• JetBlue San Francisco Office a hub of Innovation and Service Excellence. Nestled in the heart of the tech capital, JetBlue's SF office embodies the airline's commitment to innovation and customer satisfaction. With a team dedicated to elevating the travel experience, expect seamless service and forward-thinking solutions from this dynamic workspace.

    For more visit:-
    https://www.livetravoairlines.com/jetblue-airlines/jetblue-san-francisco-office-in-california/
    JetBlue San Francisco Office a hub of Innovation and Service Excellence. Nestled in the heart of the tech capital, JetBlue's SF office embodies the airline's commitment to innovation and customer satisfaction. With a team dedicated to elevating the travel experience, expect seamless service and forward-thinking solutions from this dynamic workspace. For more visit:- https://www.livetravoairlines.com/jetblue-airlines/jetblue-san-francisco-office-in-california/
    0 Commentarios 0 Acciones 846 Views
  • Searching for exceptional 3PL services in California? Look no further! Amerigo Logistics is your trusted 3PL service provider, offering tailored solutions for seamless logistics. Experience efficiency, reliability, and excellence with our comprehensive 3PL services in California. Discover unmatched logistics support today!


    https://amerigologistics.us/3pl-service-provider-california/


    Searching for exceptional 3PL services in California? Look no further! Amerigo Logistics is your trusted 3PL service provider, offering tailored solutions for seamless logistics. Experience efficiency, reliability, and excellence with our comprehensive 3PL services in California. Discover unmatched logistics support today! https://amerigologistics.us/3pl-service-provider-california/
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  • Insight Media Solution, a digital marketing agency California, offers a range of services to help businesses establish a strong online presence. Their expertise includes SEO, social media management, and email marketing, designed to drive targeted traffic and increase conversions.

    https://www.insightsmediasolutions.com/digital-marketing-agency-in-california/
    Insight Media Solution, a digital marketing agency California, offers a range of services to help businesses establish a strong online presence. Their expertise includes SEO, social media management, and email marketing, designed to drive targeted traffic and increase conversions. https://www.insightsmediasolutions.com/digital-marketing-agency-in-california/
    WWW.INSIGHTSMEDIASOLUTIONS.COM
    Digital Marketing Agency in California - Insights Media Solutions
    Get reliable digital marketing agency in California from Insights Media Solutions. We help businesses increase their online presence and reach their audience.
    0 Commentarios 0 Acciones 1163 Views
  • RESILIENCE-
    Embracing Life's Hardest Moments as Learning Opportunities.
    Six ways to see life's hardships as merely "school fees."

    When I think of the hardest moments of my life, ironically many have turned out to be blessings in disguise. While this is not the most severe example, one, in particular, was being pretty much kicked out of my PhD program at the University of Georgia in 2016. This was after I quit all my jobs in California (despite good momentum), packed my car full of my belongings, and drove across the country over a week, thus forfeiting my intern license to practice therapy in California (an unlicensed therapist is now called "associate", but before 2019 it was "intern").

    The program in Georgia turned out to not be the right fit for me despite my best efforts. I mainly went because they offered to cover my tuition and pay me to study there, but I didn't vet the program carefully enough. The whole year was riddled with exhaustion, anxiety, insecurity, fear, insomnia, and exclusion. I was in therapy myself for most of the year to cope, and the only thing that made it tolerable was a lot of support from my family and friends. I was utterly devastated when I went back home; it felt like my career was over. Fast forward to today, however, and I can see that getting driven out of the Georgia program was one of the best things that ever happened to me. As the saying goes, "Fate loves irony." I thank all my professors in perpetuity for making me see what I couldn't back then: I'd thrive in the right program. In 2017, when I transferred to a doctoral program in San Diego, I began to succeed and now my business and career are doing exceptionally well.

    I am deeply grateful I wound up in San Diego and happy that I didn't stay in Georgia in hindsight. I wouldn't have left, though, it I wasn't driven out! Ironically, the research and writing training from the University of Georgia significantly helped me develop my academic, professional, and personal writing. I worked hard in Georgia and it paid off: The learning and growth I experienced were unparalleled. It also helped me apply for and win scholarships. Almost half of the courses I took at Georgia counted towards my doctorate in San Diego, helping me save money and graduate earlier.

    As my personal example demonstrates, life is a total rollercoaster; what seems like good or bad news now can turn out to be the opposite in the future. Every now and then you are able to discover a new high, a ceiling-breaking moment, whereas in other moments you may feel like you're falling deeper and deeper into hell. While these experiences can be incredibly tough, they present us with valuable opportunities to trust life and cultivate personal growth and learning.

    Here I briefly underscore six key ways we can turn life's hardest moments into powerful learning and growing opportunities. Most of our hard moments really can be "school fees." If you work at this mindset shift like your life depended on it (as it kind of does), you can set yourself up to never really lose at the game of life.

    1. Embrace Resilience
    Resilience is the ability to bounce back from adversity and possibly also grow stronger in the process. It is a fundamental quality that enables us to turn life's hardest moments into learning opportunities. When we face difficulties, instead of succumbing to despair, we can choose, as hard as it may seem in the moment, to embrace resilience. This means recognizing our own inner strength and determination to overcome challenges. You likely know you have done it in the past and can do it again. What's something that you've mastered that you didn't think you would be good at in the past?

    Hardship often reveals our true resilience, forcing us to confront our fears and doubts. Each time we endure a difficult experience, we build resilience, making us better equipped to handle future challenges. By acknowledging and appreciating our resilience, we learn to adapt and thrive in the face of adversity.

    2. Take the Opportunity for Reflection and Self-Examination
    Turning life's hardest moments into learning opportunities requires self-reflection and examination. When we encounter difficulties, it's essential to take a step back and ask ourselves tough questions. What led to this situation? What can we learn from it? How can we grow from it? Reflecting on our experiences allows us to gain valuable insights and wisdom. As long as we derive learning, meaning, understanding, and insight from it, even the worst things that happen to us can become gifts and sources of strength and wisdom over time. The lesson is likely cheap if you don't let it happen again!

    As we reflect, we may discover our own biases, blindspots, or areas needing improvement. This self-awareness is a powerful and necessary tool for personal growth. By acknowledging our mistakes and learning from them, we can make better decisions and become more compassionate individuals.

    3. Cultivate Empathy
    Life's challenges often bring us into contact with the suffering of others. Experiencing hardship firsthand can foster empathy and compassion for those going through similar difficulties. This newfound empathy can lead to a desire to help and support others in their times of need. I'm sure I would be a terrible therapist if I didn't ever go through hardships: I would have no idea how my clients feel or what they need to hear.

    Turning our pain into an opportunity to connect with others on a deeper level can be incredibly rewarding. By offering our understanding and support, we not only help others but also create a sense of purpose and fulfillment in our own lives.

    4. Develop Problem-Solving Skills
    As ironic as this may sound, life would be incredibly boring and possibly meaningless if we had no problems to solve. Difficult moments often require us to think critically and find solutions to complex problems in ways we wouldn't otherwise. These challenges can be seen as opportunities to develop and refine our problem-solving skills. When we encounter obstacles, we are pushed to explore new perspectives, seek creative solutions, and make informed decisions. Without obstacles, we wouldn't ever discover what we're truly capable of and a lot of our potential would be squandered.

    By actively engaging in problem-solving during tough times, we become more adept at handling future challenges with confidence and competence. These skills are transferable to various aspects of our lives, contributing to our personal and professional growth.

    5. Reevaluate Priorities
    Hardship has a way of reshaping our priorities and helping us distinguish between what truly matters and what is superficial. Life's toughest moments can prompt us to reevaluate our values, goals, and aspirations. We may realize that some of our previous ambitions were misaligned with our authentic selves. In my Georgia example above, while my career backslid temporarily, I am fortunate to have been able to strengthen my relationship with friends and family, ironically, in ways that wouldn't have been possible if I hadn't gone through that. By using these moments as an opportunity to recalibrate priorities, we can make more meaningful life choices. This can lead to a greater sense of fulfillment and a life that aligns with our core values and desires.

    6. Appreciate the Ups and Downs
    There is no dark without light, and there is no hot without cold. Without the difficult moments, we would not fully appreciate the moments of joy, success, and achievement. These challenging times provide context and depth to our experiences, making the highs not only possible but more meaningful. In this spirit, I am perpetually thankful that I went through that experience in Georgia to appreciate more of my blessings in the present.

