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    5 First Steps To Take After An Early-Breast-Cancer Diagnosis

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    Receiving an early-breast-cancer diagnosis can feel like a shock to your system, prompting a wave of emotions that can range from fear to sadness, and everything in between. While you’re trying to get your wits about you, know that what to do next is at the ready for you. Here we lay out steps to take toward survivorship. Early breast cancer is when the cancer has not spread past the breast and the axillary lymph nodes. It is also considered ductal carcinoma in situ (when cells lining the milk ducts become cancerous) and stage 1 (small local tumour) through 3a cancer (cancer in nearby lymph nodes). 1. Take A Breath And Centre Yourself“It takes time to process the information when you hear you have breast cancer,” says registered nurse Susan Brown, the senior director of health information and publications at the Susan G. Komen Foundation; a breast cancer organisation in the US. “You may have to hear the diagnosis more than once. You may want to ask the doctor to name and write down what they have found so far. You also may have to learn a new vocabulary, so take a breath.”READ MORE: 11 Symptoms Of Breast Cancer In Women That Aren’t LumpsBe gentle with yourself, and remember that an early-breast-cancer diagnosis is not a death sentence. “The five-year survival rate for stage 1 breast cancer is 100 percent,” says Dr. Shari Goldfarb, an oncologist at Memorial Sloan Kettering Cancer Centre. “The earlier you diagnose and treat, the better your outcome, and most women with stage 1 breast cancer are going to be cured of their cancer.”2. Educate Yourself With Reputable SourcesBoth experts we spoke to agreed that knowledge is power – just be careful where you’re getting it. For example, the first thing many women do is research breast cancer on the internet, but there’s a right and a wrong way to do that. “Don’t just go to Dr. Google, because there is a lot of misinformation out there,” Brown says. “Take time to gather reliable information.” One good rule of thumb is to look for reputable sources with .org or .gov at the end of the site’s web address, as these sources are usually most up-to-date, Dr. Goldfarb says.3. Keep A Journal Or Notebook For Your Thoughts And QuestionsEven before your first visit with an oncologist or a breast-cancer surgeon, consider writing down questions, such as:What type of cancer do I have?

    What stage is it in?

    What is my prognosis?

    What does treatment entail?

    What does it mean for my life?Keep the journal going between doctor’s visits, especially if you begin experiencing side effects from medications and other forms of treatment. “We can often relieve many of these symptoms, so the sooner you tell your doctor what you’re experiencing, the better,” Dr. Goldfarb says. Hot flashes, diarrhoea, constipation and nausea are all common side effects of cancer treatment and documenting your symptoms can help motivate you to reach out to your doctor if you’re experiencing any of them. “For example, if you get a mouth sore two days after chemotherapy, we can prescribe something to relieve it before you come back for your next visit, so you don’t have to suffer through it for another two weeks,” she says. “Don’t let things fester.”READ MORE: 8 Breast Cancer Myths You NEED To Stop Believing

    WH Breast Cancer Awareness Guide

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    4. Establish A Support System“There used to be a stigma with cancer, but not anymore,” Dr. Goldfarb says. “There is nothing you did to get it. You were simply unlucky and you’re going to need good support going through this.” Take some time to consider who will be your support system, whether that includes your partner, other family members, friends or colleagues – or all of the above.Too many women forgo telling their boss and coworkers of their diagnosis, but Dr. Goldfarb says it’s important to share the news with them, too, because you may find yourself calling in sick more or simply not feeling well at work. ”If people understand what is going on, they are more helpful and supportive,” she says.“There is nothing you did to get it. You were simply unlucky, and you’re going to need good support going through this.” —Dr. GoldfarbAnd even if your squad consists of just one or two people, having an advocate who can help you gather information and draft questions can take some of the load off you. “Perhaps they can attend appointments with you as a second set of ears, to take notes or ask questions that you may forget to ask,” Brown says.READ MORE: “I Conquered Ovarian Cancer And Breast Cancer At The Same Time.”Where To Find Support GroupsBuilding a support system also can include connecting with others who have been through a similar experience. “This can be through a support group that’s online or in person,” Brown says. “These groups share information and encourage members to advocate for themselves.”CANSA, for example has several different CANSA Support Groups; from WhatsApp groups, zoom, face-to-face and Facebook groups where patients, friends and family can find support and friendship and share information. You can find a full list of the groups as well as how to join here.Just remember to ask your doctor about anything you read or hear that concerns you, rather than take another person’s advice as fact. Brown likens this to announcing you’re pregnant, then hearing nothing but horrible labour and delivery stories. “If someone gives you something to think about, clear it up with your doctor right away so you don’t worry unnecessarily,” Brown says. “Another person may not even have the same type of cancer as you, or maybe they had it years ago, but since treatment is always changing, what they say may have no bearing on you.”READ MORE: What To Know About Breast Cancer As A Young Woman5. Consider Getting A Second OpinionAn early-breast-cancer diagnosis is a physical and emotional diagnosis, and you must feel comfortable with the care you’re getting, says Dr. Goldfarb. Even if the diagnosis and treatment plans end up aligning, many patients find a second opinion goes a long way toward helping them make peace with their diagnosis. “The first person you meet is not always the right fit,” Dr. Goldfarb says. “This is an important, serious diagnosis, but it’s also important to feel like you’re getting good care. If it’s not a fit with the first person, a second opinion can give you peace of mind.” Brown adds that asking for another expert’s opinion may not be necessary if you have a common type of breast cancer, but occasionally a person may have an unusual type of breast cancer, something that a pathologist doesn’t see very often. Even if the diagnosis and treatment plans end up aligning, many patients find a second opinion goes a long way toward helping them make peace with their diagnosis.Whatever the reason – even if it’s just that you’ll feel better if another doctor looks at your test results – the doctor or hospital where your biopsy was done can help you find another source. “Sometimes even within the same facility, you might find a different doctor,” Dr. Goldfarb says. “I see fewer patients as an oncologist, but I see them much more frequently, which is why it’s so important to find someone you connect with, keeping in mind that this is going to be a long-term relationship.”She suggests looking for someone who approaches breast cancer holistically: “A lot of emotions are involved. Even though early-stage breast cancer is likely to be cured, for you, it’s a traumatic experience.”READ MORE: My Experience With Breast Cancer, At Age 27Lastly…It’s impossible to control an early breast-cancer diagnosis and everything that comes with it, so try focusing on the things you can control. “Reading about it and talking about it are important,” Dr. Goldfarb says – because they will help remind you that most women diagnosed with early-stage breast cancer become survivors. “This is why regular mammograms and self-exams are important – they lead to earlier diagnoses.”The key, she says, is to stay positive and surround yourself with positive people. “It’s hard and it hits you at different points, but I am always amazed at how optimistic people can be even in difficult situations,” says Dr. Goldfarb. “It will help you get through the journey.”This article by Ana Pelayo Connery was originally published by Women’s Health US More

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      What To Know About Breast Cancer As A Young Woman

