Time Value of Health

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Let’s introduce a simple term to an old problem in health care. As health problems increase, and their costs rise, we need to start thinking about ways to make it easier for the public to improve the lifestyle choices they make.

What you do today influences what happens tomorrow. Eat a deep fried donut today, have a heart attack later in life. Your health has a time value. Let me explain.


The concept is simple and it borrows from finance the concept of the time value of money:

A dollar today is worth more than a dollar tomorrow.

This is important because the opportunity cost of taking a dollar tomorrow is the investment that you could make with that dollar today. In terms of health, exercising today is an investment of effort that pays of in the future. Another way to look at it is the future value of a donut:

The future value of eating a donut today is a heart attack years later.


It’s a simple concept. One of the reasons Americans are so unhealthy these days is because we don’t consider the consequences of our lifestyle choices in ecnomic costs. Invesment always involves effort, sacrifice and consideration of options. Long-term investors almost always enjoy prosperity over the course of their lives. The essence of (good) capitalism is discipline and self-restraint. So my definition of the Time Value of Health is this:

The time value of health is the interest you accrue from delaying the cost of an acute or chronic disease later in life.

If you don’t think that the time value of money is a matter of health, just look at the primary cause of our current economic health. Do you think that if all of the people involved in the biggest ponzi scheme in history exercised discipline, that we’d all be in better financial health?

Weight-management is harder for some people than others. So is daily exercise. Our culture isn’t helping: as we move more online, it’s easier to forego healthier choices that enhance our cardiovascular systems.


The Time Value of Health doesn’t require complex calculations. It doesn’t need a number. It just requires a little imagination. Don’t make too much of this concept I’m offering you.The next time you’re tempted to go nuts on foods that you don’t need, ask yourself a simple question: is it worth the pleasure of eating this eclair to endure a stroke in 20 years?

Consumers If your a consumer, consider incorporating the idea into your lifestyle. Don’t be a nazi about it. Maybe just use it to save the goodies as a treat once in a while, or for your weekend. Create zones of healthy living. We all need indulgences (there’s health in feeling good about a nice dish). Investing some effort and discipline how you live earns a healthy return over time. What’s more, often the returns pay sooner: being fit and active produces a sharper, happier mind.

Providers If you’re a healthcare professional, consider ways of introducing the Time Value of Health into your practice. You probably don’t have much time anymore to give long speeches with tons of advice (too bad). A simple meme can often travel far. What’s to lose?

Readers Does this intuition pump help? Is it frivilous or does it offer a meaningful practical way to help improve the lives of good people who have a hard time with making healthy choices? The next time you grab those wings, or all that sugar in your coffee, could you imagine yourself on the floor panting in agony for breath in front of your children or granchildren?

What is the time value of your whole life?

(Sorry for tempting you with those donuts above. It’s OK, one won’t hurt you, will it?)

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Twitter, Heroin and Time-Warping

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Do you Twitter? Does Twitter distract you from your goals, endpoints and purposes? When using Twitter, do you lose your sense of time? Do you feel brain-drained from too much tweeting or not enough? Simple question: Are you addicted to Twitter?

Being fully engaged in any activity and feeling a sense of well-being or losing your sense of time doesn’t mean that you’re addicted. You simply could be in a state of optimal psychology referred to as Flow, a state of mind in which your skills increasingly match the challenges you face.

Whenever we experience pleasure – whether from a complement or a warm emotion or an achievement – our brains generate a remarkable cascade of bio-chemical reactions. The sense of euphoria, no matter how short or long, reinforces our desire to re-create the experience. Blogging, for example, can be a healthy release if done right.

Chemically-induced pleasures, such as those produced by drugs like heroin, easily create life-long cycles of addiction. Heroin is evil: and yet millions of good people lose themselves to it’s near-instant addiction.

Authentic experiences that require focused effort usually don’t result in addiction. Constantly refining your blogging skills, for example, can produce a euphoric state of flow without the side effect of addiction. When a behavior that doesn’t require much investment of effort but creates a chemical high, the behavior can easily transform from a healthy activity into an addiction.

Research has shown conclusively that email can be addictive. It stands to reason, then, that Twitter too can become the object of an addiction. So, how do you know if you’ve crossed from simply being a focused Twitterer in Flow into being addicted to Twitter?

An old and fairly reliable test of addiction is a clinical tool: CAGE. There are other tools which doctors and nurses use in assessing addiction, but CAGE is popular and simple. CAGE is an acronym for the following four questions:

  1. Cut down – Do you ever feel that you should cut down your tweeting?
  2. Annoyed – If someone asked you to cut down tweeting, would you get annoyed?
  3. Guilty – Have you ever felt guilty about your use of Twitter?
  4. Eye opener – Do you HAVE to tweet shortly after getting out of bed (or before)?

Now, I admit, it may sound laughable to think of Twitter as producing an unhealthy addiction. Social media addiction has received a fair amount of attention. JW Saas has an amusing blog about the problem, with an entertaining focus on Twitter. The fact is, however, our brains are wired – in varied ways – to become easily addicted to almost anything.