    Conclusion
    As corny as it sounds, it couldn't be truer: life's hardest moments, even if it may seem impossible at the moment, are not devoid of purpose. They are profound opportunities for growth, learning, and self-discovery. Embracing resilience, self-reflection, empathy, problem-solving skills, and reassessing priorities can help us navigate and transform adversity into valuable life lessons. When we view life's challenges as opportunities to learn and evolve, we empower ourselves to become more resilient, compassionate, and wise individuals. In doing so, we find that even in the darkest of times, there is the potential for growth and the opportunity to turn pain into strength. Mastering that skill is nothing less than a superpower.
    RESILIENCE- Embracing Life's Hardest Moments as Learning Opportunities. Six ways to see life's hardships as merely "school fees." When I think of the hardest moments of my life, ironically many have turned out to be blessings in disguise. While this is not the most severe example, one, in particular, was being pretty much kicked out of my PhD program at the University of Georgia in 2016. This was after I quit all my jobs in California (despite good momentum), packed my car full of my belongings, and drove across the country over a week, thus forfeiting my intern license to practice therapy in California (an unlicensed therapist is now called "associate", but before 2019 it was "intern"). The program in Georgia turned out to not be the right fit for me despite my best efforts. I mainly went because they offered to cover my tuition and pay me to study there, but I didn't vet the program carefully enough. The whole year was riddled with exhaustion, anxiety, insecurity, fear, insomnia, and exclusion. I was in therapy myself for most of the year to cope, and the only thing that made it tolerable was a lot of support from my family and friends. I was utterly devastated when I went back home; it felt like my career was over. Fast forward to today, however, and I can see that getting driven out of the Georgia program was one of the best things that ever happened to me. As the saying goes, "Fate loves irony." I thank all my professors in perpetuity for making me see what I couldn't back then: I'd thrive in the right program. In 2017, when I transferred to a doctoral program in San Diego, I began to succeed and now my business and career are doing exceptionally well. I am deeply grateful I wound up in San Diego and happy that I didn't stay in Georgia in hindsight. I wouldn't have left, though, it I wasn't driven out! Ironically, the research and writing training from the University of Georgia significantly helped me develop my academic, professional, and personal writing. I worked hard in Georgia and it paid off: The learning and growth I experienced were unparalleled. It also helped me apply for and win scholarships. Almost half of the courses I took at Georgia counted towards my doctorate in San Diego, helping me save money and graduate earlier. As my personal example demonstrates, life is a total rollercoaster; what seems like good or bad news now can turn out to be the opposite in the future. Every now and then you are able to discover a new high, a ceiling-breaking moment, whereas in other moments you may feel like you're falling deeper and deeper into hell. While these experiences can be incredibly tough, they present us with valuable opportunities to trust life and cultivate personal growth and learning. Here I briefly underscore six key ways we can turn life's hardest moments into powerful learning and growing opportunities. Most of our hard moments really can be "school fees." If you work at this mindset shift like your life depended on it (as it kind of does), you can set yourself up to never really lose at the game of life. 1. Embrace Resilience Resilience is the ability to bounce back from adversity and possibly also grow stronger in the process. It is a fundamental quality that enables us to turn life's hardest moments into learning opportunities. When we face difficulties, instead of succumbing to despair, we can choose, as hard as it may seem in the moment, to embrace resilience. This means recognizing our own inner strength and determination to overcome challenges. You likely know you have done it in the past and can do it again. What's something that you've mastered that you didn't think you would be good at in the past? Hardship often reveals our true resilience, forcing us to confront our fears and doubts. Each time we endure a difficult experience, we build resilience, making us better equipped to handle future challenges. By acknowledging and appreciating our resilience, we learn to adapt and thrive in the face of adversity. 2. Take the Opportunity for Reflection and Self-Examination Turning life's hardest moments into learning opportunities requires self-reflection and examination. When we encounter difficulties, it's essential to take a step back and ask ourselves tough questions. What led to this situation? What can we learn from it? How can we grow from it? Reflecting on our experiences allows us to gain valuable insights and wisdom. As long as we derive learning, meaning, understanding, and insight from it, even the worst things that happen to us can become gifts and sources of strength and wisdom over time. The lesson is likely cheap if you don't let it happen again! As we reflect, we may discover our own biases, blindspots, or areas needing improvement. This self-awareness is a powerful and necessary tool for personal growth. By acknowledging our mistakes and learning from them, we can make better decisions and become more compassionate individuals. 3. Cultivate Empathy Life's challenges often bring us into contact with the suffering of others. Experiencing hardship firsthand can foster empathy and compassion for those going through similar difficulties. This newfound empathy can lead to a desire to help and support others in their times of need. I'm sure I would be a terrible therapist if I didn't ever go through hardships: I would have no idea how my clients feel or what they need to hear. Turning our pain into an opportunity to connect with others on a deeper level can be incredibly rewarding. By offering our understanding and support, we not only help others but also create a sense of purpose and fulfillment in our own lives. 4. Develop Problem-Solving Skills As ironic as this may sound, life would be incredibly boring and possibly meaningless if we had no problems to solve. Difficult moments often require us to think critically and find solutions to complex problems in ways we wouldn't otherwise. These challenges can be seen as opportunities to develop and refine our problem-solving skills. When we encounter obstacles, we are pushed to explore new perspectives, seek creative solutions, and make informed decisions. Without obstacles, we wouldn't ever discover what we're truly capable of and a lot of our potential would be squandered. By actively engaging in problem-solving during tough times, we become more adept at handling future challenges with confidence and competence. These skills are transferable to various aspects of our lives, contributing to our personal and professional growth. 5. Reevaluate Priorities Hardship has a way of reshaping our priorities and helping us distinguish between what truly matters and what is superficial. Life's toughest moments can prompt us to reevaluate our values, goals, and aspirations. We may realize that some of our previous ambitions were misaligned with our authentic selves. In my Georgia example above, while my career backslid temporarily, I am fortunate to have been able to strengthen my relationship with friends and family, ironically, in ways that wouldn't have been possible if I hadn't gone through that. By using these moments as an opportunity to recalibrate priorities, we can make more meaningful life choices. This can lead to a greater sense of fulfillment and a life that aligns with our core values and desires. 6. Appreciate the Ups and Downs There is no dark without light, and there is no hot without cold. Without the difficult moments, we would not fully appreciate the moments of joy, success, and achievement. These challenging times provide context and depth to our experiences, making the highs not only possible but more meaningful. In this spirit, I am perpetually thankful that I went through that experience in Georgia to appreciate more of my blessings in the present. Conclusion As corny as it sounds, it couldn't be truer: life's hardest moments, even if it may seem impossible at the moment, are not devoid of purpose. They are profound opportunities for growth, learning, and self-discovery. Embracing resilience, self-reflection, empathy, problem-solving skills, and reassessing priorities can help us navigate and transform adversity into valuable life lessons. When we view life's challenges as opportunities to learn and evolve, we empower ourselves to become more resilient, compassionate, and wise individuals. In doing so, we find that even in the darkest of times, there is the potential for growth and the opportunity to turn pain into strength. Mastering that skill is nothing less than a superpower.
    0 Commentarios 0 Acciones 3866 Views
  • Can you say Carignan? It's a red wine grape variety produced worldwide, including California. But its peak terroir is probably the Languedoc-Roussillon region of France. Learn all about this superb and a bit unusual wine style in our latest blog!