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      Once, breast cancer affected mostly women over the age of 50. But now, the Big C is affecting women in lower age groups. New data from South African research shows that breast cancer among young women is on the rise, reflecting global trends. According to the Cancer Association of South Africa (CANSA), breast cancer is the most common cancer among women in South Africa, accounting for 23% of all cancers. Here’s what to know to protect yourself.Breast cancer and young women: the numbersIn the U.S., a recent study found that breast cancer is the leading cause of cancer death among women aged 20 to 49 years. Now, we know that this data correlates with what’s happening in SA. A 2024 study looked at radiology records among patients younger than 40 in Johannesburg over a five-year period. They found that among the test results, 73% of them were positive breast cancer diagnoses. And the average age for women being diagnosed under 40? Just 34 years old.It can be more aggressivePlus, with breast cancer in young women, the Breast Imaging Society of South Africa (BISSA), a sub-speciality group of the Radiological Society of South Africa, warns that young women are more likely to develop breast cancers with aggressive biological characteristics. These cancers often present with larger tumours and more advanced stages of the disease at diagnosis, making early detection vital for improving outcomes. According to the Breast Cancer Research Foundation (BCRF), young women with breast cancer are more likely to have triple-negative breast cancer – which has fewer treatment options (but slowly improving) – as well as a recurrence at five or 10 years after therapy.Why are younger women being affected?The BCRF notes that inherited genetic mutations like BRCA1 or BRCA2 are more commonly seen among women, which contributes to the rise of BC.Other risk factors include:Having family member(s) with:breast cancer before age 50 or breast cancer in both breasts or breast cancer as a man

      ovarian, pancreatic or metastatic prostate cancer

      triple-negative breast cancer (TNBC)

      Having had your first period before you turned 12

      Being pregnant over the age of 30, or not giving birthREAD MORE: My Experience With Breast Cancer, At Age 27Do regular screeningsDr Peter Schoub, Chair of BISSA, emphasises the importance of early detection through regular self-examinations starting in your 20s, and annual mammograms from age 40. “Awareness and education about breast cancer in young women can lead to earlier diagnoses and less invasive treatment options,” says Dr Schoub. “The growing number of younger women being diagnosed with breast cancer highlights the need to expand awareness campaigns and improve screening programs, especially for those at higher risk.” And if you have medical aid, make use of your free mammogram offers. “Although most major medical schemes offer complimentary mammogram screenings for women over 40, only about 20% of women take advantage of this service,” says Dr Schoub. “We must also be mindful that breast cancer is increasingly being detected in women in their 30s, who experience more aggressive forms of the disease that can spread rapidly if not detected early.”Dr Schoub says that while breast cancer risk increases with age, the disease does not discriminate: women of all ages, races and socio-economic backgrounds can be affected.“This is why routine self-examinations and clinical breast checks by a healthcare professional at least once a year are essential,” he explains. “Any abnormality, regardless of age or family history, should be evaluated by a medical professional immediately.”He says the goal of breast cancer screening is to detect the disease before symptoms emerge. “Cancers found through routine screening are often smaller and localised, increasing the chances of successful treatment and survival. The size of the tumour and whether the cancer has spread are key factors in determining the prognosis.”

      WH Breast Cancer Awareness Guide

      Dive in and let this digi mag arm you and yours with powerful information so we can move towards a world where breast cancer becomes that much easier to tackle. Let us work hand in hand to spread awareness, support those in need, and contribute to the ongoing fight against breast cancer. With early detection and an army of knowledgeable women, this is possible!

      How to protect yourself from breast cancer as a young womanOther ways you can protect yourself involve lifestyle shifts.Stay in shapePrevious research notes that obesity or being overweight increases the risk of breast and other cancers.Ditch the vicesTough to hear, but necessary: excessive alcohol consumption (no more than one drink a day, says Prevent Cancer Organisation) ups your risk. Also, a lack of physical activity, smoking and diets high in saturated fats contribute to risk.Go easy on meatStudies show that higher intakes of red meat, animal fats and processed meats correlate to higher rates of breast (and other) cancers. Your move: swap them out for beans, lentils, nuts and veg.Load up on vegThe five-a-day really help: they’re higher in fibre, with is associated with lower breast cancer rates. Veg and fruits are also high in antioxidants, which protect against inflammation.Get some sunSouth Africans have alarmingly high rates of vitamin D deficiency. Black South Africans are the most affected, with almost 63% living with a lack of vitamin D. But vitamin D could also play a role in cancer, per CANSA. “Research suggests that women with low levels of vitamin D have a higher risk of breast cancer. Vitamin D may play a role in controlling normal breast cell growth and may be able to stop breast cancer cells from growing,” they note.READ MORE: 11 Symptoms Of Breast Cancer In Women That Aren’t LumpsHow to self-examine your breasts“The breast changes throughout the menstrual cycle and it is important to always self-examine at the same time of the month, usually a week after your period when your breasts are less tender due to fluctuations in hormone levels,” explains BISSA. Here’s how to check ‘em.Do a visual examSit or stand, without clothing, in front of a mirror with your arms to your side and look for changes in size, shape, symmetry, puckering and dimpling.Then, do a physical examinationLie down so that your breast tissue spreads out making it easier to feel, or in the shower, using soap to glide more easily over your breasts:

      Use the pads of your three middle fingers, not your fingertips, to examine.

      Apply different pressure levels – light to feel the breast tissue closest to the skin, medium to feel deeper, and firm to feel the tissue closest to the chest and ribs.

      Use a methodical technique such as beginning near the collarbone, then moving towards the nipples, in a clockwork fashion.

      Allow enough time and don’t rush the examination.Signs to look out forIt’s important to note that many lumps may turn out to be harmless, but it is essential that all of them are checked.  Visit your doc if you notice any of these changes:Swelling of all or part of the breast,

      Skin irritation, dimpling or ridges on the skin,

      Nipple pain or the nipple turning inward,

      Redness, scaliness or thickening of the nipple or breast skin,

      A nipple discharges other than breast milk, or

      A lump or knot near the underarm area.Michelle is the features editor at WH. She’s immensely curious about the world, passionate about health and wellness and enjoys a good surf when the waves are good. More

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      Things You (Probably) Didn’t Know About Antidepressants – And Depression

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      Sadly, we still live in a time when not everyone understands antidepressants and depression in South Africa. In some cases, people disclosing their mental health issues have been labelled “crazy”, “pretending to be sick” and “not strong enough”. This kind of attitude can lead to patients not seeking help, which can deteriorate their mental health further.It’s a troubling reality in a country where a quarter of South Africans are thought to be depressed. Of those, a majority never receive treatment. Antidepressants are a powerful tool in alleviating the symptoms of depression, anxiety and other mental health conditions, but misconceptions about the meds persist. Per the South African Society of Psychiatrists (SASOP), “the stigma associated with mental illness, as well as the misconception about the benefits and use of antidepressants serve as major barriers to people seeking assistance.”In the interest of breaking the stigma that permeates mental health in South Africa, here are things to know about antidepressants and depression, from SASOP.Nobody chooses to be depressedFirst – and most importantly: depression is not a choice. “It is a common misconception that depression is a condition that can easily be overcome by simply ‘snapping out of it’,” says Dr Gagu Matsebula, specialist psychiatrist and member of SASOP. “However, no one chooses to be depressed. Depression is not a sign of weakness; a result of wallowing in grief or sadness, a lack of positive thinking or self-pity. It is a medical condition that negatively impacts brain function due to biological or environmental factors.”Depression comes in different circumstancesWhile it’s not a disease you can “catch”, there are triggers:Genetics – strong medical evidence shows that genetic factors up the risk of depressive disorders.

      Anxiety – studies show that depression is linked to other mental health disorders and that higher levels of anxiety can, over time, predict higher depression levels.

      Trauma and early adversity – It’s widely acknowledged that traumatic events (including loss, grief, stress and abuse) can lead to depression and PTSD.

