A Total-Body Resistance Band Workout You Can Do Anywhere

Resistance bands are one of the most versatile strength-training tools out there. Unlike dumbbells or kettlebells, which are obviously great but are large and heavy, resistance bands are small, lightweight, and easy to tote around wherever your workouts take you. They can be used to work pretty much every body part. And they don’t put much pressure on your joints.

“Think about pressing a heavy dumbbell overhead and then quickly bending at the elbow to return to neutral. All the weight comes down into your elbow joint,” Melody Scharff, a certified personal trainer at Fhitting Room in New York City, tells SELF. For some people, that can be uncomfortable or cause problems over time. When you use resistance bands, on the other hand, you maintain constant tension in the concentric (lifting) and eccentric (lowering) part of an exercise, so there’s no external load putting extra pressure on you. You also are in full control of the resistance, eliminating the change you’ll take on more than you can handle and risk injuring yourself.

Scharff adds that because of this, and because of their versatility, resistance bands are great for so many different groups of people. “I think they are a super approachable tool, so they are good for anyone just getting started in their workout journey. They are super portable so they are good for anyone who travels,” she says.

To help you reap the benefits of resistance bands, Scharff put together a full-body workout that uses nothing more than your bodyweight and a resistance band.

The overall goal of the workout is to work many different muscle groups—”this leads to a more efficient workout,” Scharff says. “In a full-body program like this, we move from one area of the body to another to allow for recovery while we’re still working.” To get the full benefits, Scharff suggests taking minimal breaks in between each exercise. “Not only are you getting stronger, but the constant movement and change from move to move is really going to keep your heart rate up.” After each round and each circuit, rest for about 60 seconds. (Though if you need to rest more, that’s totally OK. Do what feels best for your body.)

Scharff recommends beginners try this workout two to three times a week to reap the strength-building benefits. If you’re a more advanced exerciser, try choosing a circuit or two to mix into a longer workout.

Modeling the workout below is Teresa Hui, a native New Yorker who has run over 150 road races. She will be running her 12th consecutive New York City Marathon this upcoming November, which will also be her 16th full marathon.

The Workout

What you’ll need: One light-to-moderate weight looped resistance band, and one light-to-moderate weight resistance band with handles. You can also use a plain resistance band without handles (it is just not as easy to hold onto). There are lots of options here.

Directions

Bodyweight warm-up:

  • Inchworm—5 reps
  • Shoulder Tap—10 reps
  • Squat Thrust—15 reps
  • Air Squat—20 reps
  • Do 3 rounds.

Circuit #1:
Do each exercise for 45 seconds. At the end of each round, do 10 jump squats. Do three rounds.

  • Resistance Band Bicep Curl
  • Plank Up-Down (no band)
  • Resistance Band Lateral Walk
  • Resistance Band Glute Bridge
  • Jump squat (no band) — 10 reps
  • Do 3 rounds.

Circuit #2:
Do each exercise for 45 seconds. At the end of each round, do 20 jump lunges. Do three rounds.

  • Resistance Band Lat Pulldown
  • Push-up (no band)
  • Resistance Band Kneeling Crunch
  • Jump lunge — 20 reps
  • Do 3 rounds.

Circuit #3:
Do each exercise for 45 seconds. At the end of each round, do 10 jump squats. Do three rounds.

  • Resistance Band Upright Row
  • Resistance Band Hinged Row
  • Resistance Band Glute Kickback
  • Resistance Band Thruster
  • Jump Squat (no band) — 10 reps
  • Do 3 rounds.

Here’s how to do each move:

5 Ways to Ease Your Partner Into Trying Bondage and Kink

I’m not going to lie, talking about BDSM with a partner who hasn’t tried kinky sex of any kind in the past can be pretty awkward. There is potential for a lot of feelings when it comes to opening up your sex life to new possibilities and adventures. Luckily, I have a ton of experience in this area.

Fear and discomfort around bondage and kink typically come out of misunderstanding what BDSM is—and is not. It kind of feels like there is a “people who do kink” camp and then a “vanilla people” camp. It really isn’t this way at all. Kink is super accessible to everyone—and a lot of us have either tried it or wanted to. If you’ve been having fantasies about tying your partner up, getting spanked, being spanked, getting blindfolded, etc., that is completely normal.

If you want to get your partner involved in bringing your BDSM fantasies to life, here my expert tips for making the process less painful in the bad way and more painful in the good way.

1. Do some homework.

I’m not suggesting you need to become a connoisseur of kink in order to give kink a try. What I am suggesting is that you do your research to help you understand what’s out there and to home in on what looks good to you. It will be easier to ask for what you want if you actually know what you want to try. If your partner asks, “Why does this appeal to you?” or “What do you want to do?” you should be able to provide a reasonable answer.

If you’d like some excellent resources on BDSM, listen to Tina Horn’s podcast, Why Are People Into That?, which lets you hear from real people in the kink lifestyle so you can pick up some great advice and tips. Two Knotty Boys, authors of Showing You the Ropes, will inspire anyone interested in tying up their partner or visa versa—and who want to get really good at it!

You can even take a class from people within the BDSM community who know their stuff. If you live in a major city, check out your local feminist sex shops. The Pleasure Chest and Babeland give free weekly classes on everything from kink to anal.

If you’re in a less kink-friendly area, watch a few documentaries. Turned On is available on Netflix and can give you some excellent tips for spanking, bondage, and much more. Other great options are Kink, produced by James Franco, and Beyond Vanilla. Admittedly, these last two are pretty intense, but they have the information you need.

2. Approach the conversation with empathy and a sense of collaboration.

When you broach the topic of kink, do so with a lot of empathy and understanding. Be ready for many emotions. Your partner may be enthusiastic, terrified, angry, hurt, confused, turned on, excited, or a combination of these feelings.

Be ready to open up about your desires. Make the conversation focused on the two of you. Tell your partner how much it would turn you on to be spanked or have your hands tied together (or whatever it is you want). Bondage is not about physically and emotionally harming one another, it’s about a consensual exchange of power between two loving, consenting adults. Explain this element to your partner.

This conversation should be centered around the exciting, new sexual boundaries you can push together in a safe way. Honestly, this awkward chat can wind up being foreplay.