    https://bottlebarn.com/blogs/news/guide-to-carignan-wine
    Can you say Carignan? It's a red wine grape variety produced worldwide, including California. But its peak terroir is probably the Languedoc-Roussillon region of France. Learn all about this superb and a bit unusual wine style in our latest blog! https://bottlebarn.com/blogs/news/guide-to-carignan-wine
    BOTTLEBARN.COM
    Guide to Carignan Wine
    Carignan, also known as Mazuelo or Carignane, is a red wine grape variety grown and cultivated for centuries in various world wine regions. With its deep red color, bold flavors, and high tannins, Carignan wines offer a unique and distinctive drinking experience. This guide introduces the characteristics of Carignan wine, its origins, production methods, and food pairing suggestions. Carignan is believed to have originated in the Aragon region of Spain and has a long history of cultivation in the Mediterranean countries. It is known for its ability to thrive in hot, arid climates and can withstand drought conditions. Carignan vines produce small, thick-skinned grapes that are high in acidity and tannins. Inside that red wine bottle, Carignans typically have a deep purple or ruby-red color, and their flavors can vary depending on the region and winemaking techniques. They often exhibit aromas of dark berries, black cherries, and spices. On the palate, Carignan wines are full-bodied with robust tannins, offering a rich and intense mouthfeel. With aging, these wines can develop complex flavors of black pepper, leather, and earthy notes. How is Carignan Wine Made? Carignan wines can be produced as single-varietal wines or blended with other grape varieties such as Grenache, Syrah, or Mourvèdre. In the past, Carignan was often used as a blending grape due to its high yields and ability to add color and structure to blends. However, in recent years, there has been a resurgence of interest in producing high-quality Carignan wines as single varietals. Winemakers employ various techniques to bring out the best qualities of Carignan grapes. Careful vineyard management, including controlled yields and selective harvesting, is crucial to achieve optimal ripeness and flavor concentration. Additionally, winemakers may choose to age Carignan wines in oak barrels to add complexity and soften the tannins. Although you will find Carignan grown in California, like the Cline Ancient Vines Carignane, the Languedoc-Roussillon region in southern France is widely considered to boast one of the best terroirs for Carignan, and luckily you can find these at the best online wine store. With its Mediterranean climate characterized by hot, dry summers and mild winters, the region provides the ideal conditions for these vines to thrive. The region's diverse soil types, including limestone, clay, and schist, contribute to the complexity and character of Carignan wines. Additionally, the age of the Carignan vines in this area, some of which are over 100 years old, adds depth and concentration to the wines. The combination of the region's climate, soil, and old-vine Carignan plantings makes Languedoc-Roussillon a prime terroir for producing exceptional Carignan wines. Food Pairing After you buy wine online, pair Carignan with food! The bold and robust nature of Carignan wines makes them an excellent choice for pairing with flavorful dishes. Their high acidity and tannins help cut through rich and fatty foods, making them a great accompaniment to grilled meats, stews, and game dishes. Try pairing Carignan with roasted lamb, beef brisket, or venison for a delightful combination of flavors. The wine's fruit-forward profile and spicy notes also make it a suitable partner for Mediterranean cuisine. Consider pairing Carignan with dishes like ratatouille, roasted eggplant, or spiced lamb kebabs. The wine's acidity can complement the acidity of tomato-based sauces, while its bold flavors can stand up to the intense herbs and spices commonly used in these dishes. For cheese lovers, Carignan pairs well with aged cheeses such as Manchego or Pecorino Romano. The wine's tannins and acidity can balance the richness of the cheese, creating a harmonious pairing. Carignan wines offer a distinctive drinking experience with their bold flavors, robust tannins, and deep color. Whether enjoyed as a single-varietal wine or as part of a blend, Carignan showcases its unique characteristics and versatility. With their ability to withstand hot climates and their historical significance, Carignan wines have gained recognition and appreciation among wine enthusiasts worldwide. So, if you're looking for a wine that packs a punch and pairs well with hearty dishes, Carignan is definitely worth exploring. Cheers!
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  • Commercial Artificial Turf in Southern California

    Tough Turf Inc. excels in providing top-tier Commercial Artificial Turf in Southern California. Our premium synthetic grass redefines urban landscapes, offering low-maintenance, cost-effective, and eco-friendly alternatives to traditional lawns. From corporate complexes to public spaces, our installations thrive in the region's diverse climate. For more details, you can visit https://toughturfinc.com/commercial.html
    Commercial Artificial Turf in Southern California Tough Turf Inc. excels in providing top-tier Commercial Artificial Turf in Southern California. Our premium synthetic grass redefines urban landscapes, offering low-maintenance, cost-effective, and eco-friendly alternatives to traditional lawns. From corporate complexes to public spaces, our installations thrive in the region's diverse climate. For more details, you can visit https://toughturfinc.com/commercial.html
    0 Commentarios 0 Acciones 859 Views
  • Sonoma Valley is a beautiful wine country in Northern California that offers a unique blend of natural beauty, history, and world-class wine in the beautiful Sonoma wine store shops. Let us take you on a journey through the best wineries in Sonoma and great ideas before you buy wine online.

    https://blogrip.com/2023/07/21/10-most-beautiful-wineries-to-visit-when-you-are-in-sonoma-county/
    Sonoma Valley is a beautiful wine country in Northern California that offers a unique blend of natural beauty, history, and world-class wine in the beautiful Sonoma wine store shops. Let us take you on a journey through the best wineries in Sonoma and great ideas before you buy wine online. https://blogrip.com/2023/07/21/10-most-beautiful-wineries-to-visit-when-you-are-in-sonoma-county/
    0 Commentarios 0 Acciones 851 Views
  • ADDICTION-
    Some “Wellness Drinks” May Contain an Opiate-Like Substance.
    Kratom activates opioid receptors in the brain and can be dangerous.
    Reviewed by Tyler Woods

    KEY POINTS-
    Wellness beverages containing kratom may be dangerous, especially to people with addictive disease.
    Kratom is derived from leaves of a tree in the coffee family and stimulates opioid receptors.
    Bottles of Feel Free contain no warning that they contain an opiate-like substance. Anyone with a sensitivity to opiates should beware.

    The title of this post comes from a San Francisco Chronicle article (April 6, 2023) [1] detailing why an alcoholic man sued Botanic Tonics, the makers of the “wellness drink” Feel Free, alleging it caused him to relapse after seven years of sobriety. He claims the Santa Monica company misrepresents Feel Free as a “safe, sober, and healthy alternative to alcohol.”

    A quick internet search reveals Botanic Tonics does, indeed, advertise, “We’ve created a feel-good wellness tonic, a healthy productivity enhancer, and alcohol alternative featuring kava and other ancient plants from the South Pacific and Southeast Asia where they’ve been used socially and in wellness for centuries. A new way to feel good and feel free. Enjoy.”

    What Botanic Tonics’ above description fails to reveal is that one of their ancient plant-based ingredients is kratom, which comes from the leaf of a tropical evergreen tree in the coffee family. Elements in kratom activate opiate receptors in the brain while also having stimulant qualities.[2] I first encountered kratom roughly 15 years ago when a patient fighting Vicodin addiction reported he had been buying kratom online from Southeast Asian sources. When he tried to stop using kratom, his withdrawal symptoms were nearly identical to withdrawal from Vicodin. I prescribed buprenorphine (Suboxone) to ease his withdrawal, just as we had done when he stopped Vicodin, with equal benefit. I wrote a brief article in the California Society of Addiction Medicine newsletter describing how kratom is simply one more way to develop an opiate addiction.

    The unfortunate sober alcoholic who picked up a bottle of Feel Free at his local 7-Eleven claims he was soon drinking 10 bottles a day. When he tried to stop Feel Free, vomiting, delirium, and psychosis led him to twice visit a hospital emergency department, he says. He alleges eventually relapsing on alcohol to control withdrawal symptoms from Feel Free, followed by admission to detox and rehab.

    While Feel Free lists both kava and kratom as ingredients on its bottle, it does not provide amounts of each, nor does it warn of potential addiction and withdrawal. To be fair, Botanic Tonics’ website recommends drinking no more than one bottle a day and the site does list the ingredients and their amount in Feel Free, as follows:
    Kava (root) – 1,700 mg.
    Kratom (leaf) – 3,500 mg.
    Vitamin C – 37 mg.
    Potassium – 169 mg.
    Iron – 0.3 mg.
    Other Ingredients: Pineapple Juice, Coconut Cream, Stevia Leaf
    However, nothing on the website indicates kratom has opiate qualities or is addictive. Besides, who routinely visits the website of every new beverage they try?

