Midweek reset
Because even Wednesdays deserve a little spa magic. Steam, serenity, and slow breaths.
#WednesdayWellness #SpaLife #SelfCareRitual #CalmVibes #RechargeMidweek #SoulCare #LuxuryAtHome #DetoxYourMind #SlowDown #HealingEnergy

Supporting Indian Startups Amid Global Economic Uncertainty

Amid global economic fluctuations, one venture capital firm is doubling down on its commitment to India’s startup ecosystem. Despite challenges like funding slowdowns and rising operational costs, this Luxembourg-based firm sees opportunity in adversity — especially in India’s fast-growing tech sector. A driving force behind this vision is Rajat Khare, who brings a unique blend of global perspective and regional insight.
Discover more about how this firm is investing in India’s future by visiting the original article :-
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STRESS-
On the Joy and Wonder of Connecting With Nature.
Spring is the perfect time to dwell on possibilities.
Reviewed by Abigail Fagan

KEY POINTS-
Nature can build resilience and strengthen cognitive functioning.
Connecting with nature only takes a small "dose" to have large effects.
Share outdoor time with non-human animals. Savor nature experiences for vitality, creativity, compassion, and joy.
"I dwell in Possibility." —Emily Dickinson

Spring is a time of liminality, that in-between time, when nature begins a process of re-awakening. Liminality is being “not quite” but almost. Our senses tune in, waiting for the emergence of newness, and suddenly we hear birds singing, see the bloom of flowers, and smell fresh, fragrant grass. Animal coats begin to shed, and metaphorically, our own layers do, too. Taking lessons from nature, the liminality of spring is the perfect time to dwell on possibilities.

Being outdoors is important given the increasing reliance on technology and screen time, with more and more individuals living sedentary lifestyles. The average American spends six hours and 59 minutes looking at a screen every day. That amounts to 305 feet of mobile content on a standard 6-inch smartphone — the height of the Statue of Liberty! (Feldman, 2022). Taking a break from technology is essential. Being in contact with microbes in the outdoors can “train your immune system" to fend off foreign cells and protect against illness or disease. Similarly, it can “train your brain" to mindfully attend to the beauty of the environment, which produces feelings of awe, gratitude, and wonder. Science has shown that these nuanced experiences of positive emotions enhance health and well-being (Tan, Wachsmuth, & Tugade, 2022).

Nature Fosters Resilience
Engaging with nature promotes resilience from stress. Resilience is characterized as the ability to “bounce back” from adversity (Block & Kremen, 1996; Tugade & Fredrickson, 2004). Spending time in nature advances recovery from stress, while increasing positive well-being, lowering mental distress, and minimizing the likelihood of using medication for depression (White et al., 2021). Nature-based retreats promote resilience through activities that develop skills to build self-esteem, competency, self-confidence, and self-efficacy. Natural environments also foster post-adversity growth by promoting self-reflection and feelings of purpose (Marselle et al, 2019).

Nature Sharpens Cognitive Skills
Exposure to natural surroundings helps to improve cognitive functioning across all age groups. For young children (4th to 7th grade), exposure to “green space” (trees, grass, plantings, vegetation) vs. urban space is associated with enhanced cognitive development over time (Dadvand et al., 2015). For middle-aged adults, being in nature improves executive control, cognitive flexibility, and attentional control (Stevenson, Schilhab, & Bentsen, 2018). And for older adults (aged 65 or older), being in nature may protect against the development of certain neurodegenerative disorders. In a large study of over 62 million Medicare beneficiaries, individuals living in green spaces (vs. urban spaces) showed lower rates of hospitalization for Alzheimer’s disease and related dementias and Parkinson’s disease (Klompmaker, et al. 2020). This could be due, in part, to more opportunities for exercise and social interaction. Simply, enjoying the outdoors can enhance cognitive focus and attention, which builds our cognitive capacities in valuable ways.

