I Think Sick, Thus I Am Sick

in #steemstem6 years ago

Today´s post was inspired by a comment made to "Is Alzheimer’s Disease Caused By Viruses?". This comment stated various things I do not agree with like AD and cancer were merely emotional diseases. You can decide for yourself if you agree with this statement or not, I do not. However, there is some truth to this comment. There are diseases that can be triggered by emotional state, and our feelings and thoughts can make us sick.


I was one of those kids that HATED school. Everything was always so slow, such a waste of time. Needless to say, I wanted out. What better excuse than feeling sick?
This day will always be in my memories. I decided that I had enough schooling for one day and started pretending to feel sick. Already being a master at this game, my family was informed and somebody came to pick me up. I had to continue the show so nobody would become suspicious. Anyways, when I arrived home, I got out of the car and threw up, even though I was feeling fine. The power of the mind. How could an elementary schoolboy make himself throw up even though he was absolutely fine?

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Our mind does not just produce colorful ideas - by ElisaRiva, CC0

Our mind is a powerful tool. It enabled us to overcome complex problems by finding innovative ideas that we draw from sometimes mundane observations. Things that happen in our heads are beautiful, scary, colorful, dark. It is a fascinating and yet not well world inside our heads, one that attracts huge research efforts. Yet people say we know more about the surface of the moon than about our brains. This lack of knowledge may be one of the major causes of disease. Because the power of the mind goes well beyond creativity and feelings. Our mind does influence the state of our body more than we thought for a long time. Many diseases are now, at least in part, attributed to an unhealthy emotional state.

I remember a scene from the formerly popular TV show "Scrubbs". A lady was suffering from heart disease, but medicine was unable to determine why. Turns out a loved one had died and she was suffering from "broken heart syndrome". I picked this particular example because the relation between unhealthy emotional state and heart disease has been investigated for a while, and I think the connection may be a little bit more obvious. Here is why I think that.

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Fight or Flight, a natural response - by AlbanyColley, CC0

We all know of the fight or flight response. A stress stimulus causes our peripheral nervous system to slow our digestive system down and to focus our blood and energy supply to the major muscle groups (a shift from non-conscious to the conscious system if you will). This response is natural, and in most cases not harmful. In fact, if controlled to be triggered 2-3 times a week for roughly 30 minutes this system seems to be very healthy (a good workout routine). Our heartrate (HR) and blood pressure (BP) go up, we start sweating and feel energized. This is all natural and there is no reason to avoid sports (unless your heart is not healthy enough, check with your doctor). The problem is that in our modern world there are more stressors than ever, some of which do not seem so obviously stressful. Various stressors affect us in our everyday life. In a medicine book I found calculating in your head to be a stressor. There are several studies that show a correlation between noise exposure and incidence of CD. These studies were often linked to air traffic and car traffic as noise sources. A study suggested that this is not proof of a cause-effect relationship. Car noise comes from cars, which also produce fine particles, which are themselves a possible CD causing agent. The data for a possible correlation between noise and CD is not yet conclusive enough to determine it as an independent factor. This examplifies a general problem in the stress/disease theory. What is stress?

Friedrich Schiller, a very famous German poet, is rumored to have loved the smell of rotting apples. My whole family likes mushrooms while I hate them. Some people like to talk about every little detail of their day while others prefer to be quiet. These examples are more relevant than you may think. While Schiller was pleased by rotten apples, others may be very stressed out by the sight. While my brother may feel good eating mushrooms, I dread them. While others feel relieved sharing their thoughts with everybody they see, others may feel annoyed. It is very difficult to pin down exactly what a stressor is.

Additionally, the type of stress we experience is different. As I said, the fight flight response is natural and used to occur relatively frequently. These days, it is much more seldom (usually only if we go to the gym). A theory I encountered in "Lehrbuch der inneren Medizin" introduced an interesting idea. Our lives become faster, not physically, but emotionally. We can get around faster and talk to more people faster. This causes the number of inputs (stimulants) to raise. In the book they stated that the number of inputs we receive daily increased 1000x compared to our grandparents (this book is from 1992 btw). While each input itself may only pose a small stress level, the sum may be overwhelming. Additionally, each input may only cause a small physical reaction (like slightly increased BP and HR). However, since we receive so many inputs, the response is prolonged over very long periods of the day. While this can be tolerated for a while, this prolonged stress response can become chronic (and possibly irreversible). This is a possible direct link between stress and disease. However, how is this related to our mind-disease idea?

