Category Archives: Medical

OVERCOME INSECURITY

PsychAlive

ANXIETY, CRITICAL INNER VOICE, ISOLATION AND LONELINESS, SELF DEVELOPMENT, SELF-DESTRUCTIVE BEHAVIOR, SELF-ESTEEM

By PsychAlive

Edited By Alex Santiago

We are called a narcissistic generation. We are told that technology and social media are giving us an inflated sense of self. But most of us don’t walk around feeling like we are all that great. In fact, there is one underlying emotion that overwhelmingly shapes our self-image and influences our behavior, and that is insecurity. If you could enter the minds of people around you, even the narcissistic ones, you’re likely to encounter ceaseless waves of insecurity. A recent survey found that 60 percent of women experience hurtful, self-critical thoughts on a weekly basis.

In their research, father-and-daughter psychologists Dr.’s Robert and Lisa Firestone used an assessment tool known as the Firestone Assessment for Self-Destructive Thoughts (FAST) to evaluate people’s self-attacks (or “critical inner voices”) along a continuum. What they found is that the most common self-critical thought people have toward themselves is that they are different – not in a positive sense, but in some negative, alienating way. Whether our self-esteem is high or low, one thing is clear; we are a generation that compares, evaluates and judges ourselves with great scrutiny. By understanding where this insecurity comes from, why we are driven to put ourselves down and how this viewpoint affects us, we can start to challenge and overcome the destructive inner critic that limits our lives.

Why am I so insecure? What causes insecurity?

There is an internal dialogue that accompanies our feelings of insecurity. This is called the “critical inner voice.” Dr. Lisa Firestone, who co-authored the book Conquer Your Critical Inner Voice wrote, “The critical inner voice is formed out of painful early life experiences in which we witnessed or experienced hurtful attitudes toward us or those close to us. As we grow up, we unconsciously adopt and integrate this pattern of destructive thoughts toward ourselves and others.”

So, what events or attitudes shape this inner critic? The experiences we have with our influential early caretakers can be at the root of our insecurity as adults. Imagine a child being yelled at by a parent. “You’re so spaced out! Can’t you figure anything out on your own?” Then, imagine the negative comments and attitudes parents express toward themselves. “I look terrible in this. I’m so fat.” These attitudes don’t even have to be verbalized to influence the child. A parent’s absence can leave children feeling insecure and believing there is something fundamentally wrong with them. An intrusive parent can cause children to become introverted or self-reliant in ways that make them feel insecure or untrusting of others. Studies have even shown that exaggerated praise can be damaging to a child’s self-esteem.

The reason for this is that children must feel seen for who they are in order to feel secure. A lot of our issues with insecurity can come from our early attachment style. Dr. Daniel Siegel, author of Parenting from the Inside Out, says the key to healthy attachment is in the four S’s, feeling safe, seen, soothed and secure. Whether children are being shamed or praised, they are, most likely, not feeling seen by the parent for who they really are. They may start to feel insecurity and lose a sense of their actual abilities.

A healthy attitude for parents to maintain is to see themselves and their children realistically and to treat them with acceptance and compassion. The best way a parent can support their children is to allow them to find something that is unique to them – something that lights them up and that they will work to achieve. This activity must appeal to the child’s interest, not just the parents. As author and civil rights leader Howard Thurman famously said, ““Don’t ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive.”

As the child pursues whatever interest makes them “come alive,” the parent should offer support and acknowledgment for the effort involved as opposed to focusing too much on the result. It’s the difference between saying “What a stunning picture. You are the best artist I’ve seen” and saying, “I love the way you used so many colors. It’s awesome that you worked so hard on this. What gave you that idea?” This practice helps a child establish a sense of self-worth.

The Effect of Insecurity

It’s clear that there are many things that shape our critical inner voice, from negative attitudes directed toward us to attitudes our parents had toward themselves. As we get older, we internalize these points of view as our own. We keep these attitudes alive by believing in our insecurities as we go along in life. The most common critical inner voices Dr.’s Robert and Lisa Firestone found people to experience throughout their day include:

  • You’re stupid.
  • You’re unattractive.
  • You never get anything right.
  • You’re not like other people.
  • You’re a failure.
  • You’re fat.
  • You’re such a loser.
  • You’ll never make friends.
  • No one will ever love you.
  • You’ll never be able to quit drinking (smoking etc).
  • You’ll never accomplish anything.
  • What’s the point in even trying?

