Topic: MIND

2 Simple Actions to Help Curb Mental Illness Stigma

Mental health and substance abuse advocacy is a growing movement. Each May, the Substance Abuse and Mental Health Services Administration (SAMSHA) declares a week as National Prevention Week. It’s defined as “A week dedicated to bringing an annual health observance dedicated to increasing public awareness of, and action around, mental and/or substance use disorders.” The focus is on preventing suicide, substance abuse, and undue suffering from untreated conditions.

Unfortunately, despite such campaigns and mental health being more “out of the shadows” in recent years, stigma and misunderstanding are alive and well, and contribute to lack of care and, ultimately, undue suffering.

According to the National Institute of Mental Health (NIMH), about 51.5 million Americans have a diagnosable mental illness (2021), yet fewer than half seek care. Contributing factors include lack of providers and people not understanding that their condition is treatable. However, the stigma of mental illness is quite possibly the most significant contributor. According to trauma psychotherapist Lisa Ferentz (2021), “Our culture still perpetuates the belief that people suffering from mental illnesses are not intelligent, extremely violent, or incapable of making decisions that profoundly impact their lives.”

In 2015, the University of Memphis published four disturbing facts about mental illness perception:

  • 4 in 5 think it’s harder to say they have a mental illness than other illnesses.
  • 1 in 2 are frightened by people with mental illness.
  • “Psycho,” “nuts,” and “crazy” are the most common description of those with mental illness.
  • Mental illness ranked as the most stigmatized type of illness.

Ironically, even some treatment facilities contribute to the problem. Despite the push to destigmatize and encourage people to seek treatment, many facilities adopt names devoid of the words “psychological,” “mental,” or “behavioral.” While the intention is to make sure it is a place people feel comfortable entering without stigma, it is a double-edged sword; modeling associated with mental health care is unfavorable.

In 2019, The Austen Riggs Center, a private psychiatric care facility in Stockbridge, MA, published a newsletter devoted to stigma. The most remarkable statement was as follows:

In both entertainment and news media, individuals with mental illness are often inaccurately and disproportionately depicted as dangerous and unpredictable. This has negative repercussions for both those struggling with mental illness and for the public’s understanding of mental illness. The fact is that people mental illness are far more likely to be victims of violence than perpetrators of violence.

Wait, Smiles Do Make You Happy?

When I taught my first undergraduate social psychology course, I was excited to explain one of my favorite findings to the class: smiling makes you happier. In the original study, participants were asked to rate how funny they thought a series of cartoons were while holding a pen in their mouth. The trick was that the way they held the pen varied: in one condition, they held it with their lips, preventing them from activating smile muscles; in another, they held it with their teeth, forcing them to activate their smile muscles. When the smile muscles were active, participants rated the cartoons as funnier! You may not realize it, but smiling changes your feelings! Activating muscles associated with a specific emotion seemed to influence people’s emotional responses in a subtle, unconscious way.

Then, that finding turned out to be wrong. In 2016, a large-scale study that collected data from 17 different labs found that the original study’s results did not replicate. Activating smile muscles did not change how funny people found cartoons. This result felt definitive because this new replication included many more people, from a more representative sample (since it wasn’t just students from one university), and with a more constrained methodology and analysis plan (because they ran everything by experts in facial feedback research who provided feedback on everything). But was it?

Just two years later, new evidence was added to the debate. Tom Noah, Yaacov Schul, and Ruth Mayo keyed in on what they believed was an essential difference between the original and the replication study: the use of a video camera. Based on feedback from one of the experts they consulted, the replication group had decided to video record each session to make sure everything had worked smoothly (including the pen being held in the mouth the right way!). But having a video camera facing you might make you more self-conscious. Different literature in psychology suggested that you’re less willing to rely on “gut feelings” when making decisions when you’re aware you’re being watched. This might have messed up the results of the replication study.

So Noah and colleagues decided to run a new study, where they randomly assigned participants to one of two different versions of the experiment: the original, no camera version, versus the replication, camera-included version. When comparing people in front of a camera, they replicated the replication; there was no effect. When they didn’t include the camera, they replicated the original; there was an effect. It was the video camera that made the difference.

It is easy to interpret this as a fight between science reformers and their opponents among social psychologists. A traditional finding was rejected, and then a counter punch was thrown, rejecting the rejection. (Editorial comments by Noah and colleagues imply that replicators’ claims “decrease cumulative science” don’t help). Yet this is actually a great example of how science is meant to work. Scientists are meant to question each other’s findings, and it’s essential to find out whether results hold up. This includes questioning the results of replications and thinking through why results might be different when a study is replicated. 

One potential outcome of re-examining earlier research always needs to be “we got it wrong, this effect is not something reliable about the world.” This can be because of statistical noise–the way the data came out, it looked like there was a difference between groups, even when there really wasn’t. That’s no fault of the experimenter, but it’s something we can check by doing replications. Finding out that an earlier belief was wrong should always be an acceptable outcome of the research, and that does indeed contribute to a cumulative science.

Flatten the Mental Health Curve

Picture this: Tenth-grade Laura checks her Instagram after a long school day. And she finds something that is absolutely horrific. Her long-time adversary, Gertrude, has posted a nude photo on her Instagram story. The photo is a bit blurry, but it kind of looks like Laura. And, although it’s actually not Laura in the photo, Gertrude claims that it is and she even tags Laura with some very nasty verbiage. The post goes viral.

Laura’s anxiety level shot through the roof as she stood there alone on her driveway. She had never experienced this level of hurt before and she had no clue whatsoever as to what she was going to do about it. Feelings of hopelessness, anxiety, and depression engulf her. 

The Skyrocketing Nature of Mental Health Issues in Modern Times

In a large-scale study of the prevalence of various mental health issues, including anxiety, depression, and mood disorders, it was found that steep increases in each and every such condition were found for adolescents and young adults between the years of 2009 and 2017 (see Twenge et al., 2019). We are talking about increases in major depression, for instance, from 8 percent to more than 13 percent among those in the 12- to 25-year age range across these nine years. This same general trend seems to exist for mental health issues in general. Anyone who works on a college campus will tell you that counseling centers are running beyond capacity across the US. 

Mental health issues are on the rise. And this trend is particularly true among our young people (Twenge et al., 2019).

A year ago, when people talked about flattening the curve, they were referring to the COVID pandemic. I think it is time to revise our usage of this phrase. As we work as a global community to put the COVID pandemic behind us, I say that the phrase flattening the curve be rebranded to refer to the steep increase in the prevalence of mental health issues in the modern world—especially among young people. 

Three Potential Causes of the Problem

Twenge et al. (2019) offer a few suggestions to explain the trends found in their data. Generally, they refer to “birth cohort effects,” suggesting that people born after 1982 have access to digital media and other online resources that have had unintended adverse consequences regarding the mental health of adolescents and young adults today. While this explanation is speculative in nature given the non-experimental quality of the data in their study, I think it’s certainly a perspective that warrants further study. With this said, here are three specific potential causes that I think warrant our deepest consideration.

1. Cyberbullying. 

In line with the analysis presented by Twenge et al. (2019), we can consider cyberbullying as a specific trend that has risen hand-in-hand with rises in communication technologies such as the internet and social media. 

According to data compiled by Comparitech, rates of cyberbullying have increased sharply across the globe over the past decade. Below is a slice of the eye-opening data found in their report:

Between 2011 and 2018, rates of cyberbullying among teens have increased markedly in nearly every nation across the globe. For instance, in the US, rates of teens reporting having been victims of cyberbullying increased from 15 percent in 2011 to 26 percent in 2018. These comparable rates for a few other nations, just to put a global face to the problem, are as follows:

Turkey: 2011, 5 percent; 2018, 20 percent

Mexico: 2011, 8 percent; 2018, 18 percent

UK: 2011, 11 percent; 2018, 18 percent

China: 2011, 11 percent; 2018, 17 percent

2. Increases in industrialization have ironic effects when it comes to mental health.

Generally, we think of technological advancement as a good thing. But I would argue from an evolutionary perspective that any and all technological advancements need to be considered with caution. 

When it comes to large-scale industrialization, people who live in relatively large, industrialized areas are more at-risk for mental health issues than are people who live in relatively small-scale social environments. And this finding seems to be true across the globe (see Srivastava, 2009). As time moves forward, technology and industrialization increase. And adverse mental health outcomes of our young people seem like a fully adverse (if unintended) consequence of this pattern.

The Latest in PTSD Treatment

Today, I’m writing from the cutting-edge of innovation and research in PTSD. PTSD science continues to advance exponentially, and exciting breakthroughs are on the horizon. What I’m presenting in this post are some of the highlights from the last two years of scientific findings. 

While these approaches can’t yet be considered the gold standard for PTSD treatment, what they represent is hope for an ever-expanding array of options that might be available for sufferers one day. 

I’ve divided the treatments into three categories: psychotropic medications, procedures, and non-pharmacological approaches.

Psychotropic Medications

MDMA-Assisted Psychotherapy

May 2021 heralded promising results from the first phase 3 clinical trial testing MDMA-assisted psychotherapy for the treatment of PTSD. In MDMA-assisted therapy, the medication MDMA is only administered a few times, and the talk therapy component remains an integral part of this combination treatment.

In an article published in Nature Medicine, researchers from UCSF reported on results of their trial, which sought to test the efficacy and safety of MDMA-assisted therapy for the treatment of 90 patients with severe PTSD over 15 clinical sites. The results were impressive, with patients reporting a large drop in symptoms after receiving MDMA-assisted therapy.

Of particular interest was that the study included patients with common PTSD comorbidities such as dissociation, depression, a history of alcohol and substance use disorders, and childhood trauma. In this way, the study conditions better mimicked real-world clinical scenarios and therefore gave cause to be optimistic that such a treatment may eventually provide tangible benefit to patients treated in clinical practice. 

Another plus for this research is that, for the duration of this study, the researchers reported that MDMA did not induce adverse events such as abuse potential or suicidality. Furthermore, unlike most medications for mental illnesses which are often taken daily for a substantial length of time, MDMA is only taken a few times.

A second phase 3 trial is currently underway and, if results continue to be encouraging, a drug application with the FDA is anticipated in 2022.

Repeated Ketamine Infusions

Ketamine is a non-barbiturate anesthetic and antagonist at the NMDA receptor. It is typically administered intravenously and has been used for years to provide pain relief to patients with severe burns. It was in this use that its dissociative properties became apparent. Ketamine may disrupt the process by which traumatic memories are laid down, as some studies show that those who received ketamine after a traumatic event were less likely to go on to develop PTSD. 

In a 2021 study published in the American Journal of Psychiatry (in Advance), researchers from Icahn School of Medicine at Mount Sinai suggested that repeated ketamine infusions may lead to rapid symptom improvement in people with PTSD. 

Thirty study participants who received six ketamine infusions over a two-week period experienced greater drops in PTSD symptoms and comorbid depressive symptoms compared with participants who received the sedative midazolam, a psychoactive placebo control administered approximately three times a week for two weeks.

Side effects associated with the ketamine included blurred vision, dizziness, fatigue, and headache. Of more concern is that some participants did report dissociative symptoms that emerged during their ketamine infusions.

It’s important to note the limitations associated with ketamine: Benefits may last only a few weeks and there is a potential for patients getting addicted to this treatment.

Riluzole: A Glutamatergic Modulator

In a 2020 study published in the Journal of Clinical Psychiatry, researchers designed a randomized controlled trial that investigated the efficacy of Riluzole augmentation for combat-related PTSD symptoms resistant to treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). 

Riluzole is a neuroprotective drug that blocks glutamatergic neurotransmission in the CNS. Glutamate dysregulation has been implicated in the pathophysiology of PTSD, so medications that regulate brain glutamate concentrations may be an effective treatment strategy for PTSD. 

Over a four-year period, veterans and active duty service members with combat-related PTSD who were not responsive to SSRI or SNRI pharmacotherapy were randomized to eight-week augmentation with a starting dose of 100 mg/day of riluzole or placebo.

An analysis of PTSD symptom clusters showed significantly greater improvement on PTSD hyperarousal symptoms in the riluzole group. However, Riluzole augmentation was not superior to placebo on change in depression, anxiety, or disability severity.

Procedures

Stellate Ganglion Block Treatment

In 2008, media reports started to emerge about how a stellate ganglion block (SGB), an invasive manipulation of sympathetic nerve tissue, helped PTSD sufferers. The procedure, which consisted of injecting a local anesthetic into sympathetic nerve tissue in the neck, led to immediate symptom relief in a small group of patients. 

Still, a positive outcome in a few cases is not sufficient to label something a treatment. A treatment should be more effective than a placebo, so it needs to be studied under controlled conditions. It took some time for the first controlled study of the SGB to be done, and the initial results, which were reported in 2016, were disappointing: The block was not superior to sham injection in relieving PTSD. 

In early 2020, results of the first multisite, randomized clinical trial of (SGB) outcomes on PTSD symptoms were published in the Journal of the American Medical Association – Psychiatry and revealed reasons to not give up on SGB entirely. In this trial of active-duty service members with PTSD symptoms, the authors reported that two SGB treatments two weeks apart were effective in reducing PTSD scores over a period of eight weeks.

Instead of Waiting for Motivation, Build Habits

“But I just can’t find the motivation” is probably one of the most common complaints I hear in my private clinical psychology practice. I have heard this from clients who come in with a severe depressive disorder (where amotivation is a symptom), but also from clients who are struggling with a general lack of impetus. I have worked with people who want to work harder, study more, exercise more, develop a new hobby or commit to a new business idea, but struggle with building the momentum they need. They might think about doing things, but find themselves procrastinating, or never actually commencing an activity, despite their best intentions. I have certainly been in this space as well—most of us probably have, at various points across various arenas. Motivation is not something I struggle with much anymore, and there is one simple reason for this: I don’t wait for motivation.

When I want to do something, I try and think about whether it is something that has value for me and whether it is something I have the time and resources to commit to at present, and if yes, I plan for it, and make it a habit. I treat anything I want to do much like I treat brushing my teeth. Regardless of the circumstances of life, I brush my teeth twice daily and I try and treat other activities (such as work and exercise) in a similar way. I do these things as scheduled, regularly, typically at the same time each day, and I do them regardless of whether I want to or not. Sometimes energy and inspiration are missing, and I might amend what I do (a gentle stroll vs. a bike ride, editing a blog post vs. writing a book chapter) to account for this, but I adopt the ‘bum on seat’ philosophy (i.e., just get your bum on the seat and see what happens). This philosophy carried me through a 60,000-word doctoral thesis, and it works very well for a slew of other commitments now. I often suggest that my clients try and build habits instead of waiting for motivation to strike, and those who are able to adopt this philosophy generally have much better success with forming and adhering to commitments than those who continue to wait for that elusive motivation.

Habit formation

When forming habits, I follow a range of simple rules, these include:

Decide whether you can commit to forming a new habit. It is helpful to remember the opportunity costs that everything brings. Each hour you spend working, as an example, is an hour taken away from sleep, learning, exercise, friends, and recreation. Everything we commit to has a cost and we all have finite resources. Remember that new habit formation will necessarily come at a cost, and consider whether the benefits of a new habit outweigh the costs. The world is drowning in productivity information and exhortations to do more, but the wisest thing you can do sometimes is to simply decide that you don’t really want to swim.

Keep it simple, start small, and be regular. The best new habits are those that are achievable. We are unlikely to be able to commit to a new exercise routine that takes an hour a day, but will probably find more success if we commit to walking for 15 minutes, three times a week. It may not seem like much, but it is a lot more than nothing. Habits can build over time, and you can always increase the amount of time/energy you commit to something once an initial baseline has been established. It is better to only try and form one new habit at a time, to avoid overwhelming yourself.

Chain habits. It is much easier to commit to a new habit if you link it to something you already do. I have clients who walk their dogs daily and have recently started jogging every second day with their dogs, instead of strolling. This is far easier to commit to than a whole new form of exercise, as they leave the house to walk anyway. Some other examples might include; practicing Duolingo while waiting for your coffee to brew or meditating for five minutes straight after breakfast.

Evaluate. It is OK to start a new habit/routine and realise that it is not actually serving you in the way you hoped. Set aside time to re-evaluate habits and routines regularly (monthly is a good interval) and give yourself permission to change things that are not bringing the results or satisfaction you are seeking. Over time, as we achieve greater success with forming new habits and build interest in life and a sense of self-efficacy, we are likely to notice increased motivation as a by-product of commitment to habit formation.

Why You Don’t Believe in Happiness Anymore

You start with big dreams, full of youthful enthusiasm. Over time, challenged by obstacles and hardships, your commitment to those dreams is tested. But you’re still young, so you push on and persevere. 

Then you get hit with big disappointments, letdowns in your career, love life, or friendships. You feel unsupported and alone. “Why is this happening?” you wonder, “I’m a good person. I didn’t do anything to deserve this.” 

Then you face a health crisis, lose a loved one, suffer injuries, or financial hardships. Unforeseen stressors continue to pop up and dash your plans.

You start to lose hope. 

Losing the confidence that you’ll ever be happy

When you’re struggling, it’s natural to want to give up. You may look around and feel that everyone has an easier life than you. You forget that no one is exempt from suffering, and some of the most outstanding individuals in history faced overwhelming personal hardships. 

But no matter. The longer you stay in a place of hopelessness, the harder it is to believe that you’ll ever be happy again. You may justify your unhappiness by proclaiming your powerlessness. You even start to question the concept of happiness.

“Happiness is an illusion sold by the media to make money,” you decide. “Happy relationships? Happy families? Happy friendships? Bah! That’s not real life.”

Five conditions that cause people to abandon happiness

1. Heartbreak 

Deep wounds to the soul come in many forms, but for me, the word “heartbreak” captures the catastrophic pain of unforeseen loss. No matter what form heartbreak takes when your heart is broken, gravity shifts, your body, and mind feel sluggish, color is drained from the world, and every day is a battle with yourself. 

2. Social isolation

You withdraw from the world. Stop seeing friends or family and embrace loneliness. The more you live in isolation, the more your thoughts and feelings become deluded. You distort even the simplest of interactions and grow paranoid and suspicious of others. No one is who they seem to be.

7 Ways to Experience Inner Peace

Has modern technology and your ability to access infinite amounts of information and entertainment brought less stress or more stress into your life?

Sure, we can buy everything we want online—clothes, computers, and cars—and yes, it’s convenient. But has it made our lives more peaceful?

Emotional energy

Most of us would agree that emotional energy has become a precious commodity in our lives. When we feel emotionally depleted, then anxiety and stress are the natural by-products. Left unchecked, stress can lead to feelings of being out of control.

As a result, stress can prompt us to seek temporary relief in unhealthy habits that create more stress in the long run. Turning to alcohol, comfort food, or overspending might provide temporary relief and distraction, but these things greatly complicate our lives.

Controlling your stress

Not everything that causes us stress can be eliminated—nor should it. Low-level stress stimulates the brain to boost productivity and concentration. It can also be a big motivator to make changes, solve problems, or accomplish goals.

In addition, many sources of stress are simply beyond our control. It’s become so commonplace for people to feel stressed and overloaded that we tend to forget there is an alternative way to live.

It’s time to slow down and consider ways to bring more peace to your heart and soul. Start with these seven ideas:

1. Beware of peace pickpockets.

You encounter all kinds of people and situations that try to steal your serenity. Know what they are and take measures to fend them off.

2. Take a mental health day, or morning, or moment.

Whatever time you can allow, give yourself the space to refresh your mind and spirit.

3. Rethink your “should do” and “ought to do” lists.

If the voice in your head is guilting you into doing things that don’t bring you joy, regard these as prime candidates to delete.

4. Kick the approval habit.

It’s natural to want to be liked by others—and it’s healthy to accept that it’s not going to happen all the time.

5. Be still.

If your pace is wearing you out, set aside a half-day or a full day to sit on the sofa to think, journal, read, and nap.

6. Let the music move you.

Few things are as cathartic and cleansing as your best-loved music. Use your favorite tunes to calm you down, pump you up, or stir your emotions.

7. Give yourself a quality-of-life checkup.

It’s wise to periodically assess whether you’re satisfied with the quality of your life. If you don’t feel fulfilled, ponder what changes are in order.

Inner peace is a worthwhile goal. In today’s saturated world, having an inner peace plan—and working on it every day—is a good way to ensure you attain that goal.