Doctors Give Nature Prescriptions: Get Your Healthy Dose
The World Health Organization (WHO) describes nature as “our greatest source of health and well-being” (WHO, 2020). Physicians and health professionals give nature prescriptions as part of their health promotion plans to address issues of chronic disease arising from sedentary lifestyles. There are 75 to 100 nature prescription programs across the United States, and many more worldwide, including Scotland, Canada, New Zealand, Finland, South Korea, China, and Japan (Kondo et al., 2020). These programs show that outdoor time improves anxiety, depression, and general mood — regardless of exercise type or intensity (Shanahan et al., 2019). Connecting with nature helps reduce salivary cortisol, heart rate, high-density lipoprotein cholesterol, diastolic blood pressure, and triglycerides (Twohig-Bennett and Jones, 2018).

Notwithstanding, accessibility to nature and open space may not be easy for everyone. Public health ordinances should prioritize making green spaces available and accessible to all.

4 Ways to Bring Nature Into Your Daily Life
1. Take an “Awe Walk”: Less Screen-time, More Green-time
Awe is felt in the presence of something vast that cannot be immediately understood (Keltner & Haidt, 2003). Even brief experiences of awe can produce generosity to others, increased personal well-being, and greater humility (Shiota et al., 2007). Awe produces physical and emotional benefits, including reductions in anxiety, depression, cortisol, inflammation, and cardiovascular risk (Anderson et al., 2018; Twohig-Bennett, 2018).

Nature may be an under-utilized public health resource for psychological well-being in a high-tech era. Research shows that young children are spending less time outdoors than their predecessors (Kemple et al., 2016). A meta-analysis of 186 studies found that time spent in parks positively affects psychological well-being and academic achievement for students (Oswold et al., 2020). For college students, taking a study break in nature can help alleviate academic stress. An experimental study found that students who walked in nature for 15 minutes had significantly lower cortisol levels and greater positive emotions, compared to students who watched nature indoors on their screens (Olafsdottir et al.2018).

Nature exposure can transform social relationships and strengthen community connections. Feelings of awe fortify social relationships by prioritizing the needs of the collective above an individual’s (Keltner & Haidt, 2003). Healthy older adults (ages 60 to 90 years) were instructed to take 15-minute outdoor walks each day for eight weeks. Participants who took awe walks (focusing on vastness and novelty) vs. control walks expressed greater feelings of social connection and being part of something larger in the world.

“Around me the trees stir in their leaves and call out, ‘Stay awhile.’” —Mary Oliver

2. Go "Forest Bathing": Mindful Attention in Nature
Forest bathing involves full absorption of the five senses as you engage in nature. Derived from the Japanese phrase, shinrin-yoku, meaning “taking in the forest atmosphere,” forest bathing has positive physiological effects, including blood pressure reduction, immune function improvements, depression alleviation, and mental health improvements. In one study, participants who took a three-day forest bathing retreat showed an increase in the number and activity of natural killer (NK) cells, which help fight virus infection. NK activity during forest bathing also attenuated the stress hormone response (adrenaline, noradrenaline). Relatedly, a study showed that taking nature walks at least once per week for three months can decrease reports of stress, depression, and negative affect, while showing improvements in positive affect and mental well-being (Marselle, Warber, & Irvine, 2019).

The “5-4-3-2-1” exercise is an easy way to center one’s attention while in nature. Name and identify: five things you can see (dew drops on leaves, stars in the sky); four things you can hear (the crunch of leaves, the whisper of the breeze); three things you can smell (scent of flowers, earthy aroma of tree bark); two things you can touch (blades of grass afoot, smooth river stones); one thing you can taste (fresh picked berries or herbs). Taking time to intentionally meander and marvel about nature can produce improvements in physical and psychological health.

3. Awaken the Wild: Share Outdoor Time with Animals
Spending time with animals shows respect and gratitude for all living beings, wild and tame. Interacting with animals can increase trust, self-confidence, empathy, and compassion, while reducing anxiety and fear. Petting and grooming them relieves stress by lowering blood pressure, heart rate, and cortisol levels (stress hormone). Additional benefits include increased oxytocin (social bonding) and dopamine (motivation, reward), which together play roles in regulating psychological distress (O'Haire, Guerin, & Kirkham, 2015).