Like a mean coach, this voice tends to get louder as we get closer to our goals. “You’re gonna screw up any minute. Everyone will realize what a failure you are. Just quit before it’s too late.” Oftentimes, we react to these thoughts before we even realize we are having them. We may grow shy at a party, pull back from a relationship, project these attacks onto the people around us or act out toward a friend, partner or our children. Just imagine what life would be like if you didn’t hear any of these mean thoughts echo in your head. Imagine what reality might actually look like if you could live free of this prescribed insecurity.

Insecurity at Work

Insecurity can affect us in countless areas of our lives. Every person will notice their inner critic being more vocal in one area or another. For example, you may feel pretty confident at work but completely lost in your love life or vice versa. You may even notice that when one area improves, the other deteriorates. Most of us can relate, at one time or another, to having self-sabotaging thoughts toward ourselves about our career. Old feelings that we are incompetent or that we will never be acknowledged or appreciated can send our insecurities through the roof. Some common critical inner voices about one’s career include:

  • You don’t know what you’re doing.
  • Why do they expect you to do everything yourself?
  • Who do you think you are? You’ll never be successful.
  • You’re under too much pressure. You can’t take it.
  • You’ll never get everything done. You’re so lazy.
  • You should just put this off until tomorrow.
  • No one appreciates you.
  • You’d better be perfect, or you’ll get fired.
  • Nobody likes you here.
  • Put your career first. Don’t take time for yourself.
  • When are you ever going to get a real job?
  • No one would hire you.

Insecurity in Relationships

Whether we are single, dating or in a serious, long-term relationship, there are many ways our critical inner voice can creep in to our romantic lives. Relationships, in particular, can stir up past hurts and experiences. They can awaken insecurities we’ve long buried and bring up emotions we don’t expect. Moreover, many of us harbor unconscious fears of intimacy. Being close to someone else can shake us up and bring these emotions and critical inner voices even closer to the surface. Listening to this inner critic can do serious damage to our interpersonal relationships. It can cause us to feel desperate toward our partner or pull back when things start to get serious. It can exaggerate feelings of jealousy or possessiveness or leave us feeling rejected and unworthy. Common critical inner voices we have toward ourselves about relationships include:

  • You’re never going to find another person who understands you.
  • Don’t get too hooked on her.
  • He doesn’t really care about you.
  • She is too good for you.
  • You’ve got to keep him interested.
  • You’re better off on your own.
  • As soon as she gets to know you, she will reject you.
  • You’ve got to be in control.
  • It’s your fault if he gets upset.
  • Don’t be too vulnerable or you’ll just wind up getting hurt.

How Can I Overcome Insecurity?

Once we have a better sense of where our insecurity comes from and the profound influence it is having on our lives, we can begin to challenge it. We can start by interrupting the critical inner voice process. Voice Therapy is a cognitive/affective/behavioral approach developed by Dr. Robert Firestone to help people overcome their critical inner voice. There are five important steps to this process, which I will briefly outline.

Step I

The first step of Voice Therapy involves vocalizing your self-critical thoughts in the second person. You can also write down these thoughts. Instead of writing “I am so stupid. What is the matter with me? I’ll never be successful,” you would write, “You are so stupid. You will never be successful.” This process helps you to separate from these vicious attacks by seeing them as an external enemy instead of your real point of view. This process can also be an emotional one, as saying these statements can bring up underlying feelings from the past.

Step II

In the second step, you can start to think and talk about the insights and reactions you have to exposing these mean thoughts. Do they remind you of anyone or anything from your past? It can be helpful to uncover the relationship between these voice attacks and the early life experiences that helped shape them. This too will allow you to feel some self-compassion and reject these attitudes as accurate reflections of who you are.

Step III

People often struggle with the third step of this process, because it involves standing up to long-held beliefs and insecurities about oneself. You will answer back to your voice attacks, expressing your real point of view. You can write down rational and realistic statements about how you really are. Respond to your attacks the way you would to a friend who was saying these things about him or herself, with compassion and kindness.