      Socio-economic status – evidence shows a link between a lower socio-economic position and mental health issues. A 2019 study of South Africans noted a cycle: “people could get trapped in a vicious cycle in which poor socio-economic conditions lead to depression, which, in turn, can cause further damage to their economic prospects.”READ MORE: More People Are Using Ketamine For Depression – But How Safe Is It?Symptoms of depression can differ“Depression manifests as a persistent feeling of sadness as well as a loss of interest in previously enjoyed activities, and it typically lasts for more than two weeks,” explains Dr Matsebula. “It affects thinking, memory, motivation, eating and sleeping patterns, and can lead to substance abuse as a coping mechanism.”Other symptoms of depression include:Prolonged feelings of irritation or restlessness

      Persistently feeling sad and empty

      Poor concentration, memory or decision-making abilities

      Feelings of excessive guilt or low self-worth

      Hopelessness about the future

      Thoughts about dying or suicide

      Disrupted sleep (including insomnia or hypersomnia (oversleeping), or early morning awakening)

      Changes in appetite or weight

      Feeling very tired or low in energy

      Increased usage of alcohol or drugs

      Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

      Deterioration of social relationshipsMost notably, when you’re depressed (and not just sad), those feelings last most of the day, almost every day and at least for two weeks.Depression looks different for everyoneThe World Health Organisation notes that not one person’s experience of depression is like another’s. Depressive episodes can be mild, moderate or severe; they can occur once or repeatedly; people’s abilities to do things can differ. For example, some people with depression can retain the ability to focus, while others can’t.READ MORE: 4 Proudly South African Apps For Mental Health SupportHow to get helpIf you suspect you have depression, it’s critical (we underlined it because it’s *that* important) that you seek professional help. Even a GP will be able to assist – they can also prescribe antidepressants. But a good GP will refer you to a psychiatrist and psychologist for specialised care. If you have medical aid, take heart: Prescribed Minimum Benefits mean that with any medical aid scheme (regardless of the plan), you’re able to access a number of mental health resources, like psychiatrist or psychologist sessions – for free.These resources are there for *you*These avenues are accessible and available for you, in any situation. Never feel afraid to reach out.SADAG

      This national organisation has resources, helplines and more for anyone looking to get treatment for depression or anxiety.

      Humanitas

      Humanitas offers counselling services for anyone for free. Your counsellor will be a counselling intern with a degree in either psychology or social work.

      Headroom

      This site is a database with legs. It allows you to access psychologists, counsellors, and social workers and to book therapy sessions.

      How antidepressants workOnce you’ve spoken to a doc or psychiatrist, they may prescribe antidepressants. The technical term is selective serotine reuptake inhibitors (SSRIs). You may have heard of some of them: sertraline (Zoloft) or fluoxetine (Prozac).Here’s how they work: “SSRIs work by increasing the levels of serotonin in the brain, a neurotransmitter that carries signals between the brain’s nerve cells, ultimately improving one’s mood,” explains Dr Matsebula. In some people, serotonin can be “dumped” by the body, creating a deficit that causes mood to plummet. SSRIs work to prevent that action. “This medication prevents the reabsorption of serotonin into nerve cells, thereby increasing its availability and improving message transmission. The ultimate goal of antidepressants is to restore the balance of deficiencies of serotonin and other neurotransmitters that may be causing the depressive symptoms.”For many people, it’s a total game-changer, improving energy levels, happiness and contentment. “Some people fear antidepressants, but it is safe to use. There are several types of antidepressants, with different side-effect profiles,” says Dr Matsebula.You might need to change medsBecause of those side effects (and efficacy), it’s totally normal to have to change meds sometimes. Per SASOP, while many individuals respond well to the first prescription of antidepressants, some may need to try several different antidepressants before finding the one that works best for them.This is also why it’s crucial to stay in contact with your doctor. They will be able to take note of your symptoms and any possible side effects and tailor a solution for your body. Regular sessions (every three months) are critical. If your memory sucks or you generally don’t pay attention to your body, keep a journal! Every little thing counts.READ MORE: Many Women Are Battling Depression During Pregnancy. Here’s What To Know, If You’re StrugglingAntidepressants don’t work overnightUnlike headache pills or antibiotics, antidepressants are long-acting treatments, meaning they take a long time to work. We’re talking weeks.“It is crucial to be patient when using antidepressants and to take the medication daily as prescribed by a doctor. It may take several weeks for the medication to take full effect and it is important to continue with the prescription for at least six months to prevent symptoms from recurring. Every person responds differently to antidepressants and some individuals may require long-term usage,” says Dr Matsebula.Also, if you’re feeling better: don’t stop your treatment. It’s not like a cold; if the meds are working, so you should keep taking them. “It is vital not to stop the medication or reduce the dosage independently, even if feeling better. Unlike other medications such as sleeping tablets, antidepressants do not cause physical dependence or addiction. A doctor’s guidance is crucial when increasing or reducing the dosage or ending the treatment,” says Dr Matsebula.Antidepressants don’t “cure” depressionDr Matsebula says it is important to note that depression is treatable through medication to address the underlying biological issues contributing to the condition. The most common treatment approach combines medication with talk therapy (psychotherapy).  Plus, this approach tends to have the best outcome for patients.Talk therapy (chats with a licensed psychologist or counsellor) is highly beneficial in addressing depressive symptoms by exploring, and processing, past and current experiences with a trained professional such as a psychologist. This approach is particularly useful for situational depressive episodes (such as the loss of a loved one or partner conflict) or childhood trauma, as it helps the patient gain clarity and an understanding of the root causes of distress.You don’t have to feel depressed foreverLastly, it’s important to remember that you can get help – and feel better. Remember, seeking professional help is crucial in managing depression effectively, and there are resources available to support you throughout your journey to recovery and living a healthy, fulfilling life.To get help for your friends, family, colleagues, or yourself, please speak to your GP, or contact the South African Depression and Anxiety Group (SADAG) on 0800 12 13 14, or send an SMS to 32312 and a counsellor will call you back.

      Michelle October

      Michelle is the features editor at WH. She’s immensely curious about the world, passionate about health and wellness and enjoys a good surf when the waves are good. Find her on Instagram here. More

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      More People Are Using Ketamine For Depression – But How Safe Is It?

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      As we focus on mental health this October, it’s important to remember that of the many crises plaguing South Africa, depression is one of them. A 2022 study by Wits highlighted key findings: South Africans suffer higher rates of depression and anxiety than other countries. Only a quarter of those ever receive treatment. And, since treatments are subject to costly long-term psychologist visits or psychiatrist prescriptions, some people are turning to unconventional treatments. Among them, there’s a noted rise in people treating their symptoms with psychedelics. Now, there’s an increase in ketamine use to treat depression in cases where other medication has failed. Amazing, right? Not so much, say experts.Per experts, using ketamine for depression is a revelation (more on this below). However, the misuse as a party drug and the mounting unsupervised use as a treatment for depression is problematic.  “The anaesthetic drug can bring life-saving hope for people suffering treatment-resistant major depression or at severe risk of suicide. But unsupervised use or excessive dosages hold addictive and even lethal risks,” warned the South African Society of Psychiatrists (SASOP) in a recent press release.So… what is ketamine?Ketamine is an anaesthetic, originally used in animals since the 1960s. In humans, it’s been used to treat pain since the 1970s. It’s listed in the World Health Organization’s List of Essential Medicines as an anaesthetic. It’s also registered in South Africa for induction and maintenance of anaesthesia. If you were to break a bone, a doc might use ketamine instead of full anaesthesia.When it’s used recreationally, K produces dissociative sensations and hallucinations. Users report feeling relaxed, dream-like and nauseated. In its newest era, K is a breakthrough treatment for depression, with others claiming it works for other mental health conditions too.How does ketamine help with depression?Ketamine is available for off-label use. This means that regulations allow doctors to use it for purposes other than pain management. Studies have shown that it’s a viable treatment for depression and suicidal urges, especially in cases where other medications haven’t worked.“There is good evidence that ketamine in low doses, administered under controlled conditions with the necessary medical supervision, is an effective treatment for treatment-resistant major depression,” explains SASOP spokesperson, psychiatrist Dr Bavi Vythilingum. “It is also effective in acute cases of suicidal ideation, rapidly reducing the risk of life-threatening thoughts and acts.”How does it work? Image by Maxim Berg on Unsplash

      Per Dr Vythilingum, K improves the production and functioning of the neurotransmitter glutamate. This plays a role in mood, thought patterns and cognition.

