Yesterday I was at a training session at work called “Mental Health First Aid.” It’s a Canada-wide initiative of the Mental Health Commission of Canada. Its aim is to educate people with enough understanding of mental health issues to be able to administer “first aid” in an emergency or crisis situation, until a person can get professional help. They want to “increase mental health literacy” among Canadians.

One of the goals of this initiative is to address some of the stigma around mental health issues, which is a good thing. One of the ways they do this is to draw frequent analogies with physical health.

So far so good. But you need to know that this is a pre-packaged course that they train various people to deliver. There is a set format and curriculum, set powerpoint slides, a booklet, videos, activities and so forth. It would be astonishing if a course such as this would contain no problematic narratives even if its aims are, on the whole, positive.

Here’s what happened. One of the activities is they give each group (yes, there is group work) a baggie full of slips of paper. Each piece of paper has a “disability,” “ailment,” or “impairment” on it–quadriplegic, paraplegic, total loss of hearing, severe dementia, gingivitis, asthma, bipolar disorder, depression–you get the picture. The assignment is to rank them in terms of “most disabling” to “least disabling.”

Now maybe it’s because I’m a feminist philosopher who, though no expert on disability, has reflected on disability and oppression in recent years, but at a certain point it became clear to me that the task could not be done. I raised this with my group. My complaint is that an identified condition is only disabling if the surrounding environment is constructed in a way that excludes people with that condition.

For example, if stairs and counter tops and sinks and taps and toilets were all built for people who were ten feet tall, that would, for pretty much everyone, be a disabling environment. I thought of the deaf community and how at least some portion of that community takes serious issue with the framing of deafness as a disability. See this video.

One of my colleagues at the table agreed with me. She had just been at the Parapan Am Games the night before and has had some involvement coaching athletes (I’m sorry I don’t know exactly what). She agreed with me that some of the athletes would be offended to be thought of as disabled.

When I raised this with the facilitator, I honestly thought that we would be told that we had the “right answer,” namely, that the exercise really couldn’t be done. But instead, I was told that I was “overthinking” the exercise and couldn’t I just see that the point of the exercise is to get us to see that some mental conditions are just as disabling as some physical conditions.

Right.

The Parapan Am Games are going on in Toronto right now. The other night on CBC radio I heard them interviewing an athlete in who’d earned silver in the archery competition, Matt Stutzman from Iowa. Matt was born without arms and holds the bow with his foot. He has amazingly dextrous toes, which he’s used his whole life in ways that most of us never have (or even could). When the interviewer asked if he hoped to be the best para-archer in the world, he replied that he hoped to be the best archer, period, in the world. This is not a longshot dream. He currently holds the world record of the longest accurate shot in archery.

Read more about Matt Stutzman here.

The point is, the athletes competing in the Parapan Am Games and who will compete next year at the Paralympics in Rio are incredible athletes against whom, I dare say, most non-disabled people wouldn’t stand a chance.

It’s not that I think we should deny the idea of disability. Politically, that would be the wrong way to go. But it’s important, I’ve learned over the years, to recognize that we live in an extremely ableist world and that much of what we think of as disability is really just lack of support, lack of understanding, or a mismatch between the way the world is designed and the people in it. Think about how you would fare if communicating with the majority of people required telepathy or if navigating the world required sonar, like bats.

In this respect, I applaud the Mental Health First Aid course in its goal of reducing stigma and improving mental health literacy. Their very own materials include the idea that someone could have a mental health issue but, with the right kind of supports in place, not be affected by it. But they have some distance to go in achieving their goals. It’s true that we need to recognize that people with mental health issues need help, understanding, and supports.

But to play up the idea that disability is an inherent quality and that various conditions can be ranked in terms of most to least disabling perpetuates the wrong idea that disability inheres in individuals and has nothing (or very little) to do with context and environment.

Reflecting on the athleticism in the Parapan Am Games is a good way to see that some people with what many of us think of as disabilities are in fact extremely capable, even more so than non-disabled people. So to draw generalizations about the extent to which some feature of a person is disabling is just a mistake and doing so can contribute to, rather than help to eliminate, stigma about disability and, by analogy (as per the Mental Health First Aid Course), mental illness.

I don’t know when I heard it, but somewhere along the way someone told me that as we get older, we need less sleep. I always felt kind of skeptical about this. As I’ve gotten older I can say for certain that I get less sleep. But need? I think I need as much as I ever did.

So I felt vindicated when I read this article, “Getting less than six hours sleep a night increases risk of early death.” General, I hate articles that raise fears about risk of early death because, frankly, so many things seem to increase that risk. But it makes sense to me that consistently getting inadequate sleep can compromise our health.

The article begins with an alarming pair of statistics:

Over a third of the population are getting less than six hours sleep a night raising their risk of an early death by 12 per cent.

They link lack of sleep to increased risk of diabetes, obesity, and heart disease. There is actually a hormonal change when we don’t get enough sleep–it leads to stress, which puts pressure on the heart:

Not sleeping releases hormones that increase stress levels and in turn speed up the heart rate and raise blood pressure sparking a host of health issues.