Beyond influencing physiological changes to the brain, interactions with animals provide a broad range of emotional and social support that can buffer stress and loneliness, while improving the ability to adapt and recover from adverse circumstances.

The bonds we have with animals come in many forms, including companion animals, emotional support animals, and working animals. Animal-assisted therapy programs help individuals cope with stressors and adversity from trauma or addiction. Researchers recommend these animal-assisted therapies (often with dogs or horses) as complementary techniques alongside clinical treatments (O’Haire et al., 2015).

Animals nurture our hearts and minds in meaningful and profound ways that often go unnoticed, yet have long-lasting effects.

4. Do Less to Feel More: Savor Experiences of Nature
Savor the experience of nature with full absorption and intensification to unleash creativity, joy, and compassion (Edwards, 2019) towards greater well-being (Sato et al., 2017). Scientists have referred to the slowdown of human activity as an anthropause that reciprocally gives wildlife and humans time for renewal. This human stillness allows for "sharing space on this increasingly crowded planet, with benefits for both wildlife and humans." (Rutz et al., 2020)

The next time you go for a walk, remove your headphones, put your phone away, kick off your shoes, walk barefoot through the grass or sand, and listen deeply to the environment around you. Perhaps adopt the persona of a painter, and examine the world with new eyes. Or listen like a musician, hearing notes with new ears. Keep a nature diary, and look forward to the next chapter.

(Now the ears of my ears awake and/ now the eyes of my eyes are opened) —e.e. cummings

ADHD-
Addressing the Stimulant Shortage.
The difficulties in getting medications to people who benefit from them.
Reviewed by Lybi Ma

KEY POINTS-
There is a shortage of all stimulant medications, and it's not a manufacturing issue.
People who would benefit from them can't get their medication.
This is affecting many people who are consequently not able to focus well, with personal and societal consequences.
We hope that our suggestions will help resolve this.
In the last six months, many ADHD patients have been having trouble filling medication prescriptions. The stimulant shortage started out as a manufacturing problem for one medication—one of the generic versions of Adderall. However, it has since ballooned into a crisis of supply and demand affecting essentially all stimulant medications.

Prior to the last couple of decades, it was unusual for an adult to be diagnosed with this disorder, because it was commonly (though incorrectly) believed that ADHD tended to go away after childhood. ADHD is now understood to be a lifelong condition commonly creating challenges across the lifespan. Not only is it problematic on its own, but it is also often comorbid with other common psychiatric conditions, such as anxiety and depression, in both kids and adults.

The COVID pandemic increased the demand for ADHD diagnosis and medication because of new challenges it created for adults trying to work from home while juggling other tasks and distractions, as well as kids trying to do schoolwork without the structure and presence of in-person teachers and classmates. Another potential driver might be our “crazy-busy” lifestyle, which includes an increasing diet of electronic distractions and screens.

The lack of a biological test for ADHD, and the lack of a consensus standard around the utilization of objective psychometric tests for ADHD, contributes to a perception that the disorder, which is undoubtedly a significant challenge for many, is instead “made up” or simply a matter of subjective opinion. But no matter the causes, what is not in dispute is that the diagnosis of ADHD and the use of stimulant medications to treat it has been rising, especially among adults, and that there is no sign of a slowdown.

A lot of people are:
reporting significant daily challenges from poor attention
wanting medical assistance to address these challenges
ADHD is a disorder in regulating attention, impulsivity, hyperactivity, and according to recent research, certain types of emotional reactivity. This type of regulation is an important factor not just for getting “A’s” in school when you’re a kid, but for virtually every aspect of life into adulthood.

It can make the difference between life and death while driving. It can make a difference in relationships: “You never listen” has prompted many breakups. It is important to school success, yes, but also to success at work. It can make the difference between holding or even excelling at your job, versus being chronically or serially unemployed.

