Facts Don’t Change Our Minds – The New Yorker

Whereby.com

‘Ill, abandoned, unable to access help:’ Living with long COVID — Medical News Today

#covid19factsvsmyth #WhyFactsDontChangeOurMinds #COVID19

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Get into the state of Flow…

and live a happier, more productive life!

Wulastukw/Saint John River by Victoria Moon Joyce (Fredericton, NB)

What is Flow?

Flow is “a state in which people are so involved in an activity that nothing else seems to matter; the experience is so enjoyable that people will continue to do it even at great cost, for the sheer sake of doing it.” This is how researcher, Mihalyi Csikszentmihalyi describes this mental state. (His name is pronounced “Me hi Chick sent me hi” in case you’re wondering…) He also calls it a state of ecstasy, meaning stepping into an alternate reality or entering a mental state where you feel you are not doing your ordinary every day routines, and has spent much of his life studying artists, athletes, gamers and others who experience this regularly.

He was fascinated by people who could spend hours doing an activity they love, losing track of time and even bodily needs like hunger as they focus completely on what they are doing. He named this mental state “flow” because so many described the experience as effortlessly floating down a river, or as a sense of fluidity between the body and the mind.

Flow gives a general sense of well-being and a lasting sense of happiness and fulfillment, a pleasure that comes with being in the moment and doing something that you are passionate about. It’s a positive experience, known to produce intense feelings of enjoyment, lowered anxiety, raised self-esteem and improved mood. Getting into a state of flow regularly sounds like the ideal way to be happy and productive. It’s a state of optimal experience, and has been referred to as an active, moving form of meditation.

Here are 8 characteristics of flow:

  1. Complete concentration on the task
  2. Clear goals, value and reward of the task, and immediate feedback
  3. Transformation of time (speeding up or slowing down)
  4. A reward that is intrinsic (i.e. the reward is “inside” you)
  5. Effortlessness and ease in performing the task
  6. A balance between the challenge and your skills, with just enough challenge to keep you focused
  7. Actions and awareness are merged, a loss of self-consciousness
  8. A feeling of control over the task, and performance is improved

Anyone can get into a state of flow, but it is easier for some personality types. Those who are curious, persistent, have low levels of self-centeredness, and like to perform activities for intrinsic reasons only (for the personal satisfaction they get from it) tend to slip into flow more easily. Csikszentmihalyi describes such people as “autotelic” (from the Greek: autos=self, telos=goal or end), those who seek the experience itself as the goal rather than some future benefit.

How do you get into a “state of flow”?

You need to:

  • Know what to do and how to do it (i.e. have a goal and plan of action).
  • Care about the task at hand.
  • See or get feedback on how well you are doing, including when doing it well.
  • Have an activity that stretches your skills at a manageable level (so you don’t become distracted or bored) but not so difficult that you become anxious, stressed and frustrated. There needs to be a balance between the challenge and your skills.
  • Have freedom from distractions so you can focus totally on the activity, although once in flow, it becomes easier to resist distractions.
  • Focus on the process of the activity rather than on the outcome.

Humans can process about 110 bits of information per second. When what you’re doing totally consumes your focus, there’s no brain processing ability left to even be aware of your “self”. Conversation requires 60 bits of information per second so, in most cases (unless the conversation is part of the activity, for example in team sports), it’s impossible to get into flow while distracted by talking. Flow is possible in a team setting, however, and is reported to be even more enjoyable than being in a flow state by oneself, whether at work or in sports.

Getting into flow at work and school

Another characteristic of flow is improved performance and productivity. This makes flow a desirable state to achieve in the workplace. Matching challenges and skills, giving training regularly to increase these skills, and gradually increasing challenges to maintain focus and avoid boredom is a recipe for engaged and satisfied employees who produce the highest quality work in the shortest time. Workers need to also understand where and how their individual task fits into the overall purpose of the workplace, and to receive immediate feedback, both when they do a good job and when they need to improve.

Artists, musicians, writers, dancers, and gamers benefit from flow and this can make the activity even more pleasurable and rewarding. Spiritual practices like yoga can make it easier to learn how to get into flow as they include a meditation component. Some people even have a routine they do to clear their mind and set themselves up for flow.

In online education (and social media too, for that matter…), a goal is to keep the person’s attention as much as possible for as long as possible. An ideal goal for any learning environment is to match challenges and skills, always feeding just enough information to continually stretch current skills at a manageable level to maximize learning, without overloading and causing anxiety or frustration. The Montessori school system is noted for successfully using this individualized approach with young children.