      Ketamine has a different mechanism to traditional anti-depressant medications. And, it’s why medical researchers believe it to be at least part of the reason for its effectiveness where other treatments have failed. Unlike conventional antidepressants like SSRIs, which take weeks to work, the effects of ketamine are rapid. It also doesn’t work on the same brain receptors.READ MORE: Why Toxic Positivity Is Harmful And What To Say InsteadHow is ketamine for depression administered?To use ketamine for depression, you’re meant to head to a treatment facility. There, you’d be given a dose via I.V. It takes about 40 to 50 minutes, and there’s extra time to recover afterwards. After the treatment, you’ll need someone to take you home – no driving until after they have had a full night’s sleep. But you’re not A-OK after just one session. The initial treatment takes place in six sessions over two to three weeks. The treating psychiatrist may prescribe maintenance treatment on a case-by-case basis.The dissociative state (the trip) caused by ketamine can produce feelings of a trance-like state or hallucinogenic experience, feelings of an “out-of-body experience”, feelings of unreality, visual and sensory distortions, and euphoria or “a buzz”.“For this reason, it is important that the setting is safe, meaning that it is quiet and private, that treatment is medically supervised, that the patient is not left alone during treatment and recovery, and that the facility is equipped to manage any adverse side effects,” says Dr Vythilingum.While the dissociative side-effects can also be positive in improving depressive symptoms, she said other negative side-effects could include nausea and vomiting, raised blood pressure, respiratory depression (slowed breathing), sedation and unconsciousness.Image by Dima Pechurin on UnsplashBut… ketamine can also be lethal  While the treatment is a game-changer for many, there are significant risks. “Ketamine is a powerful anaesthetic agent. A too-high dose can cause sedation and loss of consciousness and in very high doses, may cause dangerously slow breathing and the risk of death,” explains D Vythilingum. “Even at lower doses, if administration of ketamine is not adequately supervised and the person is not in a safe, controlled setting they may become confused and inadvertently harm themselves. Ketamine is also potentially addictive and open to abuse.”Added to this is the rising number of “independent” clinics offering ketamine treatment for depression and other mental health conditions. SASOP is concerned about these facilities: whether they’re correctly diagnosing patients and using ketamine as the appropriate treatment. The treatment also has to be carefully monitored for harmful side effects.READ MORE: 4 Proudly South African Apps For Mental Health SupportKetamine’s side effects can be dangerousLong-term use of ketamine at high doses can cause bladder, kidney, liver and stomach pain or toxicity, as well as addiction demanding increasingly higher, life-threatening, doses. Plus, while some claim that ketamine is effective in treating other mental health conditions, such as post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD), SASOP cautions that there is limited scientific evidence for this.Image by Alexander Grey on UnsplashHow to stay safe in treatmentIf you choose to pursue ketamine for depression, it’s totally legal. Just make sure you’ve picked a facility that dots its i’s and crosses its t’s.Find specialists“Ketamine for psychiatric treatment must be prescribed by a psychiatrist. Only a psychiatrist can diagnose that depression is treatment-resistant,” explains Dr Vythilingum. “That diagnosis is made following at least two courses of conventional antidepressant medication with no improvement in symptoms.” She also made clear that only a doctor can administer the meds “and both physical and psychological safety are paramount during administration of ketamine.” SASOP advises that the guidelines issued by the South African Society of Anaesthesiologists (SASP) should be adhered to. These guidelines state that the medical doctor administering ketamine must be an anaesthesiologist or registered sedation practitioner who is qualified in advanced cardiac life support and resuscitation.Check the facility  “Ketamine must be administered in a facility equipped for physiological monitoring (blood pressure, pulse rate, oxygen saturation), with medication, equipment and qualified personnel to manage adverse physical or neurological events, including hypertension, cardio-respiratory events, airway management and resuscitation.“The administering clinician or member of the team should also have expertise in mental health and managing patients who may become agitated, anxious or otherwise distressed. A psychiatrist should be available in case of a psychiatric emergency,” Dr Vythilingum said.READ MORE: These 3 Mental Exercises Can Help You Find Your Purpose In Life At Any AgeIt’s not for everyoneKetamine is not considered safe for patients diagnosed with schizophrenia or for those with a history of substance abuse. Dr Vythilingum also cautioned that while there is clear evidence for the off-label use of ketamine in treatment-resistant major depression, more research was needed on the drug’s long-term effects, side effects and safety as a psychiatric treatment.Equip your mind with these reads More

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      “We Need To Have More Open Conversations About Miscarriages, Abortions And Pregnancy”