Pandemic Stress Supercharges Personal Growth

It’s no secret that the pandemic has battered our mental health. Fear of infection, grief for lost loved ones, social isolation, and financial insecurity have created the perfect conditions for a mental health crisis, and, worldwide, 15 to 25% of people have experienced depression, anxiety, insomnia, or even PTSD over the past year.

As we begin to emerge from the pandemic, though, researchers have discovered a psychological benefit to these months of tension: the same people who have experienced high stress are also showing signs of significant personal growth.

A new study published in the Journal of Anxiety Disorders found that among people who reported high levels of COVID-related stress, 77% also experienced “one or more positive changes in their lives as a result of COVID-19.”

We tend to focus on the negative impacts of trauma, but suffering has the power to transform our lives for the better, too. Post-traumatic growth is the act of finding “silver linings” in a terrible experience and has been recorded in survivors of wars, natural disasters, and life-threatening illnesses.

Growth and gratitude

Participants in the study reported that they now have:

  • Higher regard for health care workers
  • Stronger awareness of the value of their own life
  • More affection for friends and family
  • Better appreciation for each day
  • Different priorities about what’s important in life
  • Greater feelings of self-reliance

Most of these changes are rooted in gratitude, and with good reason. When the people around us have lost jobs, loved ones, even their own lives, when we ourselves have suffered deep losses, it reminds us to appreciate what we have while we have it. Study after study has shown that feelings of gratitude like these are closely linked with overall well-being.

The last item on the list—greater feelings of self-reliance—might be more surprising, since so much of the pandemic, from viral transmission to lockdown measures, has been out of our hands as individuals. Still, the social isolation and uncertainty brought on by COVID have taught many of us that we are capable of fending for ourselves in times of adversity, a lesson that can bolster our confidence as we face future challenges.

Is this growth real or an illusion?

The study, though, raises a fundamental question: is this personal growth genuine, or is it all self-deception, an attempt to reassure ourselves that we’re weathering the storm of COVID better than we really are?

An assessment of their overall functioning indicated that 17% of the study’s participants were experiencing only the illusion of growth—they were telling themselves they were resilient when their mental health was actually deteriorating. For the other 60% of participants who reported growth, though, the positive changes they reported were very real, signs of healthy adaptation and adjustment.

People with healthy hearts may have better cognitive abilities

Now, a group of researchers claims to be the first to demonstrate with a large group of healthy people that individuals with healthier hearts have better cognitive performance. 

The authors, who are affiliated with the University of São Paulo in Brazil and several U.K. institutions — Queen Mary University of London, the University of Oxford, Imperial College London, and the University of Southampton — recently published their findings in the journal European Heart Journal Cardiovascular Imaging.

“Our findings are highly relevant in an ever-aging global population, with an ever-increasing burden of common chronic diseases, such as ischemic heart disease and dementia,” Dr. Zahra Raisi-Estabragh, an author of the study and British Heart Foundation Clinical Research Training Fellow at Queen Mary University of London, explained to Medical News Today

“Understanding links between these diseases enables us to optimize our assessment of older people and to potentially develop new therapies, which will target common mechanisms of aging.”

A fresh look

The researchers used data from 29,763 participants from the U.K. Biobank, a biomedical database containing in-depth genetic and health information from half a million participants. The average age of the participants was 63 years. Overall, the participants were healthier and wealthier than the national average in the U.K. 

For the study, the researchers assessed heart health by examining cardiac MRI scans of participants, while they assessed cognitive function with fluid intelligence tests. These cognitive tests measure an individual’s capacity to solve problems using logic and reasoning rather than previously learned knowledge. The researchers also tested reaction time.

The researchers found associations between better cognitive performance and measures that likely represent a healthier heart. These measures include larger ventricular cavity volumes, larger left ventricular and right ventricular stroke volumes, higher left ventricular mass, and greater aortic distensibility. 

Reduced cognitive function was associated with smaller ventricular volumes and lower left ventricular mass, together with smaller left ventricular and right ventricular stroke volumes and lower aortic compliance.

Participants with higher distensibility — less stiffness in the artery, which indicates better health — showed less rapid age-related decline in fluid intelligence.

The researchers observed associations between brain and heart health that remained significant even after adjustment for a range of cardiometabolic, lifestyle, and demographic factors.

Dr. Scott Kaiser, a geriatrician and director of geriatric cognitive health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, was not involved in the study. He told MNT that he frequently sees patients experiencing both heart disease and dementia.

“We know that there’s a close correlation between heart health and brain health. That is no surprise,” Dr. Kaiser said. “What was really cool about this study is that […] it just gave a little bit more of a robust picture. It was a large sample of biomarkers [that allowed the researchers] to really look at what was going on in terms of the heart health in a robust way, and then matched it with some pretty cool cognitive health markers. So it just kind of filled out the picture a little.”

The Importance of Mental Health Awareness Month

Did you know that Mental Health Awareness Month has been observed in the month of May since 1949? It was originally designated as such by the national advocacy organization Mental Health America. Annually during the month of May, organizations, groups, and individuals run campaigns that are designed to raise awareness and educate the public about mental health conditions.

Here’s what you should know about the importance of Mental Health Awareness Month and how you can get involved.

Why do we need Mental Health Awareness Month?

People consistently rank health as one of the most important things in life. Sadly, however, optimal mental health is often not included. Mental health is many times the proverbial “elephant in the room”—we know that it is there, but it makes us uncomfortable to address it. 

Stigma, misinformation, and disinformation all create substantial barriers in raising mental health awareness. We believe that stigma associated with mental illness is the most problematic of these. Stigma is defined as a mark of shame or discredit. In our book, Understanding Mental Illness , we discuss the stigma of mental illness and how it impacts those living with mental health conditions. Stigma is a label placed upon people to set them apart, to make them feel ashamed, disgraced, or embarrassed about who they are, often because of factors beyond their control.

What are the consequences of the stigma around mental illness?

Because of this stigma, people are more likely to discuss physical health conditions rather than mental health conditions with others. Similarly, they are also more assertive in seeking care for physical ailments than they are for mental health disorders. Surveys show that the average time between the onset of mental health symptoms and the decision to seek care for mental health conditions can be a year or more. Making a difference in the lives of people suffering from mental illness becomes quite difficult when such a delay exists between symptoms and interventions. As with physical health conditions, early diagnosis and treatment of mental health conditions lead to better outcomes. 

How do we as a society move forward? 

Despite the barriers that exist, all hope is not lost. Increasingly, key stakeholders are having impactful conversations on ways to improve the mental health of Americans. Campaigns such as Mental Health Awareness month are playing a great role in important mental health issues such as awareness and access.

How (And Why) to Say No

Saying no is a skill that most of us struggle with. It is very common for many people in therapy to trace some of their anxiety, stress, and overwork to difficulties, or an utter inability to say no. People over-commit to a range of things and often feel like they have to say yes to every opportunity that might come their way. However, every new choice comes with an opportunity cost (i.e., the loss of capacity to invest in other options). As an example, when I made the decision to sit down and write this post, I gave up the opportunity to instead complete a yoga session, go for a walk, see a client, read, sleep. Every choice we make comes with a financial, time, and energetic cost and we forget this to our detriment.

People often struggle to say no because of a multitude of reasons, including socialisation (“you can’t say no to people”, “you must not be selfish”), expectations from friends and family, the fear of missing out, and structural commitments (having to keep up with diverse roles, such as work and childcare). Sometimes we need to say no to other people, but sometimes we need to be able to say no to ourselves first.

My clients often express a range of worries when they consider saying no to something. Some common worries include:

  • Not knowing when to say no or what to say no to
  • Being unsure how to politely say no
  • Being worried about how the no will be received (worrying that people will become upset or angry when they receive a no)

With the latter, I encourage people to remember that a good boundary to hold is knowing that we cannot control someone’s reaction to something – the only control we have is in carefully assessing a no, and in offering it respectfully and politely. Allowing other people to experience and process their feelings without making it your responsibility, is a key competency when thinking of saying no to something. It might be helpful to remember that most reasonable people will respond well to an occasional no, and if someone is unreasonable then it is even more reason to erect firmer boundaries and say no more often.

In general, when trying to work out when to say no, I encourage people to ask themselves a number of questions to assess opportunity costs. These questions are:

  • Do I have the time, energy, and money for this at the moment?
  • Do I want to do this?
  • Will this add value to my life?
  • Is this aligned with my values?
  • Am I saying yes, only because I am scared of saying no?

If the answer to any of these questions indicates that a no might be in order, then it is important to know how to say no. The main things to consider when saying no are the context of the relationship (how close is the relationship?), the request being made or opportunity being offered, and what we want to say no to (we might want to say no to part of the request but allow another part). 

Some people find it easier to say no to people close to them because they know what response they might receive and some people might hold the belief that being in a close relationship means being self-sacrificial and always being there to support someone else. In general, the closer the relationship, the more likely it is that we will want to be there for someone, but this does not mean that we never say no. It is probably even more essential to have good boundaries with the people closest to us, so we can maintain healthy and long-lasting relationships. Some simple, but relationship-maintaining ways of saying no are:

Thank you, but that is not for me/Thank you, but no.

Simple, easy to understand, and makes it about you, not the other person. It is also perfectly okay to say no without explaining why.

That’s a lovely offer, but I have over-committed and can’t fit that in at the moment. Can we try that next month?

A good one to use when you want to do something, but don’t have the time, energy, or money for it. 
Another way to say this might be, “I don’t mean to offend, but my bucket is full and I cannot take that on right now.” 

I don’t have the capacity to do X at the moment, but could do Y?

A good one to use when you feel like you can say yes to part of a request or can offer a compromise (“I can’t man the bake stall, but can drop off a cake.”)

Sorry, I have something else on.

It is important to use this one carefully only when it is true, not as an easy social white lie to avoid saying no.

“How Do I Start Therapy?”

Stepping into therapy can be a life-changing experience and the start of a journey that can take us through unexpected discoveries and insights. An unavoidable part of this is building a trusting relationship with a complete stranger: our therapist.

We will be revealing the deepest parts of ourselves, perhaps stories we might never have talked with anyone about before. It’s both exciting and daunting, and we want to make sure we create the best possibilities for an encouraging beginning to this journey of self-discovery. But where do we start?

Preparing for our journey

It is worth putting in a little effort to ensure we get the absolute best from our investment of emotions, time, and money. There are some very simple and practical preparations we can do to create a good foundation for our therapeutic journey.

Preparing will also build our confidence when we finally contact our chosen therapist. Plus, it will make us more comfortable engaging with therapy right from the beginning.

Which type of therapy is best for me and my issues?

Finding the right therapy for us and our issues can seem overwhelming: with so many different types of therapies available, how can we know which is the best for us?

We could say that any therapy is better than none, though to have the best chance of success it is worth considering our own requirements, rather than looking for a specific type of therapy. Here are some questions that might help:

  • Who is looking for therapy: is it us individually, or us and our partner, or us and a family member?

Some therapists specialize in working with individuals, these could be counsellors or psychotherapists. Others might have specialized in working with relationships such as couple’s counsellors or psychosexual and relationship therapists, or a family therapists.

Deciding who is seeking therapy will help us narrow down our search.

  • How do we prefer to work?

Some therapies are based on creating changes through giving homework and consciously changing thoughts and behaviors. Others are based mainly on making changes by talking, thinking, and reflecting on our thoughts, emotions, behaviors, and preoccupations. If we like a bit of both, then there is that option too.

Consider this: If we dislike homework and know that we are unlikely to carry out the required tasks between sessions, it is unlikely we will gain much from this type of therapy.

On the other hand, if we prefer homework, we might get frustrated by a therapy that is focused on talking and contemplating.

If we know what works best for us, we are more likely to find success in therapy. We can talk with the therapist during our initial conversation to clarify if their method suits our preferred way of working.

  • What is the main issue we are looking for help with?

Being able to name the issues we bring to therapy can make us feel a little more confident when we first contact a therapist and during our first session. Something as simple as asking ourselves why we feel in need of therapy can clarify if for example we feel overwhelmed, anxious, depressed, or scared.

These are not the only reasons to seek therapy and remember: no issue is too small or too big for therapy. Knowing a little about what we are seeking help with, will make our first conversation with a therapist easier.

Finding a therapist

It is always best to seek a therapist who is qualified, and who is accredited or licensed, and registered with one of many associations especially established for therapists.

We can try searching for ‘therapists associations’ online, which should give us a couple of choices close to where we live. If we are looking for a relationship or family therapist, we can add that description to our search, so we get results for the appropriate associations.

What It Really Means to Take Care of Yourself

Real self-care probably isn’t what you think it is. It isn’t all about escaping and relaxing. Although it pays off for your well-being in the long run, in the present, self-care can be a hard thing to do.

Taking care of yourself might look like making a plan to pay off your debt, sticking to a hard morning routine, or cooking healthy meals. It’s facing your problems and unresolved issues head-on, instead of avoiding them and then trying to distract or soothe yourself later.

Self-care means doing what makes you anxious now, like setting boundaries with tough people, saying no when you don’t want to do something, getting through a tough workout, or telling someone something they don’t want to hear. Taking care of yourself means compassionately accepting yourself for who you are instead of burning yourself out trying to be everything to everyone all the time. It’s living your life in a way that doesn’t leave you needing to check out or take a break just so you can have a bath, read a book, or sip tea.

Currently, consumer-based self-care is a very popular topic; however, a world we need to escape from in the name of self-care is a world that needs a perspective change. Self-care isn’t something we should be doing just because we’re so burnt out that we need time away from our internal and external pressures. 

Real self-care isn’t massages and green juices; it’s choosing to create a life that you don’t feel the need to regularly check out of.  

Self-care means doing things you initially don’t want to do and making the choice to do what’s uncomfortable. It means accepting your personal failures and disappointing relationships, then deciding to re-strategize them. It’s not about giving in to your immediate urges when that means giving up on a long-term goal. It’s about forgiving, letting go, and accepting what you can’t change. It’s about being willing to let people down and even saying goodbye to some of them. Self-care can sometimes be about putting your life aside to care for someone in need, and other times about putting yourself first above those who drain you. Ultimately, it’s about living a life you choose, not one that you sleepwalk through.

Self-care is allowing yourself to be normal and average, instead of always pushing yourself to be perfect or exceptional. It means letting your house stay messy when you’re tired of cleaning up or deciding you don’t need the perfect body after all. It’s knowing yourself and understanding how you operate, so you can decide what changes are the right ones to make in your life. 

If you constantly feel like you need a break, it may be because you’re disconnected from living a life that includes you in it. Real self-care isn’t so much about treating yourself as it is about taking actions for your personal growth and development, aiming to choose what’s better for your wellness in the long run.

Self-care is not about believing that being super busy is a badge of honor and making yourself so exhausted that you self-sabotage in ways that aren’t actually good for you. It’s about taking time to take care of yourself because you truly know that you aren’t broken and don’t need fixing. Once you start doing the real self-care, you start realizing that loving yourself and compassionately being there for you might just solve many of your problems.

When you take care of yourself, you become the author, not the victim, of your life. You create a life you truly enjoy, instead of one you might need recovery, or even therapy, from. It’s not creating a life that looks good on paper, but one that fits well with who you are. It’s letting go of some of your goals so that you can truly live a more balanced life. It’s choosing to no longer make decisions based on what will ease your anxiety, but instead based on what will be good for you tomorrow or the next day. It’s not looking to others to meet your needs; it’s meeting your own needs. 

Self-care is living a life that’s meaningful and being true to yourself. It’s knowing that massages and green juices are great ways to enjoy life, not escape from it. 

19 Ways to Show You Care About Your Friends

Friends deserve a special place in our lives. In the U.S., for example, they are important because they embody American values of equality, choice, self-expression, individualism, freedom, fluidity, and flexibility. They are important because our families have never been smaller than they are now, because fewer people are marrying, and those who do marry are getting to it later in life than they once did. And rates of remarriage are dropping. With fewer brothers and sisters, aunts, uncles, cousins, and all the other relatives who used to gather around during holidays and other days, Americans increasingly look to the people they choose to have in their lives, rather than the people assigned to them through family ties.

But we don’t typically accord our friends the special treatment they deserve. Instead, it is our attitudes toward marital relationships that are reverent and celebratory – matrimaniacal, even. No proposal, no wedding, is ever deemed too much. Married people routinely have their spouses invited to social events. They expect the other people in their lives to ask about their spouse. They get celebrated again if they stay married for a special number of years.

A spouse is considered an important person, an important relationship, in just about every imaginable way. I have no problem with the valuing of a spouse. I just don’t think that spousal relationships should be valued exclusively, as if no other relationship could ever be as significant. One of the ironies of the over-the-top hype that spousal relationships attract is that those relationships are not always all that enduring. For many people, including many married people, some special friendships may have lasted far longer than any of their marriages ever will.

How can we value our friends and everyone else’s, today and every other day?

Honoring Your Own Friends

  1. Be there to help when things go wrong.
  2. Be there to celebrate when things go right. 
  3. Be there just to be there. Keep in touch. Do fun things together. Don’t ever say you are too busy. If you don’t have the time, make it. After all, research shows that we are more likely to feel happy when we are with our friends than when we are with anyone else, including our romantic partners or spouse, or children.
  4. Remember their birthdays. Make a big deal out of the milestones and big accomplishments in their lives, and I’m not just talking about weddings or babies. There are graduations, houses, new jobs, big moves, and all sorts of things that matter to them.
  5. Mark their importance in your life in a big way. Celebrate holidays with them. Or go beyond that. Create a special event, maybe even akin to a wedding, to celebrate the friends in your life. For How We Live Now: Redefining Home and Family in the 21st Century, I interviewed several people, including a lifelong single woman and a lifelong single man, who did something like that.
  6. Plan travel and vacations with friends.
  7. If things are headed south, or if your friend seems to need special help or attention for any reason, consider counseling. You’d probably do that if it were your marriage that was in trouble.
  8. If you are coupled, spend some time alone with your friends. And when your friends invite you to something, don’t just assume that your partner is invited, too.
  9. If your friends are single, don’t just ask them about their romantic prospects. They have lives full of interests, passions, plans, goals, accomplishments, work experiences, people they care about – including friends, and tastes and preferences in sports, music, books, movies, food, the arts, travel destinations, and just about anything else you can think of. Ask about those things.
  10. If your friends are married with children, don’t just ask them about their spouse or their children.

How to Find Emotional Balance During These Holidays

The December holidays (Christmas, Hanukah, Kwanzaa) provide a capstone for the year. Most years are a mixed bag of experience—some combination of bright and dark—steeped in varying shades of joy and sorrow, of connection and loss, of the beautiful and the brutal. Obviously, 2020 is not most years. 

The stress and anxiety of the coronavirus pandemic have taken a devastating toll on people’s mental, emotional, and spiritual, as well as physical well-being. According to a national poll by the American Psychiatric Association (APA), more than one-third of Americans (36%) reported that coronavirus is having a serious impact on their mental health and over half (59%) reported serious impacts on their day-to-day lives. Most adults were concerned about the negative impacts of Covid-19 on their finances (57%) and almost half were worried about running out of food, medicine, and/or supplies.[1]

These results were released in March, nine excruciating months ago and early in the evolution of the pandemic. Since then, most individuals and families the stress, anxiety, financial hardships, and overall emotional dysregulation have only worsened.

During the pandemic, the number of adults exhibiting symptoms of depression has tripled [2] and alcohol and other drug use, as well as overdose rates have increased measurably. In a study published in JAMA Psychiatry this month, researchers monitoring an emergency medical systems database in 47 states found that medics were responding to more than double the number of overdose-related cardiac arrests in May, at the height of the pandemic lockdowns, than they had in 2018 and 2019.[3]

The adverse effects are also weighing heavily on children, as manifest in this year’s requests to Santa Claus based on a review of letters addressed to the North Pole collected through the USPS’s Operation Santa program. While kids across the US are still asking for toys and video games, in a year steeped in illness and uncertainty, some only want Santa to bring a cure for Covid-19. Others are asking for masks, and others write about the difficulties of going to school online or how their parents can’t afford to buy presents this year because they lost their jobs.[4]

Emotional balance occurs when we can: 

  1. Be consciously aware of and observe our feelings as they emerge
  2. Allow ourselves to present with our emotions (whether they are pleasurable, painful, or neutral) without needing to suppress them or become suffocated by them
  3. Learn to accept the full multi-colored palette of our feelings without judging them—or ourselves for having them, whatever form they may take

The wish, as well as the impulse to avoid emotional pain is natural—who wants to be in pain?! There is a tendency to think (however unconsciously) that if we can just avoid experiencing the discomfort/pain, it won’t affect us. Unfortunately, attempts to keep painful emotions at a distance always fail, even though they may seem to work temporarily. All forms of experiential avoidance ultimately boomerang on us by extending those painful emotions and amplifying the suffering connected to them. 