My experience…

I think I’m fascinated by all this because I’ve experienced flow many times. When playing classical guitar, I find myself essentially listening to myself play rather than thinking about what I’m doing and, if my concentration wanders even a bit, I’m lost and have to start the song over. I’ve always felt this was just a little weird and could never understand quite what was happening until I read about flow.

A happier life

Experts tell us that, once basic needs are satisfied, material things like a bigger house or a new car bring only fleeting enjoyment and not long-term happiness. But learning how to get into flow and making the effort to get into this mental state regularly sounds like an ideal way to create a happier and more productive life.

How about you?

Have you ever been so absorbed in an activity that you lost track of time altogether? Do you have a routine that prepares you slip easily into flow when starting an activity?

End note:

The photo above is of a painting by New Brunswick artist, Victoria Moon Joyce, entitled “Wulastukw/Saint John River”. I enjoy the serenity of hints of sunlight on the flowing water of the Saint John River (near where we lived for several years) every day… I am so fortunate to have it hanging in my living room. Enjoy more of Moon Joyce’s art on the Gallery 78 website.

References:

3 Hours of Creative ‘Flow’ Every Day Is All You Need to Change Your Life – Medium.com

‘Flow’ Can Help You Achieve Goals – Very Well Mind

What is a flow state and what are its benefits? – Headspace

Flow, the secret to happiness – TED Talk

Flow – Wikipedia

Victoria Moon Joyce — Gallery 78

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Would you like a side of plastic with that?

Two studies, one in Canada and another in Australia, have found plastic in supermarket seafood – not just in the stomachs of the fish, but in the flesh too. This means we are eating plastic when we enjoy a tasty nutritious seafood dish. But how much? And is it harmful?

For many years, the eye of environmentalists has been on plastics found floating in our oceans and lakes. We’ve all seen photos of sea life and birds being tangled in plastic rope or strangled by loops of plastic packaging. And that’s a concern.

But, at the same time, sun, wind and waves have been breaking down these plastics into smaller and smaller fragments that even the tiniest water creatures can consume. Research is just beginning to look at what effects this may be having on marine life.

However, there’s a good chance this plastic could be affecting us too when we eat seafood. Besides the content of plastic itself, which is composed of many chemicals, these microplastics are carriers of other chemicals, like PCBs, pesticides, flame retardants, and many kinds of hormone-disrupting compounds. And they’re all through the fish, not just in their digestive system, so gutting out the digestive organs doesn’t remove the plastic. How much does this affect our health? Scientists don’t know yet but, at least, they are staring to look at the problem.

My story…

I’m probably aware of the potential health effects more than most. Years ago, I thought using a Tupperware tumbler with a “sippy” lid (that my kids no longer needed) as a car coffee cup was a great idea. It fit in the car cup holder and didn’t spill all over the place in the car. And I had lots of them so they could just go into the dishwasher afterward.

I used these for months, enjoying my morning coffee daily on my way to work. But eventually, my coffee started to taste more and more like plastic. I remember stopping one day and dumping it, because it tasted just awful…

But through this time, I had started getting some health issues. A bad PAP test, breast lumps that, fortunately, were just benign fluid filled cysts (not considered dangerous), and even a little cervical cryosurgery. But a few months after I stopped using the sippy cups, the problems all went away.

I didn’t make the connection to the plastic cups until I went to a showing of a documentary film about the connections between the environment and breast cancer with a long-time friend who’s a cancer survivor. It was organized by the local breast cancer support group and open to the public. The documentary was called “Exposure: Environmental Links to Breast Cancer” and the producer and director were there to discuss the film and answer questions afterward. I have included a link to the full 53-minute documentary in the references below, if you’d like to watch it. It’s worth an hour of your time…

One of the environmental links discussed, was plastic or chemicals from plastic that make their way into our food through contact. They explained that simply microwaving food in plastic, especially fatty food, could leech hormone-disrupting chemicals into your meal. These chemicals can mimic the action of our own hormones, over-stimulating organs like the breast that respond to hormones. They can also block the beneficial actions of hormones, leaving us with a dangerous hormone imbalance.

I quickly made the connection between the coffee cups I had been using and my health problems. The coffee was leeching ingredients from the plastic, helped along by the heat and oils in the coffee, and I had been giving myself a daily dose.

A story about alligators

An additional problem is that these chemicals, those in pesticides and herbicides as well as plastics, are fat soluble and tend to be stored in fatty tissues in our bodies. Animal studies suggest that small exposures over a long period of time can add up and become equivalent to a large exposure. Studies on alligators in Florida lakes, comparing those in Lake Apopka (which was exposed to a chemical spill) to those in Lake Okeechobee (which had low levels of pollution over time) and Lake Woodruff (which was still pristine), demonstrate this.