    I contacted Botanic Tonics to discuss Feel Free and had a pleasant conversation with J.W. Ross, the developer of Feel Free and founder of Botanic Tonics. He was eager to relate his own story of alcohol addiction and what he called social anxiety when he abstained. Feeling he needed a safe replacement for alcohol to feel comfortable, he developed the mixture of kava and kratom after years of study and research. When friends confirmed it increased “sociability, productivity, and calm energy,” Ross launched Feel Free as a wellness beverage. He seemed genuinely interested in providing an alternative to more harmful drugs so many people gravitate toward and noted that a new bottle label will soon include a more detailed list of ingredients.

    The new label he sent contains more detail but is ultimately more confusing. It lists:
    “Kratom leaf (ground)
    Total Alkaloids 34mg
    Mitragynine 20mg
    7-hydroxymitangynine <0.05mg”

    I wrote back that few people know what mitragynine and 7-hydtoxymitragynine are, and, amid a serious opioid epidemic, with so many people struggling with recovery from opiate addiction, the makers of Feel Free have the responsibility to inform the public that kratom has opiate-like qualities.

    The new bottle label also reads “Note: Anything that makes you feel good can become habit-forming including nicotine, alcohol, caffeine, sugar, and kratom… If used responsibly, Feel Free has not been shown to cause any harm.”

    I replied that alcohol and kratom addiction are qualitatively different from a habit. People often use the word “habit” to soften the reality of addiction and dependence.

    Finally, new text reads “This product is not recommended for pregnant or nursing women or people who are sensitive to active ingredients like kava.”

    I responded that it would be stronger to make a clear prohibition against using Feel Free during pregnancy. I also made a strong recommendation to add “or kratom” after warning about sensitivity to kava.

    The disappointing response from J.W. Ross to my suggestions for revised text on the bottle label was:

    “One of the main issues we have is the amount of space on the bottle… without getting the font so small it can’t be clearly seen. That said, we will continue to improve over time.”

    Perhaps they will improve. Only time will tell. As for now, however, they are not protecting the public as much as they should, despite being given enough information about the hazards of kratom and their responsibility to do no harm.

    Feel Free is not safe for everyone. It contains an addictive drug that is especially dangerous for individuals with a tendency toward addiction. It can be a trap door back into addiction for unsuspecting people in recovery who are simply looking for a beverage to support wellness. Considering the amount of kratom in Feel Free, a microdose is only a rhetorical trick.

    Beware: Feel Free is not the only “wellness” beverage containing kratom. Some cannabis beverages also contain kratom, and many products contain far more kratom than Feel Free. While it sounds best to visit the website for any new beverage you are thinking of trying, this can also be misleading. One cannabis retailer describes the effect of kratom as offering natural “pain relief, energy, immune boost, and focus.”

    My recommendation? Tell all your healthcare team, patients, and friends to be aware of products containing kratom that advertise as “wellness beverages.”
    ADDICTION- Some “Wellness Drinks” May Contain an Opiate-Like Substance. Kratom activates opioid receptors in the brain and can be dangerous. Reviewed by Tyler Woods KEY POINTS- Wellness beverages containing kratom may be dangerous, especially to people with addictive disease. Kratom is derived from leaves of a tree in the coffee family and stimulates opioid receptors. Bottles of Feel Free contain no warning that they contain an opiate-like substance. Anyone with a sensitivity to opiates should beware. The title of this post comes from a San Francisco Chronicle article (April 6, 2023) [1] detailing why an alcoholic man sued Botanic Tonics, the makers of the “wellness drink” Feel Free, alleging it caused him to relapse after seven years of sobriety. He claims the Santa Monica company misrepresents Feel Free as a “safe, sober, and healthy alternative to alcohol.” A quick internet search reveals Botanic Tonics does, indeed, advertise, “We’ve created a feel-good wellness tonic, a healthy productivity enhancer, and alcohol alternative featuring kava and other ancient plants from the South Pacific and Southeast Asia where they’ve been used socially and in wellness for centuries. A new way to feel good and feel free. Enjoy.” What Botanic Tonics’ above description fails to reveal is that one of their ancient plant-based ingredients is kratom, which comes from the leaf of a tropical evergreen tree in the coffee family. Elements in kratom activate opiate receptors in the brain while also having stimulant qualities.[2] I first encountered kratom roughly 15 years ago when a patient fighting Vicodin addiction reported he had been buying kratom online from Southeast Asian sources. When he tried to stop using kratom, his withdrawal symptoms were nearly identical to withdrawal from Vicodin. I prescribed buprenorphine (Suboxone) to ease his withdrawal, just as we had done when he stopped Vicodin, with equal benefit. I wrote a brief article in the California Society of Addiction Medicine newsletter describing how kratom is simply one more way to develop an opiate addiction. The unfortunate sober alcoholic who picked up a bottle of Feel Free at his local 7-Eleven claims he was soon drinking 10 bottles a day. When he tried to stop Feel Free, vomiting, delirium, and psychosis led him to twice visit a hospital emergency department, he says. He alleges eventually relapsing on alcohol to control withdrawal symptoms from Feel Free, followed by admission to detox and rehab. While Feel Free lists both kava and kratom as ingredients on its bottle, it does not provide amounts of each, nor does it warn of potential addiction and withdrawal. To be fair, Botanic Tonics’ website recommends drinking no more than one bottle a day and the site does list the ingredients and their amount in Feel Free, as follows: Kava (root) – 1,700 mg. Kratom (leaf) – 3,500 mg. Vitamin C – 37 mg. Potassium – 169 mg. Iron – 0.3 mg. Other Ingredients: Pineapple Juice, Coconut Cream, Stevia Leaf However, nothing on the website indicates kratom has opiate qualities or is addictive. Besides, who routinely visits the website of every new beverage they try? I contacted Botanic Tonics to discuss Feel Free and had a pleasant conversation with J.W. Ross, the developer of Feel Free and founder of Botanic Tonics. He was eager to relate his own story of alcohol addiction and what he called social anxiety when he abstained. Feeling he needed a safe replacement for alcohol to feel comfortable, he developed the mixture of kava and kratom after years of study and research. When friends confirmed it increased “sociability, productivity, and calm energy,” Ross launched Feel Free as a wellness beverage. He seemed genuinely interested in providing an alternative to more harmful drugs so many people gravitate toward and noted that a new bottle label will soon include a more detailed list of ingredients. The new label he sent contains more detail but is ultimately more confusing. It lists: “Kratom leaf (ground) Total Alkaloids 34mg Mitragynine 20mg 7-hydroxymitangynine <0.05mg” I wrote back that few people know what mitragynine and 7-hydtoxymitragynine are, and, amid a serious opioid epidemic, with so many people struggling with recovery from opiate addiction, the makers of Feel Free have the responsibility to inform the public that kratom has opiate-like qualities. The new bottle label also reads “Note: Anything that makes you feel good can become habit-forming including nicotine, alcohol, caffeine, sugar, and kratom… If used responsibly, Feel Free has not been shown to cause any harm.” I replied that alcohol and kratom addiction are qualitatively different from a habit. People often use the word “habit” to soften the reality of addiction and dependence. Finally, new text reads “This product is not recommended for pregnant or nursing women or people who are sensitive to active ingredients like kava.” I responded that it would be stronger to make a clear prohibition against using Feel Free during pregnancy. I also made a strong recommendation to add “or kratom” after warning about sensitivity to kava. The disappointing response from J.W. Ross to my suggestions for revised text on the bottle label was: “One of the main issues we have is the amount of space on the bottle… without getting the font so small it can’t be clearly seen. That said, we will continue to improve over time.” Perhaps they will improve. Only time will tell. As for now, however, they are not protecting the public as much as they should, despite being given enough information about the hazards of kratom and their responsibility to do no harm. Feel Free is not safe for everyone. It contains an addictive drug that is especially dangerous for individuals with a tendency toward addiction. It can be a trap door back into addiction for unsuspecting people in recovery who are simply looking for a beverage to support wellness. Considering the amount of kratom in Feel Free, a microdose is only a rhetorical trick. Beware: Feel Free is not the only “wellness” beverage containing kratom. Some cannabis beverages also contain kratom, and many products contain far more kratom than Feel Free. While it sounds best to visit the website for any new beverage you are thinking of trying, this can also be misleading. One cannabis retailer describes the effect of kratom as offering natural “pain relief, energy, immune boost, and focus.” My recommendation? Tell all your healthcare team, patients, and friends to be aware of products containing kratom that advertise as “wellness beverages.”
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  • STRESS-
    Inequities Poison Us All.
    How inequities chronically inflame everyone’s bodies, even the most privileged.
    Reviewed by Michelle Quirk

    KEY POINTS-
    Social inequities are a powerful predictor of health.
    Inequities increase our risk of many health conditions through chronic inflammation.
    We need to heal not only the individuals who are harmed but also the systems that make us sick.
    Nothing has been more convincing of our interconnectedness than COVID-19 and our climate crisis. We can no longer pretend that what happens somewhere else won’t impact us all.