Alcohol and other drugs are one such well-worn avoidance strategy. Using substances and other addictive behaviors to feel “good” or “better” is a shortcut that inevitably leads to a dead end. Avoidance doesn’t work because pain is an inevitable part of life. It is an essential aspect of being human. It is in how we choose to respond to what we experience that determines whether we get stuck in trying to outrun, numb, or fight against it, or respond skillfully to it with presence and acceptance, which allows it to run its course and in time dissipate. 

It is important to clarify that acceptance does not equal approval. We can learn to accept and co-exist with uncomfortable, distressing, painful emotions, even when we don’t like them, and even when we dislike them intensely.

When we are under their influence, intense emotions can feel like they will last forever. However, whether they are painful or pleasurable, feelings are always temporary. They come and go like guests who come to visit: some are welcome and we’re happy to see them; others, not so much. Some leave sooner than we’d like and others significantly overstay—but eventually they all leave.

The time from Thanksgiving through the New Year typically revolves around themes of gratitude, abundance, and celebration. Yet, 2020 has left so many of us feeling diminished and exhausted. This year, more than perhaps ever, major holidays, especially those that emphasize family and social connection, can precipitate profound experiences of loss related to significant others who have passed or other serious life changes that leave us grieving what is no longer available to us, such as relationships, jobs/careers, homes, and health/physical functioning. 

Gratitude doesn’t erase or even necessarily diminish grief and vice versa. These two powerful emotional states can exist side by side, even if in any particular moment, one is much more prominent than the other. In Island, Aldous Huxley wrote about “the excruciating presence of an absence.” Empty spaces seem to spit into the face of gratitude. It’s okay to not feel grateful. 

It’s important to know that the holidays don’t have to feel like a celebration. You can give yourself permission to simply be where you are emotionally. Practicing self-compassion, kindness, and forgiveness by staying in conscious contact with the limitations of your time, energy, and finances, and carving our time for self-care is even more essential during this time of grieving and increased stress. 

You can find a balance that meets your needs between participating in holiday-focused efforts/events and self-care that includes such basics as reasonably healthy eating (in terms of what and how much you eat), physical movement/exercise—as little as 10 minutes of exercise a day can help improve your mood and reduce feelings of anxiety,[5] and getting decent sleep.

When we can develop the capacity to keep our minds and hearts open to our experience—the brutal, as well as the beautiful—our emotional life becomes more balanced and peaceful. The waves of feelings toss us about less as they lessen (even ever-so-slightly) in size and intensity and are less likely to swamp us. Learning to recognize, be present, and make peace with the parts of our experience that we may struggle with, makes it possible to be more okay with and accepting of whatever arises. 

8 Science-Based Ways to Beat Negativity

Because negativity makes us feel bad, it tends to be bad for our well-being (take this well-being quiz to see how you’re doing).

If you find that you struggle with negativity, you’re not alone. In fact, humans actually have a negativity bias. A negativity bias just means that we notice and feel negative things more intensely than positive things—and negative things have a bigger impact on our mental health. So that means we could experience a bunch of positive things but the one negative thing could ruin our entire day. If our thoughts are plagued by negativity, this can be especially true for us.

How do we stop feeling so negative?

Firstly, go easy on yourself. Remember, we are all negative sometimes and that’s okay. Remember to have self-compassion as you’re are working to shift your negative thoughts. But it’s also helpful to know that our brains like to do things the way they have always done them. If we’ve been negative for a long time, regulating our emotions and shifting to more positive thoughts may be a little harder and take a little longer. Just keep at the strategies below to see improvement over time.

1. Make positive concepts more accessible in your brain

Our brains prefer to just go to whatever is familiar—it’s easier, quicker, and requires less energy. So undoing negativity involves making positive concepts more familiar and accessible in the brain. One way to do this is to just have a “positive word of the day”. Or, memorize a series of positive words each morning and ask yourself to recall them each night. 

Although the research hasn’t shown that there are positive regions of the brain, per se, strengthening the connections between positive concepts and strengthening your ability to generate positive thoughts, words, and emotions can likely make it easier to do this again in the future.

Researchers have measured the emotional content of thousands of words to find the positive and negative ones. If you want to use the most positive of these words to reduce negativity, check out my positive word flashcard book. 

2. Deconstruct your negativity

When we feel negative, it can be easy to see the external causes of our negative emotions but not the internal causes. The truth is our thoughts have just as much (or maybe more) to do with our negativity than the situations we’re in. We really do create our own reality.

To deconstruct how your thoughts lead to your negativity, engage in self-reflection by asking yourself if you do any of the things below:

  1. Do you often expect that everything will turn out horrible?
  2. Do you only see the bad without seeing the good?
  3. Do you ignore or devalue the positive things?

If you do any of these things, you can shift your thoughts in ways that decrease negativity and increase positivity. Use these questions when you’re feeling negative to shift your thinking away from the negative and onto the positive:

  1. How could this situation turn out better than expected?
  2. What are the positive parts of this situation?
  3. Why are the positive things in this situation really important or valuable?

Forcing your mind in a new direction can help shift your emotions too.

3. Check your attribution style

Do you feel like nothing you do matters and the world is responsible for all your woes? Of course, this may be true sometimes, but this “external attribution” means we have given up control of our lives and this can end up making us feel worse. To shift this thinking, try to think of the things you dohave control over. We all have control over some aspects of our lives.

Or, do you feel like you are to blame for all of your woes? This “internal attribution” style where we blame ourselves for the bad things can hurt our self-esteem and mental health. To shift this thinking, recognize that not everything is in your control. We all have done bad things, but we can move past them when we see that we did the best we could given the situations we were in.

Want Your New Year’s Resolutions to Stick?

A few years ago, researchers from UCLA and UPenn’s Wharton School published a paper (Dai, Milkman, & Riis, 2014) that explored why something they call the “fresh start effect” motivates people to make aspirational behavior changes via New Year’s resolutions.

The gist of their “fresh start effect” theory is that temporal landmarks like New Year’s Day, birthdays, back-to-school season—which serve as delineating signposts for the passage of time on a calendar—seem to facilitate “new mental accounting periods each year, which relegate past imperfections to a previous period, induce people to take a big-picture view of their lives, and thus motivate aspirational behaviors.”

Despite the centuries-old tradition of making New Year’s resolutions in the month of December, surprisingly few modern-day, large-scale studies have investigated this “temporal landmark” goal-setting phenomenon until recently.

This week, researchers from Stockholm University and Linköping University in Sweden published a study they describe as “probably the largest and most comprehensive study on New Year’s resolutions conducted thus far.” These findings (Oscarsson, Carlbring, Andersson, & Rozental, 2020) were published on December 9 in the peer-reviewed journal PLOS ONE.

This year-long study involved over a thousand people (N = 1066) who said they’d made New Year’s resolutions and were recruited via multiple channels in the last week of December 2016. Participants agreed to follow-up interviews once a month from New Year’s Eve through December 2017.

In addition to investigating if online support could increase people’s odds of sticking with their New Year’s resolutions over the course of 12 months, the researchers examined how “approach” vs. “avoidance” goal-setting affected the likelihood of long-term success.

What’s the difference between “approach goals” and “avoidance goals”? An approach-oriented goal focuses on actively doing something (e.g., “I will start going for daily walks”), whereas avoidance-oriented goals center around not doing something (e.g., “I will stop sitting too much.”) In general, avoidance goals are about stopping, quitting, and forbidding behaviors. On the flip side, approach goals are about seeking a fresh start, new beginnings, and proactively getting out of a rut.

New Year’s Resolutions: Approach-Oriented Goals vs. Avoidance-Oriented Goals

As this “Keeping Resolutions” graph by corresponding author Per Carlbring of Stockholm University illustrates, study participants who made approach-oriented New Year’s resolutions had a higher success rate (59%) than those who made avoidance-oriented resolutions (47%).

This research suggests that flipping the script from an avoidance-oriented resolution that uses language such as “I will stop _______” to an approach-oriented script that states “I will start _______,” may increase one’s odds of sticking to a New Year’s resolution.

“In many cases, rephrasing your resolution could definitely work. For example, if your goal is to stop eating sweets in order to lose weight, you will most likely be more successful if you say ‘I will eat fruit several times a day’ instead,” Carlbring said in a news release. “You then replace sweets with something healthier, which probably means you will lose weight and also keep your resolution. You cannot erase a behavior, but you can replace it with something else.”

To the researchers’ surprise, providing study participants with extensive online support in the form of “emails with information and exercises regarding motivation, thought patterns, and negative spirals in relation to New Year’s resolutions” didn’t significantly boost someone’s odds of success.

After randomly dividing study participants into three groups that received no support, some support, or extended support, a one-year follow-up showed that providing people with “some support” seemed to be a sweet spot.

“Participants receiving some support reported greater success than those receiving extended support, and those receiving no support,” the authors explain. “This suggests that information, instructions, and exercises regarding effective goal setting, administered via the Internet, could affect the likelihood of success—another question to study further.”

“[We] found that the support given to the participants did not make much of a difference when it came down to how well participants kept their resolutions throughout the year. What surprised us were the results on how to phrase your resolution,” Carlbring concluded.

Are you making any New Year’s resolutions for 2021? If so, try to think of ways to frame your personal goals and resolutions for the upcoming year using approach-oriented language.

6 Ways to Stay Safe as Lockdown Eases

Risk is inevitable in everything that we do. It is an inherent part of our lives, intertwined with every decision we make and action we take. Ordinary acts such as walking across the road or driving a vehicle involve risk. Yet, our usual safeguards make adverse consequences rare that we seldom think about the risks involved in everyday activities. We have become accustomed to managing everyday risk, often instinctively.

In the context of the COVID-19 pandemic, we are having to contend with everyday risks we cannot easily evaluate. A previously straightforward decision of whether to leave the house or use public transport is now fraught with unknown peril. More than ever before, we are having to calculate simple everyday decisions to try and determine what is safe and what should be avoided. The threat of the virus looms over every choice we make.

Studies on the psychology of risk have shown that we intuitively respond with higher levels of anxiety in the face of unknown risks than familiar risks. This heighted anxiety is likely explained by the fact that we have an innate need to live in a predictable, orderly world that is in our control. Not adequately understanding a new risk – such as COVID-19 – makes it difficult for us to take precautionary measures to reduce risk thereby resulting in a perceived lack of control over our lives.  

There is a lot about COVID-19 that we still don’t understand. Researchers continue to seek answers to questions such as: ‘Is a person immune after being infected?’ ‘Do facemasks prevent the spread of infection?’ ‘Why do some young and healthy people die from COVID-19 while the majority have only mild symptoms or none at all?’

In the face of all this uncertainty, we are having to weigh some risks on our own. When countries had strict stay-at-home rules in place, daily decisions about the risk of contracting the virus were simple. Now, as governments relax restrictions and countries reopen parts of their economies, decisions are more complex. The government may allow schools to reopen but should we allow our children to go? Is it safe to get a haircut or go to the gym?

There is always going to be some risk of contracting the virus as we go about our day-to-day lives. Personal protective measures including social distancing, avoiding touching our faces, and hand hygiene can reduce the risk of contracting the virus but don’t eliminate risk completely.

Here are a few important points to consider when managing risk outside the home.

1. Self-assessment: Start by conducting a self-assessment to determine if you are at higher risk for severe COVID-19. Based on currently available information and clinical expertise, older adults and people of any age who have pre-existing medical conditions are at higher risk. Other risk factors associated with COVID-19 death may include being male, uncontrolled diabetes, severe asthma, and being of Asian and Black ethic origin.

2. Risk level: Consider the level of risk associated with different activities – some activities are riskier than others. For example, gatherings of large groups of people in an indoor environment is considered high risk whereas exercising outdoors alone is relatively low risk. Key risk factors that make some activities more dangerous than others include distance to other people, type of activity, indoor/outdoor environment, and time spent in close proximity to others.

How Does Racism Affect Health?

Race is at the forefront of our national consciousness this week as many mourn the death of George Floyd at the hands of a Minneapolis police officer, and protests and riots have erupted across the country.

While violence against racial minorities is a serious problem, the evidence shows that systemic racism in American society has broader effects as well.

When the mind senses a potentially harmful situation, it prepares the body by increasing heart rate, breathing and blood pressure. This response helped earlier humans outrun or fight predators and enemies. Today’s stressful situations, such as a challenging interaction at work or a misbehaving child, can result in the same physical reactions even though we are less likely to experience physical danger. The problem is, when this stress response is repeated frequently over time, evidence shows it can contribute to health problems, including depression, anxiety, insomnia, heart disease, skin rashes and gastrointestinal problems—just to name a few.

Now a growing body of evidence demonstrates that racial discrimination can trigger this stress response. Racial minorities may experience more health problems as a result. One review of 121 studies published in 2013 found that youth between the ages of 12 and 18 who reported experiencing discrimination were significantly more likely to experience mental health problems such as depression and anxiety compared to those who did not. Another review of 66 studies found that Black adults who perceived they were subjected to racism were more likely to experience mental health problems and more likely to report a lower quality of life. A third review breaks down types of racism in our society and explains the health implications of each.

A lead researcher in the field is Anthony Ong, a professor of human development in Cornell University’s College of Human Ecology. Ong explains that experiencing discrimination or mistreatment regularly can affect health through eroding a person’s self-worth and by foreclosing opportunities for purposeful living.

“Although increasing evidence suggests that chronic exposure to unfair treatment or day-to-day discrimination increases the risk for poor health, the overall dearth of data on biological mechanisms indicates it’s important to continue studying this topic,” Ong said.

He published a study in 2016 of more than 200 Black adults followed over the period of a decade. Participants completed surveys about everyday mistreatment such as being called names, insulted, threatened, or harassed. They also answered questions about acute occurrences of unfair treatment, such as being discouraged from continuing their education, not receiving a loan, or being hassled by the police.

Participants also underwent blood tests to identify 22 biomarkers of diseases including heart disease, diabetes, nerve problems and inflammation.

Ultimately, participants who reported experiencing more discrimination were in poorer health. Ong argues that’s because experiencing discrimination on a regular basis, even small instances of daily mistreatment, can lead to “wear-and-tear” on the body over time.

“Our findings suggest that coping with chronic experiences of day-to-day mistreatment and discrimination can elicit a cascade of responses that over time ‘weather’ or damage the physiological systems that regulate the body’s stress response,” he said.

How to use mindfulness to stand in solidarity with the Black Community

As many of us continue to wake up to the horror of racism, we can draw upon our meditation practice to help fight for a kinder and more just world.

Here are eleven ways that your meditation practice can help you combat racism. We hope it inspires you to see that you already have a lot of amazing tools to support you on this journey. 

1 | Sit with discomfort

Waking up to injustice can be uncomfortable, especially when we realize that some of our words, actions, and beliefs may actually be part of the problem. In the same way that we choose not to squirm during our meditation practice, how might we take a moment to notice our reaction when someone points out our privilege or lets us know that what we said was racist? Do we become defensive, shutdown, or dismissive? Those are a few examples of how we twist and turn our way out of the discomfort of feeling shame. 

Our fear of being racist prevents us from bravely exploring our own racism so that we can start the work of undoing it. If this concept feels hard to swallow, we recommend reading Ibram X. Kendi’s book, How to be an Antiracist. He says to let go of ‘racist’ being a bad word and instead see it as a helpful way to identify a thought or behavior that needs to be unpacked. 

As we engage with this uncomfortable introspection, it’s important to foster self-compassion. Gently create space to meet whatever feelings are coming up, including heartache, anger, grief, shame, and confusion. It is only from this grounded place within that we can be truly open to the perspective of another. This is where learning and unlearning begins.     

2 | Meet your mistakes with equanimity

Making mistakes is human. It’s impossible not to make mistakes and the painful reality is that when we try really hard to be perfect and in control, we tend to make more mistakes. Making mistakes is an integral part of learning.

The next time you say or do something that causes harm, take a minute to remember you’re human and offer yourself compassion. Then, take action. Apologize, and if needed, learn more about why your language or behavior was hurtful (google it, there are so many great articles and resources out there). Commit to doing better now that you know better.  

3 | Honor similarity and difference

It’s not uncommon to feel a deep sense of connection with all beings during meditation. People often describe this as a feeling of oneness. While there is no denying our interconnectedness, it is important to remember that while at some level we may indeed all be one, our lived experiences are very different, informed and influenced by intersecting privileges and oppressions. To truly see another we must recognize both how we are similar and how we are different. 

The denial of difference is the crux of the issues when people say all lives matter in response to black lives matter. Rachel Cargle explains that “stating ‘black lives matter’ doesn’t insinuate that other lives don’t.” Of course, all lives matter and it’s also important to recognize that black lives face discrimination and dehumanization at disproportionate levels. 

4 | Expand your awareness 

Depression and anxiety spiked among black Americans after George Floyd’s death

Americans were already struggling with historic levels of mental health problems amid the coronavirus pandemic. Then came the video of George Floyd’s death at the hands of police.

Within a week, anxiety and depression among African Americans shot to higher rates than experienced by any other racial or ethnic group, with 41 percent screening positive for at least one of those symptoms, data from the Census Bureau shows.Video of George Floyd’s killing began to spread on the last day of week 4.

The findings — from a survey launched by the federal government originally intended to study the effects of the novel coronavirus — indicate that the recent unrest, demonstrations and debate have exacted a disproportionate emotional and mental toll on black and Asian Americans, even as rates of anxiety and depression remain relatively flat among white Americans and decreased among Latin Americans.

The rate of black Americans showing clinically significant signs of anxiety or depressive disorders jumped from 36 percent to 41 percent in the week after the video of Floyd’s death became public. That represents roughly 1.4 million more people.

Among Asian Americans, those symptoms increased from 28 percent to 34 percent, a change that represents an increase of about 800,000 people.

The new data comes from an emergency weekly survey of U.S. households launched by the Census Bureau at the end of April to measure the pandemic’s effects on finances, housing, education and health. In the most recent data release, more than 1 million households were contacted through email and text, and more than 100,000 responded, creating a robust sample size for the findings. Analysis of the data was conducted by multiple federal agencies including the Census Bureau and the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Depression, anxiety spur pandemic alcohol consumption

Numerous studies have found that alcohol consumption has increased during the pandemic, and dramatically so for people with depression.

A new study takes a fresh look at drinking during the pandemic and finds, for the first time, that age affects the likelihood of a person consuming more alcohol as a response to the pandemic.

Lead author Ariadna Capasso, of NYU School of Global Public Health in New York City, says:

“This increase in drinking, particularly among people with anxiety and depression, is consistent with concerns that the pandemic may be triggering an epidemic of problematic alcohol use.”

The study features in the journal Preventive Medicine.

The study’s general findings

The researchers surveyed 5,850 adults from all 50 states through Facebook and its associated platforms during the months of March and April 2020. They asked the participants to describe themselves demographically and report how their alcohol use had changed since the start of the pandemic. 

The survey also included questions that allowed the researchers to identify and measure the participants’ symptoms of depression and anxiety. Each person also reported the degree to which they felt at risk of SARS-CoV-2 infection.

Of all the participants identifying themselves as drinkers, 29% reported that their alcohol consumption had increased during the pandemic.

Of the drinkers, 51.2% said that the pandemic had not affected the amount of alcohol that they consumed, while another 19.8% reported drinking less.

Of all the people surveyed, 47% and 30% reported symptoms of anxiety and depression, respectively.

Individuals reporting symptoms of depression were 64% more likely to be consuming greater amounts of alcohol, while anxiety was associated with a 41% higher likelihood of increased drinking.

The study also found that demographic factors affected alcohol consumption during the pandemic:

  • Women were more likely (33% as opposed to 24%) to have increased their drinking than men.
  • Highly educated people were more likely to have started drinking more (32%) than those without a bachelor’s degree (25%).
  • Fewer retirees (20%) reported drinking more than employed and currently unemployed participants, 31% of whom were consuming more alcohol.
  • People living in rural areas were less likely to have upped their alcohol intake (25%) compared with those living in suburban and urban areas (31%).

Worry Is A Waste: Take Control In 5 Minutes or Less

When we fail to cope properly, naturally, we worry. Why do we worry so much? Well for starters, it gives us a false sense of something called control. You know, that highly addictive substance we all love to consume? Worry allows us to “brace” ourselves.