Step IV

In step five of Voice Therapy, you start to make a connection between how the voice attacks are influencing your present-day behaviors. How do they affect you at work? With your partner? As a parent? In your personal ambitions? Do they undermine you? What events trigger the insecurity? In what areas is this insecurity most influential?

Step V

The final step involves making a plan to change these behaviors. If insecurity is keeping you from asking someone on a date or going after a promotion, it’s time to do the actions anyway. If you’re indulging in self-hating thoughts that encourage you to engage in self-destructive behaviors, it’s time to interrupt these behaviors and unleash the real you.

This process will not be easy. With change always comes anxiety. These defenses and critical inner voices have been with you your whole life, and they can feel uncomfortable to challenge. When you do change, expect the voices to get louder. Your insecurities aren’t likely to vanish overnight, but slowly, through perseverance, they will start to weaken. Whenever you notice an attack come up, stand up to it and don’t indulge in its directives. If you want to be healthy, don’t let it lure you to avoid exercise. If you want to get closer to your partner, don’t listen when it tells you to hold back your affections.

Join Dr. Lisa Firestone for a Webinar on Overcoming Insecurity

As you sweat through this tough but very worthy transition, it is important to practice self-compassion. Research by Dr. Kristin Neff found self-compassion to be far more psychologically beneficial than self-esteem. Self-esteem still focuses on evaluation and performance, where self-compassion encourages an attitude of kindness and patience. Self-esteem can increase our levels of insecurity, where self-compassion asks us to slow down and assign ourselves value simply for being human. Once we realize our own strength and importance, once we see the ways we’ve been hurt and can feel for ourselves on a deep level, we can actually start to break free of the chains that hold us back. We can shed the insecurities of our past and become the people we want to be.Share the knowledge!

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DANGEROUS SIDE EFFECTS OF SMOKING MARIGUANA

Edited By Alex Santiago

Marijuana is made from the shredded and dried parts of the cannabis plant, including the flowers, seeds, leaves, and stems. It’s also known as pot, weed, hash, and dozens of other names. While many people smoke or vape it, you can also consume marijuana as an ingredient in food, brewed tea, or oils.

Different methods of taking the drug may affect your body differently. When you inhale marijuana smoke into your lungs, the drug is quickly released into your bloodstream and makes its way to your brain and other organs. It takes a little longer to feel the effects if you eat or drink marijuana.

There is ongoing controversy around the effects of marijuana on the body. People report various physical and psychological effects, from harm and discomfort to pain relief and relaxation.

Here’s what happens to your body when this drug enters your bloodstream.

Marijuana can be used in some states for medical reasons, and in some areas, recreational use is legal as well. No matter how you use marijuana, the drug can cause immediate and long-term effects, such as changes in perception and increased heart rate. Over time, smoking marijuana may cause chronic cough and other health issues.

The effects of marijuana on the body are often immediate. Longer-term effects may depend on how you take it, how much you use, and how often you use it. The exact effects are hard to determine because marijuana has been illegal in the U.S., making studies difficult and expensive to conduct.

But in recent years, the medicinal properties of marijuana are gaining public acceptance. As of 2017, 29 states plus the District of Columbia have legalized medical marijuana to some extent. THC and another ingredient called cannabidiol (CBD) are the main substances of therapeutic interest. The National Institutes of HealthTrusted Source funded research into the possible medicinal uses of THC and CBD, which is still ongoing.

With the potential for increased recreational use, knowing the effects that marijuana can have on your body is as important as ever. Read on to see how it affects each system in your body.

Respiratory system

Much like tobacco smoke, marijuana smoke is made up of a variety of toxic chemicals, including ammonia and hydrogen cyanide, which can irritate your bronchial passages and lungs. If you’re a regular smoker, you’re more likely to wheeze, cough, and produce phlegm. You’re also at an increased risk of bronchitis and lung infections. Marijuana may aggravate existing respiratory illnesses, such as asthma and cystic fibrosis.

Marijuana and COPD: Is there a link? »

Marijuana smoke contains carcinogens, so it may increase your risk of lung cancer too. However, studies on the subject have had mixed results. According to the National Institute of Drug Abuse (NIDA), there is no conclusive evidence that marijuana smoke causes lung cancer. More research is needed.