3. Discuss desires and boundaries.

After you’ve broached the topic of giving bondage and kink a try, open up the dialogue to include what each of you would be open to trying. Everyone’s feelings and interests must be respected in order for this to work.

For instance, if you’re interested in spanking, are you the one who wants to be spanked or do you want to do the spanking? How does your partner feel about spanking and what role do they see themselves playing in said spanking scene?

BDSM isn’t hot unless everyone is enjoying it. It’s not about the dominant partner doing whatever they want to the submissive partner, willy nilly. It’s about both partners getting what they want out of the scene.

Figure out what your boundaries are and set limits. If you’re not OK with being slapped in the face, say so. If you don’t want to be tied up, but would like to tie your partner up, be transparent about that.

Set up a safe word. This is a word that lets your partner know that they need to stop what they’re doing and check in with you. This word should be non-sexual in nature. The idea is to give you an out to pause the scene, without totally getting out of your BDSM characters. I’d suggest something neutral and simple. Some suggestions: Risky Business, red, mixtape, blueberry—anything that works for you is totally fine.

4. Start simple and work your way up.

Don’t tie your partner’s arms and legs to the bed, throw on a blindfold, and pop in a ball gag on the first go with bondage. This could result in a massive panic attack. Take it from someone who’s first bondage experience was exactly that. You want to begin with simple things and work yourselves to the more advanced, should you want to.

I suggest starting by using your flat palms to give or receive spankings on the bottom. Next, try tying your or their wrists together during sex.

You do not need to buy a lot of crazy stuff to try BDSM. (If you break the bank on a leather, bespoke corset and then decide you’re really not that into bondage after all, what do you do then? You can’t exactly donate it to Goodwill, you know?)

You can use all kinds of things around the house as makeshift BDSM gear. A wooden kitchen spoon is excellent for spanking. Use a cotton t-shirt as a blindfold and a necktie or pair of stockings to make handcuffs. You can have a lot of fun with the things you already have.

5. Review the experience with your partner and plan for next time.

See how you feel about it and discuss your feelings after the fact. I suggest taking some time to cuddle and relax before chatting. Just be sure you don’t go to bed without connecting. It’s important to check in and assess your emotions before, during, and after BDSM of any kind.

If you want to do BDSM play again, talk about it. Figure out what worked for you, what didn’t work for you, and maybe even what really turned you off. If you didn’t like the play at all, be open about this. It’s OK to not want to try it again and it’s OK to want to try the play in a different way. Stay open minded, but never do something just to please a partner. All sex should be fun, even when it stings a little (wink wink).

Gigi Engle is a certified sex coach, educator, and writer living in Chicago. Follow her on Twitter and Instagram @GigiEngle.

Alzheimer’s Stages: How the Disease Progresses

Alzheimer’s disease tends to develops slowly and gradually worsens over several years. Eventually, Alzheimer’s disease affects most areas of your brain. Memory, thinking, judgment, language, problem-solving, personality, and movement can all be affected by the disease.

There are five stages associated with Alzheimer’s disease: preclinical Alzheimer’s disease, mild cognitive impairment due to Alzheimer’s disease, mild dementia due to Alzheimer’s, moderate dementia due to Alzheimer’s, and severe dementia due to Alzheimer’s. Dementia is a term used to describe a group of symptoms that affect intellectual and social abilities severely enough to interfere with daily function.

The five Alzheimer’s stages can help you understand what might happen, but it’s important to know that these stages are only rough generalizations. The disease is a continuous process. Your experience with Alzheimer’s, its symptoms, and when they appear may vary.

Preclinical Alzheimer’s disease

Alzheimer’s disease begins long before any symptoms become apparent. This stage is called preclinical Alzheimer’s disease. You won’t notice symptoms during this stage, nor will those around you.

This stage of Alzheimer’s can last for years, possibly even decades. Although you won’t notice any changes, new imaging technologies can now identify deposits of a protein called amyloid beta that is a hallmark of Alzheimer’s disease. The ability to identify these early deposits may be especially important in the future as new treatments are developed for Alzheimer’s disease.

Additional biomarkers—measures that can indicate an increased risk of disease—have been identified for Alzheimer’s disease. These biomarkers can be used to support the diagnosis of Alzheimer’s disease, typically, after symptoms are evident.

There are also genetic tests that can tell you if you have a higher risk of Alzheimer’s disease, particularly early-onset Alzheimer’s disease. As with newer imaging techniques, biomarkers and genetic tests will become more important as new treatments for Alzheimer’s disease are developed.

Mild cognitive impairment (MCI) due to Alzheimer’s disease

People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes aren’t significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events, or appointments.

People with MCI may also have trouble judging the amount of time needed for a task, or they may have difficulty correctly judging the number or sequence of steps needed to complete a task. The ability to make sound decisions can become harder for people with MCI.

Not everyone with mild cognitive impairment has Alzheimer’s disease. The same procedures used to identify preclinical Alzheimer’s disease can help determine whether MCI is due to Alzheimer’s disease or something else.

Mild dementia due to Alzheimer’s disease

Alzheimer’s disease is often diagnosed in the mild dementia stage, when it becomes clear to family and doctors that a person is having significant trouble with memory and thinking that impacts daily functioning.

In the mild Alzheimer’s stage, people may experience:

  • Memory loss for recent events. Individuals may have an especially hard time remembering newly learned information and ask the same question over and over.
  • Difficulty with problem-solving, complex tasks, and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions.
  • Changes in personality. People may become subdued or withdrawn—especially in socially challenging situations—or show uncharacteristic irritability or anger. Reduced motivation to complete tasks also is common.
  • Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging.
  • Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It’s also common to lose or misplace things, including valuable items.

Moderate dementia due to Alzheimer’s disease

During the moderate stage of Alzheimer’s disease, people grow more confused and forgetful and begin to need more help with daily activities and self-care.

People with moderate Alzheimer’s disease may:

  • Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week, or the season. They may confuse family members or close friends with one another, or mistake strangers for family.
    They may wander, possibly in search of surroundings that feel more familiar. These difficulties make it unsafe to leave those in the moderate Alzheimer’s stage on their own.
  • Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory.
  • Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom, and other self-care. Some individuals occasionally lose control of their bladder or bowel movements.
  • Undergo significant changes in personality and behavior. It’s not unusual for people with moderate Alzheimer’s disease to develop unfounded suspicions—for example, to become convinced that friends, family, or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that aren’t really there.
    Individuals often grow restless or agitated, especially late in the day. Some people may have outbursts of aggressive physical behavior.