Just as we would physically brace upon impact, we do the same psychologically. We believe that if we worry, we’ll somehow be better “prepared” to handle the situation. In reality, nothing could be more fruitless or further from the truth. As J.K. Rowling once said, “Worrying means you suffer twice.” Ask yourself this simple question, what has worrying done for me lately? When has worry every benefitted me? More importantly, when has it ever changed the outcome that I’m fearing would/could happen? I’m willing to bet, it hasn’t…ever. And it never will. Once you’re ready to accept that inalienable truth, get out a pen and paper. Together we’ll complete Cognitive Behavioral Therapy (CBT) thought record to gain back control and emotional freedom.

1. Identify the trigger or situation

What’s the thought that caused the emotional and physical reaction? Here’s a hint. One of the most common culprits of worry thought are the notorious “What ifs?” What if school doesn’t start in September? What If I get sick? What if someone in my family gets sick? What if I lose my job? What if I have a panic attack? What if I fail?

2. Rate the intensity of your worry 

Now that you’ve successfully identified the thought that sent your central nervous system into a frenzy, rate the intensity of the emotion from 1-100. For example, “Anxiety, 85/100.”

3. Write down unhelpful thoughts and images associated with the worry 

Often times, I find those of us who struggle with anxiety and worry have exceptionally active imaginations. We immediately see in our mind’s eye the worst-case scenario playing out right before our eyes and our fight-or-flight system is instantly activated. Take a minute to write down what you imagine will happen. This could include your reaction, other people’s reactions, what they’ll say, what you’ll do, etc. 

4. Examine the evidence that supports the worry thought 

Yes, you read that correctly. I want you to find factual support that validates the worry thought. Bear with me, I know that seems counter-productive, but this will give you the opportunity to step back and take inventory of just how true and realistic this worry is.

5. Examine the evidence against the worry thought

Here’s where we start acting like detectives. Get out your mental magnifying glass and start inspecting. Just as a detective would look for facts and not opinions, we need to do the same. What facts show you that this worry thought is not true? Ask yourself, has this fear ever actualized before? How many times? You may just discover that it’s only happened once in the entirety of your life or not at all. It’s often helpful to provide yourself with examples of when you’ve been successful in accomplishing the thing you’re worried about in the past. It’s also beneficial to rate the likelihood of this happening from 0-100 to help dispute the negative automatic worry thought.

6. Insert more realistic, balanced thinking 

Instead of entertaining the worst-case scenario that’s taking place in your mind, let’s think about what we would tell a loved one or friend who is worrying about the same thing. This is where we use compassion to combat the catastrophe. How likely is it that something positive will occur instead? Have I had positive experiences with this situation, person, or event in the past? One question I personally love is, “In the spectrum of my life, how important is this situation?” Is the amount of energy I’m putting into worrying about this situation proportionate to the importance?” No? Then recalibrate accordingly.  

7. Re-rate intensity of anxiety and worry 

By this point, most will experience a significant reduction in anxiety and the evidence of that will be quantified. This alone can give us incentive to start challenging the negative automatic thoughts instead of mindlessly believing them. Remember if this exercise didn’t work for you, don’t judge yourself, it will only intensify the anxiety. Sometimes we’re so entrenched in worry, it’s hard to think of an alternative possibility. Grab a loved one or friend and go through the thought record together. It may help to get another’s perspective, especially if you respect their opinion.

22 brain exercises to improve memory, cognition, and creativity

Although the brain gets plenty of exercise every day, certain activities may help boost brain function and connectivity. This in turn may help protect the brain from age-related degeneration.

The brain is always active, even during sleep. However, certain activities can engage the brain in new ways, potentially leading to improvements in memory, cognitive function, or creativity.

This article outlines 22 brain exercises that may help boost memory, cognition, and creativity.

1. Meditation

Meditation generally involves focusing attention in a calm, controlled way. Meditating may have multiple benefits for both the brain and the body.

According to the National Center for Complementary and Integrative Health, research suggests that meditation may benefit the brain by slowing brain aging and increasing the brain’s ability to process information.

2. Visualizing more

Visualization involves forming a mental image to represent information. The mental image may be in the form of pictures or animated scenes.

A 2018 review notes that visualization helps people organize information and make appropriate decisions.

People can practice visualization in their day-to-day lives. For example, before going shopping, people can visualize how they will get to and from the grocery store, and imagine what they will buy when they get there. The key is to imagine the scenes vividly and in as much detail as possible.

3. Playing games

Playing card games or board games can be a fun way to socialize or pass the time. These activities may also be beneficial for the brain. A 2017 study found a link between playing games and a decreased risk of cognitive impairment in older adults.

4. Playing memory card games

Memory card games test a person’s short-term memory and ability to remember patterns. They are a simple and fun way to engage the brain and activate areas related to pattern recognition and recall.

5. Practicing crossword puzzles

Crossword puzzles are a popular activity that may stimulate the brain. An older study from 2011 notes that crossword puzzles may delay the onset of memory decline in people with preclinical dementia.

6. Completing jigsaw puzzles

Completing a jigsaw puzzle can be a good way to pass the time and may also benefit the brain. A 2018 study found that puzzles activate many cognitive functions, including:

  • perception
  • mental rotation
  • working memory
  • reasoning

The study concluded that doing jigsaw puzzles regularly and throughout life may protect against the effects of brain aging.

7. Playing sudoku

Number puzzles, such as sudoku, can be a fun way to challenge the brain. They may also improve cognitive function in some people.

A 2019 study of adults aged between 50 and 93 years found that those who practiced number puzzles more frequently tended to have better cognitive function.

8. Playing chess

A 2016 meta-analysis notes that chess and other cognitive leisure activities may lead to improvements in:

  • memory
  • executive functioning, which is the ability to monitor and adapt behavior in order to meet set goals
  • information processing speed

9. Playing checkers

A 2015 study found that there is a connection between regular participation in checkers or other cognitively stimulating games and larger brain volume and improved markers of cognitive health in people at risk of Alzheimer’s disease.

10. Playing video games

A 2015 review notes that some types of video games — such as action, puzzle, and strategy games — may lead to improvements in the following:

  • attention
  • problem solving
  • cognitive flexibility

11. Socializing

Enjoying company of friends may be a mentally engaging leisure activity and may help preserve cognitive function. A 2019 study found that people with more frequent social contact were less likely to experience cognitive decline and dementia.

Some social activities that may help stimulate the brain include:

  • having discussions
  • playing games
  • participating in social sports

12. Learning new skills

Learning new skills engages the brain in different ways and may help improve brain function.

A 2014 study of older adults found that learning a new and cognitively demanding skill, such as quilting or photography, enhanced memory function.

The Hedonic Treadmill: A Look at Our Relationship With ‘Happiness’ and ‘Stuff’

When I graduated with my bachelor’s degree in 2005, I was driving an early 90’s model Chevy Lumina. It had a single spinner on the rear passenger wheel, because I was ballin’. I had purchased this car for $900 from a college friend. It was an old car, but it ran perfectly and never failed to get me to and from work and school (which honestly was about all I needed it to do).

Once I graduated and got my first big kid job, what did I do with my awesome Chevy Lumina? Traded it in for a bigger better truck of course! Let me explain.

Upon graduation I was quickly promoted to management by the casual dining restaurant chain I served tables for through school. When I saw that job offer, my jaw dropped… $40k, 2 weeks paid vacation, and benefits. This was it, I was big time now, a 22-year-old hotshot ready to take on the world. And what does every 22-year entry level manager need? You guessed it, a $35,000 truck. I rushed to the nearest Nissan dealership, traded in my paid off Lumina for a brand-new Nissan Frontier (or as I affectionally now call it, a boat load of vehicle debt summing up to half of my monthly income).

The buying didn’t stop there. Within 4 months of graduating, I also traded in my $400 per month rental room from my sister for a $1400 per month interest only mortgage on a new condo, another must have for the penniless new professional. If you have a brand-new condo, you have to fill it with stuff, so next I hit the Lay-Z-Boy store and Best Buy like they were going out of style.

Do you see the trend I’m describing? If not, here it is… the acquisition of ‘stuff’ ruled my initial post-collegiate years. Within one year of graduating college, I had somehow accrued nearly $250,000 in debt for stuff (including my truck, condo, and a variety of other stuff I bought that I had lived without for years before). This continued for me for a couple more years. Then one day, I decided to sell every last thing I owned and move to Europe (Azores, Portugal to be specific). Interestingly, I lived in the Azores for one year devoid of ‘stuff’ and have some of the best memories of my life. But within a few years of returning home, I once again have acquired an unruly amount of stuff.

Why?

Why on Earth would one be so driven by the acquisition of more stuff? Does it make life better or result in an increase in net happiness?

The answer lies in the hedonic treadmill (otherwise known as hedonic adaptation). Simply explained, this expression describes the natural tendency of a human being to return to a baseline level of happiness after a very positive (or negative) change. For instance, I would go buy a new gadget and it gave an initial rush of happiness, but after a period of time, that rush wore off leaving me with little net change in my overall happiness. Seeking further temporary boosts in happiness, I would go buy something else and so the hedonic treadmill perpetuated.

There is absolutely nothing wrong with wanting to live a comfortable life, and to do so there are basic human needs that must be met. But I would argue that many of our relationships with acquiring stuff have far superseded the basic needs for survival and therefore do not result in a net gain in happiness. If you have unlimited resources and buying power, then perhaps this is no problem for you. But I don’t fall into that category of buying power and therefore feel compelled to dive deeper into my own hedonic tendencies and how to transition them into more sustainable mechanisms to increase my net happiness over time. Let’s dive into a few of my learned lessons on hedonic adaptation.

Money doesn’t buy happiness, but not stressing about how to pay the mortgage helps

I’ve seen both sides of the economic spectrum. I’ve been a struggling entry level manager trying to feed a family of 3 on peanuts and I’ve been a successful entrepreneur with no concern about paying my bills. And presently, I sit somewhere in the middle. Both ends of the economic spectrum come with tradeoffs. However, one thing I’ve learned to be true is that there is a baseline standard of living needed in order to maintain an equilibrium in net happiness. It’s pretty hard to be happy when you don’t know for sure if you’re going to pay the mortgage next month. These self-help gurus that spew catch phrases like ‘money doesn’t buy happiness’ clearly have never gotten to Friday night and not had $20 to buy a pizza for their wife and kid. While I can admit that the 5-star dinner really is just for show and doesn’t contribute to a net gain in happiness, being able to afford to treat my family once in a while and know the bills will still be paid is a must for me to maintain a baseline.

The latest and greatest gadget is a waste of money

Part of the hedonic treadmill is the rhetoric that we need the newest, latest and greatest stuff. For instance, I used to be that guy who bought the new iPhone every single year. Truth be told, this did not contribute to a net gain in overall happiness. Rather the new tech, gadget, or thing quickly just became a normalized part of my life. The way that new phones or gadgets are marketed makes it sound like your life will improve 10-fold by sheer virtue of owning them. But the reality is at the end of the day you’re still holding a newer version of a device that connects you to your loved ones and the rest of the world. The micro-second of speed or few extra pixels in the camera really don’t contribute to net happiness in the long run.

10 Odd and Fun Activities That Keep Your Brain Healthy

In my previous blog, I summarized the extensive research behind 12 lifestyle choices that can protect your brain.  In brief, these “Terrific Twelve” are: 1. Reduce alcohol consumption. 2. Avoid head injury. 3. Breathe clean air; stay in on polluted-air days. 4. Provide access to early-childhood education. 5. Correct mid-life hearing loss. 6. Monitor and reduce high blood pressure. 7. Maintain a healthy weight.  8. Quit smoking; avoid inhaling second-hand smoke. 9. Find help for depression and anxiety. 10. Prevent social isolation by connecting with others. 11. Exercise and stay active. 12. Manage and/or reverse diabetes. These twelve lifestyle factors account for a whopping 40% of dementias.

This blog will focus on an additional 10 surprising and pleasurable actions anyone can take to reduce the risk of dementia. But first—a few definitions and an overview.

“Dementia” is a collection of signs and symptoms that includes memory loss; difficulty reasoning, solving problems, and learning new things; inappropriate behavior; and difficulty performing many activities of daily living. It is not a disease itself but is caused by an underlying disease such as Alzheimer’s. (Other major causes of dementia include vascular problems, neurodegenerative disorders, and Lewy body dementia.) “Mild cognitive impairment” (MCI) is a condition involving less severe problems with thinking and remembering. Good news: MCI does not necessarily progress to dementia.

While age is a major risk factor for dementia, dementia is not a normal part of aging, according to the Mayo Clinic. That’s why it is so helpful to realize that we can all make good lifestyle choices right now that can help our mental functioning as we age.

10 More Odd and Pleasurable Activities That Your Brain Will Love

In addition to the 12 key prevention measures above, researchers have documented various unusual and fun activities that can keep our brains healthy.  Here are 10 activities that seem to help, according to recent studies. (Note of caution: Most of the studies cited below show a correlation between the activity and cognitive health but do not prove causality.)

1. Sing out. Past research has shown that playing a musical instrument has positive effects on cognitive functioning, especially cognitive flexibility, the ability to switch the mind’s focus from one thought process to another. Now, new research from the University of Helsinki reveals a chorus of benefits from singing. According to the researchers, elderly singers have better cognitive flexibility than non-singers and also experience a mood lift from singing together. In addition, participants in choral groups develop a strong feeling of togetherness as they sing, which can protect them from the mind-sapping effects of loneliness that many people experience as they age.

2. Try sauna bathing. Strangely enough, recent research indicates a strong relationship between Finnish sauna bathing and prevention of Alzheimer’s disease. (PT blogger Arash Emamzadeh describes the research in his blog.) Why might sauna bathing lower dementia risk? The mechanisms could include the activation of protective proteins by the heat, better cardiovascular functioning, reduced inflammation, better sleep, reduced stress, and increased relaxation. (Warning: The extreme heat would not be healthy for every person. Consult with your doctor.)  

3. Practice tai chi. Tai chi is a Chinese slow-motion exercise for self-defense and meditation. Is tai chi more beneficial than other forms of exercise when it comes to preserving mental function? According to the Harvard Health Letter, it is: “In a meta-analysis of 20 studies on tai chi and cognition, tai chi appears to improve executive function—the ability to multitask, manage time, and make decisions—in people without any cognitive decline. In those with mild cognitive impairment, tai chi slowed the progression to dementia more than other types of exercise and improved their cognitive function in a comparable fashion to other types of exercise or cognitive training.”

I recently took an introductory tai chi class via Zoom. I discovered that while tai chi is gentle physical exercise, it does give your brain a tough workout.  

4.  Cultivate a positive attitude toward aging.  Negative attitudes about aging have a striking effect on memory and on health in general. In studies by Yale researcher Becca Levy, “older people exposed to … positive messages about aging showed better recall and more confidence in their abilities than those exposed to negative ones.” Other research showed that those with positive views of aging had better balance, did better on memory tests, walked faster, recovered from disabilities more quickly, and lived, on average, seven and a half years longer. Fighting one’s own internalized ageism is a constant battle but one well worth the effort. And why not savor all the good things about aging?

5. Get a flu and/or pneumonia vaccination.  Research in 2020 indicates that getting a flu or pneumonia vaccination, in addition to the obvious benefits, may provide protection against Alzheimer’s disease. Too good to be true? Apparently not.

After investigating a large data set of 9,066 individuals, researchers found that those who received flu vaccinations had a decreased risk of cognitive decline.  To summarize: “…people that consistently got their annual flu shot had a lower risk of Alzheimer’s. This translated to an almost 6% reduced risk of Alzheimer’s disease for patients between the ages of 75-84 for 16 years.”

In another study of 5146 people aged 65 and above who had been vaccinated against pneumonia, “The researchers found that pneumococcal vaccination between ages 65-75 reduced risk of developing Alzheimer’s by 25-30% after adjusting for sex, race, birth cohort, education, smoking, and number of G alleles.” (“G alleles” are known risk genes for Alzheimer’s.)

The ADHD Owner’s Manual for Grown-ups

This does not mean that they are more normal (whatever that is) or better than we are; however, it does mean that their ways of thinking are not only accepted, but expected, and endorsed.

From the outside looking in, neurotypicals just seem to inherently know how to be grown-ups. They can make it to appointments, balance checkbooks, pay bills on time, remember to get the car inspected each year, etc. They can even sit at a desk all day without completely losing their minds. And, they make it all look so easy.

This is largely because for neurotypicals, being interested in a task, finding this new and exciting, or even challenging might be helpful, but it is not essential. It is a bonus and not a prerequisite. In fact, they have a three-step check list for their action plan which involves the concepts of importance, secondary importance, and rewards. First, the neurotypical grown-up will evaluate whether or not they should get said task done. Next, they are motivated by authority pressure, meaning that someone they respect (spouse, professor, or boss) deems the task important and would like it completed.  Lastly, they are moved to the completion of said task by rewards such as a grade, promotion, approval, or punitive consequences for not completing said task (Dodson, 2020).

For adult ADHDers, we get what’s important, too, and we like rewards and understand punishment. It’s just that we don’t find dangling these in front of us all that motivating. What motivates the rest of the world we find annoying, or at best, insignificant.

We are motivated from the inside-out because we are driven by our very curious, interest-based nervous systems. ADHDers chase shiny objects because they are new and exciting. Then, once they cease to be shiny, we cease to be interested and move on. This seeming inability to use the concepts of importance and rewards to motivate us has had a huge impact on us trying to navigate and adult in a neurotypical world (Dodson, 2020).

Because of this we are often perceived (and labeled) as immature, irresponsible, and reckless. Neurotypicals wonder if we will ever grow up. Hopefully not, but thank you for asking.

Neurotypicals can find this frustrating, because they are trying to motivate us according to their rules, the Neurotypical Owner’s Manual. They keep trying and it keeps not working. This is because when we were born, we were given the neurotypical owner’s manual also, only this didn’t make any sense to us so we threw it out. Hence, the disconnect.

We ADHDers, or better yet, members of The Fast Mind Club, need to write our own rules. We need to create an owner’s manual which is better suited to our wiring, one which is clear and paves the way to success.

Here it is:

1.       The Fast-Mind disclaimer. The ADHDer’s Owner’s Manual is for those with unwavering curiosity and a natural ability for creativity, problem-solving, and innovation. It is your birthright to embrace this.

2.       Positive self-talk. You are fun and spontaneous, not immature and irresponsible.

3.       Embrace your child-like spirit. Being playful is ok and healthy, even as a grown-up. Set a good example for neurotypicals. They’ll live longer.

4.       Don’t focus on where you fall short; focus on where you shine. Evaluate what excites you versus what drains you. The Strengthscope assessment can help with this. Then, move towards jobs and tasks that you naturally find interesting and exciting. This cannot be forced as we don’t operate that way. We’re about passion.

5.       Feel the charge. Once you get in the ADHD zone, stay there, and feel the charge of operating at this remarkable level. Feel the electricity, theflow. This will make it more familiar and easier to enter into the zone next time.

6.       If you need a competitive environment, find one.

7.       Most importantly, surround yourself with really good people. We are not talking about mere tolerance, or even acceptance. We need people to value and embrace our wild and wonderful minds. Think of this as making the cut for a sports team. The judgers can have a seat on the bench. We’ll let them know when they get a chance to play.

8.       We don’t want to be neurotypicals. No offense. We just like ourselves exactly the way we are so stop trying to make us be like you. Thank you.

Most of all, the world at large needs to realize that ADHD is not disorder, but rather a difference in cognition. Once we become aware of which triggers we need to pull to align our unique, interest-based nervous systems with what excites us, we are off and running. This is when we write that novel, movie script, start a business, invent something amazing, and find the solutions to problems everyone else missed.

Why Practicing Self-Love Isn’t Optional But Necessary

I had the honor of interviewing the band On the Outside. They are inspirationally challenging youth and others to cultivate body positivity and self-love with their #HowBeautifulChallenge. Their song “How Beautiful” advocates for self-love. This is an incredible message for youth by their peers, especially given all the external influences such as social media that significantly impact self-perception.

In my practice, I often find myself feeling wishful that others could see the beauty that I see in them. I recognize there are factors that inhibit our ability to truly see our wholeness and that we are enough just as we are.  

Factors That Inhibit From Internalizing Self-Love

We tend to be judgmental, unkind, and our own harshest critic. To protect us from failure, discomfort, or anything it perceives as threatening, our mind resorts to strategies that could sometimes thwart us. It can become overprotective, hypervigilant, and avoidant, which can keep us remote from acting on behalf of our values, being our best selves, and fully accepting all that we are.  