Circulatory system

THC moves from your lungs into your bloodstream and throughout your body. Within minutes, your heart rate may increase by 20 to 50 beats per minute. That rapid heartbeat can continue for up to three hours. If you have heart disease, this could raise your risk of heart attack.

One of the telltale signs of recent marijuana use is bloodshot eyes. The eyes look red because marijuana causes blood vessels in the eyes to expand.

THC can also lower pressure in the eyes, which can ease symptoms of glaucoma for a few hours. More research is needed to understand the active ingredients in marijuana and whether it’s a good treatment for glaucoma.

What’s the impact of cannabis on health?

In the long term, marijuana has a possible positive effect on your circulatory system. Research Trusted Source isn’t conclusive yet, but marijuana may help stop the growth of blood vessels that feed cancerous tumors. Opportunities exist in both cancer treatment and prevention, but more research is needed.

Central nervous system

The effects of marijuana extend throughout the central nervous system (CNS). Marijuana is thought to ease pain and inflammation and help control spasms and seizures. Still, there are some long-term negative effects on the CNS to consider.

THC triggers your brain to release large amounts of dopamine, a naturally occurring “feel good” chemical. It’s what gives you a pleasant high. It may heighten your sensory perception and your perception of time. In the hippocampus, THC changes the way you process information, so your judgment may be impaired. The hippocampus is responsible for memory, so it may also be difficult to form new memories when you’re high.

Changes also take place in the cerebellum and basal ganglia, brain areas that play roles in movement and balance. Marijuana may alter your balance, coordination, and reflex response. All those changes mean that it’s not safe to drive.

Very large doses of marijuana or high concentrations of THC can cause hallucinations or delusions. According to the NIDA, there may be an association between marijuana use and some mental health disorders like depression and anxiety. More research is needed to understand the connection. You may want to avoid marijuana if you have schizophrenia, as it may make symptoms worse.

When you come down from the high, you may feel tired or a bit depressed. In some people, marijuana can cause anxiety. About 30 percent of marijuana users develop a marijuana use disorder. Addiction is considered rare, but very real. Symptoms of withdrawal may include irritability, insomnia, and loss of appetite.

In people younger than 25 years, whose brains have not yet fully developed, marijuana can have a lasting impact on thinking and memory processes. Using marijuana while pregnant can also affect the brain of your unborn baby. Your child may have trouble with memory, concentration, and problem-solving skills.

Digestive system

Smoking marijuana can cause some stinging or burning in your mouth and throat while you’re inhaling.

Marijuana can cause digestive issues when taken orally. For example, oral THC can cause nausea and vomiting because of the way it’s processed in your liver. It may also damage your liver.

Conversely, marijuana has also been used to ease symptoms of nausea or upset stomach.

An increase in your appetite is common when taking any form of marijuana, leading to what many call “the munchies.” This is considered a benefit for people being treated with chemotherapy for cancer. For others who are looking to lose weight, this effect could be considered a disadvantage.

Immune system

THC may adversely affect your immune system. Studies Trusted Source involving animals showed that THC might damage the immune system, making you more vulnerable to illnesses. Further research is needed to fully understand the effects.

38 SINGS OF A TOXIC RELATIONSHIP? GET HELP NOW

Edited By Alex Santiago

Is Your Relationship Toxic?

When you’re in a healthy relationship, everything just kind of works. Sure, there are bumps in the road, but you generally make decisions together, openly discuss any problems that arise, and genuinely enjoy each other’s company.

Toxic relationships are another story. And when you’re in one, it can be harder to see red flags.

If you consistently feel drained or unhappy after spending time with your partner, it could be a sign that things need to change, says relationship therapist Jor-El Caraballo.

Here’s a look at some hallmark signs of toxicity in a relationship and what to do if you recognize them in your relationship.

What does it look like?

Depending on the nature of the relationship, signs of toxicity can be subtle or highly obvious, explains Carla Marie Manly, PhD, author of “Joy from Fear.”

If you’re in a toxic relationship, you may recognize some of these signs in yourself, your partner, or the relationship itself.

Lack of support

Your time together has stopped being positive or supportive of your goals.

“Healthy relationships are based on a mutual desire to see the other succeed in all areas of life,” Caraballo says. But when things turn toxic, every achievement becomes a competition.

In other words, you don’t feel like they have your back.