In addition to "living faster", our lifestyle provides us with many opprtunities to compare us to others. We are pressured by a perceived requirement to be succesful financially, to be individual, to have many friends and even to be happy. Never before were we subjected to such a vast amount of suggestions as to how we should live our lives.

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Work by the beach, CC0

Here an illustration. Mr. Richards works in an office. By accident, he stumbles upon a video on Youtube, which has been posted by an Australian guy. Mr. Richards sees images of people working by the beach, drinking ice-cold beer while hammering code into their laptops. "They are doing what I am doing, but seem to be much better of and happier than I am", Mr. Richards thinks. He is jealous, he wants that lifestyle for himself. But he is scared of the risks. He tries to think through how he could achieve such a lifestyle. Does he really want to quit his job and live in a foreign country? Will he make enough money? He sees more videos. People say that they should just go for it. What can happen? What could be worse than the situation they are already in? People are too scared to pick up their dreams. Mr. Richards starts feeling bad, his self-esteem drops because he feels like a failure for being to scared to live out of a backpack.

This constant comparison of what we have to what others have can cause us to lose focus of who we are and what is best for us. It also subjects us to immense pressure. Anxieties arise, and the risk of becoming depressed increases. And this is a very dangerous condition, not just for our minds, but also our bodies.

Depression is a very complex disease and I have heard various explanations for it ranging from infections of the cortex to "willingness" to be depressed. Some of the more accepted causes are social isolation, constant pressure, genetic predisposition and conditioning when we were kids. Depression has been found to be a possible independent risk factor for cardiovascular disease (CD). Especially the onset of myocardial infarctions seems to be influenced by a depressed mood. Even the aforementioned Broken Heart Syndrome could be seen as a possible link between depression and heart disease. Intense emotional stress can trigger heart insufficencies.

But even pre-depressive emotional distress can be unhealthy. Almost everything I have talked about above can be classified as stress (stressors, comparison, social isolation, etc.). Acute stress influences the immune system. It can activate the immune system and surpress the immune response, thus potentially affect the occurance of cancer and CD. Generally, it appears that both cancer and CD are more frequent in highly stressed people.

The key in this model are so called cytokines. Pro-inflammatory cytokines are there to invoke inflammatory responsed and are part of our immune system. However, they interact with many different systems in our body. Some of these systems are linked to the pathological (bad) changes that are associated with depression. This includes neurotransmitter metabolism and even behavior.

Let´s take a step back and take a look at the big picture. Bad thoughts can induce emotional stress, which can trigger immune responses that influence our health and mood, in the worst case leading to more bad thoughts that can enhance the effect, ultimately putting us at risk of falling into a depression. While stress itself can increase the risk of CD, general illnesses and even cancer, depression causes another independent risk factor. As you can see, a sad mind could be at greater risk of falling ill. But what can we do?

Well, that is a tough question. Looking at my argument here the solution at hand would be to adopt a positive mindset. To some this is very easy, for others almost impossible. One study even suggested that there is no "universal" prevention and that the most succesful preventive actions were more "treatment" than actual prevention. This shows that prevention of despression and stress are for each individual to figure out. However, there are things that may help. Excercise could help in the prevention of anxiety and depression, eventhough I found at least one study that stated the available data was inconclusive.
I will share personal experiences. We all have depressive tendencies, at least once or twice in our life. As I stated, there is no universal preventative method. This is solely my own observation, I do not claim scientific accuracy or general applicability.

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My personal depression prevention

My depression prevention includes a "always try to say yes" approach. Whenever somebody asks me to do something, unless I feel absolutely crapy, I will say yes. This also applied to myself, meaning if I have an idea, something that sounds like something I may want to do, I will at least start doing it (that is how I got to learn English, playing the guitar, and chart analysis for trading). Accomplishment is a great feeling. However, it also poses the risk of information overload. Whenever I feel like it is too much, I go for a walk or on a hike (I do that daily, btw). For me nature is the ideal place to calm down, be active and breath. I get alone time without being alone. If you have not found your personal depression prevention, do not worry, it is neither your fault nor does that mean that it does not exist. Just keep looking for it and try new things. And do not be afraid to talk about your feelings. There is always somebody who will listen.