We never quite learn how to cultivate self-love because we are socialized to tamp down thoughts, feelings, and actions in which we appear “full of ourselves,” “self-absorbed,” “cocky,” or “arrogant.” We get confused about how to be appropriately confident, proud, and grateful for who we are.

We may get fearful if we’re self-accepting and practice self-love that we’ll let ourselves off the hook and settle for mediocrity. Quite the opposite, we acquire self-belief, and move toward striving, being more productive, and live life more meaningfully.   

We naturally seek external validation because we are taught to. Developmentally our brain is hardwired to seek the love, assurance, and acceptance from our parents and caretakers. Some are fortunate to receive that unconditionally, while others are not. A child often interprets, “If my own parents, who are supposed to love me and treat me better than anyone else in the world, can’t love me, I must not be loveable, and others may not love me either.” It is also challenging to practice self-love if it is a rarity, and something we haven’t routinely seen, felt, or experienced.  

In our childhood, we also hear about how others perceive us and are proud of us but are rarely directed toward assessing how we feel about ourselves and what it means to us. We hear “the coach and team are proud of you,” rather than “how did you feel about that hit and what you accomplished?”

Our mind also leads us in that direction as it uses comparisons to others as a way of holding us accountable and living up to a certain standard. Unfortunately, it most often selects unrealistic and lofty comparisons. In an attempt to motivate us to live up to these standards, it tends to discourage and deplete us.

We are not taught to hear, accept, and internalize complimentary sentiments directed at us. Think about how it feels when someone approaches us with a warm or kind sentiment. It can often feel awkward and uncomfortable. We may question if it is factually true, whether they are sincere, and struggle with how to respond that does not appear or sound “narcissistic.”  

Our mind makes it its mission to defend against anyone seeing our flaws and imperfections or judging us based on them, despite it being part of our humanness. We also can’t forget about our past experiences and possible mistakes. When we have these to contend with, which we all invariably do, our mind incessantly reminds us of them to avoid being in the position of repeating them. These factors all naturally impact our ability to accept and appreciate all of us.

Benefits of Cultivating Self-Love

When discussing self-love, the objective is not to maintain feeling enduring positivity toward the self. That is not realistic or sustainable. It is understandable and expected that our thoughts and feelings ebb and flow and depending on our circumstances and how we’re behaving, we can expect an array of comfortable and uncomfortable feelings to surface.

What is more attainable is to carry simultaneously the more uncomfortable thoughts and feelings while non-judgmentally and unconditionally holding onto self-compassion and self-love. This will afford us with considering and being open and accepting of our thoughts and feelings, personal insight and perspective to consider our needs, and making mindful and intentional decisions that will move us in the direction of our values and being our best self.

Inhabiting self-love, we are more likely to be less self-critical and more compassionate toward ourselves and expect to be treated thoughtfully and respectfully in our relationships with others. Our worthiness and value will increase exponentially. It becomes the foundation by which we assert our needs, set boundaries, and lead our life in the direction that we are personally proud of.

Methods to Practice Self-Love

1. Acknowledge and celebrate when you lean into your values, goals, and accomplishments. Do this no matter how insignificant your mind may tell you that it is and take note of the process and steps along the way.

2. Fully take in when someone is complimentary. Besides expressing appreciation, share what it means to you that they shared that sentiment.

3. Act with mindfulness and intentionality. The more you behave on behalf of who you truly want to be, the easier it is to be accepting of self-compassion and self-love.

4. Be aware of comparing yourself to others. You can only enhance when you are being a better version of yourself, rather than focusing on being better than others or an unrealistic ideal.

5. Practice being mindful and being in the present moment. It helps to give you space between the thinking, feeling, and doing. It allows you to be more focused, intentional, and mindful in your actions.

6. Remember that your thoughts and feelings do not define who you fundamentally are. You cannot control your thoughts and feelings, only the actions you take on behalf of them. You can have “mean” or “unkind” thoughts and feelings and that does not equate to you being a mean or unkind person. You can still elect to practice being thoughtful and kind in your actions. You are not your thoughts and feelings.

7. Accept your imperfections as part of your humanness and allow yourself to make mistakes. Your imperfections may be underdeveloped parts of yourself that you can still grow. Evaluating, studying, being curious, and open to them can facilitate life lessons and immense personal growth and enhancement.  

8. Internalize that you have many parts to you that make up who you are and how you function. Your value and worth do not lie central to one part of you. Sometimes we define ourselves solely by how we appear, how intelligent we are, etc.

Key Insights From 2021’s World Happiness Report

Here are three of the more compelling takeaways from this year’s report.

Takeaway #1: Finland retains its spot as the world’s happiest country

Finland is the happiest country in the world for the fourth year in a row, tallying a 7.889 on the “average life evaluations” measure, shown here:

“Please imagine a ladder, with steps numbered from 0 at the bottom to 10 at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. On which step of the ladder would you say you personally feel you stand at this time?”

Other top performers were Iceland (7.575), Denmark (7.515), Switzerland (7.508), the Netherlands (7.504), Sweden (7.314), Germany (7.312), Norway (7.290), New Zealand (7.257), and Austria (7.213).

And, of the 95 countries surveyed in 2020, the top 10 unhappiest countries were Zimbabwe, Tanzania, Jordan, India, Cambodia, Benin, Myanmar, Namibia, Egypt, Kenya, and Ethiopia.

Takeaway #2: Croatia makes gains, the United Kingdom dips

Zambia, Croatia, Nigeria, Ukraine, and Kyrgyzstan were the countries that showed the most improvement when comparing 2020 happiness ratings to earlier years. Impressively, Croatia jumped from 61st to 23rd position. This may have something to do with policies that kept Croatian citizens working during the pandemic while citizens of other countries were forced into employment hiatuses. The researchers also point out that the pandemic’s effect on employment disparities between high-skilled and low-skilled workers in Croatia wasn’t nearly as pronounced as in other countries such as Ireland and Portugal.

On the other end of the spectrum, the Philippines, El Salvador, Benin, Malta, and Ecuador showed the steepest declines in happiness in 2020. Other notable dips were found in the United Kingdom (13th to 18th position), Canada (10th to 15th position), and the UAE (19th to 27th position).

The United States improved its standing slightly, to 14th place (previously 16th). And, despite its troubles with COVID-19, Italy improved from 28th to 25th place.

Takeaway #3: The world shows resilience in the face of COVID-19

In comparing average overall life evaluations in 2020 to 2017-2019, the researchers found evidence of a (statistically non-significant) uptick. Gains were most apparent in East Asia and South Asia while Latin America and the Caribbean showed the steepest regional declines.

The Power of Gratitude

My email interview on this topic with Parveen Panwar went live on Authority Magazine. Here are some excerpts from that interview.

How do you define the concept of Gratitude? Can you explain what you mean?

Gratitude means giving thanks for what you have and what you are given. It means seeing your blessings and knowing how big they are. Gratitude helps us turn away from resentment and feeling like a victim. It is about acknowledging all those who are dealing with bigger problems with fewer resources instead of focusing on people who seem to have more or sail through life without problems. Gratitude is about recognizing that everyone has problems, instead of comparing the outside of someone else’s life to how yours feels inside.

Why do you think so many people do not feel gratitude? How would you articulate why a simple emotion can be so elusive?

I believe gratitude is a completely learnable skill. But, most of us aren’t taught to be grateful. Our whole society tends to be about getting more — more money, more love, more recognition. We are addicted to “more”. We think happiness depends on getting and keeping more. We are poisoned by comparisons. And, we learn about blame, shame, and not being enough far more than we know about appreciation, being in the moment, being content. We often think happiness is loud and glittery instead of quiet, self-contained, peaceful. I know that I am far more grateful than I used to be, and that is because I have worked long and hard and consciously on making that shift.

This might be intuitive to you but I think it will be constructive to help spell it out. Can you share with us a few ways that increased gratitude can benefit and enhance our life?

Increased gratitude helps us better love ourselves and the wonderful imperfect people in our lives. Gratitude leads to more cheerfulness, which makes others want to be around us at home and at work. It frees up more mental and emotional resources to solve problems, take action, be creative. I think gratitude can also help us be more willing to listen, because we’re less likely to rehearse grievances, and gratitude can help us communicate calmly in conflicts because we have more trust that we can work it out.

What are Five Ways That Each Of Us Can Leverage The Power Of Gratitude?

  1. Set an intention — Be willing and persistent. I began by recognizing the healing power of gratitude and being willing and determined to retune my thinking in that direction.
  2. Make a gratitude list and say it out loud — start looking for things to be grateful for, thank people. I learned a long time ago that what we focus on gets bigger. The more I and my clients look for the good, the bigger it grows.
  3. Be like Pollyanna. Focusing on the positive, on our blessings, the disasters we’ve avoided, points us in the right direction.
  4. When you think of difficulties in the past, be grateful for resolution.
  5. Act as If — One final effective way to start leveraging gratitude is to act as if you’re grateful, even if that’s not how you’re really feeling.

10 Positive Outcomes of the Pandemic

As I type from my kitchen island on a Thursday in the middle of the day (working from home, pandemic-style) I am producing what will be my 400th Psychology Today post. A lot has happened in my life and in the world since I started blogging here in 2013. Without question, the COVID pandemic stands as perhaps the most conspicuous and (for many of us) unexpected event that we have collectively encountered during this time.

The adverse consequences associated with the pandemic are obvious. Millions of people from all around the world have tragically died as a result of COVID. Entire industries have been decimated. Education around the world has been dramatically affected. Millions have lost their jobs and homes. And the whole thing has, tragically, become highly politicized, exacerbating already dramatic political fissures. And more.

People who know me well know that I generally try to keep things positive. With this in mind, here are ten outcomes of the pandemic that actually are having positive outcomes and that will, hopefully, continue to have positive outcomes into our shared future.  

1. Staying connected across miles.

Humans did not evolve to be separated from kin and other loved ones by thousands of miles (see Evolutionary Psychology 101 for a discussion of this). My family, for instance, is dispersed across New York, New Jersey, Florida, and California. For members of a species that evolved to be close to kin, this is rough. 

During the pandemic, people have been more encouraged than ever to reach out to family. People are having regular ZOOM meetings with family. People are texting family members regularly. People are checking on one another with seemingly increased care and compassion. And this is a good thing. 

2. Harnessing technology for good.

While I have written extensively about the dark side of technology, the pandemic has shown us many bright facets that modern technology holds. It has become easier than ever to communicate with others. In many cases, technology has improved at lightning speed to make virtual meetings productive, efficient, and legitimate. And these improvements in such technologies will surely allow us, moving forward, to have more options for getting people together for all kinds of purposes. 

3. Seeing life in a bigger frame.

The pandemic has definitely given all of us pause. I still get the chills when I go into a business and see all the tables and chairs pushed to the side or see all of my students socially distanced in a giant lecture hall and wearing masks. The immediate changes in our daily lives have been so deeply dramatic. And this fact has the capacity to have us see life in a bigger frame as we move toward the other side of the pandemic. 

4. Learning new skills.

Many people chose to take up new skills and hobbies during the pandemic. People are learning how to paint with watercolors, write poetry, speak other languages, and more. And these skills and interests will certainly transcend the pandemic. 

5. Appreciating nature.

As someone who has always been an avid hiker, the abrupt change in the appreciation of nature that so many people have experienced has been obvious. Trailheads near me that usually have one or two parked cars will, these days, often be overflowing. The trails are filled with people who are tired of being cooped up and who are ready to adventure into the mountains. Humans are naturally biophilic, having a natural inclination toward the natural world (see Wilson, 1984). For so many of us, the pandemic has unleashed this beautiful facet of the human experience. 

6. Appreciating science.

The vaccines were developed to completion within about a year. Think about that. For this kind of highly technical work, one year truly is record-speed. During the pandemic, scientists across the world have raced to enhance our understanding of all facets of the virus and the nature of its spread. If ever there were a time to pause and appreciate science, that time is now. 

Six Ways We Can Work on Our Mental Well-Being

We are now a year into social distancing, mask-wearing, staying home, and holding all of our meetings via Zoom. Despite our best efforts and best intentions, most of us are struggling with pandemic fatigue. We’re bored and have come to find ourselves doing the same things over and over without much joy. This wears on our sense of happiness and well-being. It may be time to step back and reassess how we spend our days.

Let’s start with examining the usual sources of well-being in our lives. Happiness and well-being tend to be connected to our natural human needs in several areas of our lives:

  • Activities that provide some challenge or learning
  • Physical activities and exercise
  • Social support and relationships
  • Activities that are fun and pleasurable
  • Activities that provide personal expression and creativity
  • Activities that give our lives meaning or purpose

If one or two of these things drop out, we can get by, but if many of these are reduced or eliminated, we become bored, despondent, and even depressed. Take a little time to evaluate your week and identify which areas are satisfied and which areas are missing.

Challenging or learning activities:

There are many possible activities that fall into this category. Have you read something challenging? Tried a new and complex recipe? Learned to play an instrument? Built something? Tried a new hobby? 

What have you done in the past week that challenged you or led you to learn something new? The more the activity really absorbed your mind, the more helpful it is likely to be. What can you do next week to meet the need for mental challenge and learning?

Physical activities and exercise: 

Stay-at-home recommendations and social distancing can make this more challenging, but it is still essential. If you live somewhere with more temperate weather, get outside, go for walks, jog, or ride a bike. Finding something to get you moving will help with your mental well-being. There are still activities you can do if your weather is cold, rainy, or snowy. You can join an online exercise class, go sledding, build a snowman, or even invest in a used treadmill or exercise bike.

Analyze what you’ve done in the past week to meet your need for physical activity. What can you do this coming week?

We also can’t forget about our basic self-care. Has your diet been healthy? Are you getting regular sleep? If not, take the time to reevaluate how you can better incorporate self-care and physical activity into your weekly routine.

Social support and relationships:

Social interaction is extremely influential to our mental health. Since the pandemic took away our holiday traditions, parties, and even coffee breaks at work, finding ways to maintain social support and relationships should be prioritized. Who have you talked with or spent time with in the past week? Has “Zoom fatigue” led you to spend less time engaging with others? Who have you talked with on the phone or had good text conversations with?

Think about how this need was met in the past week and what more you could do next week. Who could you call? Who could you invite on an outdoor walk with masks?

Find time for fun:

With many of us still working from home, it can be difficult to shut off when the day is done. However, boundaries are important, and making time for the activities that we find enjoyable will help our overall mental well-being.

What did you do this past week that was fun and enjoyable? Did you play any games? Watch a funny movie? What made you laugh? What could you do next week to meet this need? 

Activities that provide personal expression and creativity:

This can encompass a wide array of activities, such as art, music, writing, woodworking, tying flies, needlework, sewing, baking, or even rearranging furniture. Find things to do that will exercise the creative side of your brain. What have you done in the past week that involved creativity? What can you do next week that involves creative expression?

Finding Meaning in Loss, Grief, and Saying Goodbye

They are particularly open to learning from this perspective, aware more than they ever imagined of the fragility of human life as they are surrounded by the harsh reality of death in the global pandemic. As their teacher, I want to bring in elders who can share their wisdom of how to live in the face of death.

Isabel Stenzel Byrnes is a young elder who was supposed to die many times because she has cystic fibrosis, a fatal lung disease. But she hasn’t died and has survived to the age of 49 with the help of a double lung transplant. She was left behind by her twin sister Ana who also survived cystic fibrosis and two double lung transplants before succumbing to colon cancer in September 2013. A few months earlier Ana and Isa had given a Tedx talk together, and after Ana’s passing, Isa gave another talk, this time alone. Those of us who knew the twins as “the power of two,” marveled at her ability to share her story, but she explained:

“I have the strength to stand before you and talk about loss because I spent my entire life practicing the art of saying goodbye.”

Isa is a master of loss. She has lost countless friends to cystic fibrosis and credits them with teaching her to be the best person she could be through loving and being loved. But Isa also reminded us that losing someone we love is the hardest experience any of us will have to go through, because it goes against our basic instinct; we are wired for attachment in a world where everyone is temporary.

Isa offered the lessons she has learned through her own struggles, kidding those who might be in denial, “if you are not planning on losing any loved ones, these lessons don’t apply to you.”

Her first lesson is that we are more than our emotions and are capable of being mindful of our feelings, observing them likes the ocean’s waves and not being paralyzed or overwhelmed by them; to go with the flow. “Trust that we can be stronger than our sorrows.”

The second lesson is that we can find purpose in all of this losing. Fully experiencing her own pain enables her to be more compassionate of others’ pain. Isa personally finds purpose by working as a hospice social worker where wisdom she has gained from her life experiences provides peace of mind to those in terminal stages of dying. She also leads therapeutic writing groups for those grieving a loss.

Isa warns us that although we may wish it was clear and orderly, there is no right or wrong way to say goodbye, because dying is chaotic and illogic. She says that grief is an art, not a science and we make sense of what happened and find purpose in our own individual ways. She notes that her own Japanese and German cultures influence her to be stoic, reflective, and persevering, putting one foot in front of the other.

How the immune system watches over the brain

Generations of students have learned that the central nervous system has “immune privilege.” This means that — to an extent — the immune system tolerates the presence of foreign proteins, or antigens, and tissue in the brain and spinal cord.

The immune system cannot respond in the usual way to infections, injuries, or tumors in the brain and spinal cord, because the blood-brain barrier prevents immune cells from entering or leaving.

Despite this, scientists know that inflammation plays a pivotal role in many neurological and psychiatric conditions, including Alzheimer’s disease, MS, autism, and schizophrenia.

So the question remains, if there is no exchange of information, how does the immune system respond to and influence the brain in such a broad range of conditions?

A team of scientists led by Washington University School of Medicine in St. Louis, MO, have discovered that immune cells are stationed in the dura mater, which is the tough outer membrane of the brain.

From this vantage point, they monitor the cerebrospinal fluid draining from the brain. If they detect the molecular calling cards of infection, cancer, or injury, they can mount an immune response.

The research appears in the journal Cell.

Immunity and the brain

“Every organ in the body is being surveilled by the immune system,” says senior author Dr. Jonathan Kipnis, Alan A. and Edith L. Wolff Distinguished Professor of Pathology and Immunology.

He explains:

“If there is a tumor, an injury, an infection anywhere in the body, the immune system has to know about it. But people say the exception is the brain; if you have a problem in the brain, the immune system just lets it happen. That never made sense to me. What we have found is that there is indeed immune surveillance of the brain — it is just happening outside the brain.”


In 2015, a study in mice revealed a network of vessels in the dura mater that drains cerebrospinal fluid from the brain into lymph nodes in the neck. Also in 2015, a study led by Dr. Kipnis recorded similar findings in both mice and humans.

Lymph nodes are part of an extensive network of fluid-filled vessels known as the lymphatic system. An accumulation of pathogens in lymph nodes can lead to the initiation of an immune response.

This suggested a more intimate connection between the brain and immune system than previously suspected. However, it remained unclear exactly where and how immune cells surveil the contents of the cerebrospinal fluid as it drains from the brain.

Dr. Kipnis and his colleagues knew that the lymph vessels that carry fluid from the brain run alongside blood-filled cavities, or sinuses, in the dura mater.

Crucially, the walls of these sinuses are more permeable than the blood vessels of the blood-brain barrier.

Following up this clue, the scientists showed in their experiments that small molecules from the brain and immune cells accumulate in the sinuses.

Some of the cells, known as antigen presenting cells, which include dendritic cells, pick up suspicious molecules and present them to other immune cells, called T cells, which patrol the body in the bloodstream.

When they bind to these suspect molecules, the T cells can initiate an immune response.

14 Natural Ways to Improve Your Memory

Genetics plays a role in memory loss, especially in serious neurological conditions like Alzheimer’s disease. However, research has shown that diet and lifestyle have a major impact on memory too.

Here are 14 evidence-based ways to improve your memory naturally.

1. Eat Less Added Sugar

Eating too much added sugar has been linked to many health issues and chronic diseases, including cognitive decline.

Research has shown that a sugar-laden diet can lead to poor memory and reduced brain volume, particularly in the area of the brain that stores short-term memory.

For example, one study of more than 4,000 people found that those with a higher intake of sugary beverages like soda had lower total brain volumes and poorer memories on average compared to people who consumed less sugar.

Cutting back on sugar not only helps your memory but also improves your overall health.