    But it’s not only physical threats we share. Social inequities hurt everyone, too. We are in this together: The inequities experienced by some will poison everyone’s health, even the most privileged.

    Simone Schenkman and Aylene Bousquat, researchers at the School of Public Health at Universidade de São Paulo, Brazil, compared countries around the world to evaluate the role of inequity in determining health outcomes. Their 2021 study showed that countries with the most inequity of income, education, and health dimensions—regardless of the country’s wealth—had the worst health outcomes.1

    Living in an inequitable country doesn’t only affect those with the least privilege; it harms those at the top, too, they found. They concluded that policies that lead to inequities are “a disastrous political choice for society.”

    Not only do the inequities lead to poor health outcomes and lower life expectancies for everyone but also higher levels of mental illness, substance use, incarceration, segregation, disrespect, violence, social distrust, and poor cohesion, they showed. “Inequity deteriorates the whole of society and not just the marginalized groups,” they concluded.

    The Double-Edged Sword of Inflammation
    Scientists now understand how inequity harms our health: because it’s stressful for everyone, says Robert M. Sapolsky, professor of biology and neurology at Stanford, who researches how stress damages our biology. “Basically, more unequal societies have a worse quality of life,” he says.2 “When inequality increases, everyone’s health suffers.”

    Inequality creates stress, and stress creates the “double-edged biological sword” of inflammation, continues Sapolsky. Our stress response system is an essential adaptation to living in a world of threats around every corner or flick of our phones. When we anticipate a threat, our bodies are built to ramp up inflammatory responses, preparing them to repair the potential wound from a scary creature with big teeth and sharp claws.

    Steve Cole, a genomics professor at UCLA, studies how social stresses affect our gene expression. His research, in collaboration with the late John Cacioppo, who was a social scientist at the University of Chicago, provided the first indication that social stress could increase inflammation—at the expense of immune function—in all our body’s cells.

    Perceived danger sets off a stress response that signals to every tissue in our bodies to favour inflammation and sacrifice our immune response to get ready for a wounding injury, Cole says.

    Cole, Cacioppo, and their colleagues repeated these findings time and time again, identifying the cellular mechanisms of how it happens—that social stress consistently activates a process in our bodies that increases the expression of genes that promote inflammation and decreases the expression of antiviral and antibody-related genes.3

    This stress system works well if what we are fighting is a saber-toothed tiger, says Cole, but not if the threat is the complex social stresses that we face in modern society. This is because our stress response isn’t that specific; it’s still largely stuck in the Stone Age by assuming the most helpful response to all threats is preparing the body to heal from a physically wounding injury.

    Adaptation is a slow process, and we haven’t yet evolved to the stresses that affect us most in modern society, Cole says—be they emotional or social stresses instead of physical wounds, or the long-term stress of inequities over brief injuries.

    When our stress response is constantly going off, our body gets stuck in a state of chronic inflammation, which hurts our bodies and brains. While a brief burst of inflammation can be helpful to repair our body in the short term, countless studies show that chronic inflammation damages our bodies over time, increasing our risk of inflammatory-mediated diseases such as cardiovascular disease, diabetes, Alzheimer’s, depression, cancer, and many other illnesses, says Cole.

    Molecular biologist and Nobel Prize winner Elizabeth Blackburn joined health psychologist Elissa Epel to study how stress affects the health of our telomeres—the bits at the end of our chromosomes that protect our DNA from damage. The length of our telomeres indicates our biological “age”—a sign of the body’s wear and tear. As we age and our cells divide, our telomeres shorten. Blackburn and Epel’s research kept finding the same conclusion: that stress makes our telomeres shorten faster. And, once again, one of the big stressors we face is inequality, which they found to shorten the telomeres of those on both the top and bottom of unequal societies. They offer a “Telomere Manifesto,” listing ways to protect our telomeres and, thus, aging.4 High on the list? Reduce inequality, they argue.

    A Society Inflamed
    In medical school, we learned risk factors for illnesses—being Indigenous, for example, was listed as a risk factor for a vast number of health problems, from type 2 diabetes to depression. But it is not an inherent characteristic of being Indigenous to be vulnerable to these health conditions. The health disparities between certain cultural or racial groups can often be explained by the intersecting social and structural determinants of health, such as intergenerational trauma, systemic racism, socioeconomic status, colonialization, exposure to environmental toxins, and access to health care and other resources.

    “To wonder why some things settle in some bodies and not others is to begin to ask questions about power, injustice, and inequity,” writes Rupa Marya, a physician and associate professor of medicine at the University of California, San Francisco, and Raj Patel, a public health researcher and professor at the University of Texas, in Inflamed: Deep Medicine and the Anatomy of Injustice.

    As the world faced the pandemic, we uncovered the shocking injustices and inequities that we’d been observing for decades, this time in the graves of people who lost their lives to COVID-19. “Black, Indigenous, and people of color (BIPOC) were over-represented, their bodies subject to inflammation of all kinds, long before the SARS-CoV-2 virus ever settled into their lungs,” argued Marya and Patel. “Not only the lack of access to health care, but systemic social and economic disenfranchisement rendered their bodies more susceptible to Covid when it hit,” they add.

    Severe COVID-19 and other inflammatory-mediated conditions are more common in oppressed groups because of the cumulative burdens of toxic stress. And the majority of these stresses are involuntary. No amount of “self-care” or advice to reduce stress or focus on one’s health can erase the weight of systemic and intergenerational oppression. And, yet, so often we blame individuals, groups, or ourselves for poor health.

    Perhaps it helps some of us sleep at night to think that we’re healthy because of our own merits, rather than unfairly hoarded privileges. Or maybe we feel more empowered if it’s our own fault that we’re sick, because, then, it's within our power to fix it, even if the added burden of stigma and blame hurts us more.

    The only thing harder than recognizing and holding empathy for the unjust distribution of toxic stress that hurts the health of others is carrying these toxins in our own bodies. Inequality hurts us all, but it gravely harms the health of those who are most oppressed.