With these words I will end today´s post. There is much more I could talk about, more detail as well as application of the mind-disease theory (for example in healing). I will leave this to somebody else. This is a very complex topic, interesting nontheless, and I would recommend everybody to read about it. Body and mind are closely connected. A broken body can corrupt the mind, and vice versa. Stick with what makes you happy. Be mindful of your friends and do not force yourself to be social if you are not.


General Sources

  • Oldest study indicating link between personality and ability to deal with stress Link
  • Articles showing link between disease and psyche suspected for long time Link
  • Calculating in your head can raise HR and BP and be a stressor - Table 1.50, Chapter 1 from "Lehrbuch der inneren Medizin" 1992 (Siegenthaler, Kaufmann, Hornborstel, Waller)
  • General Physiology enquiries "Human Physiology: From Cells to Systems" 2016 (Sherwood)
  • Broken Heart Syndrome - Link
  • Attachment and Psychosomatic Medicine: Developmental Contributions to Stress and Disease - Link
  • How does stress affect you? An overview of stress, immunity, depression and disease - Link
  • Depression and the risk for cardiovascular diseases: systematic review and meta analysis - Link
  • Cytokines sing the blues: inflammation and the pathogenesis of depression - Link
  • Exercise in prevention and treatment of anxiety and depression among children and young people - Link
  • The prevention of depressive symptoms in children and adolescents: A meta-analytic review - Link
  • A meta-analytic review of depression prevention programs for children and adolescents: Factors that predict magnitude of intervention effects - Link
  • Psychosomatic medicine on ScienceDirect - Link
  • Article in The Telegraph by Neurologist Suzanne O´Sullivan - Link

Studies Suggesting Link Between Noise And CD

  • Traffic Noise and Risk of Myocardial Infarction - Link
  • Traffic noise and cardiovascular disease : Epidemiological review and synthesis - Link
  • The association between noise exposure and blood pressure and ischemic heart disease: a meta-analysis - Link

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Thank you for reading today´s post. If you have any opinions I would be happy if you want to share them in the comments. If you are interested in this topic and want to write about it I could give you some pointers about possible topics. If you spotted mistakes please let me know (be nice or I will just ignore you).

As always,
Cheers @lesshorrible!

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Hey, really great post. This is a topic that I think a lot about. In healthcare were trying to move the system away from a purely biological approach towards what is known as the Biopsychosocial approach to healthcare. This takes the biological aspect and add a social background (i.e. socio-economic, ethnicity, level of education) and aspects of the psychological (i.e. coping strategies, personality mood). As you mention in your post biological cause of illness are not the only reason for their occurrence/exasperation.

One of the great challenges we face now is how do we build in the psychological aspect into healthcare without people thinking that positive thought alone can cure their cancer. Us humans are not the best at nuance we like things very black and white. The issue therefore is we have science showing that the mind has an effect on the body and then we have those in the complementary and alternative health community pointing to that literature and saying “see, all you need is good thoughts!”. Tough job, we’ve still a lot left to learn.

Keep up the good work, I’d suggest you take a look at Robert Sapolsky sometime here’s a video him talking about Type A and Type B personality and there link to health (note: personally is vastly more complicated but this finding is quite nice and links well with your post here. 6 mins long).

I agree with everything you said. Especially with medicine, it is very difficult to communicate new findings with the public. I did have some conversations with people how to communicate science with a society that includes graduated bachelor students who cannot tell a mol from a mole.
I think that the mind still is a purely biological thing (I am not spiritual). On a more abstract level you could compare the mind with our gut. Food (input) triggers local effect which can become systemic. I am glad that psychology and sociology are being incorporated into medicine because it really is a factor. I see one big problem with that though: who will take care of it? I know that in the US there is a medical school admissions test (MCAT) which now features a big psychology section asking useless details (what stage is this kid in if it does that?). I think it would be wrong to ask doctors to be psychologists (which seems to become a thing in the US). Rather, psychologists should be employed in hospitals and team work should be encouraged. Another thing is that people now tend to be less social. My grandparents and even parents were very involved in clubs and societies, things that are not as popular anymore (unless you are a student). Anyways, sorry for the VERY long reply. Thanks for stopping by and the quality comment! Cheers!