2. Try a Fish Oil Supplement

Fish oil is rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

These fats are important for overall health and have been shown to lower the risk of heart disease, reduce inflammation, relieve stress and anxiety, and slow mental decline.

Many studies have shown that consuming fish and fish oil supplements may improve memory, especially in older people. 

One study of 36 older adults with mild cognitive impairment found that short-term and working memory scores improved significantly after they took concentrated fish oil supplements for 12 months.

Another recent review of 28 studies showed that when adults with mild symptoms of memory loss took supplements rich in DHA and EPA, like fish oil, they experienced improved episodic memory.

Both DHA and EPA are vital to the health and functioning of the brain and also help reduce inflammation in the body, which has been linked to cognitive decline.

3. Make Time for Meditation

The practice of meditation may positively affect your health in many ways. 

It is relaxing and soothing, and has been found to reduce stress and pain, lower blood pressure and even improve memory.

In fact, meditation has been shown to increase gray matter in the brain. Gray matter contains neuron cell bodies. 

As you age, gray matter declines, which negatively impacts memory and cognition.

Meditation and relaxation techniques have been shown to improve short-term memory in people of all ages, from people in their 20s to the elderly.

For example, one study demonstrated that Taiwanese college students who engaged in meditation practices like mindfulness had significantly better spatial working memory than students who did not practice meditation.

Spatial working memory is the ability to hold and process information in your mind about the positions of objects in space.

4. Maintain a Healthy Weight 

Maintaining a healthy body weight is essential for well-being and is one of the best ways to keep your body and mind in top condition.

Several studies have established obesity as a risk factor for cognitive decline.

Interestingly, being obese can actually cause changes to memory-associated genes in the brain, negatively affecting memory.

Obesity can also lead to insulin resistance and inflammation, both of which can negatively impact the brain.

A study of 50 people between the ages of 18 and 35 found that a higher body mass index was associated with significantly worse performance on memory tests .

Obesity is also associated with a higher risk of developing Alzheimer’s disease, a progressive disease that destroys memory and cognitive function .

5. Get Enough Sleep

Lack of proper sleep has been associated with poor memory for quite some time.

Sleep plays an important role in memory consolidation, a process in which short-term memories are strengthened and transformed into long-lasting memories.

Research shows that if you are sleep deprived, you could be negatively impacting your memory.

For example, one study looked at the effects of sleep in 40 children between the ages of 10 and 14.

One group of children was trained for memory tests in the evening, then tested the following morning after a night’s sleep. The other group was trained and tested on the same day, with no sleep between training and testing.

The group that slept between training and testing performed 20% better on the memory tests .

Another study found that nurses working the night shift made more mathematical errors and that 68% of them scored lower on memory tests compared to nurses working the day shift.

Health experts recommend adults get between seven and nine hours of sleep each night for optimal health.

Walk Off Your Anxiety

I woke up feeling stressed today. I hadn’t gotten enough sleep, so that was probably the main cause, but I’ve also been unusually busy with work. As I got up and started to move around, I could feel the telltale flutter of anxiety in my chest. It wasn’t tied to anything specific that’s going on, it was just there.

Unless I did something about it, it was going to bother me all day. I had enough to do already. I didn’t need or want that yucky anxious feeling following me around.

As I’ve written about before, low blood sugar can cause anxiety symptoms. I’d already had some food with a good dose of protein and fat, so that wasn’t the cause today. I’d also done my morning mindfulness practice, but still felt off. What else could I do, to change how I was feeling? I decided to go for a power walk.

There hasn’t been a lot of rigorous, well-designed research about the impact of walking on clinical anxiety. However, a 2018 review article that looked at 15 randomized controlled trials found that aerobic exercise was indeed effective, especially if done at a higher intensity level.

I often share the story of a trauma expert whose lecture I attended at a conference. She told the whole audience that she suffers from Generalized Anxiety Disorder, and that her mandatory morning exercise routine was the one thing that kept her anxiety at bay. If she exercised first thing, it was as if her anxiety wasn’t even a thing.

I recommend exercise to all my mental health patients, and instruct them to pay attention to how they feel after. Over and over, I hear what a powerful impact it has on their moods and their ability to cope with stress.

I made sure that today’s walk was truly a “power” walk. When I’m stressed, upset, angry or anxious, a good brisk stompy walk (easily done with big boots on a snowy path, as I did today) is enormously helpful. I also chose a route with uphill climbs, and walked as quickly as I could.

Though I walked for about forty minutes, it took a while for the stress and anxiety to dissipate. On the return leg of the walk, I could feel it starting to lift.

It wasn’t until I was back home, though, and chatting with my husband about some (mildly stressful) home repair issues, that I was realized that I was suddenly in a great mood. Whereas the home repair topic might have normally made me feel a little stressed or burdened, I felt positively sunny about it all. It was really striking.

It’s now a couple of hours later, and the anxious tension in my chest has been solidly replaced by that sunny optimism. It’s hard to imagine that I ever felt anxious, I feel so different now. I also feel much more awake, and no longer feel that uncomfortable tension that comes from a lack of sleep.

If you’re an anxious type, I really recommend that you make exercise a part of your daily life. The brisker, the better. Pay attention to how good it makes you feel, and you’ll become an exercise enthusiast for life.

9 Ways to Cultivate Emotional Wellness

Feeling bad in the context of stress is normal. So cultivating emotional wellness is not about getting rid of negative emotions. It’s more about working with our emotions so that we use the negative ones and capitalize on the positive ones. Here are some strategies to help you cultivate more emotional wellness.

1. Explore your current level of emotional wellness

To first get a better idea of your current level of emotional wellness, take this well-being quiz. You can discover the aspects of your wellbeing that you might benefit from working on.

2. Get to know yourself better

Engaging in self-reflection is a fantastic way to cultivate emotional wellness. Think about what areas of your life could use some attention. Try to notice the things that bother you most or seem to cause you the most trouble. By becoming aware of yourself, you can more easily make the changes that can help increase your emotional wellness.

3. Practice mindfulness

Mindfulness involves awareness of ourselves, others, and our emotions. It also involves acceptance (or non-judgment) of these things. When we accept our emotions, we can prevent ourselves from feeling embarrassed or guilty about having these emotions. So that cuts off a whole layer of negative emotions. Instead, we just let our emotions be as they are. We only focus on changing the things that we actually can change.

4. Strengthen the positive connections in your brain

Any time we activate particular regions of our brains they get stronger. In fact, research shows that training that teaches people to focus on neutral content instead of threatening content can reduce anxiety. So activating the connections in the brain for positive information can potentially make these regions stronger. This may be a good tool for emotional wellness, to decrease the brain’s reliance on negativity and focus more on positivity. One way to do this may be to memorize positive words. Here’s a positive word workbook to help with this practice. 

5. Develop a self-care routine

Developing a self-care routine that includes science-based relaxation techniques can be beneficial for emotional wellness. By helping the body better manage stress and decrease HPA-axis activation, we can feel better, calmer, and more “well”.

​6. Start a gratitude practice

Gratitude is a fantastic tool for cultivating emotional wellness. Gratitude can improve our social relationships and make us feel happier. Some ways to increase gratitude include making a gratitude list, writing a gratitude letter to someone, or starting a gratitude journal. All of these techniques can help us cultivate our gratitude and emotional wellness. 

4 Soft and Soothing Breathing Techniques

In fact, Yoga—together with other ancient disciplines—has always seen the breath as a source of mystical connection between physicality and spirit, and the most tangible representation of the vital energy—pranaPrana, known as Chi in Taoist tradition, is believed to be the life force that animates the entire universe.

The Benefits of Conscious Breathing

When you are under stress, you often hold your breath or breathe very fast. When you are relaxed, your exhalations are usually longer, deeper, and bring a sense of relief. However, you rarely notice the nuances of your breathing; in reality, there are only two ways of breathing: conscious and unconscious. Human breathing is controlled by your autonomous nervous system, which means that most of the time you breathe unconsciously, and do not regulate the quality or speed of your breaths. 

In the past few decades, western scientists have been exploring how the nervous system can be affected with controlled, conscious breathing. For example, by regulating the quality of breaths—length, rhythm, intensity—you can switch from the sympathetic to the parasympathetic nervous system, and vice versa.

You do not even have to believe in Chi or Prana to feel the benefits of conscious breathing. While it usually takes some time to see the progress when healing the body with medical herbs or meditation, conscious breathing can give you immediate results that can be easily measured by heart rate, blood pressure, etc.

Numerous scientists, including Patricia L. Gerbarg, MD, coauthor of The Healing Power of the Breath, and Professor Jon Kabat-Zinn, the founder of Mindfulness-Based Stress Reduction (MBSR), have been exploring the impact of conscious breathing on the nervous system, hormones, homeostasis, resilience, and mental health. If, in the past, breathwork was mostly connected to the obscure mystical practices of the East, today it is a regular therapeutic tool used in positive psychotherapy, positive psychology, stress management, MBSR, dance/movement therapy, and many other fields.

Breathe Softly

But is it enough just to breathe consciously? What is the key to real healing breathing? The answer is simple: it is its softness. To breathe softly means to breathe consciously but with an intensity that is just right for you. Softness is guided by intuition, and intuition knows better. 

Today, many people talk about the importance of breathing deep, but in most cases, it is its lightness, sweetness, and stillness that makes breathing feel so good. In a world full of stress and anxiety, you may tend to breathe aggressively—too fast or too much. So, switching to softness and sweetness can help you relax and heal.

Breathe Less

On my pilgrimage in the Himalayas, my Yoga and Buddhist teachers always encouraged me to breathe less. Most of them were mountain people who actually breathe quite differently than people who live in lower altitudes. For the mountain people, breathing less happens quite naturally due to the different oxygen density and even some oxygen deprivation, which actually can be stimulating in small doses. Soft and soothing breathwork usually involves practices that switch the body into the parasympathetic mode, activate restorative processes, and promote deep relaxation.

Breathe less, think less, talk less, worry less—that is what I learned in the Himalayas. It seems that happiness of those mountain people is rooted in softness, calmness, and the ability to relax, even when things go wrong. Let the softness of your breath be your first step toward happiness.

The following are examples of soft and soothing breathwork that you can try at home.

1. Anapanasati (Basics)

It is believed that the Anapanasati technique was created by the Buddha himself. The initial practice is simple, and its purpose is for you to feel the sensations caused by the movements of your breath in your body.

Try it: 

  • Sit or lie down in stillness with your eyes closed. Observe the natural flow of your breath.
  • To keep your mind focused, count your inhales and exhales from one to ten. Make sure that your breathing is neutral, soft, and sweet.
  • Practice as long as it is pleasant.

2. Equal Breathing

The main principle of this exercise is to create an equal pattern of inhaling, suspending, exhaling, and suspending. For example, you can try a count of 2-2-2-2 or 3-3-3-3. Note: Do not hold your breath for longer than five-six counts.

Try it:

  • Get comfortable, close your eyes, and find your natural breath.
  • Allow your body to relax and feel safe.
  • When you are ready, inhale through the nose to a count of two, then suspend your breath on two, exhale on two, and then suspend your breath again on the same count before your next inhale.
  • Repeat for 8-10 rounds.

3. Dirgha Pranayama

This breathing exercise involves slowly filling your lungs as much as possible. In fact, dirgha means “long” in Sanskrit, and is often referred to as “the complete breath”, “the yogic breath”, or “the three-part breath.”

Try it:

  • Lie down on your back, get comfortable, and put one hand on your belly and the other on your upper chest.
  • Close your eyes and start observing your breathing. Make your breathing even and smooth.
  • Now, inhale slowly into the lower abdomen and pelvic area, and feel your hand rise.
  • Then, continue inhaling into the mid-section of the torso, expanding the diaphragm and the ribs.
  • Finally, bring your breath into the upper chest and shoulders. Feel how your second hand rises up.
  • Start exhaling slowly in the reverse order, releasing the upper chest first, then the diaphragm and ribs, and finally the lower abdomen.
  • Expelling all the air, allow yourself to feel relief.
  • Pause if you need to and then repeat a few more cycles at a slow pace.

4. Parasympathetic Breathing and the Vagus Nerve

One of the most fundamentally important elements in the restorative parasympathetic nervous system is the vagus nerve. This nerve works as a connector between many vital organs, linking the brain to the tongue, vocal cords, heart, lungs, digestive tract, and various hormone glands. It influences the internal processes of the body (e.g., inflammation, blood pressure, heart rate, digestion, and absorption of nutrients) and supports homeostasis and immunity. Working on the softness of the breath, especially with parasympathetic breathing exercises, helps to tone the vagus nerve and activate self-healing powers of the body.

Try It:

  • Get in a comfortable position, close your eyes, and start observing your breathing.
  • When you are ready, inhale for a count of two, hold your breath in for a count of two, and then exhale gently, counting out to four.
  • After you exhale fully, hold the breath again from two to four counts.
  • Keep your breathing round and smooth. The main principle of parasympathetic breathing is elongating exhalations that become at least twice as long as your inhalations. You can experiment by creating different patterns, for example, try a “2-2-4-2, 4-2-8-2” or any other pattern that works for you.
  • Repeat 8 to 10 times. Never exaggerate or push too hard. Remember, it is all about doing less, but feeling more.

Breathwork can be a powerful therapeutic practice. Try these four breathing techniques and let the softness of your breath be your first step toward healing and relaxation.

You Can Actually Build Brain Resilience: Strategies

In the face of adversity and hardship, most cope as best they can. What if you could change the structure and function of your brain to become even more stress-resilient?

Resilience has been defined as the ability to deal with adversity, be it small daily stressors or unexpected traumatic events. More specifically, resilience is seen as having the capacity to return to successful adaptation and functioning even after a period of disorganization and disruption.

Most often, resilience has been considered a function of our ability to call upon enduring personal attributes as physical strength, intelligence, interpersonal strengths, independence, sense of humor, creativity and spirituality.

While these are no doubt valuable assets for coping and stress reduction, recent research offers good news–You can expand on these. You can actually build resilience.

Building Brain Resilience–Findings

According to scientists, Steven Southwick and Dennis Charney, resilience is actually tied to brain function and we have the power to change the structure and function of our brains to become more stress-resilient.

When we face traumatic events we go into fight/flight responses because our brain activates the neural pathways of fear. Daily worry and stress do a similar thing. Ruminating about negative events, faulting yourself for mistakes, believing you cannot risk change, can activate the same neural pathways of fear that a pandemic or imminent hurricane invites. Essentially the more we activate the stress response and the neural fear pathways, the more this becomes our default setting.

One of the things these scientists report is that new techniques like functional magnetic resonance imagining reveal that resilient brains shut off the stress response and return to baseline quickly. 

For example, scientist Martin Paulus found that imagining of the brains of Navy Seals shows that they don’t get glued to the traumatic or emotional experience. They “ let go” and move on to the next mission. Essentially they focus less on the negatives and respond with alternative neural pathways.

Can We Do That?

What these scientists are proposing is that we can train our brains to build and strengthen different connections that don’t keep activating the fear circuit. We can train ourselves to “ Let Go” of the negative and the frightening, so that we can move forward despite adversity.

Neurologically “ Let Go”

This is not the first time any of us have heard the suggestion to “ Let Go.” We have heard and often been inspired by it for decades:

You can only lose what you cling to. (Buddha)

There’s an important difference between giving up and letting go. (Jessica Hatchigan)

“Letting Go” of The Negative is Difficult

Our focus on negative experiences persists because such experiences actually involve more brain activity than positive ones. This is called the Negative Bias.  

Another reason that letting go of the negative is difficult is that many of us have the mistaken belief that if we continue think about the disaster or the possibility of losing our job, we will be able to prevent it from happening again or be prepared for it. 

The reality is that it doesn’t prepare us–it frightens us. Ruminating about the mistake, the failed mission or what should have happened keeps us in a dysregulated state.

New Perspective

It is worth considering that letting go of the frightening is not just “letting go” – It is making possible the activation of alternative neural paths and that equates to having a place to go other than fear in the rough times. It equates to resilience.

Strategies to Build Resilience

Drawing upon Steven Southwick and Dennis Charney’s book Resilience: The Science of Mastering Life’s Greatest Challenges, here are three strategies that stimulate brain change and resiliency building.

Use Realistic Optimism

Optimism is considered to be a fuel that ignites resilience and empowers other resilience factors. That said, there is a very big difference between blind optimism and realistic optimism. 

Blind or unrealistic optimism underestimates risk, overestimates ability and results in inadequate preparation. For example:

 A group of young adults believe that if they only go out to the bars with each other, they won’t contract Covid-19.

Realistic optimism, as opposed to blind optimism, is active not passive. The person using realistic optimism does not miss the negatives but disengages from problems that appear unsolvable and attends to problems they can solve. For example:

Addiction: 5 Early Warning Signs

The earlier the diagnosis, the better the prognosis. This medical principle applies to addiction, and the importance of recognizing early warning signs cannot be overstated. Addiction is a progressive disorder that, if left to run its course, gets worse, not better. When someone has lost their personality along with family, friends, and a job, they have lost many of life’s most important incentives for getting better.

The best-known symptoms of addiction are late-stage physical symptoms—the red face of an alcoholic, the emaciation of someone who is addicted to crack, the facial sores of meth users. The earliest warning signs, however, are changes in behavior that family members, friends, and colleagues can identify.

Rationalization and Projection

“I always had a convincing reason to drink,” remembers a 45-year-old patient in long-term recovery from an uncontrollable craving for alcohol. “First I drank to be social, then to relax after work. Next I drank to sleep, and then to forget. None of these explanations seemed like rationalizations. I had real needs and believed only alcohol could meet them.”

As craving deepens, addicted individuals begin organizing their lives, often in rigid ways, around the need for uninterrupted access to alcohol and other drugs. They may become increasingly irritated by schedule changes and blame their odd behavior on parents, partners, their children, or an unfair employer. Family members are especially vulnerable targets and will often change their own behavior to placate addicted loved ones.

Mood Swings and Personality Changes

While addicted individuals can be highly critical of other people, their own behavior may be unpredictable and can quickly change from jubilant euphoria to angry suspicion. When an addicted individual is “on the wagon” or trying to cut back, mood swings become more pronounced.

At the extreme end is the Dr. Jekyll and Mr. Hyde syndrome. For reasons not yet known, some people experience a personality change when they are drinking or using other drugs. At its worst, this transformation resembles the presence of two different personalities in one body. A loved one disappears, and an out-of-control stranger takes her place.

One of my patients was a highly moral person who, when drinking, watched pornographic movies in front of his children. Another was a kind father and husband until he drank heavily. He spent one European vacation roaming the streets in his underwear, knocking on doors and challenging people to fight. His children and wife barricaded themselves behind a door, terrified that he would make good on his promise to kill them.

When they returned home, his wife asked me to help with an intervention. It was successful in part because her husband was shocked to hear about his behavior, of which he had no memory. He willingly went to a treatment program, but it took many years before he was able to restore a relationship of trust with his family members.

Deteriorating Relationships

When I could control my drinking, I could still charm a crowd and make new friends. But when I partied, I often became a raging lunatic. One night, I taunted some fraternity guys who were in mourning for a frat brother killed in a car wreck. They jumped me in an alley, breaking my nose and leaving me with a deep gash above my eye. Except for a stranger’s intervention, they might have stomped me to death.

—James B., co-author with Dr. Spickard of The Craving Brain

Many people, like my co-author James B., begin their journey into addiction as the life of the party. As their craving deepens and their behavior deteriorates, their social circle narrows to other users or addicted individuals, feeding the delusion that heavy drinking and drug use is normal behavior. In the end, even these friends may disappear, leaving them isolated and alone.

“As an addicted person, I was a consumer of relationships and people,” says James. “When I wasn’t drinking, I was lots of fun and could easily land a good job, win people over, and make new friends. Then I would get loaded, and all my anger came pouring out. People walked away from me, or I from them.”

“For years, I went from one circle to the next, not connecting my broken relationships to my behavior and drug use. It was always everyone else’s fault—their loss, not mine.”

The family life of addicted individuals is often marred by sudden or unexplained changes, including separation and divorce. Children may run away, go to live with relatives, or otherwise prematurely separate themselves from home.

Poor Work Performance

Most addicted individuals take great pains to keep their jobs, in part to pay for their drugs. Sooner or later, however, their work performance deteriorates. They find it harder to concentrate and make simple mistakes. They may become moody or aggressive toward fellow workers and show up late for work, or not at all—especially on Mondays or after holidays.