    That’s why social justice is the most important medicine I can prescribe as a physician. Rather than putting Band-Aids on the illnesses caused by inequities to individuals, we need to heal the larger systems that are making them sick. As Seth Godin advises, “Don’t save the canary. Fix the coal mine.”
    STRESS- Inequities Poison Us All. How inequities chronically inflame everyone’s bodies, even the most privileged. Reviewed by Michelle Quirk KEY POINTS- Social inequities are a powerful predictor of health. Inequities increase our risk of many health conditions through chronic inflammation. We need to heal not only the individuals who are harmed but also the systems that make us sick. Nothing has been more convincing of our interconnectedness than COVID-19 and our climate crisis. We can no longer pretend that what happens somewhere else won’t impact us all. But it’s not only physical threats we share. Social inequities hurt everyone, too. We are in this together: The inequities experienced by some will poison everyone’s health, even the most privileged. Simone Schenkman and Aylene Bousquat, researchers at the School of Public Health at Universidade de São Paulo, Brazil, compared countries around the world to evaluate the role of inequity in determining health outcomes. Their 2021 study showed that countries with the most inequity of income, education, and health dimensions—regardless of the country’s wealth—had the worst health outcomes.1 Living in an inequitable country doesn’t only affect those with the least privilege; it harms those at the top, too, they found. They concluded that policies that lead to inequities are “a disastrous political choice for society.” Not only do the inequities lead to poor health outcomes and lower life expectancies for everyone but also higher levels of mental illness, substance use, incarceration, segregation, disrespect, violence, social distrust, and poor cohesion, they showed. “Inequity deteriorates the whole of society and not just the marginalized groups,” they concluded. The Double-Edged Sword of Inflammation Scientists now understand how inequity harms our health: because it’s stressful for everyone, says Robert M. Sapolsky, professor of biology and neurology at Stanford, who researches how stress damages our biology. “Basically, more unequal societies have a worse quality of life,” he says.2 “When inequality increases, everyone’s health suffers.” Inequality creates stress, and stress creates the “double-edged biological sword” of inflammation, continues Sapolsky. Our stress response system is an essential adaptation to living in a world of threats around every corner or flick of our phones. When we anticipate a threat, our bodies are built to ramp up inflammatory responses, preparing them to repair the potential wound from a scary creature with big teeth and sharp claws. Steve Cole, a genomics professor at UCLA, studies how social stresses affect our gene expression. His research, in collaboration with the late John Cacioppo, who was a social scientist at the University of Chicago, provided the first indication that social stress could increase inflammation—at the expense of immune function—in all our body’s cells. Perceived danger sets off a stress response that signals to every tissue in our bodies to favour inflammation and sacrifice our immune response to get ready for a wounding injury, Cole says. Cole, Cacioppo, and their colleagues repeated these findings time and time again, identifying the cellular mechanisms of how it happens—that social stress consistently activates a process in our bodies that increases the expression of genes that promote inflammation and decreases the expression of antiviral and antibody-related genes.3 This stress system works well if what we are fighting is a saber-toothed tiger, says Cole, but not if the threat is the complex social stresses that we face in modern society. This is because our stress response isn’t that specific; it’s still largely stuck in the Stone Age by assuming the most helpful response to all threats is preparing the body to heal from a physically wounding injury. Adaptation is a slow process, and we haven’t yet evolved to the stresses that affect us most in modern society, Cole says—be they emotional or social stresses instead of physical wounds, or the long-term stress of inequities over brief injuries. When our stress response is constantly going off, our body gets stuck in a state of chronic inflammation, which hurts our bodies and brains. While a brief burst of inflammation can be helpful to repair our body in the short term, countless studies show that chronic inflammation damages our bodies over time, increasing our risk of inflammatory-mediated diseases such as cardiovascular disease, diabetes, Alzheimer’s, depression, cancer, and many other illnesses, says Cole. Molecular biologist and Nobel Prize winner Elizabeth Blackburn joined health psychologist Elissa Epel to study how stress affects the health of our telomeres—the bits at the end of our chromosomes that protect our DNA from damage. The length of our telomeres indicates our biological “age”—a sign of the body’s wear and tear. As we age and our cells divide, our telomeres shorten. Blackburn and Epel’s research kept finding the same conclusion: that stress makes our telomeres shorten faster. And, once again, one of the big stressors we face is inequality, which they found to shorten the telomeres of those on both the top and bottom of unequal societies. They offer a “Telomere Manifesto,” listing ways to protect our telomeres and, thus, aging.4 High on the list? Reduce inequality, they argue. A Society Inflamed In medical school, we learned risk factors for illnesses—being Indigenous, for example, was listed as a risk factor for a vast number of health problems, from type 2 diabetes to depression. But it is not an inherent characteristic of being Indigenous to be vulnerable to these health conditions. The health disparities between certain cultural or racial groups can often be explained by the intersecting social and structural determinants of health, such as intergenerational trauma, systemic racism, socioeconomic status, colonialization, exposure to environmental toxins, and access to health care and other resources. “To wonder why some things settle in some bodies and not others is to begin to ask questions about power, injustice, and inequity,” writes Rupa Marya, a physician and associate professor of medicine at the University of California, San Francisco, and Raj Patel, a public health researcher and professor at the University of Texas, in Inflamed: Deep Medicine and the Anatomy of Injustice. As the world faced the pandemic, we uncovered the shocking injustices and inequities that we’d been observing for decades, this time in the graves of people who lost their lives to COVID-19. “Black, Indigenous, and people of color (BIPOC) were over-represented, their bodies subject to inflammation of all kinds, long before the SARS-CoV-2 virus ever settled into their lungs,” argued Marya and Patel. “Not only the lack of access to health care, but systemic social and economic disenfranchisement rendered their bodies more susceptible to Covid when it hit,” they add. Severe COVID-19 and other inflammatory-mediated conditions are more common in oppressed groups because of the cumulative burdens of toxic stress. And the majority of these stresses are involuntary. No amount of “self-care” or advice to reduce stress or focus on one’s health can erase the weight of systemic and intergenerational oppression. And, yet, so often we blame individuals, groups, or ourselves for poor health. Perhaps it helps some of us sleep at night to think that we’re healthy because of our own merits, rather than unfairly hoarded privileges. Or maybe we feel more empowered if it’s our own fault that we’re sick, because, then, it's within our power to fix it, even if the added burden of stigma and blame hurts us more. The only thing harder than recognizing and holding empathy for the unjust distribution of toxic stress that hurts the health of others is carrying these toxins in our own bodies. Inequality hurts us all, but it gravely harms the health of those who are most oppressed. That’s why social justice is the most important medicine I can prescribe as a physician. Rather than putting Band-Aids on the illnesses caused by inequities to individuals, we need to heal the larger systems that are making them sick. As Seth Godin advises, “Don’t save the canary. Fix the coal mine.”
    0 Commentarios 0 Acciones 1613 Views
  • RESILIENCE-
    6 Underestimated Drivers of Well-Being.
    Research shows these psychospiritual forces may be critical for health.
    Reviewed by Kaja Perina

    KEY POINTS-
    Meaning, purpose, value, connection, resilience, and transcendence are key drivers of well-being.
    Research shows these psychospiritual forces may be critically important for decreasing risk of illness.
    When I was in graduate school studying world religion, philosophy, and psychology, I became intrigued by what, if anything, undergirds the world’s wisdom traditions. I had no interest in diluting them or melting them into one. I was more curious about what was beneath belief. After much research, I arrived at what I termed the Six Fundamental Human Desires. Taken together, they are what all the major traditions, each in their own way, using their own language, care about and try to make real for people’s lives.

    It turns out these desires can positively affect the body and mind as much as the spirit and soul.

    1. Meaning
    Meaning helps us to make sense of life and find significance in life. It satisfies our desire to have a life filled with understanding, awareness, peace, and satisfaction. Meaning helps us to see how we fit into the world, and that greatly shapes the stories we live by. Meaning gives us the sense that we, others, and certain things in life matter, which helps us to craft a rich and rewarding existence. Meaning gives us confidence that within each moment or each situation, there is something important and worthwhile that can orient us, carry us forward, and help us to be well.

    Research (Bigony & Keitel, 2020) shows that meaning-making can lessen the negative effects of people adjusting to and living with chronic illness. Studies (Fredricksona et al., 2013) also reveal that people who believe their existence has meaning have lower levels stress hormones and more favorable gene expression related to inflammation. Further research (Park, 2012) shows that meaning-making can positively influence the transition of cancer patients into longer-term survivorship and help people harness the will to live, which has been shown to contribute to longevity.

    2. Purpose
    Purpose grounds and motivates us, unifies our life, and directs us toward some ultimate concern or “North Star” around which we shape our lives. Purpose satisfies our desire to have a reason to get up in the morning and go to bed at night feeling as though we’ve done something important or worthwhile. Purpose gives us confidence that we have “miles to go before we sleep.”

    In a meta-analysis of 10 studies involving more than 136,000 people, researchers found that having purpose in life can lower your mortality risk by roughly 17% (Cohen et al., 2016) — about as much as following the much-celebrated Mediterranean diet. Another study (Boyle, 2012) found that if a 90-year-old with a clear purpose in life develops Alzheimer’s disease, that person will probably continue to function relatively well despite pathological changes in the brain.

    Research (Alimujiang et al., 2019) also shows that people who have high levels of purpose spend fewer nights in hospitals and have lower odds of developing diabetes and over two times lower risk of dying from heart conditions than others. People with purpose are similarly more likely to keep active, get their cholesterol levels checked, even undergo colonoscopies; they can also buffer stress better (Kim, 2014).

    3. Values
    Values help us determine what we give priority and precedence to, and what we pursue in life. Values satisfy our desire to have something to work for, find deserving, invest in, and live by. Values give us confidence that there are certain things we can always turn to and rely upon to keep our integrity intact and keep us headed in the right direction.

    Emotional or affective states, in particular the shame and guilt that often come from not living our values, can have a significant impact on health, illness, and health-related behaviors.