Toxic communication

Instead of treating each other with kindness, most of your conversations are filled with sarcasm, criticism, or overt hostility. You may even start avoiding talking to each other.

Jealousy

While it’s normal to experience jealousy from time to time, Caraballo explains it can become an issue if you can’t get yourself to think or feel positively about their success.

Controlling behaviors

Questioning where you are all the time or becoming overly upset when you don’t immediately answer texts are both signs of controlling behavior, which can contribute to toxicity in a relationship.

In some cases, these attempts of control over you can be a sign of abuse (more on this later).

Resentment

Holding on to grudges and letting them fester chips away at intimacy.

“Over time, frustration or resentment can build up and make a smaller chasm much bigger,” Caraballo notes.

Dishonesty

You find yourself constantly making up lies about your whereabouts or who you meet up with to avoid spending time with your partner.

Patterns of disrespect

Being chronically late, casually “forgetting” events, and other behaviors that show disrespect for your time are a red flag, Manly says.

Negative financial behaviors

Your partner might make financial decisions, including purchasing big-ticket items or withdrawing large sums of money, without consulting you.

Constant stress

A normal amount of tension runs through every relationship, but finding yourself constantly on edge is an indicator that something’s off.

This ongoing stress can take a toll on your physical and emotional health.

Ignoring your needs

Going along with whatever your partner wants to do, even when it goes against your wishes or comfort level, is a sure sign of toxicity, says clinical psychologist Catalina Lawsin, PhD.

For example, you might agree to a vacation they planned, either intentionally or unintentionally, for dates that aren’t convenient for you.

Lost relationships

You’ve stopped spending time with friends and family, either to avoid conflict with your partner or to get around having to explain what’s happening in your relationship.

Alternatively, you might find your free time is wrapped up in dealing with your partner.

Lack of self-care

In a toxic relationship, you might let go of your usual self-care habits, Lawsin explains.

You might withdraw from hobbies you once loved, neglect your health, and sacrifice your free time.

Hoping for change

You might stay in the relationship because you see the other person’s potential or think that if you just change yourself and your actions, they’ll change as well.

Walking on eggshells

You worry that by bringing up problems, you’ll provoke extreme tension, so you become conflict avoidant and keep any issues to yourself.

Can the relationship be saved?

Many people assume that toxic relationships are doomed, but that isn’t always the case.

The deciding factor? Both partners must want to change, Manly says. “If only one partner is invested in creating healthy patterns, there is —unfortunately — little likelihood that change will occur,” she explains.

Here are a few other signs that you might be able to work things out.

Willingness to invest

You both display an attitude of openness and willingness to invest in making the relationship better.

“This may manifest by an interest in deepening conversations,” Manly says, or setting aside regular blocks of time for spending quality time together.

Acceptance of responsibility

Recognizing the past behaviors that have harmed the relationship is vital on both ends, Manly adds. It reflects an interest in self-awareness and self-responsibility.

Shift from blaming to understanding

If you’re both able to steer the conversation away from blaming and more toward understanding and learning, there may be a path forward.

Openness to outside help

This is a big one. Sometimes, you might need help to get things back on track, either through individual or couples counseling.

How can we move forward?

According to Manly, repairing a toxic relationship will take time, patience, and diligence.

This is especially the case, Manly adds, “given that most toxic relationships often occur as a result of longstanding issues in the current relationship, or as a result of unaddressed issues from prior relationships.”

Here are some steps for turning things around.

Don’t dwell on the past

Sure, part of repairing the relationship will likely involve addressing past events. But this shouldn’t be the sole focus of your relationship moving forward.

Resist the temptation to constantly refer back to negative scenarios.

View your partner with compassion

When you find yourself wanting to blame your partner for all the problems in the relationship, try taking a step back and looking at the potential motivators behind their behavior, Caraballo says.

Have they been going through a hard time at work? Was there some family drama weighing heavily on their mind?

These aren’t excuses for bad behavior, but they can help you come to a better understanding of where your partner’s coming from.

Start therapy

An openness to therapy can be a good sign that things are mendable. Actually following through on this can be key to helping the relationship move forward.

While couples counseling is a good starting point, individual therapy can be a helpful addition, Manly says.

Find support

Regardless of whether you decide to try therapy, look for other support opportunities.