It is a significant contributor to alcoholism, other types of drug abuse, exposure to all kinds of trauma, and risk-taking behaviors. These behaviors can result in many types of medical problems as well as early pregnancy. The growth in stimulant prescriptions is a reflection of people wanting to address such challenges in their lives—and we believe that is good for them personally and also for society as a whole.

As physicians, we are thrilled when people ask for help with their attention—because we can help them. The stimulant medications (that is, chemicals found in Ritalin, Adderall, and their derivatives) that doctors have to treat poor attention are among the most effective and useful in all of pharmacopeia, certainly when it comes to behavioral conditions. They work extremely well (non-stimulants also work, but many people with ADHD find them less effective). If you’re an ADHD patient, and we’re your doctor: you’ve got a problem, we’ve got a solution—we should be good to go.

Except we’re not good to go. Due to stimulant medications being classified as having a high abuse potential, they are tightly regulated. Pharmacies are only allowed to sell a certain amount per month. At this point, given the growth in people seeking help for these challenges, demand is outpacing these allotted amounts.

And thus, there is a general stimulant shortage. This leads to significant difficulties in getting medications to people who benefit from them. Some of our patients have been out for months.

The thing is, stimulants are not actually so problematic for addiction at the doses and in the forms typically prescribed for ADHD. The classification of stimulants as having a high potential for abuse is based on what can happen when very high doses of immediate-acting stimulants are ingested, inhaled, or injected.

Yes, you can abuse stimulants in that way and get addicted to them: Crystal meth abuse is a huge problem—but crystal meth is a street drug, not a prescription medication, and Adderall and Ritalin are not crystal meth. At doses and in the forms commonly used to treat ADHD, the addiction potential for prescription stimulants is low and manageable.

Our patients easily stop using their stimulants altogether, and many more use them only intermittently—a few days per week. Many people with ADHD take these medications only as needed Monday-Friday (for school or work) and routinely skip taking them on weekends and vacations. Unlike opioids, where an almost bottomless tolerance can lead to a need for greater and greater doses over time, the effective dose of stimulant medication for any individual ADHD patient tends to remain stable once clinically established in the first few months of treatment—stable over decades or even over an entire lifetime.

In short, the addiction potential of prescription stimulants at doses used for ADHD is significantly less than that of coffee or nicotine (the world’s most common non-prescription stimulants, which unfortunately don’t work well for ADHD). If you doubt that, try drinking espresso or smoking cigarettes just on weekdays and not at all on Saturdays and Sundays—the way many ADHDers routinely take prescription stimulants.

Stimulants come in both long-acting (extended-release) and short-acting (immediate-release) forms. The short-acting forms tend to have slightly higher addiction potential (although still low at prescribed doses). The long-acting forms tend to be less addictive in general, and some have been manufactured in a way that renders them even less so.

Yet all of these medications are classified and regulated exactly the same—as though they are as addictive as opioid medications and more addictive than many other commonly prescribed psychiatric medications, such as benzodiazepine tranquilizers (Xanax, Ativan, Valium). Yet the abuse and addiction of prescription tranquilizers are arguably more of a clinical and societal problem than that of prescription stimulant drugs.

Stimulants usually can’t be prescribed, even at a completely steady dose, for more than 30 days at a time, no refills are allowed (they can’t be put on auto-refill) and prescriptions can’t be transferred from pharmacy to pharmacy (which has been extremely problematic for patients trying to obtain their regular medications amidst the current supply shortage).

We should partially down-regulate the long-acting prescription stimulant formulations so that they could be prescribed more easily. These prescriptions could still be monitored along with other controlled substances—but at a level that is more appropriate to their actual observed abuse potential.

Aside from being more clinically appropriate, this would likely lead to an increase in the percentage of ADHD patients taking long-acting stimulant formulations at the expense of the arguably more problematic short-acting forms. Presumably, this is desirable from a public-health safety perspective.