The same health changes were found in alligators in the first two lakes, although more severe in the lake that received the large chemical spill. Animals in both lakes had disruptions in hormones: low testosterone and small penis size in males, malformed “burned out” ovaries in females; all had altered thyroid hormone levels. This showed that low level chemical exposure accumulated over time, resulting in health problems similar to those caused by a single large exposure.

Alligators are considered worth of study and comparison to humans because we are both at the top of the food chain and tend to concentrate the environmental chemicals consumed by the chain of organisms that create our food. Lowered testosterone levels have been reported in humans, fertility problems are on the rise and thyroid issues are rampant in humans. The thyroid replacement drug, Synthroid, is among the most prescribed medications.

Back to plastics…

I read an article this week about how campaigns to reduce single-use plastics have had to be put on hold during the pandemic. To protect cashiers in stores, they were told to begin using disposable plastic bags and this is understandable (although one should be asking, why not paper bags!). However, I never stopped using my reusable bags and simply asked to pack them myself. In Costco, we pack our bags as we put our goods into the car. We need to get back on track with reducing our use of plastics and find a way to do it safely.

There are so many ways for chemicals from plastics and other sources to be introduced into our food supply. Microbeads in toiletries were banned in Canada and elsewhere 2018 but much more microplastic makes its way into the environment through plastic bags, Styrofoam containers and plastic cutlery, according to Chelsea Rochman, University of Toronto ecologist. “It has infiltrated every level of the food chain in marine environments…and so now we’re seeing it come back to us on our dinner plates.”

Is it affecting our health?

Researchers say they don’t fully understand the risks to human health yet, but new methods of detecting microplastics in food will make it easier to find out. However, microplastics and the tinier bits called nanoplastics have been found in sea salt, beer, honey and bottled water. They can also be deposited on food as dust particles and during processing and packaging of the food, so there’s a good chance it’s in more than just fish. Even opening plastic packaging can result in shedding of microplastics in your home.

It’s very difficult to avoid all exposure to environmental chemicals now, but we do have some control on the level of exposure in our personal environment. I wrote about strategies to do this in my August 3, 2018 blog: Plastic? Think twice.

We can also demand that our governments find safe ways to continue the process of reducing and eventually eliminating sources of plastic that end up polluting our environment and our food. And we can change our personal use of plastic items, starting with avoiding single-use plastics and purchasing foods that are not wrapped in plastic. Stores respond to demands of consumers… Think of it as a sort of “voting with your wallet.”

So, what will you do differently, starting today, to reduce your exposure to plastics and other harmful chemicals? Comment below so we can all benefit from YOUR ideas…

#Environment #HormoneDisruptors #PlasticInSeafood #EnvironmentalConnectionsToBreastCancer

References:

Exposure: Environmental Links to Breast Cancer – Martha Butterfield, Francine Zuckerman, Dorothy Goldin Rosenberg

Research Finds Alligator Problems Also Evident In Less Polluted Lakes – Science Daily

Microplastics found in supermarket fish, shellfish – CBC News

Study found plastic in every seafood sample it analyzed – Medical News Today

Fight against single-use plastics sidelines by COVID-19, report finds – CBC News

Plastic bans, environmental monitoring get short shrift during pandemic – CTV News

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Should I download the COVID App? and can I Reuse my Masks?

Canada has a new government-approved app, called COVID Alert, to detect possible exposure to the Coronavirus. It is designed to function as an extra layer of protection to add to physical distancing, hand-washing and wearing masks… and privacy for users is built in.

How does it work?

It works by exchanging random codes with nearby phones using Bluetooth wireless technology. Every day, the app checks the list of random codes on your phone with codes from phones belonging to people who later entered a code supplied by Public Health to tell the app they tested positive. If you’ve been near a phone with one of these codes in the previous 2 weeks, within 2 meters for at least 15 minutes, the app will alert you to get tested or call Public Health. The data is stored on each individual phone, not a central server, maintaining each person’s privacy. The user isn’t told where, when or with whom the possible exposure occurred… the app simply directs them to call public health for advice. For most of us, this means calling 811.

The downside of this design is that it’s impossible for researchers to measure how effective the app is… it’s the price being paid for a high level of privacy. However, they can measure the rate of download among Canadians, the number of positive codes given out, and users willingness to follow the advice given by Public Health after making the call.