Maybe this involves talking to a close friend or joining a local support group for couples or partners dealing with specific issues in their relationship, such as infidelity or substance misuse.

Practice healthy communication

Pay close attention to how you talk to each other as you mend things. Be gentle with each other. Avoid sarcasm or mild jabs, at least for the time being.

Also focus on using “I” statements, especially when talking about relationship issues.

For example, instead of saying “You don’t listen to what I’m saying,” you could say “I feel like you aren’t listening to me when you take out your phone while I’m talking.”

Be accountable

“Both partners must acknowledge their part in fostering the toxicity,” Lawsin emphasizes.

This means identifying and taking responsibility for your own actions in the relationship. It’s also about being present and engaged during difficult conversations.

Heal individually

It’s important for each of you to individually determine what you need from the relationship and where your boundaries lie, Lawsin advises.

Even if you feel like you already know what your needs and boundaries are, it’s worth revisiting them.

The process of rebuilding a damaged relationship offers a good opportunity to reevaluate how you feel about certain elements of the relationship.

Hold space for the other’s change

Remember, things won’t change overnight. Over the coming months, work together on being flexible and patient with each other as you grow.

Abuse vs. toxicity

Toxicity in a relationship can take many forms, including forms of abuse. There’s never an excuse for abusive behavior. You’re unlikely to change your partner’s behavior on your own.

Abuse comes in many shapes and sizes. This can make it hard to recognize, especially if you’ve been in a long-term, toxic relationship.

The following signs suggest physical or emotional abuse. If you recognize any of these in your relationship, it’s probably best to walk away.

This is easier said than done, but we’ve got some resources that can help at the end of this section.

Diminished self-worth

Your partner blames you for everything that goes wrong and makes you feel as if you can’t do anything right.

“You end up feeling small, confused, shamed, and often exhausted,” Manly says. They may do this by patronizing, dismissing, or embarrassing you in public.

Chronic stress and anxiety

It’s normal to have periods of frustration with your partner or doubts about your future together. But you shouldn’t be spending significant amounts of time worrying about the relationship or your safety and security.

Separation from friends and family

Sometimes, dealing with a toxic relationship can cause you to withdraw from friends and family. But an abusive partner may forcefully distance you from your support network.

For example, they might unplug the phone while you’re talking or get in your face to distract you. They may also convince you that your loved ones don’t want to hear from you, anyway.

Interference with work or school

Forbidding you from seeking employment or studying is a way to isolate and control you.

They may also attempt to humiliate you at your workplace or school by causing a scene or talking to your boss or teachers.

Fear and intimidation

An abusive partner might explode with rage or use intimidation tactics, such as slamming their fists into walls or not allowing you to leave the house during a fight.

Name-calling and put-downs

Insults aimed to humiliate and belittle your interests, appearance, or accomplishments are verbal abuse.

Below are some examples of what things a verbally abusive partner might say:

  • “You’re worthless.”
  • “You can’t do anything right.”
  • “No one else could ever love you.”

Financial restriction

They may control all the money that comes in and prevent you from having your own bank account, restricting access to credit cards, or only giving you a daily allowance.

Gaslighting

Gaslighting is a technique that makes you question your own feelings, instincts, and sanity.

For example, they may try to convince you that they’ve never abusive, insisting it’s all in your head. Or they may accuse you of being the one with anger and control issues by acting like the victim.

Threats of self-harm

Threatening suicide or self-harm as a way to pressure you into doing things is a form of manipulation and abuse.

Physical violence

Threats and verbal insults can escalate to physical violence. If your partner is pushing, slapping, or hitting you, it’s a clear sign that the relationship has become dangerous.

Get help now

If you suspect you might be in an abusive relationship, trust your instincts and know you don’t have to live this way.

Here are some resources that can help you safely navigate next steps:

  • The National Domestic Violence Hotline provides services at no cost and offers 24/7 chat and phone support.
  • Day One is a nonprofit organization that works with youth to end dating abuse and domestic violence through community education, supportive services, legal advocacy, and leadership development.
  • Break the Cycle provides services to young people and adults in peer-to-peer abusive relationships.
  • DomesticShelters.org is a mobile-friendly, searchable directory that can help you quickly find domestic violence programs and shelters in the United States and Canada.
Healthline

Cindy Lamothe

Cindy Lamothe is a freelance journalist based in Guatemala. She writes often about the intersections between health, wellness, and the science of human behavior. She’s written for The Atlantic, New York Magazine, Teen Vogue, Quartz, The Washington Post, and many more. Find her at cindylamothe.com.