Not only that, there is a risk of some mental health consequences as well:

Research suggests that routinely getting less than six hours sleep a night can impact attention, concentration and memory and is also linked to Alzheimer’s disease.

And then there’s this idea that is kicking around that we need less sleep as we get older.  See this article, “Older Adults Need Less Sleep.”  According to the research reported there:

new research in the U.K. confirms previous indications that older people need less sleep. It also suggests that variations in sleep hours needed are normal and healthy — so long as one is not overly sleepy during the day.

“Healthy aging appears to be associated with reductions in the sleep duration and depth required to maintain daytime alertness,” the scientists said in a statement.

According to the UK study on a group of people who did not have any sleep disorders, people get less sleep as they get older. Here’s the chart:

During the first night with eight hours in bed, the resulting average sleep time, by age group:

Age 20-30: 433.5 minutes (7.23 hours)
Age 40-55: 409.9 minutes (6.83 hours)
Age 66-83: 390.4 minutes (6.51 hours)

Now, this was in a lab, so they’ve qualified their findings with a statement that these times are not necessarily “normal.” The key finding is the difference between age groups:

The researchers do not suggest that these times, achieved during lab conditions much different from real life, are normal. But the comparison between groups is what’s interesting, with the oldest group snoozing about 20 minutes less than the middle-agers, who in turn slept about 23 minutes less than the youngest group. The amount of time spent in deep sleep, measured as “slow-wave sleep,” was also less in the older groups.

What about naps? Do older adults nap more (or need to nap more?)? I’ve always welcomed an afternoon nap. To me, it’s an all-ages indulgence. Here’s what they found about naps:

Daytime sleepiness was measured by asking the subjects to nap, which count in tallying your overall sleep, said study leader Derk-Jan Dijk, professor of sleep and physiology at the University of Surrey in the U.K. (Previous research has shown that naps are good for you.)

“But, we need to be careful; naps very late in the day may make you feel better for the remainder of the waking day but also disrupt your subsequent night time sleep episode,” Dijk told LiveScience.

When participants were asked to lie in bed and try to nap, here’s how long it took on average for the members of each group to doze off:

Age 20-30: 8.7 minutes
Age 40-55: 11.7 minutes
Age 66-83: 14.2 minutes

They claim that if you’re sleepy during the day, then you probably need more sleep.  Pretty much all of their studies indicate that older people sleep less, take longer to fall asleep, and given an opportunity to stay in bed for an extended period time will spend less of that time asleep than their younger counterparts.

They recognize that lots of us are actually sleep deprived, but state as their conclusion that:

“The most parsimonious explanation for our results is that older people need less sleep,” said Elizabeth Klerman of Brigham and Women’s Hospital & Harvard Medical School. “It’s also possible that they sleep less even when given the opportunity for more sleep because of age-related changes in the ability to fall asleep and remain asleep.”

But the study about lack of sleep and increased health risk calls these findings into question, at least where the idea of “need” is concerned. As I said up top, maybe we need just as much sleep as ever as we age. We’re just not getting what we need. This is most pressing in the middle-age demographic, not just because so many of us are just really busy, but also because there is this prevalent idea that we actually need less sleep.

Recognizing that the 40-60 age group are the most afflicted by inadequate sleep, Public Health England is starting a new campaign aimed at that age group:

Focusing on middle-aged people the new campaign will ask people to make seven lifestyle changes including stopping smoking, drinking less, exercising more and improving sleep.

Describing the new campaign Public Health England said in a document released last month: “Only around 20-30 per cent of what we think of as “ageing” is biological; the rest is “decay” or “deterioration”, which can be actively managed or prevented.”

“The years between ages 40 and 60 are thus a unique but neglected opportunity for intervention.”

So do we need less sleep, more sleep, or the same?

Artis said: “It’s a myth that older people need less sleep. Middle-aged people need the same amount of sleep, even if they don’t get it in one big block like people in their 20s and 30s. It may mean that people catch up on their sleep with an afternoon nap.”

It may be harder to get that same amount all in a stretch. I know that while I used to put my head down on the pillow, fall asleep within a few minutes, and stay sleeping until dawn, it’s not like that for me anymore. It’s a relief to know that I can make up for some of those losses with naps, though the afternoon nap is still a luxury that is not possible in my regular work day and not likely on a busy weekend.

Still and all, it’s helpful to have this information because it reassures me that when I’m feeling tired, there’s a good chance that the explanation is quite simple: I’m not getting enough sleep.

Summertime is such a great time to be out and about. It’s warm, often sunny, and greenness and lushness abound. Flowers, fresh produce, trees, grasses—everything is busting out in full glory. I know, I know, it’s August 9, and summer is almost… uh… over.

But let’s not think about that right now.