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      Social psychologist Hilary Davies shares her experience and lays out the need for open conversations about miscarriages, abortions and pregnancy.**Trigger Warning: This personal experience piece discusses sensitive topics such as abortion, miscarriage, pregnancy and grief. Please proceed with caution and take care of yourself while reading this content.**Five uncertain days About a year ago, I found out that I was pregnant. I was not in a stable relationship with the man involved. It was still the early days of starting up my first business. I was not financially stable, and my living situation was not conducive to raising a child. The logical decision was to terminate the pregnancy. But even at that early stage, there was a deep internal desire and instinct to keep this pregnancy. Whilst I was grappling with what felt like an impossible choice, the decision was taken out of my hands. I miscarried. In the space of five days, I found out I was pregnant, registered the impact on my future, experienced the miscarriage and felt the emotional loss. Those five days of turmoil, fear and uncertainty felt like months.  After the initial rawness of my experience wore off, I found myself talking openly about it to friends, family and colleagues. To my surprise, this opened up new layers of conversations on a topic that until then, for me, remained relatively unspoken. It has led me to reflect on how we respond to pregnancies, especially the unplanned ones, and the subsequent miscarriages and terminations that may follow. Once I started peeling back the layers of conversation, I was shocked by the frequency and similarity of this common experience, and the lack of open dialogue we have around them.Miscarriage, by the numbers This isn’t a debate on the moral standing of abortion. In South Africa, abortion is regulated and protected by the Choice On Termination Of Pregnancy Act of 1996. It gives us the freedom to choose based on our own morals and lived experiences. Grounding into the freedom that we are bestowed with this Act, I’m sharing my experience. It’s a small step to normalise conversations about miscarriages, abortion and pregnancy.Globally, the prevalence of miscarriage is estimated at 10-25%. One recent WHO source putting the number at one in four pregnancies. Per the WHO Department of Sexual and Reproductive Health and Research, 30% of all pregnancies end in abortion, either through choice or for medical reasons. In South Africa, 461 000 pregnancies ended in abortion between 2015 and 2019. The official figure, however, is known to be underreported. This is because of social stigma, financial barriers and access issues that result in women seeking abortions that are not recorded in official statistics. Research shows that including unreported and illegal abortions, the total figure could be more than double the official data. Adding to this the miscarriage rate of 20% and the number of births each year – just under one million live births annually?  It can be estimated that up to nearly half a million women each year could experience a miscarriage or abortion in South Africa.READ MORE: No, Women’s Fertility Isn’t Suddenly Doomed At Age 35The power of conversation With these numbers in mind, how do we – both as individuals and as a society – support women in these experiences? I believe in storytelling as one of the intrinsic ways that we seek to connect to each other. Through this, we learn from others’ experiences, normalise our own and form connections and safety with similar experiences. Storytelling is one of the most direct ways we can meet our psychological need for belonging and acceptance. So if topics of miscarriage and abortion remain taboo and unspoken, what is the impact of that on women? How does the experience of pregnancy, miscarriage and abortion shape our emotions, lives and relationships?“Storytelling is one of the most direct ways we can meet our psychological need for belonging and acceptance.”During those turbulent five days, my emotional response was an uncomfortable cocktail of shock, overwhelm, anxiety, vulnerability and fear. My body was processing the sudden and dramatic spike in hormones that occurred from around the time of the first missed period, followed by the sudden and dramatic drop that came after the miscarriage. Physically sore and emotionally exposed, I went into a state of numbness that protected me against the very heightened feelings. In a bid to avoid anything that felt uncomfortable, I threw myself into work. Within ten days, I was on an overseas work project that kept me busy. Through this, I could avoid any feeling of discomfort.Dealing with griefAfter about two months, I slowed down enough to start dealing with what happened to me. Two major things hit me: grief and shame. The loss of a pregnancy can trigger layers of grief – whether it’s planned or not. The pregnancy itself, the longed-for future of a family, the life plan unfolding, and many more. For some women, miscarriages deeply affect their relationship with their bodies and the deep, evolutionary sense of purpose some of us hold linked to motherhood and childbearing. My grief was for something I didn’t even know I wanted. In my mid-thirties, fiercely independent and career-focused, a baby at this stage was almost disruptive. But suddenly a new future unfolded before me that I had never considered with any serious thought. I started to plan and dream – and then just as suddenly as it arrived, it was gone again.  Stages of grief Brené Brown identified three elements of grief in her research. The first is loss: the actual process of losing either a person or thing, as well as the loss of a ‘sense’ such as a sense of normality, a belief about a person, or an understanding. The second element is longing: an involuntary yearning for something. The third element is feeling lost, experienced as a disorientation of ourselves in our physical or emotional world. Things stop making sense the way they did before the loss happened. All three of these were present for me in the months after the loss of my pregnancy.It was only in January this year, with time alone and having taken a break from work, that I was ready to start feeling the grief. Robert A. Neimeyer, a leading researcher in grief, wrote, “A central process in grieving is the attempt to reaffirm or reconstruct a world of meaning that has been challenged by loss.”  The process of reconstructing could only be started when I created space between the acute grief I felt and was ready to start integrating it back into my life.  Part of that reconstructing is in establishing a connection with others through shared storytelling – one of the components that make support groups so impactful in grief healing processes.READ MORE: Here’s How To Actually Practise Mindfulness And Unlock Inner PeaceWhy we need conversations about miscarriages, abortion and pregnancyThe need for connection after a loss is a common response to sadness, as it helps us feel seen and held in compassion. The connection also helps overcome the isolation that accompanied my other major response: shame. Shame is the sense that we, as our unique selves, are flawed or unworthy. It can be triggered by events in our lives where we feel we have fallen short. Shame thrives on secrecy, self-judgement and isolation. We continue to perpetuate the stories that we tell ourselves about our failures or inadequacy. In the context of pregnancies, shame is worsened by the social taboos that still exist around unplanned pregnancies, the judgement around abortions, and the sometimes perceived failure of our bodies during a miscarriage. In my case, I felt irresponsible for getting pregnant outside of a relationship. I felt that I would be judged for the situation I found myself in. I felt ashamed that my body was unable to keep the pregnancy. None of this is logical, but in my own mind, the conversation became a dark spiral. The inability to talk openly about these experiences only worsens them.The remedy to this comes again from connection, from feeling understood and from empathy. The fastest way to eliminate shame is to put it in broad daylight, to expose all of the gremlins that are waiting to catch us.  But to do this, we need to create safe spaces where conversations can be had without judgement that leads to further shame. Through this, I was also able to show myself empathy. Slowly but surely, I rebuilt my trust in myself and my body.Support is keyIt took me three months of running away from the feelings before I could address them. But I was lucky in the support I had around me when I was ready. What became abundantly clear was that rather than dealing with this on my own, I needed to lean on my support, through family and friends, to help me process my feelings and reactions. By sharing my experience, I managed to reframe the self-judgement and self-blame that I’d had with for months. Research by Martin Seligman into resilience factors helps us address this with the three P’s: personalisation, permanence and pervasiveness. Through hearing other’s stories and sharing my own, I recognised that this was not all my fault. It was not a permanent pain that I couldn’t work through. It was not pervasive in all areas of my life.These conversations developed in me a sense of belonging and connection with women that helped me feel safe and accepted. It also helped me accept myself and what had happened, turning the blame into compassion. With that, I was able to give myself a break – literally and figuratively. Easing the pressure on myself and taking some time off to rest and recover from the events was the single most important thing I could do.Connections create healingIt’s taken me a year, a lot of conversations and hours of embodiment practices, but I can now reflect on the events of last year with a gentle sadness and deep acceptance. Despite the loss, I’ve gained invaluable wisdom from it. For starters, I know for the first time that being a mother one day is a deep desire that I hope to be lucky enough to fulfil. My miscarriage has given me clarity on my future that I’ve never had before. Although I don’t plan to start a family in the next few years, the decisions I make now around my business, my health and my lifestyle are already helping me prepare and build that future life.This experience has also given me a newfound respect for a woman’s body, what she is capable of and how she continues to be judged, talked about, misunderstood and misrepresented in our society. In general, our understanding of our own bodies, cycles and needs often falls below par. Education about our cycle, how to work with it and adapt our daily lives to optimise it, is one of the most empowering gifts we can give ourselves.“I felt that I would be judged for the situation I found myself in. I felt ashamed that my body was unable to keep the pregnancy. None of this is logical, but in my own mind, the conversation became a dark spiral. The inability to talk openly about these experiences only worsens them.”Men should join, too The men in our lives also play a key role in how we heal and recover from experiences of pregnancies. We often focus on the women’s experience in these matters, even though they can have a significant impact on the men as well. Creating space for conscious conversations about each person’s experience is a powerful way to process it together, through being vulnerable and present with each other. Successfully navigating these conversations can, as well as help with healing for both, ultimately create a stronger trust and sense of belonging within the relationship.READ MORE: Why Toxic Positivity Is Harmful And What To Say InsteadOpen up Every woman’s experience when it comes to pregnancy, miscarriages and abortions is different. Mine is neither unique nor representative. How we feel, respond and process this depends on a myriad of factors. On reflection though, one thing I can say for certain is that we need to be having more open conversations about these very normal and very common experiences that women have. We need to speak about it so that we can ask for the support that we need – from our loved ones, from work, from our friends. So we challenge the shame and isolation that women face. We need to speak so others feel safe as well. We need to speak about it so that we can tell our own stories, and through that find the sense of belonging and support we need through these challenging times.If you find yourself or a loved one going through this, I encourage you to embrace the vulnerability to be open about the experience. Take time to rest. Be compassionate and gentle. Ask for help. Share your feelings. Lean into the support around you, or seek out the support you need, rather than withdrawing into the pain. Together, through the shared experiences and storytelling of women, we can normalise our experiences to create safety and acceptance, that allows us to heal.