For most addicted individuals, job-related problems are the beginning of the end. They experience a snowballing decline in physical, emotional, and intellectual function that plunges them into ever deepening levels of chaos. For many, the endgame will be a long period of suffering and disability, and a premature, addiction-related death.

Crisis of the Spirit

The dramatic alterations in brain function caused by uncontrollable craving create profound changes in the psychological and spiritual lives of addicted persons. Many find themselves living in the deep shadows of life, strangers not just to their families, friends, and colleagues but to themselves.

“By my mid-twenties I was totally living in the dark side of my personality,” says James. “A part of me still wanted to quit using, but it no longer seemed like the real me. When an inner voice told me to get my life back on track, I wondered, Who is this stranger talking?

The emergence of a shadow self can begin even before heavy users cross the line into addiction. Mood-altering drugs alter the frontal lobe of the brain, affecting judgment, impulse control, and inhibition. The breakdown of this ‘behavior safety system’ leaves heavy drinkers and users more vulnerable to the weaknesses that plague us all—anger, self-pity, greed, hatred, violence, inertia, and sexual betrayals, to name only a few.

When heavy users cross the line into craving, they may abandon their spiritual life, giving up practices like prayer and meditation and severing their connection with a faith community. James, by nature, was an unusually conscientious and spiritually reflective young man. At the precocious age of 11, without influence from his parents, he went searching for a church to attend. He even became an acolyte.

By his early twenties, James’s moral life was in a steep decline. He habitually told lies, verbally abused friends and strangers, and borrowed money that he knew he couldn’t pay back. The disinhibiting qualities of alcohol made it easier for him to use cocaine, which he had vowed never to do. Before long, he was gambling heavily and selling drugs.

Many addicted individuals—to their own shame and horror—find themselves in a similar downward spiral. They start hiding bottles or drugs, and lie or steal to keep their drug pipeline open. They show up for work under the influence, even when they hold the health and safety of other people in their hands. Some emotionally or physically abuse their spouses and children.

Despite appearing calm or confident, addicted individuals who violate their personal values almost always experience a deep sense of failure and humiliation. “It’s impossible to describe the emotional pain experienced by an addict,” my friend and colleague, Dr. Jordan, told me. “No matter how arrogant or self-confident he may seem, his primary emotions are shame and self-hatred.”

These feelings trap an addicted individual in a self-perpetuating cycle of drug use and self-loathing. Some, like my colleagues Andrew and Sara, take their own lives. In one study, two-thirds of all suicides by people under the age of 30 were connected to substance abuse or addiction. Others, like James, experience a living death, falling into ever deeper levels of despair.

Minding your memory

Everyone experiences the occasional “senior moment” as they age. You may misplace everyday items, fail to recall the name of someone you just met, or forget to do something. While these memory slips can be embarrassing and stressful, they usually don’t mean that you are on a path to dementia.

“Some degree of memory lapses is a normal part of aging,” says Lydia Cho, a neuropsychologist with Harvard-affiliated McLean Hospital. “You can’t expect to hold on to all information you’ve gathered throughout your life, whether it was long ago or recent. It’s not realistic or adaptive.”

Factors at play

There are times when frequent forgetfulness should be checked out by your doctor, as it could be a symptom of an underlying treatable health problem. For example, insomnia, anxiety, and depression can affect brain functions, including memory.

If your lapses become more frequent or severe, or if they affect your daily life (like forgetting to pay bills or take medicine), your doctor may recommend a neuropsychological evaluation. In that exam, a specialist assesses your memory and other cognitive skills, such as attention, executive function, language, and visuospatial abilities.

Brain assistance

Even though most memory lapses are not cause for concern, you can take measures to manage and improve your existing brain skills. Adopting various lifestyle behaviors is one way (see “Manage your memory with DANCERS”). For specific types of everyday memory issues, adopting certain strategies can help you retain and recall information or navigate memory hiccups when they arise.

Manage your memory with DANCERS. There are steps you can take to enhance your memory and help to delay or even prevent dementia. Lydia Cho, a neuropsychologist with Harvard-affiliated McLean Hospital, suggests focusing on DANCERS, a set of lifestyle criteria created by Dr. James Ellison, former director of the geriatric psychiatry program at McLean.
D: Disease management. Maintain a healthy weight, don’t smoke, and keep blood pressure, cholesterol, and blood sugar levels in line to help preserve cognitive function.
A: Activity. Any cardio exercise, like walking, swimming, and playing sports, is good for brain health. “Cardio can increase energy in the brain by improving oxygen and blood flow,” says Cho.
N: Nutrition. Poor nutrition leads to poor brain health. The DASH, MIND, and Mediterranean diets emphasize whole fruits and vegetables, whole grains, lean meats, fatty fish, and healthy fats.
C: Cognitive stimulation. “Challenge your brain regularly,” says Cho. “The more you engage your brain, the more likely you can retain memory.”
E: Engagement. Research continues to show a reliable link between isolation and lower cognitive function. Any kind of social engagement is helpful.
R: Relaxation. Your brain needs adequate downtime. Do activities that you find relaxing, whether it’s exercise, yoga, meditation, reading, or bathing.
S: Sleep. Sleep is when your brain cleans out toxins. To get the recommended seven to nine hours of sleep per night, practice good sleep hygiene. Examples: Set a sleep schedule and stick to it. Avoid any electronic devices for at least an hour before bedtime. Don’t eat after dinner time.

The following is a look at the memory obstacles you are most likely to encounter and ways to deal with them.

Absent-mindedness. This happens when you multitask and don’t concentrate on less critical tasks. (Think of the stereotypical absent-minded professor who can recall complex formulas but keeps misplacing his glasses.) Sometimes, the seemingly small details can have significant consequences, like forgetting to take medicine or leaving the house without your phone.

What you can do: When faced with multiple tasks, put them in order of importance and then focus on only one task at a time before moving on to the next. Setting up routines and reminders also can help prevent absent-mindedness.

For example, create a memory table by your front door or in the bedroom where you place all your vital objects, like your phone, medicines, and glasses. To make sure you take your medicines on schedule, use a pillbox labelled with dates and times, or set alarms on your smart phone to remind you.

Blocking. This is referred to as the “tip of the tongue” phenomenon, when you can’t recall a name or specific detail. “You know the information, but you can’t immediately place a label on it,” says Cho. “This happens to everyone at times, no matter a person’s age, and isn’t cause for concern unless it becomes a more frequent occurrence.”

What you can do: Recalling names of people is the most common type of blocking. Cho suggests trying to associate a person with something that may help trigger name recall, like his or her hobby, work, background, or spouse. “Many times you know more detail about a person beyond his or her name,” she says. Another option is to associate the person with someone who has the same name or a similar one, like a relative, celebrity, or movie character. “You can also connect the name with a rhyming word or song,” says Cho. For large functions where you know the attendees, like family gatherings or meetings, rehearse people’s names beforehand.

Transience. Transience is the loss of certain memories — typically facts or events — over time. “The brain decides what information becomes less crucial or integral,” says Cho. For instance, you can memorize a phone number to use immediately, but then you don’t retain it because it’s no longer needed.

What you can do: If you want to retain certain memories, try to keep that information emotionally charged. “If you believe it’s important, your brain will likely hang on to it longer,” she says. You can do this by revisiting the memory through sharing it in conversation, recording it for future reference, and reviewing photographs.

Misattribution. Here, you recall accurate information from an event but can’t attribute it to the correct source, or you recognize a familiar face but place the person wrongly. Another type of is misattribution is false recognition, which scammers often exploit. “People try to convince you that you owe money, and you don’t trust your memory and second-guess yourself,” says Cho.

What you can do: If you have trouble connecting information with a source, write down the details of an event when they occur. You can also record the information (most smartphones have voice memo capabilities), or take pictures or videos. “But keep in mind that many times what you know is more important than where it came from, so focus on that,” says Cho.

To protect yourself from scams, never share financial information like account or credit card numbers on the phone or over the Internet. If you have doubts about an inquiry, and don’t trust your memory, run it by a friend or family member to ensure its legitimacy.

Self-Care and Gratitude: How They Go Hand in Hand

For many, the glass seems half empty.  With loved ones tragically passing or loneliness seeping into our daily moods or responsibilities of kids overtaking many parents’ schedules, there is reason to consider gratitude in our daily regimen of self-care.

Turning to gratitude can, in part, help us see the glass as half full. 

Here are three ways gratitude promotes self-care:

1. Gratitude promotes self-care via healthier living.

A brief yet regular gratitude practice promises more benefits than may be expected.  For example, college students who write about what they’re grateful for weekly for 10 weeks also exercise more than those who engage in other types of writing.  A gratitude practice promotes exercise, better nutrition, better sleep, and not smoking, among other things.

2. Gratitude promotes self-care via selflessness and humility.

Self-care via gratitude holds benefits for social well-being as well.  Among three hundred college students, those picked to write gratitude letters showed greater stimulation in the reward region of their brains when observing money given to charity.  A regular gratitude practice, in turn, motivates us to seek kindness and generosity to reward our minds as well as to improve circumstances for others; the latter, improving the lives of others, makes us more selfless and humbler. 

3. Gratitude promotes self-care via meaningful connection to others.

Another benefit for social well-being was seen among adults and college students in the U.S. and Korea asked to perform two gratitude activities: remembering a grateful experience or writing a gratitude letter.  Other participants engaged in activities such as hiking or shopping.  In contrast to the two groups, participants exercising gratitude felt more connected to others.  (Loneliness, which is rampant due to COVID lockdowns, for example, might be tackled via gratitude practices.)  Feeling socially connected in the time of COVID could go a long way to promoting self-care as well as societal care. 

Countries are each addressing COVID health consequences, but what about the self-care and societal care that’s needed as well?  Using a gratitude practice can address the needs of members feeling unfairly affected by the pandemic.  Not only does gratitude help at this critical time, but gratitude is also useful to individuals and societies outside of times of public health crisis.  Hopefully, we apply such a practice daily or weekly to reap its countless benefits. 

What are some ways you can practice gratitude?

  • Use your social media platforms, or alternatively a journal, to list what you are grateful for weekly.  Try to keep this up for over six weeks.
  • Say thank you in-person to someone you care about.
  • Say thank you to yourself before you go to bed, recounting three things you appreciate about yourself.
  • If possible, appreciate the love shown to you by others by showing it back in ways shown in 1 and 2 above.

How to De-escalate Conflict

And while conflict isn’t bad per se–talking through the issues that will inevitably arise is probably a good idea–there are ways we can do it better, so each of us isn’t left sulking in the corner until we find a vaccine. 

When things get tense, here are five ways to deescalate conflict and salvage your relationships: 

Accept Influence: Couple’s therapist John Gottman’s conducted groundbreaking studies that predict which couples will get divorced. His findings? Couples were more likely to stay together when, during times of conflict, husbands accepted their wife’s influence. Accepting influence looks like the opposite of defensiveness; when the other person has a complaint, instead of telling them why they’re wrong, tell them why they’re right. Share “you have a good point” and look for things to agree with them about. When you accept influence, you’re not out to win the conflict. You’re out to find a solution that works for both of you. 

Take a Break: To understand why taking a break helps, let’s visit psychiatry professor Dan Siegel’s concept of the window of tolerance. According to Siegel, we all have a “zone of optimal arousal” at which we are functioning at our best; we’re able to think rationally and consider others’ perspectives. However, when we’re stressed–like when our toddler upchucks on our new shirt, or when our dog starts humping our leg during our zoom work meeting–we exceed this optimal zone. We may be hyper-aroused (feeling on edge; ready to fight or run) or hypo-aroused (shut down; feeling numb). Siegel argues that when we’re outside our zone of optimal arousal, our goal is not to keep arguing, because that will be futile or even damaging. It is to calm ourselves down. One great way to do this is to take a break. Returning to the conflict when we feel calm will lead us to blame one another less and listen to one another more.

Affirm One Another: Another gem from the couple’s researcher John Gottman is the concept of “the magic ratio.” Gottman found that couples that last have a 5;1 ratio of positive to negative comments. More generally, Gottman’s couples therapy technique addresses not only working through negative experiences between couples but also building up positive ones. When we find ways to affirm others around us, we’ll be better prepared when disagreements inevitably arise. We start preparing to have healthy conflict before the disagreement happens by weaving a safety net of love and respect for one another. Expressing fondness and appreciation, sharing compliments, and showing admiration are all ways to do this. 

Name the Underlying Emotions: Research finds that the simple act of naming emotions deactivates our amygdala, the part of the brain activated when we’re angry or stressed. We can use this to our advantage in conflict by trying to name the emotion the other person might be feeling during the conflict. Instead of responding to the content of their message, we can state the feelings behind it. So for example, if your roommate says “I can’t think because you’re so loud during your zoom meetings,” instead of defending yourself, you might reflect, “So you’re saying you’re feeling stressed out and unable to focus?” 

Embrace Happiness

Positive emotions – such as feelings of gratitude, love, and confidence – strengthen the immune system, protect the heart against loss and trauma, build relationships, increase resilience, and promote success. Based on studies that have already been done, if a drug company could patent a happiness pill, we would be seeing ads for it every night on TV.  

Technically, emotions can be organized along two dimensions: intensity (how strong they are) and hedonic valence (how good they feel). Tranquility, for example, has low intensity but can feel really really good, a profound inner peace.

Low intensity positive emotions are great. They are the bread and butter of everyday well-being. This said, high intensity positive emotions have special benefits. They actually help lengthen the lifespan. They steady the mind and improve concentration by engaging steady and high levels of the neurotransmitter, dopamine, that stabilize the contents of working memory and block out distractions – perhaps a reason why “bliss” is recommended in Buddhist meditation training as a factor of non-ordinary states of consciousness and awakening altogether. And they can pull us out of the numbing, blahs, and meh-ness of ordinary routines, stresses, disappointments, and frustrations – sort of like that transition in the Wizard of Oz movie from black and white to color.

Intense positive emotions include delight, passion, rapture, thrill, triumph, head over heels in love, exuberance, elation, and rejoicing. In a word, joy.

Finding and protecting joy is worth doing at any time. And it’s especially important when you’re facing challenges at any scale, from worries about your child to alarm about your world.

Joy is a reminder that you are not defeated in the sanctuary of your own mind. Sometimes joy comes with other feelings that actually add to it rather than diminishing it, such as a fierce joy, an exhausted joy, a grim joy, or a rebellious joy. Consider the joy in these lines from Dylan Thomas: “Time held me green and dying/Though I sang in my chains like the sea.”

No matter what is happening in the world around us, no matter what situation we’re stuck in, no matter how anguished we are for others, no matter how hopeless it seems and helpless we feel – we can always turn to joy, claim it, and welcome it. A kind of triumph, a lighting of at least a single candle no matter the gathering darkness.

How?

Of course, positive emotions are not about suppressing or covering over pain, anxiety, or outrage on behalf of others. Positive feelings can be present in the mind alongside negative ones. In fact, they help us cope with the hard things and hard feelings of life, and fuel us to keep on going for the sake of others. The worse a person’s life is, the more important it is to find and feel authentically positive emotions – including joy.

Sometimes joy is a sustained experience. Perhaps your child is born and you hold her and your day is filled with a stunned and solemn joy. But I’ve found that intense joy usually comes in brief pulses. You inhale and smile and there is joy for a few seconds, often for no reason at all. Recognizing and valuing these little moments of delight expands the possibilities for having them. Adding even just a few “beads” of joy changes the whole necklace of seconds that make up your day.

One way to evoke joy is to value opportunities to feel it that naturally appear in daily life. Intense gratitude for hot water, amazement at the sun, the extreme pleasure of sneezing, blown away that your partner still loves you, so so so happy to come home after a long day of work . . . all of these are chances for joy.

You can also deliberately call it to mind, perhaps remembering a beautiful mountain meadow at sunset and then the world changing overnight to white silence as you crawl out of your tent at dawn to a foot of new snow. Perhaps thinking about someone you love, or a major challenge you have put to rest behind you.

And you can just flick a kind of switch in your mind and turn directly toward joy. Really. The more experiences of joy that you’ve had and taken into yourself, the easier this gets. Additionally, try things like saying to yourself, “May there be joy,” and open and receive it. Look for and call forth quick pulses and rushes and flashes of joy. If it’s real for you, joy may have a spiritual aspect to it, perhaps a joyful sense of something divine.

Research exposes the many biases Black people face in American society

Instead, they charged one of the officers with three counts of “wanton endangerment” for firing shots that flew into and adjacent apartment when Taylor’s neighbors were there.

This outcome has at once sparked anger and heartbreak. Taylor was simply watching a movie with her boyfriend at home. The sheer ordinariness of how she was spending her evening underscores why many Black Americans feel that their lives are seen as comparatively less valuable in American society.

 The #BlackLivesMatter movement has been criticized, maintaining that as a society we should remain focused on “all lives.” But Taylor’s horrific death, one of far too many, once again demonstrates the very real dangers that Black people face that others in American life do not.

Psychology, in a sense, can be an ally to BLM in providing empirical support. Here are just five psychology studies that demonstrate systematic bias against Black people in America.

Black people are superhuman. Take a study in which researchers investigated whether White people see Black people as superhuman, that is, possessing supernatural, extrasensory, and magical mental and physical qualities. Popular culture is just one sphere in our society, the authors maintain, in which Black people are portrayed as superhuman, as evidenced by characters in The Green Mile and The Legend of Bagger Vance. In a series of five experiments, the team administered tests of implicit and explicit bias, to see whether White people superhumanize Black people relative to White people. For instance, in one task, participants categorized pictures of Black and White, male and female faces, and superhuman and human words on a computer screen, with investigators measuring the strength of associations between two concepts (Black Americans and White Americans) and two attributes (superhuman and human). Analyses revealed that Whites implicitly and explicitly superhumanize Blacks versus Whites. The authors interpret the results as supporting the idea that Black people are dehumanized not through “animalization or mechanization,” but by depicting them as superhuman.

Black people feel less physical pain that Whites.  Analyzing National Football League injury reports data, investigators found that by comparison to injured White players, injured Black players are assessed as more likely to play in a subsequent game. In a series of four experiments, researchers found that White and Black participants – which included registered nurses and nursing students – assume that Black people feel less pain than do White people. The investigators also found that this bias is based in perceptions of status, and not race per se, such that Black people and others who are seen as “low-status” in our society are characterized as comparatively “tougher.” The authors contend that their work helps us to better understand not only race-related biases and healthcare disparities, but also police brutality. The researchers aver that while although some Whites (and non-Whites) condone police brutality against Black men simply because they are Black, it might also be that police brutality against Black men is tolerated because it is presumed that Black men feel less physical pain.

Black people are associated with danger.  Studies show that Black men and boys are viewed in the light of violence and criminality, and that this association generalizes to Black women and Black girls. In a series of experiments, non-Black participants completed tasks in which they saw faces varying in race, age, and gender before categorizing danger-related objects or words. Non-Black and Black participants performances on this task were also compared. The results were striking. Black children and adults, male and female, were more closely associated with danger by comparison to their White counterparts, revealing racial bias.

Physicians talk to Black patients differently. Does racial bias permeate the doctor’s office? Unfortunately, research suggests that it does. Take a study that investigated how non-Black physicians communicated with Black patients. Investigators transcribed and analyzed 117 video-recorded “racially discordant medical interactions” from a larger study, using Linguistic Inquiry and Word Count software to analyze their word use. What did they find? Physicians with higher levels of implicit and explicit racial bias used anxiety-related words and language reflective of social dominance with greater frequency when meeting with Black patients. Those who are high on social dominance favor group-based domination and inequality; this preference has been linked to language usage, with ample research finding that higher status speakers tend to use more first- person plural pronouns (e.g., we, us, our) and less first-person singular pronouns (e.g., I, me, my).

Black children are seen as more angry than White children. Are people racially biased when judging the emotions of others? Take a study that investigated “racialized emotion recognition accuracy” and anger bias toward children. The investigators had 178 prospective teachers (70% White, 9% Hispanic, 8% Asian, 6% Black, 5% Biracial, 1% Native American, and 1% Middle Eastern) complete an emotion recognition task made up of 72 children’s facial expressions, portraying six emotions, and divided equally by race (Black, White) and gender (female, male). Participants were also given questionnaires of implicit and explicit racial bias. What did the researchers find? Both Black boys and Black girls were erroneously seen as angry with greater frequency than White boys and White girls.

These are just five studies in a sea of research demonstrating the range of pernicious biases that Black people confront in their everyday lives. If you want to share additional studies, please do so in the comments section.