It’s easy to understand that the app’s success will depend on how many Canadians download the app, and relies on each provincial government to opt in. So far, only Ontario is giving out codes to those who test positive, although Prime Minister Trudeau has suggested that the Atlantic Provinces (eastern Canada, where I live) are expected to join next and several other provinces have indicated that they plan to join. I can’t help wondering what the hold-up is – my husband and I downloaded the app when we first read about it a couple of weeks ago – but it must have something to do with generating the codes when someone tests positive for the virus.

And, of course, there are some people who don’t have a cell phone or who don’t carry it with them regularly. However, a research team at Oxford University suggested that if 60% of the British population downloaded their app it would be effective in stopping the epidemic. This number is believed to apply to other countries also. But the researchers also believe that lower numbers – as low as 15% or possibly less – could still make a difference by detecting cases early enough to prevent spread of the virus.

Within the first 2 weeks, the app had been downloaded almost 2 million times…that represents 5% of Canada’s population. Because of the design, however, it’s not clear in which provinces the users are located. I would encourage all Canadians to download the app so they will be in the system as soon as their province goes online with the system.

To download the app, just go to Google Play Store or Apple’s App Store and search “COVID Alert”. It’s free and secure!

Reusing disposable masks

We all know about the shortage of protective equipment, especially masks. Many (like me!) have been making their own masks and supplying family and friends and we are starting to see them for sale in various locations, both cloth and disposable ones.

However, the top level N95 masks are still a precious commodity, mostly reserved for health care workers. There has been much debate about whether these can be sterilized and reused and, finally, a research team has found a simple way to do this.

The used masks can be stacked and placed in a dry electric cooker (a toaster oven or rice cooker works fine) at 212F (100C) for 50 minutes. They tested the masks afterward and, even after 20 sterilizing cycles, the masks maintained their ability to filter, their shape and still properly fit the wearer’s face. They recommend placing a cloth or towel under the masks to avoid direct contact with the oven’s surface.

Presumably, this procedure could be used for disposable medical masks as well. You’d want to ensure any strings or ear loops are kept away from the heating element. Cloth masks, however, are still recommended to be washed in hot soapy water after each use. I swish then soak mine in a bucket of water for 10 to 15 minutes, rinse, then roll in a towel to absorb excess water so they’ll dry faster and hang them to dry overnight. I also press mine with a steam iron for additional heat sterilization and to make them look nice!

If you’re a Canadian reader, please go to your phone app store and download the COVID Alert app right away so you’ll be ready for implementation in your province. If you live elsewhere, join your country’s warning system or encourage your local politicians to initiate one, and we’ll all work to stop this pandemic in every way possible.

References:

Download COVID Alert today – Government of Canada

Misconceptions persist about the effectiveness and privacy of Canada’s COVID Alert app – CBC News

Dry heat can effectively sanitize N95 masks – Medical News Today

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Corona dreams

People around the world have been reporting stranger, unsettling and more vivid dreams since the start of the pandemic. And research suggests that the quantity of dreams that are remembered are up by 35%. Some have nicknamed these “corona dreams” or “quarandreams”…

Some common themes reported to dream researchers include:

  • getting sick: becoming infected with the virus, being unable to breathe or admitted to hospital;
  • metaphors for sickness: like being threatened by storms, fires, insects, or mobs of attackers
  • jeopardized safety: forgetting their mask, getting too close to others, or people coughing on them
  • isolation: being stranded on a desert island or the opposite, being with lots of friends or extended family

Understandably, living with lockdowns, physical distancing requirements and mandated mask wearing means our brains need to process a lot of information about the coronavirus. Since the dreaming phase is believed to be part of the brain’s processing of information, it isn’t all that surprising that these themes would creep into our dreams.

But, as we learned last week, we usually forget our dreams unless we wake up during them or soon afterward. A 35% increase in remembered dreams suggests that many of us are not sleeping as well in response to the stress of the pandemic. Reports of surveys suggest that essential workers, heath care workers, and those who have been sick (people most likely to have higher levels of COVID-related stress) are most likely to have disturbing dreams. This supports the likelihood that increased stress from dealing with the virus on a daily basis could be disturbing sleep.

We also often dream about the things we think about and do during the day. Researchers call this the “day residue” effect on nightly dreams. The more we are focused on the coronavirus or have to deal with its effects during the day, the more likely we will dream about it as our brains process the memories of the day.

And since stress hormones are designed to keep your brain more alert and activated, ready to respond to a danger, your sleep will tend to be lighter when you are stressed, allowing you to wake up more easily.