      Hilary Davies

      Hilary Davies is a social psychologist specialising in Diversity, Equity, and Inclusion (DEI) coaching and consulting. Her focus is on gender equality and organisational transformation. She is passionate about supporting women’s development by addressing the invisible barriers that impact their lived experiences. Hilary is the founder of 328 Women’s Coaching. It’s a programme designed to help women deepen self-awareness and catalyse growth in both their personal and professional lives. For more information, visit www.hedcoaching.com or learn more about coaching at www.328.co.za. More

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      4 Most Common Questions Women Ask About Their Sexual Health

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      What does your ‘Girls Night’ consist of? Pizza, wine and a few episodes of Emily In Paris? Or is it a night where you and your girls get deep into conversations about sex, toys and men? For many, it will be the first option, as the latter tends to make many feel uncomfortable. Why is it difficult to engage in conversations about our sexual health? Perhaps it’s a fear of judgement, that something may be “wrong” with you?Did you know that a staggering 63% of women experience some form of sexual discomfort? Yes. It’s you and almost every woman around you!Don’t worry, we have your back. Here’s a list of questions and answers you may be thinking of, but have never been comfortable to ask before.1. My period is irregular — have I reached menopause?You’ve crossed off all the calendar days and Aunty Flo hasn’t paid you a visit yet. Your initial thoughts could be pregnancy or menopause. Menopause is a reality between 45 and 55, but irregular periods can happen at any age. Dr Bradley Wagemaker, Medical Director at Lamelle Research Laboratories says, “When your body experiences hormonal imbalances and changes in hormone levels (such as when taking contraceptives or falling pregnant), you could experience an irregular flow.”Research suggests that stress and pollution can affect the body, causing devastating effects on your sex organs and your vital sex hormone: oestrogen.READ MORE: These Unusual PMS Symptom Treatments Actually Work – Minus Painkillers2. Why am I so moody?I find it offensive when people accuse me of being moody. It’s never my fault, but my hormones fault. Mood swings are very common when there are hormonal changes happening inside your body. “Oxidative stress depletes nitric oxide in your body, causing the type of hormonal changes that lead to mood swings at any age,” says Dr Bradley Wagemaker.3. I’m struggling to “get in the mood” — help me!You want to get your groove back, but it’s a bit of a struggle? Dr Bradley Wagemaker says, “A decrease in libido or sexual desire is a normal psychological (mental) response to the physiological (physical) damage in your organs. When you experience dryness and discomfort during sex, your brain will often trigger a natural response in your brain to try and avoid the uncomfortable situation again.” Don’t be embarrassed and don’t avoid sex either. Explore different ways to spice things up in the bedroom.READ MORE: The 9 Best Natural Lubes For A Happy Vagina4. How can I improve intimacy with my partner?A couple’s physical intimacy requires work to maintain beyond the “honeymoon phase”. Take care of yourself by investing in your wellness, your personal development and your mindfulness. When you’re feeling your best, you bring an important vitality to your relationship. Be curious and open yourself up to new things. More

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      12 Unexpected Health And Beauty Benefits Of Epsom Salt

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      Epsom salt is popularly used to solve a myriad of different ailments, including everything from soothing tired and achy muscles to easing stress and eliminating toxins from the body. It’s cost-effective and safe, making it a great product to keep at home for the whole family. Plus, the benefits don’t end with healthcare – there are also various ways of using them around the home.What exactly is Epsom salt?Epsom salt was named after a bitter saline spring at Epsom in Surrey, England. Epsom salt is not actually salt at all, in fact, it comprises a naturally occurring pure mineral compound made up of magnesium, sulphur and oxygen.It’s been around forever, too: There “have been recorded uses of Epsom salt to solve health problems since the 1500s,” says Jim Hill, president of the Epsom Salt Council.It was most likely named Epsom “salt” because of its chemical structure and appearance, as it looks very similar to traditional table salt. Most of its benefits are due to the presence of magnesium, a mineral that many people do not get enough of.‌When Epsom salts are dissolved in water, they release magnesium and sulphate ions. Studies indicate that magnesium and sulphate ions can be absorbed through the skin, which is why Epsom salt baths are so popular.READ MORE: 10 Signs You May Have a Magnesium Deficiency‌Why we need magnesiumWhat’s so special about magnesium? Well, it takes on several important roles in the body. It helps regulate enzymes, reduces inflammation, supports muscle and nerve function, helps the body flush out toxins and much more. You may have written it off as something collecting dust in your grandparents’ bathroom closet, but Epsom salt has a number of practical – and effective – uses. Stock up on it to reap the benefits:1. It exfoliates skin“People use it as an exfoliator, a blackhead reduction [method], and a standard facial cleanser,” says Andrew C. Krakowski, a dermatologist. That’s because unlike a lot of exfoliators on the market, Epsom salt isn’t made up of plastic. “It provides gentle abrasion and then dissolves into your tub or shower,” says Hill.2. It pumps up puny strandsHills says Epsom salt can also be used as a hair volumiser since it’s great at removing gunk. “It will definitely give hair more body,” he says.How to use it: mix equal parts Epsom salt and conditioner, massage into your hair, and let it sit for 10 to 15 minutes before rinsing out. You can also use Epsom salt to create a paste that will eliminate dead skin on your scalp if you’re plagued by itching.3. It temporarily reduces bloatYep, soaking in an Epsom salt bath can be a quick fix for temporarily reducing water weight, says Sabrina Sarabella, certified personal trainer. The reason: The sulphate ions pull toxins and water out of your system. (Word is Amanda Seyfried has used this trick to squeeze into a red carpet dress.)The best bath recipe: Add ½ cup of Epsom salt to your bath for every 25kgs of body weight, says chiropractor David Jockers.Get the benefits of Epsom salts with these products

      This food-grade bag is natural and multi-purpose.

      This lavender-scented bath bomb helps relax the body and mind.

      This vitamin-enriched Epsom salt also has shea to moisturise.

      4. Epsom salt soothes sore muscles“If you have a sprained ankle or are just in pain, it can help drain out toxins or [reduce] inflammation,” says Jockers. He even points out that it can decrease pain during the early stages of labour. So fill up your tub!5. It relaxes the mindJockers recommends that his clients regularly turn electronics off, throw on some music, lower the lights, and soak in the tub in an Epsom salt bath. “It’s a really awesome practice to be doing on a regular basis,” he says. “It’s really good for relaxation.” One study found that the magnesium in Epsom salt helps to lower cortisol, the stress hormone.READ MORE: Here’s How To Actually Practise Mindfulness And Unlock Inner Peace6. Improves Your Bone HealthBecause Epsom salt has magnesium, taking a bath in the product allows users to absorb the element, which can help with bone health, says Sarabella. “Many people think that consuming calcium through dairy products is [the most important thing for bone health],” she says. “But that’s untrue. You need magnesium.”7. It could boost happinessMagnesium helps produce serotonin, the happy hormone that’s key for good mood. It also affects the binding of serotonin receptors, enhancing its transmission. Some studies suggest that Epsom salt, because of its high magnesium content, can benefit your mood. A perfect pre-bedtime routine.‌8. It treats constipationMagnesium is very useful in alleviating constipation because it draws water into the colon, stretching the intestines and helps move things along.How to use it: mix two to six teaspoons of Epsom salt with 250ml (one cup) of water and drink it. Make sure to use edible Epsom salt and not the kind with added essential oils for baths. Also, make sure to not use it for more than a week. Avoid if you have kidney conditions, stomach pain, nausea or vomiting.Soaking feet in a mixture of warm water and Epsom salts for ten minutes has been shown to neutralize odour, soften rough skin and even relieve the symptoms of athlete’s foot.10. It helps remove splintersGot a splinter or something stuck under your skin? Soak the area in a bowl of Epsom salt water to draw it out.11. It cleans tiles and other surfacesGet your bathroom and kitchen sparkly clean by mixing equal parts Epsom salt and dishwashing detergent and use as a scrub on tiles and other surfaces with stubborn stains.READ MORE: These Unusual PMS Symptom Treatments Actually Work – Minus Painkillers‌12. It can fertilise plantsPlants rely on magnesium and sulphur in the soil to stay in good health and flourish. Sprinkle Epsom salts over the plant soil weekly to nourish flowers, veggies and houseplants.When to *not* use Epsom saltThough there is information floating around out there about the possibility of using Epsom salt for an internal cleanse, Krakowski warns against it, stating that many outrageous claims about the product should be “taken with a grain of salt” – pun intended. “Do not confuse this product with something that you would want to use internally [by ingesting it],” he says. “You will get into trouble doing that.” Noted. More