Severe dementia due to Alzheimer’s disease

In the severe (late) stage of Alzheimer’s disease, mental function continues to decline, and the disease has a growing impact on movement and physical capabilities.

In severe Alzheimer’s disease, people generally:

  • Lose the ability to communicate coherently. An individual can no longer converse or speak coherently, although he or she may occasionally say words or phrases.
  • Require daily assistance with personal care. This includes total assistance with eating, dressing, using the bathroom, and all other daily self-care tasks.
  • Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions.

Rate of progression through Alzheimer’s disease stages

The rate of progression for Alzheimer’s disease varies widely. On average, people with Alzheimer’s disease live eight to 10 years after diagnosis, but some survive 20 years or more.

Pneumonia is a common cause of death because impaired swallowing allows food or beverages to enter the lungs, where an infection can begin. Other common causes of death include dehydration, malnutrition, and other infections.

Updated: 2015-11-24

Publication Date: 2006-06-26

I Rarely Run More Than 3 Miles at a Time—But I Still Deserve to Call Myself a Runner

As someone who writes about health and fitness for a living, I regularly find myself chatting with people about workouts. And, as one of the most classic workouts around, running, often comes up in conversation.

But when people ask if I’m a runner, my answer is pretty much always a noncommittal: “Um, sort of.” Which is interesting, because that thing I do a few days a week at the park near my house certainly looks a whole lot like running.

Before I even realize what I’m saying, I hear myself explaining, “Oh, I’m not very good, I’m not training for anything, I don’t run long distances, I’m a little slow.” My list of “buts” goes on. Even though I’m all about leisurely 2- to 3-mile runs, I’ve always had a hard time just answering that question with a resounding “yes,” sans disclaimers.

Funnily enough when I ask other people the same question, many of them will also tell me that they’re only “sort of” a runner, followed by those same caveats. And my response to them is always the same—it still counts! I know this, and I preach it to other people. I sometimes still find myself in this weird “I run, but I’m not hardcore enough to be a runner” limbo.

For the last year, I’ve been actively trying to fight my gut reaction to deny myself the runner label. And throughout the process, I’ve learned two things: why it’s so hard for me to own it, and more importantly, how I can work to change my mindset.

I never identified as a runner growing up—in fact, I despised running.

Growing up, there were few things I hated more in life than being forced to run.

Completing the mile in middle school phys ed was 13-year-old me’s version of torture. My senior year of high school, the final in my gym class was finishing a 5K in under 31 minutes (so, an average pace of about a 10-minute mile). I finished it in 34 minutes, which I was proud of, until it dropped my grade from an A to an A-. My freshman year of college, I’d drag myself to the indoor track because I felt like it was what I was supposed to do, because the other women in my dorm did.

I hated being forced into running, either by other people or by the pressure I’m putting on myself because I feel like it’s what I’m supposed to be doing. And all this time, I told myself (and every gym teacher I ever had) that I sucked at running and always would. I now realize that this protected me from ever feeling like I’d fail at it. My expectations were set at zero, because I didn’t believe that I could meet even the most basic goal. After all, I “just wasn’t a runner.”

Even after I started to actually like running (gasp), I never felt like I could call myself a runner.

The impossible happened in my early 20s. I stopped hating running.

It started out when I realized that running was a convenient workout to do while traveling abroad. All I needed were sneakers, and it was a great way to explore new cities while getting in some exercise. Win-win. Even when I wasn’t traveling, I continued to run 2 or 3 miles here and there when I didn’t have time to make it to a gym and back for a full workout.

I realized I liked running when I was doing it my way—as in, no gym teacher telling me to “pick up the pace.” Even still, I felt unworthy of accepting the title of runner.

Because I knew runners. These were people who signed up for 10Ks and half-marathons. People who followed training schedules and tracked their mileage on Garmin watches. People who posted photos of race bibs on Instagram. Even people who ran the same amount as me but looked more like what I thought runners were supposed to look like—women who were leaner than me, had more defined calf muscles, and wore more running-specific gear.

Me? I had no real running cred. (Or so I told myself.)

The truth is, “impostor syndrome” has been a pretty big theme in many areas of my life, including running. Sometimes, just the activity itself left me feeling fraudulent—as if by heading out for a jog, I was “posing” as a runner, and I was tricking people into thinking I accepted the title even though I wasn’t worthy.

So while I liked going out for a run, every time someone passed me on a trail or I took a walking break when someone else kept going, it fed right into my own narrative that I wasn’t a runner. As far as I was concerned, I wasn’t good enough at it, or committed enough.

But starting to uncover what I actually love about running has helped me chip away at my impostor syndrome.

About a year ago, I challenged myself to focus on only doing workouts that I actually enjoyed. I was kind of in a slump, feeling disenchanted by exercise, and thought that if, once and for all, I gave up what I “should” do for what I liked to do, maybe I’d get excited about fitness again. Soon into my experiment, I was surprised to find myself gravitating toward short, 20- to 30-minute runs.

I started noticing some patterns around when and why I opted for a run. From a practical standpoint, running is super convenient for me. And sometimes, it’s not even about the exercise. It’s a great excuse to get some fresh air, listen to music or a podcast, and reset when I’m feeling frustrated, overwhelmed, or even just excited. And sometimes it’s just, “because I feel like it,” which is also a perfectly good reason.

Finding myself actually opting to spend time running made me realize that there’s no better reason to identify as a runner than actually wanting to run and then spending time on the road doing it.

I’ve started saying “yes,” more often when people ask if I’m a runner. Not every time, but I’m getting there.

Don’t get me wrong. I still have to actively and intentionally remind myself that I have just as much of a right to be running around the park by my house as anyone else there. But the rewards of actually calling myself a runner (even on days I don’t feel like I’m worthy of it) have actually made running more fun for me. Being able to own it, to say “I do this thing and I do it for me,” is more powerful than I thought it would be.

What’s more, this practice has allowed me to take a hard look at the other areas of my life, like my job and relationships, and work on shifting my thinking about my motivations and what I deserve in those areas, too.