My grandparents and even parents were very involved in clubs and societies, things that are not as popular anymore

Ah yes, this is the decline in social capital it’s a massive factor in public health research.

Thanks for the reply, I’m going to have to go look through the other comments you‘ve had here. Looks like you’ve sparked quite the debate!

I am overwhelmed by how much appreciation this post got if I am honest. However, the amount of opinions shows us that there are still many things that need to be clarified. Glad though that I seemingly inspired some people. Cheers!

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Hey cool, thanks! 😀

Beautiful, I wish a speedy recovery .. Well done on these words
Great work from you
Thanks for sharing‏..

I agree the mind is very powerful! If you think it, you can have it. My problem with this is that I can think it just fine, but I have problems removing doubt from my mind. And that is what is preventing me from achieving the things I want it.

That is the case with many people. You should try, but do not stress yourself with it. Cheers!

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I closely follow the work of Donny Epstein. He is my Chiropractor's mentor, and he created the healing art of Network Chiropractic. He is probably the world's most successful healer. He has worked with over 200,000 people in 30 years. The basic premise of his work is to heal and transcend traumas and emotional problems. There's a great story of a man in his book The 12 Stages of Healing: of a man who suffered from a heart condition. One day he was home alone in bed when all the trauma of his father's passing years ago came bubbling to the service. He had avoided dealing with it for over a decade and he drowned himself in work and productivity. He was in shear agony. He said if anyone had been home with him, they would have called an ambulance because he was in such a state. But it was a good thing he was alone and he went through the process, he said. His heart was in agony as he went through this process. But wouldn't you know, after he went through this process, the energy was released, and he no longer had heart trouble. There are many such stories in this book.

Have you ever researched about the mind not being in the brain? The newest research is pointing to this not being the case. They're not really sure where "mind" is.

Well, the "mind" is a word we invented to describe our consciousness I think. However, the studies I have seen suggest that mind and body work together. I mean, they are the same thing. From a biological standpoint the mind is the body as it is based on the physics of the body. To me the mind really is not all that spiritual. Its like you need to feed your body the right things - it is the same with the mind. There is a trend in not separating psychovegetative medicine anymore, but incorporating it in every medical specialization. What I think is entirely wrong is to take the mind as the cause of all disease. Yes it does have a big influence (possibly bigger than we think), but psychotherapy for a diabetic probably will not cut it.
Thank you for your elaborate comment! Cheers!

mind and body work together. I mean, they are the same thing.

Bingo

Indeed, one may need to change their eating habits or stop smoking, or there may be an allergen they're in contact with, or they may need a certain mineral, etc. But the premise is that if a person is unwell psychologically or emotionally or has unresolved trauma, that person is also not well enough to make healthy choices. The energy is blocked. Since the "mind" and body are connected, well, they are the same thing, energy from traumas get built up in the body. This causes a blockage of energy. Health is a healthy flow of energy. If energy isn't flowing properly to an organ or an area of the body, then that organ will be unbalanced and unwell. I know this sounds very "spiritual" and woo woo, but science is starting to verify these things. Donny Epstein discovered a "wave" in the body when he heals his patients with Chiropractic. This wave is being studied by scientists and doctors and many different professions.

In Chiropractic science and philosophy (traditional - many modern Chiropractors have diverged from this principle), there is a concept called Innate Intelligence. It says that this Innate Intelligence runs our bodies. It beats our hearts, it performs all the functions. The goal of Chiropractic is to remove any interference from Innate Intelligence being able to express fully.

Sounds like this is actually being more and more incorporated into modern medicine (like in osteopathic medicine in the US. I have heard of innate intelligence (but rather in the context of "what is intelligence"). What I heard was that innate intelligence is the ability of the body to detect its position in space among other things (athletes would have a high intelligence).
I am not denying that spirituality is useless and bogus. Rather I would say it is misunderstood. All parts of the body communicate and people are moving away from a "brain" only view. We long know of the peripheral nervous system that is capable of dealing with certain things by itself. Recently talk of a brain-gut axis arose. We are understanding our perception better and better every day.
I believe that the aforementioned "conversation" of different tissues in our body is responsible for the link between psyche and health. I am not sure if this is an "energy" flow problem. The issue is the word "energy". These events you mention are probably due to bioelectricity and chemistry, but have not yet been described. Again, I am not saying your statement is wrong, but there is something very physical even behind these spiritual events (physical as in electrons and atoms doing something we do not know exactly what as of now).
Cheers!