I predict that as we all adopt new social media tools while our world becomes increasingly reliant to electrons for our fundamental need to connect with on another, that we will all run greater risks for addictive behaviors. If you sincerely believe in the power of social media strategies to change the world for the better, then you should consider the risk of our addiction to these tools to be an important part of our ongoing social media conversation.

Why should we be afraid to discuss this? If we value the truth then fear of the truth is never a rational fear.

I love to use Twitter. Lately it’s become a sort of Social RSS for me: I can connect with good people, exchange ideas and experiences and follow leads to a disparate pool of useful or entertaining information.

Still, I find myself every now and again in a time warp: in short, I lose time and I lose focus on my goals. They aren’t major disruptions, just an interesting phenomenon. Fortunately, I always assess where I am, close up shop and return to my work and life.

If you enjoy Twitter wouldn’t you want to know that your enjoyment is real and not an addiction? There’s a lot of Twitter-heroin and time-warping in those 140 characters, isn’t there?

What about you? Do you find Twitter addictive? Can you honestly ask yourself the CAGE questions? What do you do to check your tweeting routines? Does this post help you? Or am I totally off-base and Twitter has no potential to cause any harm?

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Advice for the Bipolar Hearted

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Bipolar affective disorder might be one of the most common afflictions among some of the most productive members of society. In fact, much of what we find most exciting about our civilization owes some measure of debt to the accomplishments of talented people who happened to inherit a disordered genetic trait. Unfortunately, the cost of this elusive illness is higher than its apparent benefits.

Somebody you know or work with (or for) probably has bipolar illness. You know famous people who have the illness. Every once in a while you hear about a suicide that seems to have come right out of nowhere. It most likely was due to manic-depression.

Successful people that you look up to have the disorder. Sooner or later, however, that person’s illness will take a nasty downturn.

Contrary to public mis-information, most people who have some form of bipolar illness are functioning, productive and otherwise healthy contributors to our world

Still, the illness is lethal. It crashes career parties. Bipolar illness has demolished good, hard-working and intelligent people’s lives. The stigma that our society loves to stamp around is just about as dangerous. (More on that in a future post, so subscribe here for updates.)

So, what do you do if you’re a successful lawyer or neurosurgeon or entrepreneur with bipolar disorder?


Well, if you have bipolar disorder, or know someone who does, I’d like to share some pointers about how to live a good life in spite of the illness. Having worked a bit in psychiatric nursing, I learned a few things from some amazing patients. Here’s some advice to those of you have have bipolar disorder and would like to remain healthy and productive:

  1. Sleep. Lack of sleep is both a symptom and a cause of hypomania
  2. Keep taking your medications, especially when you think you no longer need them
  3. Keep up with psychotherapy if only to get feedback on your mental status
  4. Don’t glorify hypomania: depression always shadows hypomania
  5. Don’t over-pathologize your illness: accept it, treat it and keep your life in perspective
  6. Attend support groups and include your family or most trusted friends in the loop
  7. Don’t get discouraged by setbacks: it’s an illness, not a punishment
  8. Keep a mood chart up-to-date and show your doctor and therapist
  9. If you find yourself suddenly dabbling into religious or alternative philosophies, be suspicious and talk to your therapist
  10. Understand that you and your illness are two different things
  11. You don’t always have to be productive: accept the fact that you will need downtime
  12. Know your pressure points (aka triggers): determine what sets you off and develop simple tactics for cooling off

This list can go on and on. I’ve missed a lot, perhaps you can add your suggestions to the comments below.


Some of the brightest, most successful people I have met in my life turned out to suffer from the disease. Some of them went undiagnosed for decades. They spent most of their lives in a mild form of hypomania and never experienced depression. For them, when their illnes caught up to them, their depressions were utter hell.

When people who have bipolar illness enter depression, it’s a much more hellish experience than it is for most people. Imagine: you’re sky high, everything in life feels to be going for, your libido is fully charged and satisfied. Then: slam, the door shuts, the lights go dim and life conspires against you. Could you handle that? Could you go on? Of course, you could: but most likely, without help, without knowledge, without hope, you could find yourself right in the center of Dante’s Inferno.

So, to you who have this illness: don’t give up. Don’t kill yourself. We need you. You, and your ancestors who carried the genes that you inherited, have made this world so much more interesting, in spite of the illness. If you’re up: be careful. If you’re down: be kind to yourself and get help.

To you who don’t have this illness: be aware that the manifestation of bipolar illness is all around you. Traces of it are in the art you view; the movies you watch; the music you love; the books you read. You need to start caring for these peoples’ lives. You have much to learn and much to lose when these beautiful people leave our world out of painful desperation.

These days, fortunately, we no longer have to let good people die from a bad disease. Bipolar disorder is not a character flaw, nor a punishment, nor a justification for ignorant stigma. Neither is it something to glorify. Hendrix said it best: Manic depression is a frustrating mess. But it doesn’t have to kill you or end the beating hearts of those you love and who love you.

Learn more at NAMI and become a hero. If you think this post is useful, please use the ShareThis button below to email or otherwise share it.

Disclaimer: none of this is medical or other professional advice. It’s just some chicken soup. If you or someone you know is in crisis, just dial 911. Thank you.



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