    Shame has been linked to high levels of stress-related hormones that can meaningfully impact the immune system. Shame has also been linked to high elevation of cytokine activity. Cytokines are signs in the body of inflammation, indicating that a disease process may be in progress. Toxic shame — different from ordinary shame, which passes in a day or a few hours — has been shown to result in substance abuse, eating disorders, and self-harm. One large-scale meta-analysis (Kämmerer, 2019) showed shame’s link with depression is especially strong. Shame has also been linked to irritable bowel syndrome (IBS; Muscatello et al., 2016).

    Similarly, guilt is related to anxiety and depression, but also to obsessive-compulsive disorder (OCD), insomnia, loss of appetite, stomach and digestion issues, and an overall dreary or “weighted down” feeling (Hotchkiss, 2013).

    4. Connection
    Connection helps us relate to and form relationships with others and the world around us. Connection satisfies our desire to bond and belong — to have a type of familial warmth and security. Connection gives us confidence in the very real power of trust, intimacy, community, empathy, and love.

    Connection is a critically important contributor to good health and longevity. According to the Harvard Women’s Health Watch, numerous studies (2010) have shown that people who have satisfying relationships are happier, have fewer health problems, and live longer. One study (Harvard Woman’s Health Watch, 2010) of more than 309,000 people, found that not having strong relationships increased the risk of premature death by 50% — that’s comparable to smoking as many as 15 cigarettes a day, and greater than obesity and physical inactivity. Another study (Berkman et al., 1979) showed that people who were disconnected from others were roughly three times more likely to die than people with strong social ties.

    Researchers (Ruberman, 1984) at the Health Insurance Plan of Greater New York found that of 2,320 men who had survived a heart attack, those with strong bonds had only a quarter the risk of death within three years as those who lacked social connectedness. Researchers (Brummet, 2021) at Duke University Medical Center also found that connection can reduce deaths in people with serious medical conditions. Among adults with coronary artery disease, the mortality rate was nearly two and a half times higher among those who were socially isolated. Other studies show that connecting with others also helps relieve harmful levels of stress and inflammation, which can have an adverse effect on gut function, insulin regulation, and the immune system.

    In contrast, loneliness can lead to disrupted sleep patterns, elevated blood pressure, delayed recovery from injury, surgery, illness, cognitive and functional decline, including dementia, and a wide range of diseases, including cardiovascular disease and cancer (American Psychological Association, 2017).

    Overall, there is consistent and compelling evidence (Umberton & Montez, 2010) that connection contributes to lower rates of anxiety and depression, higher self-esteem, greater empathy, and more trusting and cooperative relationships.

    5. Resilience
    Resilience shows us how to flourish, not despite but because of adversity, in a way that improves, rather than hurts our lives, and fortifies, rather than weakens our spirit. Resilience satisfies our desire to live fully, love deeply, and thrive—every day, come what may. Resilience gives us confidence that life is always worth living.

    More and more research shows that resilience can buffer various mental health conditions, such as depression and anxiety. Resilience can also help offset factors that increase the risk of mental health conditions, such as being bullied or previous trauma.

    Resilience has been found to lower blood pressure; offset insomnia, heartburn, indigestion, and heart disease; and boost a weakened immune system (Harvard Health Publishing, 2017).

    The link to resilience and the immune system is particularly important. In one study (MentalHeath Net, 2023), depressed women suffering from breast cancer were found to have fewer immune system cells and weaker overall immune functioning when compared to non-depressed breast cancer sufferers. Because the job of the immune system is, in part, to hunt down and kill cancer cells, depressed breast cancer sufferers’ weaker immune function means that their bodies are less likely to be able to resist their cancers. Similarly, another study found that depressed bone marrow transplant patients were significantly more likely to die during the first post-treatment year than non-depressed transplant recipients. In a third study (McGowen, 2018) in adults with HIV, high resilience was related to a lower prevalence of depression, anxiety, and problems with ADLs.

    6. Transcendence
    Transcendence wakes us up to the fullness of life — to experience something greater than our daily to-do lists, something truly sublime or, for some, even the divine. Transcendence satisfies our desire for wonder and awe. Transcendence gives us confidence that there are things in life that will always inspire, encourage, humble, and excite us.

    Many people associate transcendence with religion and spirituality. Researchers (Mueller, 2001) at the Mayo Clinic concluded that religious or spiritual involvement is associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness), and less anxiety, depression, and suicide. Other studies have found that addressing a patient’s spiritual needs enhances recovery from illness.

    Frequent attendance at church, temple, mosque, or other spiritual gatherings may also improve health. For instance, in one study, religious or spiritual attendees were more likely to stop smoking, increase exercise, increase social contacts, and stay married. Multiple studies (Koenig et al., 2012; Strawbridge et al., 1997) also show that religiously inclined people live longer. Research at Duke University has similarly found that those who are religious have a strong internal sense of control, which can help people cope with depression and anxiety and deal better with adversity.

    Of course, you don’t have to be religiously inclined to benefit from the experience of transcendence. Research (Allen, 2018) at the University of California, Berkeley on the relationship of positive emotions and levels of proinflammatory cytokines found that awe, more than any other emotion, significantly reduced inflammation. As mentioned previously, proinflammatory cytokines are cell-signaling proteins that help to fight infection or injury. High levels of these cytokines have been linked to several chronic diseases, such as cancer, cardiovascular disease, diabetes, and depression. In this study, awe was the strongest predictor of lower IL-6 levels, a proinflammatory cytokine.

    Experiencing transcendence while in nature or viewing awe-inspiring images decreases sympathetic activity and increases parasympathetic activity, effectively switching our nervous system from a heightened state of arousal to a place of calm (Shiota, 2011). A study (Chirico, et al., 2018) with Virtual Reality stimuli found that looking at high, snowy mountains increased people’s mood and sense of awe, while viewing the Earth from space or a forest did not; the mountain scene also induced the highest level of awe, although the other stimuli also increased awe significantly.

    A study (Anderson et al, 2018) with military veterans and youth from underserved communities found that the transcendence and awe they experienced while whitewater rafting, significantly reduced stress and increased overall well-being. The effects continued to improve one week later. Researchers also found that on days participants spent time in nature, generally, they reported feeling more awe — as well as greater life satisfaction and well-being, suggesting that awe may be a crucial ingredient in nature’s restorative abilities.