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Your post just won my heart @lesshorrible man. Right now, I am in 12th grade and feeling the same way you feel about school. There's nothing to learn new. They teach us in the same manner, the same thing. They never ask what their students wanted to be. They just tell them to get an A in every exam. And if I talk about real practical work, well that isn't going to happen out there. All they care about is theory stuff. If we compare 90s classrooms to today's classroom, in some places, everything is still same.

By the way, I am sticking with you and following you because you just made me happy. Thanks for such a great post.

Yeah, the school system needs a real update! They do that with Windows, cars, mobile phones, clothing, why not with schools? The earth is changing and also the mind of people because of the new technology, the new inventions. We have to get rid of the old school :)

If I got the money and power, someday I will surely try to end this mess for good.

Agreed, in full! But let me tell you, it will get better if you go to uni and study something you care about. I was shit in high school, but a lot better in uni. So keep pushing through, it gets better. Cheers!

Well, I know that and I care about internet marketing stuff. And in our country schools, there's no such thing. All they study is history, political science, maths, science, english, hindi, sanskrit, economics, business studies, accounts that's all.

You mean at your universities?
Well, what helped me to at least finish high school well enough to study abroad was to learn what I like on the side. If you like marketing, buy a book and check out Youtube. You could start a little business (like where you sell T-shirt designs as an example), and see how Search Engine Optimization (SEO), promotion and ads help (obviously make sure you follow the law). Keep yourself busy with stuff you like, as a reward for stuff that you have to do. I know school can suck ass, but it should not stop you from learning what you are interested in.
Cheers!

Bro I have been studying internet marketing the way you are telling me. ☻ Finally, I found a place like steemit where I can grow myself as an internet marketer and writer also.

Awesome! Good luck with your future projects! Cheers!

@lesshorrible i think that today's life is becoming busy and tough by passing day by day. People are now no more emotionally active. because of the busy and technically advance life, everyone have their on world of living.
Depression is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable.
Meditation is a best way to get out from the painful world of depression. because in meditation, you really try to understand about your own self and learn the ability to how to control your emotions and live the live peacefully.

Thanks for your comment! I have to disagree. There is NEVER a single best way to solve a problem. I think meditation could be a good thing to try (for anybody, btw), but it may not work for some. Nothing against you or what you said, but I have to make sure people put things into perspective and see the big picture rather than focusing on a single solution to problems that usually do not have a single source. Cheers!

This is an excellent post and it's great to read @nonzerosum comments on moving healthcare towards a more integrated understanding including the impact of psychological and emotional factors on what has been deemed to be purely physical in the past.

I am really excited about these understandings becoming more publicly accepted and the future of medicine with an understanding of epigenetic factors, therefore looking at physical, mental, emotional, social and environmental aspects in health.

I agree. I feel like this will require healthcare to be changed dramatically. It also causes some concern, at least for me. Because things like emotion, etc. are very subjective, how will it be applied to modern healthcare? The doctor will need more time with a patient. Doctors tend to be overworked as is, so we’ll need more doctors. This is just an example, but there are many more issues. Modern healthcare, I think, will not be feasible in the future (there are already huge problems here in Germany). This will require smarter people to work harder than the clowns we somehow continue to elect into offices. Cheers!

Some things will always be subjective. Emotions are felt differently by different people, although there is some common ground of course. Likewise, anything that is happening in the subconscious and unconscious mind will be subjective as well.

However, there are very effective ways of working with these aspects that can be done along with medical treatment.

Examples are EFT (tapping), Havening, hypnosis, NLP etc, which are all being increasingly understood and tested. These could save health authorities a lot of money as they can be quick and effective.

So, finally I got the time to read and write something about your post as well.

Excercise could help in the prevention of anxiety and depression, eventhough I found at least one study that stated the available data was inconclusive

The mechanisms behind physical exercise are quite complex and yet not fully understood. As far as I know, most of the available literature seem to indicate a positive correlation between prevention and/or treatment of at least affective disorders - although it cannot be said for sure, whether there is a causation or not.

But even if the correlation turns out not be be relevant at all - there are so many more already proven benefits of regular exercise, which should encourage everybody to workout constantly.