Ultimately, my runs are great for my physical and mental health, and right now, I’m absolutely content with not increasing my mileage or speed—there’s no benchmark I need to meet to feel like a runner anymore, because for me, the reward is in each short run itself.

That’s not to say I’ll never run a long race. I’ve toyed with the idea of a half-marathon in 2019, but for now, the most official run I’ve got planned is a 4-mile turkey trot on Thanksgiving.

But even if I didn’t, I’d still be a runner. No disclaimer necessary.

Chrissy Teigen Says She Woke Up ‘Covered in Chewed Gum’ After Taking a Sleeping Pill

Sleeping pills are notorious for causing people to do weird things in their sleep, and apparently Chrissy Teigen and John Legend are no exception. Teigen tweeted on Tuesday that the couple had an odd experience the morning after she took a sleeping pill.

“I took a sleeping pill (consult your doctor) and john and I woke up covered in chewed gum,” she wrote.

Fans replied with their own sleeping pill stories. “My mom woke with a sheet cake in her lap. When I went to bed there was no cake in the house. Or cake mix. She made a cake from scratch and took it to bed,” one person wrote. “I once took a sleeping pill and woke up with a garbage can filled with water at the foot of my bed and no memory of that adventure,” another said. “At least you didn’t book a 4-day vacation at a luxe spa for your entire family…although we did have a great time!” another shared.

Sleepwalking and doing other activities while you’re asleep are known to be potential side effects when taking prescription sleeping pills.

In fact, the website for Ambien (zolpidem) specifically warns that the drug can have “serious side effects” including “sleep-walking or doing other activities when you are asleep like eating, talking, having sex, or driving a car.” Additionally, the labeling information for Lunesta (eszopiclone) also warns about “complex behaviors” like “sleep-driving,” noting that patients have also reported preparing and eating food and making phone calls while sleeping.

These things do happen, and probably more often than you’d think. “So many people describe these bizarre events,” board-certified sleep medicine doctor and neurologist W. Christopher Winter, M.D., of Charlottesville Neurology and Sleep Medicine and author of The Sleep Solution: Why Your Sleep is Broken and How to Fix It, tells SELF. “We’ve got a list a mile long. They’d be incredible if they weren’t terrifying.” Dr. Winter has had patients, for example, who have eaten fistfuls of chocolate or brown sugar in their sleep and were shocked to wake up to a total mess in the kitchen.

“People can go to the fridge, grab a stick of butter, and eat it,” Rita Aouad, M.D., a sleep medicine expert at The Ohio State University Wexner Medical Center, tells SELF. “Some people have even recorded family members cooking an entire meal while on a sleeping pill. Exactly why this happens, we’re not completely sure.”

But it’s probably not surprising that if you have a history of parasomnias—unusual behavior when you’re sleeping, like sleepwalking or sleep-eating—you shouldn’t take a sleeping pill since you’re already at a higher likelihood of experiencing those behaviors, Dr. Aouad says. And we know that mixing these medications with other substances, such as alcohol, can make issues during sleep more likely.

Every sleeping pill is a little different, but they all work in a similar way.

Prescription sleeping pills are designed to treat insomnia, a common sleep disorder that can make it hard to fall asleep or stay asleep or can cause you to wake up too early and not be able to get back to sleep, per the Mayo Clinic.

The most common prescription sleeping pills (including zoplidem and eszopiclone) work on receptors for the neurotransmitter GABA (gamma-aminobutyric acid), the main inhibitory neurotransmitter in your central nervous system. GABA is heavily involved in regulating your level of alertness, Jamie Alan, Ph.D., an assistant professor of pharmacology and toxicology at Michigan State University, tells SELF. And because these drugs alter the function of GABA receptors, they cause a hypnotic effect that allows you to fall asleep more easily, she explains.

Although experts don’t know exactly why sleepwalking and other weird behaviors might happen while you’re asleep, there are some theories. For one thing, this type of drug can cause retrograde amnesia, a condition in which you don’t remember things after they happen, Alan says. So, it might be that people are awoken at some point during the night (or awoken into a different stage of sleep), do something relatively normal, and simply don’t remember why they did it. In that case, the drug isn’t necessarily causing the weird behavior, it’s just making it difficult to remember why or how you did it.

Prescription sleeping pills can definitely be helpful in certain situations, but they aren’t recommended for long-term treatment. Luckily, there are some alternatives.

According to the Mayo Clinic, doctors don’t recommend using prescription sleep medications for more than a few weeks. “A sleeping pill is not treating your insomnia,” Dr. Winter points out. “It’s sedating you to sleep at night.”

For more long-term help, you’ll need to make some larger changes to your life. That might include seriously reducing your stress levels, changing other medications you’re taking that might be keeping you up, or even taking part in specialized cognitive behavioral therapy (CBT).

This type of therapy can help you control or get rid of negative thoughts and actions that keep you awake, the Mayo Clinic explains, and it can be as effective (or even more effective) than taking medications. For instance, it can help you recognize and work through that negative cycle of worrying so much about sleep that you can’t actually get to sleep.

On top of that, CBT often includes training in basic sleep hygiene practices, such as setting a consistent bedtime and wake time, avoiding naps, using relaxation techniques to reduce anxiety at bedtime, trying to stay awake rather than fall asleep when you get into bed (in an effort to reduce the worry and anxiety about being able to get to sleep), and light therapy to try to help you stay up later and stay in bed later.

So, if you’re consistently having a hard time getting good quality sleep, talk to your doctor. There are many things they can do to help you, and that may or may not include prescription medication.

Related:

How to Do Chin-Ups Using a Resistance Band

If you’ve ever wondered how to do chin-ups (or pull-ups), you might have heard that it can be a slow, deliberate process while you build up your strength and learn the correct technique. Just ask Victoria’s Secret model Kelsey Merritt, a first-timer in the runway show this year, who has set a fitness goal of doing a chin-up by the time she walks the show.

Merritt shared a video of herself at NYC gym Dogpound, doing a set of chin-ups with a little help. “My fitness goal for the #VSFashionShow is to be able to do a chin up!!” she wrote. “For now I can only do it with the help of a resistance band. 😬 Got to #TrainLikeAnAngel and hopefully I’ll be able to reach my goal before the fashion show!”