    The connection of the body, mind, and spirit and its relation to well-being has been a topic of discussion throughout millennia. Today, a holistic biopsychosocial-spiritual model of health is increasingly finding its way into the mainstream, as individuals, families, and health and mental health providers recognize that just as we have basic physical needs, we also have fundamental human desires like meaning, purpose, value, connection, resilience, and transcendence that may be as important for decreasing the risk of illness and death and increasing overall health.
    RESILIENCE- 6 Underestimated Drivers of Well-Being. Research shows these psychospiritual forces may be critical for health. Reviewed by Kaja Perina KEY POINTS- Meaning, purpose, value, connection, resilience, and transcendence are key drivers of well-being. Research shows these psychospiritual forces may be critically important for decreasing risk of illness. When I was in graduate school studying world religion, philosophy, and psychology, I became intrigued by what, if anything, undergirds the world’s wisdom traditions. I had no interest in diluting them or melting them into one. I was more curious about what was beneath belief. After much research, I arrived at what I termed the Six Fundamental Human Desires. Taken together, they are what all the major traditions, each in their own way, using their own language, care about and try to make real for people’s lives. It turns out these desires can positively affect the body and mind as much as the spirit and soul. 1. Meaning Meaning helps us to make sense of life and find significance in life. It satisfies our desire to have a life filled with understanding, awareness, peace, and satisfaction. Meaning helps us to see how we fit into the world, and that greatly shapes the stories we live by. Meaning gives us the sense that we, others, and certain things in life matter, which helps us to craft a rich and rewarding existence. Meaning gives us confidence that within each moment or each situation, there is something important and worthwhile that can orient us, carry us forward, and help us to be well. Research (Bigony & Keitel, 2020) shows that meaning-making can lessen the negative effects of people adjusting to and living with chronic illness. Studies (Fredricksona et al., 2013) also reveal that people who believe their existence has meaning have lower levels stress hormones and more favorable gene expression related to inflammation. Further research (Park, 2012) shows that meaning-making can positively influence the transition of cancer patients into longer-term survivorship and help people harness the will to live, which has been shown to contribute to longevity. 2. Purpose Purpose grounds and motivates us, unifies our life, and directs us toward some ultimate concern or “North Star” around which we shape our lives. Purpose satisfies our desire to have a reason to get up in the morning and go to bed at night feeling as though we’ve done something important or worthwhile. Purpose gives us confidence that we have “miles to go before we sleep.” In a meta-analysis of 10 studies involving more than 136,000 people, researchers found that having purpose in life can lower your mortality risk by roughly 17% (Cohen et al., 2016) — about as much as following the much-celebrated Mediterranean diet. Another study (Boyle, 2012) found that if a 90-year-old with a clear purpose in life develops Alzheimer’s disease, that person will probably continue to function relatively well despite pathological changes in the brain. Research (Alimujiang et al., 2019) also shows that people who have high levels of purpose spend fewer nights in hospitals and have lower odds of developing diabetes and over two times lower risk of dying from heart conditions than others. People with purpose are similarly more likely to keep active, get their cholesterol levels checked, even undergo colonoscopies; they can also buffer stress better (Kim, 2014). 3. Values Values help us determine what we give priority and precedence to, and what we pursue in life. Values satisfy our desire to have something to work for, find deserving, invest in, and live by. Values give us confidence that there are certain things we can always turn to and rely upon to keep our integrity intact and keep us headed in the right direction. Emotional or affective states, in particular the shame and guilt that often come from not living our values, can have a significant impact on health, illness, and health-related behaviors. Shame has been linked to high levels of stress-related hormones that can meaningfully impact the immune system. Shame has also been linked to high elevation of cytokine activity. Cytokines are signs in the body of inflammation, indicating that a disease process may be in progress. Toxic shame — different from ordinary shame, which passes in a day or a few hours — has been shown to result in substance abuse, eating disorders, and self-harm. One large-scale meta-analysis (Kämmerer, 2019) showed shame’s link with depression is especially strong. Shame has also been linked to irritable bowel syndrome (IBS; Muscatello et al., 2016). Similarly, guilt is related to anxiety and depression, but also to obsessive-compulsive disorder (OCD), insomnia, loss of appetite, stomach and digestion issues, and an overall dreary or “weighted down” feeling (Hotchkiss, 2013). 4. Connection Connection helps us relate to and form relationships with others and the world around us. Connection satisfies our desire to bond and belong — to have a type of familial warmth and security. Connection gives us confidence in the very real power of trust, intimacy, community, empathy, and love. Connection is a critically important contributor to good health and longevity. According to the Harvard Women’s Health Watch, numerous studies (2010) have shown that people who have satisfying relationships are happier, have fewer health problems, and live longer. One study (Harvard Woman’s Health Watch, 2010) of more than 309,000 people, found that not having strong relationships increased the risk of premature death by 50% — that’s comparable to smoking as many as 15 cigarettes a day, and greater than obesity and physical inactivity. Another study (Berkman et al., 1979) showed that people who were disconnected from others were roughly three times more likely to die than people with strong social ties. Researchers (Ruberman, 1984) at the Health Insurance Plan of Greater New York found that of 2,320 men who had survived a heart attack, those with strong bonds had only a quarter the risk of death within three years as those who lacked social connectedness. Researchers (Brummet, 2021) at Duke University Medical Center also found that connection can reduce deaths in people with serious medical conditions. Among adults with coronary artery disease, the mortality rate was nearly two and a half times higher among those who were socially isolated. Other studies show that connecting with others also helps relieve harmful levels of stress and inflammation, which can have an adverse effect on gut function, insulin regulation, and the immune system. In contrast, loneliness can lead to disrupted sleep patterns, elevated blood pressure, delayed recovery from injury, surgery, illness, cognitive and functional decline, including dementia, and a wide range of diseases, including cardiovascular disease and cancer (American Psychological Association, 2017). Overall, there is consistent and compelling evidence (Umberton & Montez, 2010) that connection contributes to lower rates of anxiety and depression, higher self-esteem, greater empathy, and more trusting and cooperative relationships. 5. Resilience Resilience shows us how to flourish, not despite but because of adversity, in a way that improves, rather than hurts our lives, and fortifies, rather than weakens our spirit. Resilience satisfies our desire to live fully, love deeply, and thrive—every day, come what may. Resilience gives us confidence that life is always worth living. More and more research shows that resilience can buffer various mental health conditions, such as depression and anxiety. Resilience can also help offset factors that increase the risk of mental health conditions, such as being bullied or previous trauma. Resilience has been found to lower blood pressure; offset insomnia, heartburn, indigestion, and heart disease; and boost a weakened immune system (Harvard Health Publishing, 2017). The link to resilience and the immune system is particularly important. In one study (MentalHeath Net, 2023), depressed women suffering from breast cancer were found to have fewer immune system cells and weaker overall immune functioning when compared to non-depressed breast cancer sufferers. Because the job of the immune system is, in part, to hunt down and kill cancer cells, depressed breast cancer sufferers’ weaker immune function means that their bodies are less likely to be able to resist their cancers. Similarly, another study found that depressed bone marrow transplant patients were significantly more likely to die during the first post-treatment year than non-depressed transplant recipients. In a third study (McGowen, 2018) in adults with HIV, high resilience was related to a lower prevalence of depression, anxiety, and problems with ADLs. 6. Transcendence Transcendence wakes us up to the fullness of life — to experience something greater than our daily to-do lists, something truly sublime or, for some, even the divine. Transcendence satisfies our desire for wonder and awe. Transcendence gives us confidence that there are things in life that will always inspire, encourage, humble, and excite us. Many people associate transcendence with religion and spirituality. Researchers (Mueller, 2001) at the Mayo Clinic concluded that religious or spiritual involvement is associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness), and less anxiety, depression, and suicide. Other studies have found that addressing a patient’s spiritual needs enhances recovery from illness. Frequent attendance at church, temple, mosque, or other spiritual gatherings may also improve health. For instance, in one study, religious or spiritual attendees were more likely to stop smoking, increase exercise, increase social contacts, and stay married. Multiple studies (Koenig et al., 2012; Strawbridge et al., 1997) also show that religiously inclined people live longer. Research at Duke University has similarly found that those who are religious have a strong internal sense of control, which can help people cope with depression and anxiety and deal better with adversity. Of course, you don’t have to be religiously inclined to benefit from the experience of transcendence. Research (Allen, 2018) at the University of California, Berkeley on the relationship of positive emotions and levels of proinflammatory cytokines found that awe, more than any other emotion, significantly reduced inflammation. As mentioned previously, proinflammatory cytokines are cell-signaling proteins that help to fight infection or injury. High levels of these cytokines have been linked to several chronic diseases, such as cancer, cardiovascular disease, diabetes, and depression. In this study, awe was the strongest predictor of lower IL-6 levels, a proinflammatory cytokine. Experiencing transcendence while in nature or viewing awe-inspiring images decreases sympathetic activity and increases parasympathetic activity, effectively switching our nervous system from a heightened state of arousal to a place of calm (Shiota, 2011). A study (Chirico, et al., 2018) with Virtual Reality stimuli found that looking at high, snowy mountains increased people’s mood and sense of awe, while viewing the Earth from space or a forest did not; the mountain scene also induced the highest level of awe, although the other stimuli also increased awe significantly. A study (Anderson et al, 2018) with military veterans and youth from underserved communities found that the transcendence and awe they experienced while whitewater rafting, significantly reduced stress and increased overall well-being. The effects continued to improve one week later. Researchers also found that on days participants spent time in nature, generally, they reported feeling more awe — as well as greater life satisfaction and well-being, suggesting that awe may be a crucial ingredient in nature’s restorative abilities. The connection of the body, mind, and spirit and its relation to well-being has been a topic of discussion throughout millennia. Today, a holistic biopsychosocial-spiritual model of health is increasingly finding its way into the mainstream, as individuals, families, and health and mental health providers recognize that just as we have basic physical needs, we also have fundamental human desires like meaning, purpose, value, connection, resilience, and transcendence that may be as important for decreasing the risk of illness and death and increasing overall health.
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