As I was saying—summer is a prime time to be out in nature, swimming, walking, climbing, biking, camping, sitting, etc. And science tells us that contact with nature is good for us; it’s been shown to boost mood, reduce production of stress hormones. increase pain tolerance and now, we find it can even reduce our tendencies for negative thinking. A recent New York Times article by Gretchen Reynolds focused on a study investigating how being in nature affects our brain function so to improve mood. In short, taking a walk for 90 minutes can help keep us from brooding.

No, I don’t mean this.

I mean this.

Here’s more from the article about brooding:

Brooding, which is known among cognitive scientists as morbid rumination, is a mental state familiar to most of us, in which we can’t seem to stop chewing over the ways in which things are wrong with ourselves and our lives. This broken-record fretting is not healthy or helpful. It can be a precursor to depression and is disproportionately common among city dwellers compared with people living outside urban areas, studies show.

Leaving aside a lot of the interesting neurophysiological detail (which you can find in the article) the researchers decided to test the effects of nature on brooding.

…The scientists randomly assigned half of the volunteers to walk for 90 minutes through a leafy, quiet, parklike portion of the Stanford campus or next to a loud, hectic, multi-lane highway in Palo Alto. The volunteers were not allowed to have companions or listen to music. They were allowed to walk at their own pace.

Immediately after completing their walks, the volunteers returned to the lab and repeated both the questionnaire and the brain scan.

As might have been expected, walking along the highway had not soothed people’s minds… their broodiness scores were unchanged.

But the volunteers who had strolled along the quiet, tree-lined paths showed slight but meaningful improvements in their mental health, according to their scores on the questionnaire. They were not dwelling on the negative aspects of their lives as much as they had been before the walk.

…These results “strongly suggest that getting out into natural environments” could be an easy and almost immediate way to improve moods for city dwellers, Mr. Bratman said.

Cool, huh? And not surprising. Our bloggers have written lots about the benefits of trips to nature, including here.   In Japan, the term forest-bathing  or shinrin-yoku, is used to refer to spending time outside in green spaces in order to get stress-reduction-related health benefits. There’s more info about it here.

But it does leave us with a question: what counts as nature for brooding-reduction purposes? I’m wondering because this year I’ve done a fair amount of urban and suburban adventuring outdoors—on a bike, on foot, on skis and in a kayak.  On Tuesday I went kayaking with my friend Janet and her sister in the Charles River basin. Here’s where we rented our kayaks:

This is a very urban and industrial (albeit watery) area. You launch the boat in a side canal, go under a rusty old bridge, and pop out in the Charles River basin, next to the Longfellow bridge, which is under construction. There’s a lot of activity, with a barge, lots of floating orange barriers, noise, and the sparks of welding going on. I didn’t take photos myself on this trip (didn’t want to tempt the fates by taking out my phone), but here’s an older photo I found online that gives you an idea of what it’s like:

In addition to navigating this steely industrial landscape, there were also the ubiquitous-in-summer duck boats trolling around. Here’s a lovely photo of one of them:

Actually, the photo above is misleading, as there were in fact loads of them all over the place, so we had to keep watch for them and try to stay out of the way. Of course, we had a great time, enjoying a picnic lunch on the Esplanade park area along the river in Boston, then getting back in the boats to return to the canal docks.  We did, however, make a quick detour to the local mall before returning.  I didn’t get out of the boat, but here’s proof I was there:

But the question remains: does urban nature provide those coveted mental health benefits? How many trees do I have to see, how verdant does it have to be in order to chill us out?

This may seem like a silly or pedantic question (and as a philosopher, I embrace both), but it could have real consequences for public health. If we know that some amount of green space in urban areas confers real benefits on populations (like lowered blood pressure, cortisol, pulse rate, etc.), then this would give us reason to fund more public green spaces and offer more nature programs in cities. There are lots of reasons to do this anyway, but here’s one more: it may be good for our health. We don’t know enough yet about the interaction between urban space and green space, which is worth pursuing. In the meantime, I’ll keep a healthy dose of urban outdoorsiness in my activity diet.

I’ve written before about cyclists and our tan lines. See here.

I manage to avoid sharp tan lines on my arms thanks to arm coolers and sunscreen but my legs are another matter.

This year my cycling short tan lines really came into their own on the Friends for Life Bike Rally. Six days of riding in heat alert conditions will do that. Each day we rolled into the campsite, stashed our bikes, and changed into our bathing suits and hit the lake.

Each day I noted the expanse of white thigh between my bathing suit bottom and my tanned cycling legs and each day it got worse. And this year since my favorite pairs of bib shorts are different lengths, I even got the two tone version.

After the rally I hit the beach at the Pinery with friends, family, and dog and by then it was pretty remarkable. There’s no big solution. I’m not sure I’m even looking for one. I ride my bike a lot and it shows.

I’m not usually a big fan of the many rules of cycling but these days it seems I’m doing well by rule 7.

Rule #7 // Tan lines should be cultivated and kept razor sharp.

Under no circumstances should one be rolling up their sleeves or shorts in an effort to somehow diminish one’s tan lines. Sleeveless jerseys are under no circumstances to be employed.

What’s your strategy for cycling’s distinctive tan lines? Love them or hate them?