We love the idea of setting a fitness goal for yourself—as long as they are realistic and you give yourself plenty of time and emotional encouragement along the way (that’s why you should use the SMART method to find a goal that will be specific, measurable, attainable, relevant, and timely). According to certified personal trainer Nadia Murdock, chin-ups are an especially good goal since, to be frank, they are so difficult to achieve. “[Chin-ups are] so mentally intimidating, some participants may be discouraged before they even begin,” Murdock tells SELF. “But I strongly believe in order to successfully knock this workout out the box it will take time and focus. Baby steps are key.”

For a successful chin-up, you should work on strengthening your biceps and back muscles, says Murdock. Exercises along the way should focus on your lats and biceps to help build up the strength that you’ll bring to the bar. “In addition, consistency is key,” Murdock says. “Focus on these muscle groups on a regular basis to help you achieve your chin-up even faster.”

Many trainers also recommend doing assisted chin-ups to help your body practice the exercise, since as you build up strength you might not be able to perform many reps of the execise unassisted. In Merritt’s case, the resistance band modifies the chin-up to make it a bit easier, allowing her to practice the correct movements. Think of it like a big rubber band, helping propel her towards the bar. That’s not to say that the resistance band does all the work for her. “The band helps you work with proper form,” says Murdock, since it keeps the body controlled and the back muscles engaged. If you’re training to do a chin-up, try adding assisted chin-ups into your training routine to help with form as you continue to build your strength; this guide to how to do resistance-band assisted pull-ups will help. (In case you were wondering, a chin-up is done with an underhand grip while a pull-up uses an overhand grip, but the set up for both exercises is the same.)

That’s one part of training. The other is building strength in the muscles you use to execute a chin-up. To help build up the strength needed to make a chin-up happen, Murdock suggests focusing on upper body exercises. Add exercises like push-ups, bent over rows, and rope climbing into your routine, all of which will encourage the upper body strength needed for a chin-up. “A standard push-up works similar muscle groups as a chin-up, focusing on the shoulders and upper back,” Murdock says. Grab a set of free weights for a bent-over row, which works the lats, rear delts, and biceps. Finally, a rope climb will help develop the gripping and pulling action that you’ll need at the chin-up bar.

For now, Merritt is documenting her journey on Instagram, and we’ll be cheering along. A fitness goal is a great thing to work towards, whether it’s a chin-up, a perfect plank, or simply getting to the gym a few days a week.

Related:

Flu Shot Effectiveness: Why You Still Need to Get Vaccinated Even Though It Doesn’t Always Prevent Illness

I study infectious diseases for a living. I’m also a mom of three kids. So every fall, I schedule an appointment with the pediatrician for my youngest and drag the older kids with me to a pharmacy, and we all get our flu shots. I do this even though I know that, most years, the vaccine is generally only about 40 to 60 percent effective at preventing the development of illness from the influenza virus.

These stats make some people wonder, so why bother?

For anyone skeptical about getting a flu shot due to its shortcomings, there are two things you should think about: influenza vaccination is not just about protecting yourself against acute infection, but also from ongoing complications if you do fall ill. Secondly, it’s not just about you.

Let’s take a step back and first discuss why the flu vaccine isn’t 100 percent effective.

Because the circulating influenza viruses change from year to year, a new vaccine is needed every fall to maintain protection. To choose the composition of each year’s vaccine, more than 100 centers around the globe track influenza viruses. Based on these data, and with input from the World Health Organization (WHO), specific vaccine strains are selected by February of each year for the following season. The strains chosen are the ones that the data suggest are the most likely to spread and cause illness.

Each new flu vaccine contains two strains of influenza A, which is typically the flu virus we associate with severe disease as well as causing influenza pandemics. Depending on which vaccine you get, it will also contain one or two strains of influenza B. (Traditional vaccines are “trivalent,” meaning they are made to protect against three viruses, but there are also “quadrivalent” vaccines that are designed to protect against four.) Influenza B is generally considered more mild, but it can also lead to serious infections and even death.

In the injected vaccine, all of the viruses included are “killed” or “inactivated,” so they cannot replicate in your body. In the nasal spray that is once again being offered this year (FluMist), the viruses are live but attenuated, meaning they do not cause disease.

So, do these strains always match perfectly with the illness that ends up circulating in the fall and winter? No, not always. In some years, a new virus starts to dominate the population after strains have already been chosen for the vaccines in February, resulting in a bad match by the time influenza season is in full swing. This happened during the 2004 to 2005 season with one of the influenza A strains, and over 2005 to 2006 with an influenza B strain.

The vaccine viruses themselves can also be difficult to develop. As the Centers for Disease Control and Prevention (CDC) explains, flu vaccine viruses are often grown in chicken eggs. But some viruses, like H3N2 viruses, don’t grow well in eggs, making it tricky to get a viable vaccine virus with no mutations.

In fact, the H3N2 portion of the vaccine was modified for the 2018 to 2019 influenza season. Litjen (L.J) Tan, M.S., Ph.D., chief strategy officer with the Immunization Action Coalition, tells SELF that “the H3N2 strain changed from last year partly in response to the concerns that there was some adaptation happening in the vaccine virus strain that could have potentially made the vaccine less effective.” This mutation is believed to be in part due to how difficult it is to grow the H3N2 virus in eggs without adaptations developing.

Figuring out how effective the vaccines are each year is a complicated process.

As mentioned, there is constant surveillance taking place for influenza infection. At the sites that carry out this surveillance work, researchers type the viruses that are making people sick to see how well they match current vaccine strains. They also try to find out the medical history of sick individuals, including whether they received the vaccine. However, this gathering of data takes months to do correctly, so while we get some preliminary numbers during influenza season, we don’t know the final results of a vaccine’s effectiveness until the following fall.

Case in point: We’re still waiting on final numbers from the 2017 to 2018 influenza season, but preliminary data shows that last year’s vaccine effectiveness was about 36 percent overall—much higher than the 10 percent figure reported by many news agencies based on Australian data. It was even more effective in kids: about 59 percent. For the H1N1 strain of the virus, it was about 67 percent effective, while for the H3N2 strain it was lower (25 percent). Effectiveness against the 2017 to 2018 influenza B viruses was 42 percent.