Last medically reviewed on November 11, 2019

HOW A PILL COULD SPELL THE END OF AGEING

The science of senolytics: how a new pill could spell the end of ageing

‘In England and Wales, life expectancy has risen by almost 25 years in the past century …’ Illustration: Guardian Design/Getty

A simple treatment to stave off the health problems of old age could be available in five to 12 years. Here’s how it would work

Amy Fleming

Amy Fleming Mon 2 Sep 2019 06.00 EDT

Edited By Alex Santiago

The science of extending life is a subject of morbid fascination, conjuring the image of old billionaires being cryogenically frozen. But imagine if, instead of a pill you could take to live for ever, there was a pill that could push back the ageing process – a medicine that could stave off the fragility, osteoarthritis, memory loss, macular degeneration and cancers that plague old age.

It could happen, with the science of senolytics: an emerging – and highly anticipated – area of anti-ageing medicine. Many of the world’s top gerontologists have already demonstrated the possibilities in animals and are now beginning human clinical trials, with promising results. If the studies continue to be as successful as hoped, those who are currently middle-aged could become the first generation of oldies who are youthful for longer – with a little medical help.

Most scientists studying longevity are more concerned with prolonging what they call “healthspan” than they are lifespan: that is to say, helping people to age with less pain and illness, with a better quality of life. Not only would this be good for old people, but in these times of booming elderly populations worldwide, it would be great for economies.

In England and Wales, life expectancy has risen by almost 25 years in the past century; the Office for National Statistics predicts that the UK’s population of over-65-year-olds will grow by 8.6 million (about the population of London) over the coming 50 years. This will be expensive: the NHS spends more than twice as much on 65-year-olds as it does on 30-year-olds; 85-year-olds cost more than five times as much.

Dr Ming Xu.
Dr Ming Xu. Photograph: The Mayo Clinic

“Healthy ageing is a huge project – it can come with a lot of benefits, both for governments and older patients themselves,” says Ming Xu, an assistant professor at the University of Connecticut’s Centre on Ageing. Ageing, as Xu notes, is the biggest risk factor for most chronic diseases; the goal of his lab is to unearth novel interventions to slow down the ageing process and simultaneously prevent the diseases.

Xu is at work on senolytics, a branch of medicine that targets senescent cells; the various faulty cells that have been identified as instrumental in our eventual demise. These so-called “zombie” cells linger and proliferate as we age, emitting substances that cause inflammation and turn other healthy cells senescent, ultimately leading to tissue damage throughout the body.

Xu was part of a team at the Mayo Clinic, an academic medical centre in Minnesota, that showed in 2011 that “using a genetic trick to get rid of these senescent cells can significantly improve health and lifespan” in prematurely aged mice. In 2016, the same group achieved similar results in naturally aged mice, releasing an arresting image of two elderly rodents born of the same litter. The one cleared of its senolytic cells seems spry and glossy, while its sibling is shrunken, greying and looks its age.

Litter-mates, almost two years old; the mouse on the right had its senescent cells cleared and appears younger than the mouse on the left.
Litter-mates, almost two years old; the mouse on the right had its senescent cells cleared and appears younger than the mouse on the left. Photograph: Jan van Deursen

The picture alone helped bring in millions from investors including Jeff Bezos and PayPal co-founder Peter Thiel, who saw the promise of replicating the same results in humans. Kevin Perrott, president of the Washington DC-based Global Healthspan Policy Institute, said in 2018 that the response showed that Silicon Valley tended to view ageing as a problem that could be solved “with enough time and enough steps”: “The size of the return is huge. If you’re able to bring anything like that to the market, you have something that’s universally needed.”

However, the “genetic trick” used to destroy senescent cells in the mouse studies was not viable as a safe treatment for people, so a new company, called Unity Biotech, was formed to raise funds to develop medicine that could safely clear zombie cells from the human body.

The first hurdle – for them, and the other scientists investigating the unknown intricacies of senolytics – was identifying what, exactly, they were trying to treat. In order for a drug to be approved, it has to be shown to be effective in treating a disease; but ageing is a natural built-in process, and, far from a localised problem, it involves complex systemic degradation.