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      7 Signs You’re At Risk For Gum Disease – And What To Do

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      Fact: gum disease is super common. In fact, per the South African government, around 90% of us experience it at some point. The only other thing more common? A cold. But it’s also risky. That’s because gum disease is mostly not noticeable – and research has linked the problem to a range of serious health issues. Alzheimer’s, heart disease, infertility and even cancer. Here’s how to dodge the danger. What are the symptoms of gum disease? According to Dirna Grobbelaar, oral hygiene advisor for Ivohealth and a member of the Oral Hygienists Association of South Africa (OHASA), most people don’t realise they have gum disease. Visible signs include redness, swelling or bleeding gums. “Bleeding gums are never normal,” she says. “You may attribute bleeding gums to using the wrong brush or floss; in most cases, bleeding gums indicate gingivitis, the early form of gum disease.”Fortunately, gingivitis can be treated and is reversible. If untreated, it can develop into a more serious form of gum disease – periodontitis – which can lead to bone and tooth loss. “Gum disease is best prevented and the earlier you intervene the better,” says Grobbelaar.Can you be at risk of gum disease? Bummer: yes you can. Genetics play a role, as does dry mouth and diabetes. But your habits can also contribute to a higher risk of yucky bacterial growth and unhealthy gums. Here, some signs you’re putting your oral health at risk – besides smoking or vaping. You brush too hard Maybe not a precursor for gum disease per se, but “aggressive brushing can cause gum recession,” says Grobbelaar. Your fix: use a soft-bristled brush or one that snaps back when you apply too much pressure. Or, think of it this way: your teeth are not your enemy. You skip flossing We’ve all been guilty of it – but making it a habit puts you at risk. Plaque and food debris love to hide between teeth where brushing cannot reach. If you don’t floss, it builds up and irritates the gums, potentially causing gingivitis.You should be brushing twice a day for at least two minutes – 15 seconds per quadrant. Then, a daily floss is in order. If you can’t stand the strand kind, get a water flosser or interdental brush pick – see those below. READ MORE: Are Wellness Shots With Turmeric, Ginger, Or ACV Actually Good For You? A Dietician Weighs InYou’re brushing like a see-sawGood brush technique gets to the far back of the mouth and uses small, circular motions. “Incorrect brushing can damage the gums or leave plaque behind,” explains Grobbelaar. You ignore bleeding gums Per experts, bleeding gums are never normal – and is usually a sign of gum disease, Grobbelaar says. “If you see red when you brush or floss, follow a meticulous oral hygiene routine for a week,” says Grobbelaar (details below). “If it continues, consult a dental professional.” More scary stuff: “If untreated, bleeding gums can lead to more serious problems including periodontitis, tooth loss, cardiovascular disease and pregnancy complications,” says Grobbelaar. “It is also more expensive to treat gum disease at an advanced stage.”You use alcohol-based mouthwashes Weird but true! “Alcohol dries out the mouth, which can lead to gum problems,” says Grobbelaar. “Opt for alcohol-free options.” You skip the dentist Set up an auto-alert every six months for the dentist – and actually stick to it. “Regular dental check-ups allow your dentist to spot issues before you can,” says Grobbelaar. What’s more, even with your good routine, pesky plague and troublesome bacteria still need to be professionally cleaned. Excitingly, it no longer has to be painful. EMS Guided Biofilm Therapy® is a new treatment to clean the mouth – and it’s gentler, more comfortable and more effective. Find a practitioner for it here. You’re not replacing your brush heads Another thing to schedule, maybe: an old brush can’t clean well, which can lead to… you guessed – gum disease. And, the longer you have it, the more mould it can grow, which can make you sick. It also collects more bacteria over time, which could lead to a dental infection. Replace the brush every three months – or sooner, if it starts looking worn out or dirty. You have hormones Ah, another wonderful side-effect of being a woman. “Pregnancy, menopause, and menstruation can make gums more sensitive and prone to disease,” says Grobbelaar. While that’s certainly not something you can blame yourself for, take the time to pay special attention to your teeth during this time. READ MORE: Manual vs Electric Toothbrushes: Which Is Better?How to treat gum disease at homeIf you have the early signs of gum disease, follow these steps every day for a week. If things don’t resolve, see a dentist. Brush twice a dayAnd brush for two minutes every time. Use a soft-bristled brush, and make it a small head that can get to tricky spaces more easily. Ordo Sonic+ Toothbrush

      Not only us it pretty, it also has four brush modes, 40 000 sonic pulses per minute and does the job well.

      Oral B IO Series 3 Electric Toothbrush

      This brush even monitors your brushing, featuring a pressure sensor, interactive display and gum protection.

      Balene Toothbrush

      Made for anyone with mobility issues, this brush has a dual-sided head that brushes inside and out and rotates 180°.

      READ MORE: 11 Ways To Get More Energy When You’re Feeling TiredGet flossing These get in between your teeth to remove stuck bacteria. Pomafloss Portable Water Flosser

      This nifty water flosser is perfect for sensitive teeth and makes flossing way easier.

      GUM Soft-Picks PRO

      These picks are part brush, part toothpick and all plague-busting, making cleaner teeth.

      White Glo Tight Fit Toothpicks

      These handy picks easily slide between each tooth to scrape off debris and is mint-infused.

      Use the right mouthwash These alcohol-free formulas won’t dry out your mouth and are friendly to sensitive gums. GUM Paroex Intensive Action

      This alcohol-free rinse helps restore gum health, especially before or after oral surgery.

      Faithful To Nature Mouthwash

      Made with natural materials, this minty, cooling wash banishes bacteria and plaque build-up.

      Listerine Total Care Mild Mouthwash

      Also alcohol-free, this milder wash maintains healthy, strong teeth and gums.

      Test your gum health Ivohealth has a nifty quiz that gauges your gum sitch from just a few questions. Take the #HealthyGUMCheck to quickly assess your gum health, discover early indicators of disease and receive expert advice from a trusted oral health professional. Try it out here. Women’s Health participates in various affiliate marketing programmes, which means we may get commissions on editorially chosen products purchased through our links to retailer sites. More

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      Adult Bullying Often Goes Overlooked—Here’s How To Spot It And Shut It Down