But getting the flu vaccine, even if it’s imperfect, helps keep both the individual and the community healthy and safe.

A report published in April in the journal PNAS (Proceedings of the National Academy of Sciences of the United States) showed that even if a vaccine is only 20 percent effective, it could still prevent 20 million infections or illnesses, 129,000 hospitalizations, and 61,000 deaths compared to no vaccine—even if only 43 percent of the population gets it (which is roughly the amount of people we see get vaccinated each year).

The flu vaccine also reduces a person’s risk of needing to go to the doctor by 30 to 60 percent, even if you do get sick. And it reduces the risk of hospitalization and entering intensive care due to the flu. In children, the vaccine lowers risk of death and ICU admission for serious influenza-associated complications. And if you’re vaccinated, that means you’re less likely to spread the virus to others around you, including those you might not realize are vulnerable to a serious influenza infection, like infants, elderly persons, and anyone with a compromised immune system.

There are a number of people who are particularly vulnerable to the effects and complications associated with influenza. “Pregnant women really are impacted negatively by flu, so you don’t want to catch it while you’re pregnant,” Tan says. Pregnant women who develop influenza have an eight-fold increased risk of complications, including death, as well as complications for the fetus, such as stillbirth. The WHO and CDC both have pregnant women as the top risk group on their vaccine priority list. Getting the vaccine during pregnancy can also help to protect newborns after birth, before they can get their first influenza vaccine at 6 months of age.

Many adults also think that because they’re healthy and, perhaps, have never experienced a serious bout of influenza infection, they don’t need the influenza vaccine. But Tan cautions against relying on this false sense of security: “A lot of adults have chronic health conditions that they are not aware of, especially if they are over 50. You might have an underlying heart condition, you might have an underlying respiratory disease, and you don’t know it because you haven’t been diagnosed. And for those folks with underlying chronic conditions, influenza is certainly nasty, and potentially deadly.”

For those over 65, it gets worse. “There’s a term a lot of gerontologists use called ‘inflammaging,’ which is a low-level chronic inflammation that happens as you get older,” Tan explains. “And we know that inflammaging is one of those factors that lead to severe influenza responses.” This can include an increased risk of cardiovascular events such as heart attack and stroke in the time period after an influenza infection.

So even though it’s not perfect, the flu vaccine is one more precaution we can all take to protect ourselves and those around us, just like washing your hands regularly and keeping your distance from sick people.

Ultimately, the flu vaccine is a safe, simple way to protect yourself and your family during influenza season. And, as previously mentioned, there’s also a nasal spray vaccine available if needles really aren’t your thing. That nasal spray option, FluMist, was taken off the market for the past two seasons due to an unexpected lack of protection in the 2014 to 2015 influenza season; but with the new formulation, preliminary tests have suggested it will work again this year. As SELF reported previously, there isn’t as much data to support the nasal spray compared to the shot. So, the shot is still the primary recommendation. But if it’s a question of getting the spray or not getting vaccinated at all, the spray is a good option.

As Tan notes, “We have a safe vaccine. We have an effective vaccine in multiple outcomes. So why are you gambling with potentially your independence, potentially your vacation, potentially your ability to live a high quality of life in this upcoming flu season? It doesn’t make sense to me.” I have to agree—and it’s not too early to get yours now.

Tara C. Smith, Ph.D., is an infectious disease epidemiologist and professor at the Kent State University College of Public Health.

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14 Bipolar Disorder Facts That Everyone Should Know

Bipolar disorder is one of the most misunderstood mental health conditions out there. If your perception of the illness is mainly shaped by pop culture depictions like Carrie’s counter-terrorist exploits on Homeland, then spoiler alert: The reality of bipolar disorder is much more nuanced than it may seem. Keep reading to learn 14 key facts about bipolar disorder that everyone should know.

1. Bipolar disorder is a mental illness characterized by dramatic shifts in mood and behavior.

These shifts are referred to as “mood episodes,” according to the National Institute of Mental Health (NIMH). There are two main types of episodes: manic episodes and depressive episodes. (Hence why bipolar disorder used to be referred to as manic depression.)

In between these episodes, a person with bipolar disorder may have periods without symptoms of either mania or depression.

2. Bipolar depressive episodes tend to look a lot like classic depression.

Without knowing somebody’s medical history, it’s virtually impossible to determine whether their depression is the result of bipolar disorder or something like major depressive disorder, Dolores Malaspina, M.D., director of the Psychosis Program in the department of psychiatry at the Icahn School of Medicine at Mount Sinai, tells SELF.

But in general, the NIMH highlights these as the signs and symptoms of a bipolar depressive episode:

  • Unusually low energy
  • Decreased activity levels
  • Feelings of hopelessness and despair
  • Loss of enjoyment in activities
  • Sleeping too little or too much
  • Feeling worried or empty
  • Fatigue
  • Eating too little or too much
  • Trouble concentrating or remembering things
  • Suicidal thoughts

Severe episodes of depression can also involve psychosis involving delusions or hallucinations, the NIMH notes.

3. Manic episodes are more complicated than simply being “up.”

Experiencing mania doesn’t necessarily mean a person is running around feeling invincible and happy, says Dr. Malaspina.

As the NIMH explains, there are many different signs and symptoms of mania:

  • Unusually high energy
  • Increased activity levels
  • Feeling wired or jumpy
  • Feelings of elation
  • Feelings of agitation or irritability
  • Feelings of overconfidence
  • Trouble sleeping
  • Talking unusually quickly
  • Trying to take on too many things at once
  • Engaging in risky behavior, such as taking sexual or financial risks you wouldn’t otherwise

4. Hypomania can involve many of the same symptoms of mania but on a less severe scale.

“There are very different severities of the mood elevation,” Wendy Marsh, M.D., director of the Bipolar Disorders Specialty Clinic and an associate professor in the department of psychiatry at the University of Massachusetts Medical School, tells SELF. At the lower end of the spectrum is hypomania, which is when a person doesn’t experience a full-blown manic episode, but only some of the symptoms on a milder scale. “It can seem like useful, goal-oriented energy,” Dr. Malaspina says.