Trials in senolytics are initially targeting specific conditions such as age-related macular degeneration, glaucoma and chronic obstructive pulmonary disease (which includes emphysema). Most are in the fledgling stages, working on rodents or human tissue in petri dishes, although in February a small early human trial showed an improvement in the distance patients were able to walk.

Also this year, a pre-clinical pilot trial for injecting a senolytic drug into the knees of people with osteoarthritis showed promising, if mixed results. In the first part of the study, where patients received varying doses of the drug, significant improvements in pain and function were observed, whereas the second experiment, in which patients received the maximum dose, didn’t see significant benefits. It is hoped that, eventually, there will be a number of senolytic drugs that could potentially target different senescent cell types, but currently much of the research has involved a combination of a leukaemia drug called dasatinib and quercetin, a polyphenol common in plants.

Dr Sebastian Grönke.
Dr Sebastian Grönke. Photograph: Max Planck Institute for Biology of Ageing

This is an extremely new field of research. “That’s why there’s so much interest,” says Sebastian Grönke at the Max-Planck Institute for Biology of Ageing in Cologne. Senolytics are particularly exciting, he says, because “they seem to still work very late in life” … “So it will be possible to study more quickly whether they actually work in humans, and they are applicable to people already at the end of their lives.”

Xu says that, in theory at least, it should prove impossible to build up a resistance to the drugs, “because senescent cells cannot proliferate”. Even more importantly, he says, there is significant data to show “that you don’t have to treat these patients every single day. You just treat them once a week or once a month … intermittent treatment is more than enough to have huge benefits.”

Senolytic drugs may also be able to play a part in other conditions. Xu has found that obesity can cause senescent cells to develop prematurely. “We also found that clearing senescent cells improves insulin sensitivity. So senolytic drugs not only work on ageing but also on obesity … Senescence is a connection between these two very common conditions.” While treating obese mice with senolytics, Xu observed that their anxiety levels reduced, too.

These aren’t the only potential added benefits. Grönke says that senescent cells “play a big role after cancer treatment”, developing as a result of chemotherapy and radiation therapy. “If senolytics can be used to help eliminate the damaged cells before they can spread, a detrimental side-effect of cancer treatment could be alleviated.”

Xu usually administers senolytics to mice at their equivalent of 70 to 80 years old in humans. “You don’t want to take it when you’re young, which would have zero effect, or harmful effects – but you don’t want to leave it too late. When to start giving the drug is a huge project and a huge question for us to answer over the next several decades.” He expects the ideal treatment age will differ from person to person, and that ultimately scientists will develop a blood or urine test that can assess the level of senescence present. “Some people age very fast, and some age very slow, so it could vary a lot,” he says.

So what can anyone determined to hold off the debilitating effects of age do while we await the wonder drugs? Intermittent fasting may have senescent effects. Grönke says caloric restriction, whereby “people eat less in general”, has been linked to healthy ageing and longevity. Mouse trials have shown that they can live 30 to 50% longer than control animals able to eat as much as they want. “It’s also well known that these animals have less senescent cells at comparable ages.” There is also a diet, developed by the gerontologist Valter Longo at the University of Southern California, that mimics the effects of fasting for those too frail to skip meals.

Of course, the risks of disease that increase with ageing are heightened by sedentary living, alcoholism and bad diet. Grönke recommends, along with a healthy diet, “reducing the amount of animal protein you consume – you can eat meat but ideally maybe once per week, maximum.” He says an association between low protein intake and longevity is well established in humans. “Ideally the protein should come from vegetables and not from meat.”

Just as obesity has been shown to increase the burden of senescent cells in tissue, exercise can reduce it, says Xu. But the effects were recorded in obese mice that had undergone a lot of vigorous exercise: “I don’t think the aged population is able to take intense exercise like that.”

So some signs are promising, and the potential is huge, but much still remains unknown about senolytics for ageing. There are clinical trials in the pipeline, with drugs for osteoarthritis leading the way, but an effective pill accessible to all is certainly not imminent. Xu puts it at five to 12 years away: “Theoretically I’m confident.” Those looking to live for ever might be wise to book that cryogenics appointment, just in case.