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      When you think of bullying, high school drama might immediately come to mind: Perhaps you picture the girls you thought were your friends passing mean notes about you in class, or you replay the scene where Johnny Lawrence beats up Daniel LaRusso in the O.G. Karate Kid movie. Unfortunately, bullies don’t magically disappear on graduation day—many of them continue these habits through adult bullying.Causes Of BullyingBullies—both as children and adults—feel a need to dominate others for their own personal gain or satisfaction and can cause serious harm to their victims, says Bill Eddy. However, bullying has nothing to do with the victim and everything to do with the bully themselves, as they often have low confidence that causes them to behave this way, says Eddy. Perhaps the bully themself was abused from an early age and consequently, learned that bullying was the best way to handle conflict, he adds.Too much praiseOn the flip side, bullying can also stem from too much positive reinforcement. Someone who was overly praised as a child by their parents and their community “to the point where they think they can get away with injuring others” can easily become a bully, Eddy says. Because they’ve been told they can do no wrong, they might have a “my way or the highway attitude,” and anyone who doesn’t agree with them faces the consequences.Mental illnessAnother cause might be that the bully is genetically predisposed to a mental illness like narcissism, which can cause a lack of empathy, says Eddy. However, there’s a range of how severe the behaviour is. Similarly, those with borderline personality disorder often do have empathy but sometimes experience mood swings and anger that can cause them to bully others. However, just because someone struggles with narcissism or borderline personality disorder doesn’t automatically make them a bully, he adds.Bullying takes many formsBut while bullies may not mature with age, their methods evolve from typical school lunchroom drama. Experts say adult bullying takes many forms, such as unwanted touching, rumour spreading, insulting someone, yelling and online harassment, including sending threatening emails or texts. In fact, the existence of adult bullying and the profound impact it can have on victims is particularly troubling now since cyberbullies and trolls run rampant online, Eddy says.What’s more: Victims of work-related bullying can actually develop health-related issues as a result, according to research in Personality and Individual Differences. Bullying can wreak havoc on a person’s confidence, causing them to suffer from mental and physical problems like anxiety, depression, headaches, gastrointestinal problems and suicidal ideation, says Eddy. Victims are also sometimes driven to concerning behaviours, like binge drinking and eating, and overall, may feel disengaged from their life and the world around them, adds Roberta Fida, who co-wrote the study.While you’re likely bound to run into an adult bully now and again—that’s life—you don’t have to live in fear of mean comments from a frenemy or unfair office politics. Here’s how to identify all the different types of adult bullying and how to handle it in the workplace and beyond.READ MORE: People Pleasing Can Have Some Harmful Mental Health Effects — Experts Say This Is How To StopAdult bullying can take many forms.Adult bullying sometimes looks like outright yelling at someone or physically harming them, which are common behaviours in perpetrators of domestic violence, says Eddy. But it can also be more covert, like leaving someone off an important email thread at work.Here are the five main types of adult bullies:CyberbullyAs the name suggests, a cyberbully creates negative posts about another person or engages in “trolling” or other harmful behaviour online, says Eddy. This type of bully might comment rude things on someone’s post repeatedly, send someone direct messages full of insults, screenshot and share private text messages, or spread intimate photos. However, cyberbullies can also engage in more passive-aggressive behaviours, like leaving someone off a text chain with friends.While it may seem like there are more online trolls than ever in 2024, that’s actually not the case, according to Eddy. It’s just that “the small percent of people who are bullies are much louder and they feel free to bully,” he says. Plus, bullies are especially motivated when they’re anonymous, because they feel they can get away with it—cyberbullying lacks the face-to-face element of IRL bullying, which means people can be bolder online, safely hidden behind their screen.Verbal BullyThis bully uses words to shame, insult and distress their victim. They always have a critique or negative comment to say, sometimes even making snide remarks about your appearance, says Julie Robinson.This is the person who walks into their office meeting saying, “Someone smells in here,” alluding to their victim, she says. Even though the bully isn’t actually saying anything directly, this can still cause the victim to feel self-conscious. “They do this to undermine the confidence of the individual,” she says.Physical BullyThis type of bully uses their physical presence to threaten victims, says Robinson, and they can be extremely dangerous. Their behaviour can show up as physical abuse with a romantic partner, family member, or friend, such as hitting, pushing, hair pulling, or even sexual coercion or assault. But it can also be more subtle, like coming up behind a coworker and touching their shoulders or constantly bumping into someone in the hall on purpose to annoy them, says Robinson.Material BullyThis bully tries to withhold or take something from their victim. Maybe your boss doesn’t pay you on time or a coworker takes your favourite pen, your lunch, or even an idea or client at work, while your roommate steals your clothes or money at home, says Robinson.Passive Aggressive BullyThe passive-aggressive bully can be challenging to spot, as they generally try to stay under the radar, says Robinson. They use underhanded remarks to intimidate victims and break down their confidence. The behaviour may seem innocent to others, but it has malicious intentions, says Robinson. At work, maybe someone comes into the office and makes a comment about how another co-worker always seems to be having so much fun and not working. The passive-aggressive bully can also be the friend who always seems to “forget” to invite you to the group plans or add you to group chats.There are several ways to deal with bullying.VictimIf you are being bullied, hang in there—it can be challenging to deal with, but fortunately, there are many ways to find relief.Go to therapy. Talking to a professional is extremely important for victims because it can help you build your confidence and learn self-care techniques to help fill your cup, says Eddy. Through therapy, victims can also work on strategies to deal with their bully, Robinson adds.Use non-violent communication. By being calm and non-violent with your bully, you decrease the chances that they’ll become defensive. Try “I am” statements: If you have a workplace bully who frequently stands over your desk and makes passive-aggressive comments about whether you’re capable of hitting deadlines, for example, say, “I feel uncomfortable when you stand over my desk and make these comments, and I would like to talk through a solution for this,” Robinson suggests.

      Document the events. “It is important for targets to keep track of what happened and if there are witnesses,” says Fida. This is especially helpful in case you need to file a workplace bullying complaint with your Human Resources (HR) department. The more evidence—like screenshotting text messages or emails to yourself or even typing up notes (and marking the date and time) after interactions—the better position you’ll be in later on to file the complaint, adds Robinson.

      Leave the situation. If you are a victim of domestic violence and/or physical bullying, removing yourself from the situation as soon as possible is critical. That way, you’ll get out before the situation escalates further. If you’re in a toxic work environment that is not being adequately remediated, consider applying to jobs elsewhere, adds Robinson. While, of course, you shouldn’t have to leave a job that makes you happy (outside of these bullying interactions) and want to make a financially-sound decision, keep your mental health in mind and consider how it would feel to have this burden lifted.READ MORE: Here’s How To Actually Practise Mindfulness And Unlock Inner PeaceBystanderBystanders have the most power in bullying situations because they can diffuse what’s happening and provide support to the victim, says Eddy. Some tips from the experts:Speak up. If you witness bullying, pull the bully aside to separate them from the person and ask them if they intended to come off as harsh, says Eddy. Keeping the conversation light rather than accusatory can prevent the situation from getting worse, Eddy says. Additionally, bystanders of workplace harassment can also speak to HR and file a complaint detailing what they saw, says Fida.

      Talk to the victim. If you don’t feel comfortable speaking up in the moment because of work politics, family dynamics, or something else, try reaching out to the victim one-on-one, says Robinson. This can help the person feel supported and less alone, which can ease some of the mental and physical strain of bullying. You can tell them you are sorry that they are being bullied and validate how they are feeling, letting them know you see the behaviour too.

      Document what is happening. While it is important for the victim to record details of their own, any additional information the bystander can provide will only strengthen their complaint. If you are witness to something that made you feel uncomfortable or was out of line, even if you weren’t directly targeted, write down the facts of the event, including what happened and when. If the victim decides to file a complaint, you will be well-equipped to back them up.BullyIf you find yourself harming others physically or emotionally, here are some strategies you can use to find out why and then stop:Seek therapy. The challenging thing about bullies is that they don’t often take accountability or even acknowledge their wrongdoing. Therapy can help them develop these skills, in addition to identifying the root cause of their toxic behaviour and working to correct it, says Eddy.Take a deep breath. Deep breathing can have a bigger impact than you might think—it can help diffuse a situation and bring a person’s nervous system back to centre, says Robinson. If you find that you are very reactive or behaving in a way you don’t like, try to slow down, breathe and then address the situation later when you’re feeling a bit more level-headed, she adds.

      Walk away. If you find yourself engaging in harmful behaviour, remove yourself from the situation, the experts say. While it can be difficult to have the self-awareness to do so, it is an incredibly powerful move that will calm the situation immediately.Unfortunately, adult bullying may always exist, but so do the strategies to shut down this harmful behaviour.Meet the Experts: Bill Eddy, LCSW, is the co-founder of High Conflict Institute and the author of Our New World of Adult Bullies. Roberta Fida, PhD, is a professor at Aston Business School in Birmingham, England. Julie Robinson, PsyD, is a licensed marriage and family therapist and president of Las Vegas Therapy Center.This article written by Jacqueline Tempera first appeared on Women’s Health US. More