Some people only ever experience hypomania, but it’s also possible to experience full mania, which can eventually become dangerous. “You can have too much belief in yourself … [and] very poor judgment,” says Dr. Malaspina. This can contribute to behavior like having unprotected sex or investing all your money in a business venture, she says. This grandiose thinking can also escalate into delusion. “When someone has mania, they really need to be under a doctor’s care,” Dr. Malaspina says.

5. People can experience symptoms of mania and depression at the same time.

These “mixed episodes” involve the high energy and activity of mania and the hopelessness and despair of depression. “That’s a really high-risk situation because people are miserable and they have all this extra energy,” says Dr. Marsh. These episodes are just as or more dangerous and life-threatening than severe mania, Dr. Marsh says, and require immediate care.

6. There are several types of bipolar disorder.

The symptoms of bipolar disorder can present at different severities and in various combinations in different people, so there are actually four different conditions related to the disorder.

Bipolar I consists of manic episodes lasting seven days or more—or manic symptoms that last any amount of time but are severe enough to warrant immediate hospitalization, according to the NIMH. Bipolar I typically also comes along with depressive symptoms lasting at least two weeks, or it can cause those mixed episodes that include signs of depression and mania.

With bipolar II, people experience depressive episodes along with episodes of hypomania, but not the full mania involved in bipolar I.

Then there’s a condition called cyclothymia, which resembles a less severe form of bipolar disorder. People with cyclothymia experience symptoms of hypomania and symptoms of mild depression for at least two years, interspersed with symptom-free periods, but the symptoms aren’t severe enough to qualify as actual hypomanic or depressive episodes. “Cyclothymia has both pieces—a little bit too high and a little bit too low—but never so much that they really appear dysfunctional,” Dr. Malaspina explains. People with untreated cyclothymia are at an increased risk of eventually developing bipolar disorder, though.

Finally, someone with symptoms of bipolar disorder that don’t fit neatly into the above buckets can have what is termed Other Specified and Unspecified Bipolar and Related Disorders, the NIMH explains.

7. The length of these mood episodes can vary from person to person.

Two weeks is the set minimum for a depressive episode, according to the NIMH but they often stretch out for months, Dr. Marsh says. Mania typically lasts for at least a week. However, “There’s not really a fixed range,” says Dr. Malaspina.

8. There is no known single cause of bipolar disorder.

Scientists are still investigating the roots of the disorder, but they have identified three risk factors that contribute to your likelihood of developing the condition, according to the NIMH: genetics, brain structure and functioning, and family history.

Experts have yet to pinpoint which genes may be involved here and to what extent. Same goes for brain structure and functioning; there’s a lot that’s still to be determined. What’s clearer is that bipolar disorder does tend to run in families, according to the NIMH. While most people with a family history of the condition will not develop it, having a parent or sibling with bipolar disorder does increase your odds.

9. It can take a while to receive a proper diagnosis of bipolar disorder, which is often misdiagnosed as depression.

People who have bipolar disorder are typically more likely to reach out for help during a depressive episode than a manic or hypomanic one, according to the NIMH. (Remember, mania can sometimes feel productive instead of like a problem that needs treatment.) Diagnosing bipolar disorder requires establishing a history of both mania and depression, so if all the doctor sees during the first evaluation are signs of depression, a misdiagnosis is not unlikely, Dr. Malaspina says.

Even if the person first presents with only symptoms of depression, a good clinician that sees them regularly should be able to recognize the mania over time and reassess their original diagnosis, Dr. Malaspina says.

10. Children and teenagers can have bipolar disorder, too.

Most people who have the condition develop it in their late teenage or early adult years, according to the NIMH. However, younger teenagers and children can develop it, too.

Diagnosis can be even more difficult in children and teenagers because their symptoms may not fully fit the diagnostic criteria, according to the Mayo Clinic. Children and adolescents with bipolar disorder also often have co-occurring mental or behavioral health conditions, like ADHD, that make teasing out a bipolar diagnosis trickier. Finally, it can be hard to determine when mood swings and changes in activity level are simply part of growing up or something more. Specialized child psychiatrists can be helpful in these cases.

11. Treatment almost always involves medication, but effective drugs and dosages vary widely by individual.

The main goal of medication is to stabilize a person’s mood over time in order to minimize the number of manic and depressive episodes they experience, says Dr. Malaspina.

There are several kinds of medication that have been shown to be effective for bipolar disorder in various ways. Mood stabilizers work by decreasing the amount of abnormal activity in the brain, according to the NIMH. Lithium is a common one. Anticonvulsant or antiseizure medications, first developed to treat disorders like epilepsy, are also sometimes used as mood stabilizers.

Another class of medications prescribed for bipolar disorder is antipsychotics to treat mania (during which psychotic episodes can occur), according to the NIMH.

Some people will also benefit from antidepressants to manage the lower moods associated with bipolar disorder. However, antidepressants have the potential to trigger manic episodes, Dr. Malaspina says. They are typically paired with a mood stabilizer or antipsychotic or administered as a drug that works as both an antidepressant and an antipsychotic, according to the Mayo Clinic. Some people benefit from short-term use of anti-anxiety medications as well.

Some of these medications are better at treating depressive or manic episodes, so combinations are often most effective, Dr. Malaspina says. Figuring out the best mix can be challenging at first, but people who work closely with their doctors will almost always find the right balance, Dr. Malaspina says, though the medicines may need to be adjusted over time.

12. Bipolar disorder medications can affect pregnancy and birth control.

People with bipolar disorder who plan on becoming pregnant (or who already are pregnant) should to talk to their doctors. Medications can pass through the placenta and enter breast milk, and various drugs used to treat bipolar disorder have been linked to an increased risk of birth defects, according to the Mayo Clinic.

Additionally, certain bipolar disorder medications such as antiepilepsy drugs may lessen the efficacy of birth control pills. Talk to your doctor if you’re taking medications for bipolar disorder and trying to avoid an unintended pregnancy.

13. Therapy can help people cope with bipolar disorder in a few different ways.

Therapy can help people come to terms with the disparate ways they behaved during mood episodes, especially when someone first receives a diagnosis, Dr. Malaspina explains. “So many people have been suffering for years before they get the bipolar diagnosis, and some people will have made decisions based on a [manic or depressive] mood.” With the proper diagnosis and an understanding of their disorder, therapy can help someone reframe their experiences and self-understanding.