I think, some of the most prevalent diseases can be at least partly prevented with a healthy lifestyle, which is mainly a combination of strong mental resilience as well as a strong body.

There is no reason to avoid a healthy lifestyle and I would HIGHLY suggest people to adopt a diet rich in vegetables and fruit, and work out MODERATELY. It’ll be interesting to see what we will learn in the future. Cheers!

Awesome article... I agree with you completely, Our body respond to what we make it feel. when we are so stressed, we are more prone to diseases.
and health, now days, It has become a commercial business. Doctor can not make money if everyone is healthy. There are lot of Doctors available and still we can see there is lot of diseases spreading. Doctor don't like to cure, they just manage the disease so that you could come back and pay them your hard earned money.
For example...
diabetes is a very common now days, when a diabetic patient go to a doctor they just give them medicine which can only regulate their sugar they dont cure it. I recommend you guys plz search Dr. Joel Wallach and see yourself how the health industries playing with people's life.

and if you like visit my post and share your opinion...

https://steemit.com/health/@shanks25/how-to-make-your-body-less-prone-to-diseases

Bad thoughts can induce emotional stress, which can trigger immune responses that influence our health and mood, in the worst case leading to more bad thoughts that can enhance the effect, ultimately putting us at risk of falling into a depression. While stress itself can increase the risk of CD, general illnesses and even cancer, depression causes another independent risk factor. As you can see, a sad mind could be at greater risk of falling ill. But what can we do?

@lesshorrible, I found out that this post making distilled is as a result of good judgement of the editor. Truely the state of our mind plays a long role in the state of our health. The quote I made from your post is a pointer to it.our immune system rely on absolute peace of our mind

Turns out a loved one had died and she was suffering from "broken heart syndrome".

Just yesterday I discovered a book called Can You Die of a Broken Heart?, and looking inside I saw the answer is apparently 'yes' 😧

Ever read Why Zebras Don't Get Ulcers? It's been in my reading list for ages, but I've never read it. It too seems pertinent to what you're writing here.

Ironically I am planning a post about ulcers, especially the role of H. pylori. Coincidence? Probably alien illuminati. Anyways, there are still many things we do not know about us and the world we live in which is why science is important. Cheers!

brain the most misterious part of every living creature's body some times shows us wonderous things..such is the power of brain that it can take us back to any part of our life while we take a nap or sleep at night the scenes maybe darker or some times happier moments of life... it is so amazing that it can even show us our fictious flashes that we usually daydream off...and the best part is it feels like its actually happening with us...
this topic on brain is as vast as the universe and every person has i
his/her's own perception and story regarding this most important organ of the living beings....
sir,(@lesshorrible) your article was an informative as well as enjoyable(the story parts) there are many things u mentioned above that happened with me also during my childhood days...u just made me remember those moments
one again thankyou for such a great article...

this is an awesome interesting read! Especialy to know about the cd's and the relation to stres... I was during study to get some practice in the field a research analyst where we did research what receptors possible are triggered by what and all... for my own relief or prevention i experienced that letting out what i struggle with in any way ,, sometime in the offensive is relieving a little... walking around i did too but now is not helping anymore... but thanks for this read i think a lot of people can relate aswel.. i am going to keep an eye on your articles!

lesshorrible how to solve dog feeling sir

There is no simple solution. Try new things and figure out what makes you feel well. Cheers!

very nice and informative post https://steemit.com/mgsc/@abhishekkashyap/sophia-a-scam please checkout my post and help me grow

Way beyond that stage. Cheers!

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good knowledge about health good job

As a boarding school student long time ago, i think i understand the power of the mind better as it pertains to sickness.

This is so much information @lesshorrible. Good work!

Resteemed

I agree, too often we try to separate body and mind as if they were completely antagonist but the truth is that the mind affects the body and the body the mind.

If you don't sleep, eat badly or don't do any physical activity you'll find your mind not functioning properly and if you get depressed, well, your body will suffer from it as well.

@lesshorrible how to increase reputation in steemit. by upvoting to others i found that our steemit estimated account value is decreasing by upvoting how to keep up.

If people upvote your posts your reputation increases. If they flag you (which seemingly happened to you) it decreases. Keep upvoting, thats how this platform works. Cheers!