Controlling your dreams

When we’re stressed, we tend to have more intense and unpleasant dreams and dream experts say this increases the chance that you will become aware that you are dreaming. This is called “lucid dreaming”, when you are still asleep but aware that you are dreaming and not awake. You know the dream is not real.

With practice, lucid dreamers can even control their dreams. So, for example, in a dream where crowds are pressing in on you and you’re terrified you will catch the coronavirus, you can simply tell the crowd to back off and they will! You’re in control…

Another technique for controlling dreams is called “dream incubation”. Since you often dream about things you have been thinking about or doing during the previous day, you can plant some pleasant thoughts or experiences into your memory before you go to sleep, giving your brain some alternative pleasant material for its dreams. For example, try watching a movie or reading a book with content that you would like to dream about. If you don’t have time for a movie or an entire story, try thinking about your favourite vacation spot or a happy family event before you drift off to sleep. As dream expert, Deirdre Barrett, explains – “a pleasant experience as you’re falling asleep greatly raises the odds that your dreaming mind will honor your request.”

Lucid dreaming

According to research, around half of us have had a lucid dream at some time in our lives, perhaps as many as 75%, and about 11% have 1 or 2 lucid dreams per month. It typically occurs during the dreaming REM phase of sleep and it’s a skill that can be learned and improved.

Lucid dreamers report it is easiest to achieve dream awareness when you’re in the half-asleep/half-awake process of awakening. While some people simply wake up when they realize they’re dreaming, others can control their own actions within the dream, or parts of the dream itself, including the narrative of the dream.

Therapists sometimes use lucid dream training to address recurring nightmares that affect a person’s quality of life. This can be done by questioning the action taking place during the dream while dreaming, or by developing dream superpowers and either flying away or fighting back in the dream.

Others look at lucid dreaming as a sort of entertainment, being able to go on an adventure and experience something they cannot in real life. They describe the experience as similar to writing a story or playing a video game that they also can become immersed in. As one dreamer described it, “It’s not got much use apart from just being interesting, [but] it makes me happy usually… I tend to wake up quite content.”

How to become lucid in your dreams

Several techniques are suggested to increase the chance you will be aware you are dreaming and remember the experience afterward:

  1. “Reality testing” – This involves verifying whether you are dreaming both in real life and during a dream. Checking “Am I dreaming right now?” or trying to pass your hand through a solid surface like a wall will give obvious results during the day, but at night this could alert you that you’re dreaming. Asking yourself regularly during the day increases the chance that you will also test yourself when you’re dreaming, when your hand will easily pass through a wall.
  2. “Waking back to bed” – This requires setting an alarm to wake up 5 to 6 hours after going to sleep. Stay awake for a short while before going back to sleep. This technique is supposed to immerse you immediately into REM, the dreaming phase of sleep during which you are most likely to experience a lucid dream.
  3. “Mnemonic induction” – Just before going to sleep, repeat a phrase such as “Tonight I will notice that I am dreaming,” to program yourself to achieve a lucid dream.
  4. Dream Journals – The strongest predictor of whether you have lucid dreams is how good you are at remembering your ordinary dreams, according to dream researcher, Dr. Denholm Aspy at University of Adelaide in Australia. Some find it useful to keep a dream journal where they record their dreams in as much detail as possible.
  5. Meditation and mindfulness – These techniques train people to become more aware of themselves and their surroundings in general. The idea is that, if you’re more aware during the day, you’re more likely to notice that you’re dreaming while you’re asleep.

Any risks?

Some worry that they might get “stuck” in a dream and have difficulty waking up, but people only dream for a certain amount of time each night. Others are concerned that the extra focus and effort to dream lucidly might mean that the sleep is less restful or more disrupted. However, lucid dream researchers explain that test participants do not report more tiredness or poorer sleep quality.

However, they do recommend against those with mental health conditions, such as schizophrenia, pursuing lucid dreams. The concern is that it may cause them to have difficulty distinguishing between hallucinations and real-life events and might worsen their condition.

So, I can’t say that I’ve ever experienced a lucid dream… at least not one that I can remember! But I’m quite fascinated with the idea. Perhaps it could be a way to experience a warm weather vacation this winter… just a little, in my dreams each night!

How about you? If half to three-quarters of sleepers have experienced lucid dreams at least once, many of you must have interesting stories to share…

References:

Dreams in the time of the coronavirus: How have they changed, and why? – Medical News Today

Lucid dreaming: Controlling the stories of sleep – Medical News Today

#coronadreams #luciddreaming