Seeing a mental health professional can also help people manage the stressors in their lives that may aggravate their condition, Dr. Malaspina says, and allow them to “catch” a mood episode before it gets more severe.

14. People with bipolar disorder can and do lead happy, healthy lives.

There is no doubt that living with bipolar disorder presents its challenges. But it’s equally true that with proper treatment, people can achieve stability and happiness. “It’s something you get help for as if you had diabetes,” Dr. Malaspina says. “With care and time, people can do much, much better.”

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Postnatal depression could be linked to fewer daylight hours during late pregnancy

Women in late pregnancy during darker months of the year may have a greater risk of developing postpartum depression once their babies are born. This is consistent with what is known about the relationship between exposure to natural light and depression among adults in the general population. Deepika Goyal of San José State University in the US is the lead author of a study published in a special issue “Post-partum Health” in Springer’s Journal of Behavioral Medicine. The findings of Goyal and her colleagues should lead clinicians to encourage at-risk women to increase their exposure to natural daylight and vitamin D.

Although reduced exposure to natural light has been associated with depression among adults in the general population, there is not yet a consensus about whether light exposure or seasonality influences the development of depression during and after pregnancy.

In this study, Goyal and her colleagues at the University of California San Francisco analysed available information from 293 women who participated in one of two randomized controlled clinical trials about sleep before and after pregnancy. The participants were all first-time mothers from the US state of California. Data included the amount of daylight during the final trimester of their pregnancy, along with information about known risk factors such as a history of depression, the woman’s age, her socioeconomic status and how much she slept.

Overall, the participants had a 30 per cent risk of depression. The analysis suggested that the number of daylight hours a woman was exposed to during her final month of pregnancy and just after birth had a major influence on the likelihood that she developed depressive symptoms.

The lowest risk for depression (26 per cent) occurred among women whose final trimester coincided with seasons with longer daylight hours. Depression scores were highest (35 per cent) among women whose final trimester coincided with “short” days and the symptoms continued to be more severe following the birth of their babies in this group of women. In the northern hemisphere, this timeframe refers to the months of August to the first four days of November (late summer to early autumn).

“Among first-time mothers, the length of day in the third trimester, specifically day lengths that are shortening compared to day lengths that are short, long or lengthening, were associated with concurrent depressive symptom severity,” Goyal explains.

The findings suggest that using light treatment in the late third trimester when seasonal day length is shortening could minimize postpartum depressive symptoms in high-risk mothers during the first three months of their children’s lives. Goyal says that women with a history of mental health problems and those who are already experiencing depressive symptoms in the third trimester might further benefit from being outdoors when possible, or using devices such as light boxes that provide light therapy.

“Women should be encouraged to get frequent exposure to daylight throughout their pregnancies to enhance their vitamin D levels and to suppress the hormone melatonin,” adds Goyal, who says that clinicians should also advise their patients to get more exercise outdoors when weather and safety permit. “Daily walks during daylight hours may be more effective in improving mood than walking inside a shopping mall or using a treadmill in a gym. Likewise, early morning or late evening walks may be relaxing but would be less effective in increasing vitamin D exposure or suppressing melatonin.”

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The warm glow of kindness is real, even when there’s nothing in it for you

Psychologists at the University of Sussex have confirmed that the warm glow of kindness is real, even when there’s nothing in it for you. In their study, published in NeuroImage, they undertook a major analysis of existing research showing the brain scans relating to over 1000 people making kind decisions. For the first time, they split the analysis between what happens in the brain when people act out of genuine altruism — where there’s nothing in it for them — and when they act with strategic kindness — when there is something to be gained as a consequence.

Many individual studies have hinted that generosity activates the reward network of the brain but this new study from Sussex is the first that brought these studies together, and then split the results into two types of kindness — altruistic and strategic. The Sussex scientists found that reward areas of the brain are more active — i.e. use up more oxygen — when people act with strategic kindness, when there is an opportunity for others to return the favour.

But they also found that acts of altruism, with no hope of personal benefit, activate the reward areas of the brain too, and more than that, that some brain regions (in the ‘subgenual anterior cingulate cortex’) were more active during altruistic generosity, indicating that there is something unique about being altruistic with no hope of gaining something in return.

Dr Daniel Campbell-Meiklejohn, the study’s lead and Director of the Social Decision Laboratory at the University of Sussex, said:

“This major study sparks questions about people having different motivations to give to others: clear self-interest versus the warm glow of altruism. The decision to share resources is a cornerstone of any cooperative society. We know that people can choose to be kind because they like feeling like they are a ‘good person’, but also that people can choose to be kind when they think there might be something ‘in it’ for them such as a returned favour or improved reputation. Some people might say that ‘why’ we give does not matter, as long as we do. However, what motivates us to be kind is both fascinating and important. If, for example, governments can understand why people might give when there’s nothing in it for them, then they can understand how to encourage people to volunteer, donate to charity or support others in their community.”

Jo Cutler, the PhD student who co-authored the study at the University of Sussex, added:

“The finding of different motivations for giving raises all sorts of questions, including what charities and organisations can learn about what motivates their donors. Some museums, for example, choose to operate a membership scheme with real strategic benefits for their customers, such as discounts. Others will ask for a small altruistic donation on arrival. Organisations looking for contributions should think about how they want their customers to feel. Do they want them to feel altruistic, and experience a warm glow, or do they want them to enter with a transactional mind-set?”

“Given that we know there are these two motivations which overlap in the brain, charities should be careful not to offer something which feels like a token gesture, as this might undermine a sense of altruism. Sending small gifts in return for a monthly donation could change donors’ perceptions of their motivation from altruistic to transactional. In doing so, charities might also inadvertently replace the warm glow feeling with a sense of having had a bad deal.”

“The same issues could also apply when we think about interactions between family, friends, colleagues or strangers on a one-to-one basis. For example, if after a long day helping a friend move house, they hand you a fiver, you could end up feeling undervalued and less likely to help again. A hug and kind words however might spark a warm glow and make you feel appreciated. We found some brain regions were more active during altruistic, compared to strategic, generosity so it seems there is something special about situations where our only motivation to give to others is to feel good about being kind.”

Jo Cutler and Dr Campbell-Meiklejohn analysed 36 existing studies relating to 1150 participants whose brains were scanned with fMRI scans over a ten-year period.

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