The Power of Journaling

The six months since the World Health Organization declared COVID-19 a pandemic have been harrowing ones, to say the least. Against the backdrop of the disease and the economic impact it has brought, the world has witnessed ongoing racial injustice, natural disasters, and widespread wildfires, among other painful events.

For many people, it has been hard to stay emotionally afloat. Even the U.S. Centers for Disease Control and Prevention (CDC) has published guidelines regarding how to cope, with suggestions running the gamut from engaging in leisure activities and taking media breaks to getting sufficient sleep and eating right. This article adds one additional idea to that list: journaling.

There’s a one-in-two chance you’ve kept a journal. Perhaps you needed an outlet for your thoughts, or maybe you were recording your experiences to revisit later in life. According to surveys, about half of us have written in a journal at some point in our lives, and somewhere in the neighborhood of 1 in 6 people are active journalers right now. The number may be even higher for kids, with a 2014 survey showing that 21% of children and young people write in a diary at least once a month.

But considering the current need for additional coping practices, maybe more of us should.

Over the past couple of decades, dozens of studies have shown that certain journaling practices can positively impact a variety of outcomes, including happiness, goal attainment, and even some aspects of physical health. This research is often challenging to locate, given that the word “journaling” is not often used by investigators. Instead, they may label their interventions with names like “setting implementation intentions” or “engaging in expressive writing.”

Some of the effects of journaling are well-known. Most of us know, for instance, that keeping a gratitude journal can improve mood, an idea that first gained traction in a seminal paper published in 2003 by Robert Emmons and Michael McCullough in the Journal of Personality and Social Psychology.

Although versions of this practice differ slightly, the basic idea is to write down a few good things that occur every day for anywhere from 2 to 10 weeks. They can be big things like “I just got a new job” or small things we might normally overlook, like “The flowers in the back yard were blooming today.” Given the turmoil in our world, it’s easy to overlook the little things that fill us with gratitude, instead focusing exclusively on the many negatives around us. Journaling may be a way of “hacking into” the brain, helping us be more mindful of the positive. 

But the effects of journaling can also be more dramatic. In a 2013 study published in the journal Psychosomatic Medicine, researchers found that a certain kind of journaling—sometimes known as expressive writing—may help in healing physical wounds, at least small ones. Investigators asked healthy adults ages 64 to 97 to journal for 20 minutes a day, three days in a row. But not everybody used the same journaling practice: Half were encouraged to write about things that upset them, honestly discussing their thoughts and feelings about those events. The other half wrote about a much dryer topic: how they manage time during the day.

Financial hardship is a top risk factor for suicide attempts

A study that appears online in the American Journal of Epidemiology indicates that financial strain is a significant risk factor for suicidal ideation and suicide attempts.

The researchers also warn that, due to the current pandemic’s impact on economies, suicide attempts may become an even greater worry in the near future.

“Our research shows that financial stressors play a major role in suicides, and this needs to be recognized and appreciated in light of the unprecedented financial instability triggered by the COVID-19 pandemic,” says lead author Prof. Eric Elbogen, from the Duke University School of Medicine in Durham, NC.

“We could well be seeing a dramatic increase in suicide rates moving forward,” he further speculates.

Worrying predictions

Prof. Elbogen and his colleagues conducted their research before the start of the pandemic, on a representative cohort of adults in the United States.

They analyzed data from 34,653 adults interviewed first in 2001–2002 and then in 2004–2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions.

The researchers found that being in debt or facing a financial crisis, unemployment, past homelessness, and having lower income were each associated with suicide attempts.

The researchers predict that people who have experienced all of these financial stressors could face a 20-fold higher risk of attempting suicide than individuals who have experienced no financial strain.

The team predicts a similar trend for suicidal ideation in relation to economic stressors.

“Our study, while assessing this connection using pre-COVID data, shows a direct risk that should raise alarm as millions of people experience economic hardship resulting from the pandemic,” notes Prof. Elbogen.

“Although the ultimate health impact of COVID-19 is still unknown, it is all but certain that the longer infections spread, there will likely be more people who will experience significant financial strain resulting from work stoppages and disruption.”

– Prof. Eric Elbogen

In the study paper, the authors also write that: “In the context of suicide prevention, considering income, employment or both are necessary but not sufficient. Policymakers and clinicians should address how people manage their income.”

They also explain that their study may have some limitations, in particular, due to the fact that suicidal ideation and suicide attempts were self-reported by the participants.

Since society often attaches stigma to mental health issues and suicide attempts, some interviewees may have chosen not to disclose the full extent of their conditions, the investigators note.

Finally, they caution that the study did not measure all dimensions of financial strain, such as a person’s current risk of homelessness or the nature of their job loss, whether permanent or temporary.

There is a “need for further research examining relationships between financial strain, mental health, and empowerment,” they write, explaining that a person’s lack of opportunities for financial mobility may also play an important role.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

6 Steps to Calming Anger

Your anger is important.

This fiery emotion is an appropriate reaction to injustice, betrayal, loss, hurt, trauma, or violation. It’s essential to acknowledge and honor this fierce feeling so that we can attend to the harm that has been caused. When we deny or suppress our anger we often cause ourselves further suffering. And, when we don’t slow down to find the ground and get clear when our anger is ablaze, we end up hurting others.

So the next time anger arises, here are six steps to meet the moment with curiosity and inspire a constructive response.

1 | Notice where there’s tension in your body.

Anger shows up physically in the body. Notice if you’re clenching your fists, tightening your jaw, heating up, or feeling sensations in the belly. You may also notice an impulse to run, fight, or withdraw.

Take some space to be with whatever is coming up for you. While it may be uncomfortable, remember that no feeling is permanent. Observe how the physical manifestations of anger naturally shift and change with time.

Note: Our thoughts often fuel anger, so it can be helpful to notice when you’re caught up in a fury of thoughts and invite your attention back to the body.

2 | Slow down and tend to the wisdom of your body.

Anger often comes with a sense of urgency. You may be thinking, “We must figure this out now!” or “ We must get justice now!” While it’s important to address what’s happened, our words and actions usually don’t yield the outcome we’d like when we’re still in the intensity of the emotion. So, it’s crucial first to slow down and take care of yourself.

If you’re noticing physical tension, then invite relaxation into that body part. If you’re heating up, place an ice pack on your neck. If you’re feeling the impulse to run, give yourself permission to walk away for a bit and collect your thoughts (you can always say something like, “I need some time to digest what just happened, I’d like to come back to this tomorrow”). If you’re withdrawing, you might not feel safe, give yourself permission to leave and do something that helps you feel safe and connected (maybe reach out to a friend, meditate or go spend some time in nature). If you feel the desire to fight, find a way to move that energy (maybe go for a run, cook dinner, or do some jumping jacks).

3 | Take long soothing breaths.

The experience of anger is stressful and takes a lot out of us. Breathing deeply and slowly can help reset the nervous system. Take at least five deep breaths as a way to settle the mind and body.

4 | Meet yourself with compassion.

Anger is destabilizing, uncomfortable, and painful. Be kind to yourself. Place your hands over your heart and offer yourself soothing affirmations like, “You don’t deserve to be treated like this.” or “That wasn’t fair.” Or, try saying to yourself, “Wow! This is a lot to process and manage. I’m sorry things feel so hard right now.”

5 | Notice if there are any feelings underneath the anger.

Take as much time as you need in steps one through four. Once you’re feeling calmer, investigate what else might be going on for you. Sometimes anger can serve as protection for other feelings that may be even more challenging to feel. For example, many of us weren’t taught how to deal with feeling disappointed, so anger sometimes arises to shield us from a deeper sadness. Diving beneath the surface of a big emotion and exploring the complexity of our experience can help inform our next steps.

6 | Give yourself time to respond rather than react to the situation.

Mindfulness: A Time Tested Tool To Improve Your State Of Mind

Before the COVID-19 turned our world of its axis, many people regularly felt stressed and overstretched. Now, in the midst of a crisis that has led many organizations to restructure and reduce headcount, 82% of workers reported being asked to do even more with even less according to a recent study by VitalSmarts. This has resulted in a spike to stress lesses and an increasing toll on mental health and state of mind.

Clearly there is no magic bullet for combatting the pressures of work overload or the challenges of operating across virtual teams. However, if you’ve been feeling overwhelmed, stressed out or more anxious than usual, practicing mindfulness can make all the difference to your state of mind.  

Over the last decade, mindfulness has become a new buzzword. Yet the practice of mindfulness dates back thousands of years. Biblical scriptures encouraged us to “be still” and become present to God. Perhaps one of the most profound mindfulness practices of all. 

Of course unlike our ancestors who sat around a fire each night gazing into a flame while sharpening implements, most people today spend their lives staring at a screen, racing to keep up. As a client recently shared with me, “Each day feels like I’m drinking from a fire hose trying to keep up.”  It explains why a recent study found that 96% of respondents made about 15 mindless decisions each day.

While busy people often feel it’s indulgent to press pause on their busy productive ‘doing’ and connect to who they are ‘being, research proves otherwise. That is, practicing mindfulness doesn’t take time out of your day—it expands your ability to effectively utilize your time so you can fit more of what truly matters into your day. More time on Pareto’s ‘vital few’ and less on the ‘trivial many.’ 

There are as many ways to practice mindfulness as there are mindfulness experts (of which, I am not.) Yet as a student of mindfulness I’ve found that the most effective are usually the least complicated.  All of them flow from “paying attention to what we are paying attention to” – becoming a more attuned observer of our own inner world. Here are a few of the simplest yet most powerful ways for helping you to do just that.

1. Mindful breathing

If you get nothing else from reading this article, I encourage you to pause right now, and follow your breath in and out three times, breathing in through your nose and out through your mouth. Allow your breath to settle into its own rhythm. Then as you simply follow it in and out, observe the rise and fall of your chest and belly as you breathe. Pretty simple, huh? Once you’re done, notice the subtle way it shifts how you’re feeling.

While mindful breathing is clearly not anything new, we can easily forget to take full breaths when we are flying from one thing to the next, powered along by a false sense of urgency that stimulates our fight-or-flight responses, shallows our breathing, and leaves us operating in a perpetual state of emergency.

A few long, calm, deep breaths can disrupt your default stress response and enable you to see your situation more objectively and respond more rationally. In doing so it also spares you the negative fall out that often occurs when you are operating mindlessly – firing off a heated email, snapping at someone or just doing something you’d never do if you were truly grounded. 

2. Practice your inner observer

You don’t see the world as it is, but as you are. Through your own lens that has been shaped by your past experiences, social conditioning, cultural norms, personality and a myriad of other factors. 

So a key aspect of building mindfulness is “looking at how you’re looking at life: This is about practicing being an inner observer of how you are perceiving, processing and interpreting the world around you; becoming more in tune to your own cognitive, emotional and behavioral responses. Broken-down into parts, it is about 

a) Noticing what you are observing

b) Noticing what you are thinking about what you are observing

c) Noticing how what you are thinking about what you are observing is making you feel

For example, what are you telling yourself about the person who just sent the email about sales numbers that has triggered you? How is that interpretation showing up in your body—in your physical sensations, in your posture, your breathing and facial muscles? How else could you view what’s going on? What might be going on for them? What could be a more constructive way of responding?  

These sorts of questions lay at the heart of developing the soft skills that are so paramount to success in every domain of life.

3. Cultivate compassion

Cultivating compassion calls on us to look both inward and outward. 

Inwardly, to reflect on where we can be more self-compassionate – embracing our own humanity, forgiving our fallibility and being gentler with ourselves in our fallen moments. 

Outwardly, to consider what is going on for others— their anxieties, insecurities, fears, hurts, hopes and aspirations. 

8 Ways Managers Can Support Employees’ Mental Health

And that’s taking a toll on our mental health, including at work.

We saw an impact early in the pandemic. At the end of March and in early April, our nonprofit organization, Mind Share Partners, conducted a study of global employees in partnership with Qualtrics and SAP. We found that the mental health of almost 42% of respondents had declined since the outbreak began. Given all that’s happened between then and now, we can only imagine that the figure has increased. Much has been said about this short-term mental health impact, and the long-term effects are likely to be even more far-reaching.

Prior to the pandemic, many companies had increased their focus on workplace mental health (often in response to pressure from employees). Those efforts are even more imperative today.

As we navigate various transitions over the coming months and years, leaders are likely to see employees struggle with anxiety, depression, burnout, trauma, and PTSD. Those mental health experiences will differ according to race, economic opportunity, citizenship status, job type, parenting and caregiving responsibilities, and many other variables. So, what can managers and leaders do to support people as they face new stressors, safety concerns, and economic upheaval? Here’s our advice.

What Can Managers Do?

Even in the most uncertain of times, the role of a manager remains the same: to support your team members. That includes supporting their mental health. The good news is that many of the tools you need to do so are the same ones that make you an effective manager.

Be vulnerable. One silver lining of the pandemic is that it is normalizing mental health challenges. Almost everyone has experienced some level of discomfort. But the universality of the experience will translate into a decrease in stigma only if people, especially people in power, share their experiences. Being honest about your mental health struggles as a leader opens the door for employees to feel comfortable talking with you about mental health challenges of their own.

Prior to the pandemic, the biotech firm Roche Genentech produced videos in which senior leaders talked about their mental health. They were shared on the company intranet as part of a campaign called #Let’sTalk. The company then empowered “mental health champions” — a network of employees trained to help build awareness for mental health — to make videos about their experiences, which were used as part of the company’s various mental health awareness campaigns. (See the editor’s note below regarding our relationships with this company and others mentioned in this article.)

Those of us working from home have had no choice but to be transparent about our lives, whether our kids have crashed our video meetings or our coworkers have gotten glimpses of our homes. When managers describe their challenges, whether mental-health-related or not, it makes them appear human, relatable, and brave. Research has shown that authentic leadership can cultivate trust and improve employee engagement and performance.

Model healthy behaviors. Don’t just say you support mental health. Model it so that your team members feel they can prioritize self-care and set boundaries. More often than not, managers are so focused on their team’s well-being and on getting the work done that they forget to take care of themselves. Share that you’re taking a walk in the middle of the day, having a therapy appointment, or prioritizing a staycation (and actually turning off email) so that you don’t burn out.

Build a culture of connection through check-ins. Intentionally checking in with each of your direct reports on a regular basis is more critical than ever. That was important but often underutilized in pre-pandemic days. Now, with so many people working from home, it can be even harder to notice the signs that someone is struggling. In our study with Qualtrics and SAP, nearly 40% of global employees said that no one at their company had asked them if they were doing OK — and those respondents were 38% more likely than others to say that their mental health had declined since the outbreak.

Go beyond a simple “How are you?” and ask specific questions about what supports would be helpful. Wait for the full answer. Really listen, and encourage questions and concerns. Of course, be careful not to be overbearing; that could signal a lack of trust or a desire to micromanage.

When someone shares that they’re struggling, you won’t always know what to say or do. What’s most important is to make space to hear how your team members are truly doing and to be compassionate. They may not want to share much detail, which is completely fine. Knowing that they can is what matters.

When Your Mind’s Full of Dad Stuff, You Need Mindfulness

I most recently had the chance to do a course called ‘Search Inside Yourself ‘. It’s a system developed by Google that helps you build the emotional intelligence skills needed for sustained peak performance at home and at work.

There are a number of really interesting parts to this course: Listening, empathy, self-awareness and SBNRR (A technique for not freaking the hell out).

Why is something like this relevant to dads? Because being better at these things can help us become better dads, better people and better at work. When you work better, you work smarter and faster and you can spend more time with your kids.

MEDITATION.

We began with some basic meditation and breathing exercises. I won’t go into the details of this, the internet is full of great meditations and there are some good apps including Headspace, Buddhify and Calm. I personally have some guided meditations on my phone created by Kamal Sarma who runs a company called Rezilium. His book Mental Resilience came with a CD of meditations that I’ve used a lot over the years. With meditation I find the simpler the better, if it’s simple you’ll do it more often and get more out of it.

One thing I will say about meditation is that when you’re starting out and trying to focus you’ll notice that your mind will wander. I used to struggle to get refocused, the same thoughts would keep coming back. I eventually realised that if I actually acknowledged them by thinking, “Yes I hear what you’re saying but it’s not a good time. Come back later.” the thought would stop interrupting my meditation (more often than not it never comes back at all). Basically by acknowledging the thought for what it was, a valid concern not an interruption, it seemed to give it the attention it needed to let me get on with it. This leads nicely into the next bit of ‘See Inside Yourself’, listening.

LISTENING.

On the day we did a couple of listening exercises.

In the first exercise we broke up into groups of two and your partner spoke for about 3 minutes while the other person had to listen and then repeat back what their partner had said. Not word for word, just the general story. The interesting thing that you notice in this exercise is that listening, really listening, is really hard. We’re taught to be active in conversations, to contribute to the discussion, but this means that when we should be listening we’re actually thinking about what we’re going to say next. We’re not actually listening at all. We’re just pretending.

By practising really listening and focusing on what is actually being said we can become better dads. By giving our kids our full attention, by putting things down and deleting distractions, they’ll be more likely to continue talking to us. This goes for the workplace too, better listening means better communication which means better results.

…being better at these things can help us become better dads, better people and better at work.

EMPATHY.

In a slightly different version of this exercise one partner spoke for 3 minutes and the other person had to listen and then relate back the emotions they could hear their partner expressing. “I could hear that you were angry, sad, etc.” This is designed to get you thinking about empathy.

Again, another important part of being a dad and partner is empathising with your family. I tried this with my daughter the other night. She’d had a bad dream and rather than just tell her that there was nothing to be scared off I began by saying that I could hear she was scared and upset. It seemed to help validate her feelings and stopped me looking like I was just dismissing her concerns or basically not listening.

SBNRR

Although the guys at SIY refer to it as the Siberian North Rail Road, SBNRR actually stands for Stop, Breathe, Notice, Reflect and Respond. They regard it as a great way to deal with negative emotions, emotional triggers and other emotional hot spots.

From my point of view I’m not sure it’s ‘great’, it’s good but it takes a long time to do the steps and in the heat of the moment I reckon if can you remember the first two (STOP / BREATHE) before you respond you’ve done well. So my version would be SBR or Stupid Bastard Response because it’ll come in handy the next time some stupid bastard at work winds you up.

SBNRR’s five steps:

1) Stop. This is the most important step. Instead of becoming wrapped up in the emotion or making an impulse decision, just stop and take a moment.

2) Breathe. Take a deep breath. This helps clear your mind, as well as helps physiologically calm down your brain.

3) Notice. Notice what you’re experiencing on a moment to moment basis. What are you feeling in your body? What emotions are you experiencing? Is it static or is it changing? Does the emotion seem out of proportion compared to the trigger?

4) Reflect. What’s causing the emotion? Is it the right response? Is a part of you feeling attacked, belittled or threatened?

5) Respond. Think of all the different courses of actions you can take. Consider the kindest, most compassionate way to respond to the situation (even if you don’t take that path.) Finally, make a conscious decision on how to respond.

As I said, much like a trip on the Siberian North Rail Road, it’s a bit long for me. You can’t really keep leaving the room every time one of your triggers gets pulled so you might want to try abbreviating it first. If nothing else you’ll become more aware of the way you react to things, or more likely ‘over-react’, and start being calmer and more considered with your responses.

For black men, higher education and incomes don’t lower risks of depression

But for high-achieving black men, more success actually increases the likelihood they will experience symptoms of depression and anxiety.

That’s the conclusion of Shervin Assari and T.J. Curry, researchers who have spent decades studying depression in, and discrimination against, black men in the United States.

In an article in The Conversation, they discuss the results of six studies that show an inverse effect between black men’s achievement and adverse mental health outcomes.

One long-term study followed 681 black youths over 18 years. For black male participants, an increase in perceived racial discrimination between ages 20 and 23 was correlated with increased anxiety and depression symptoms as they grew older.

Another, which compared black men with black women, white men and white women over the course of 25 years, found that men with higher educational credentials also experienced more depressive symptoms.

“According to our studies, regardless of their economic success and personal ambitions, black males are still perceived as more threatening and dangerous than their female counterparts,” Assari and Curry write. “Race alone may not be the issue here. Instead, it is an issue of race and gender, that may stem from hopelessness, inequality and blocked opportunities.”

Successful black men are not the only ones at risk, they said. But they challenge views that mere attainment can improve mental health outcomes for black men, whose success is attained in a world rife with personal and systemic biases and discrimination.

Visual Strategies for Reducing Stress

Pictures of Peace

Research has shown that looking at pictures of greenery makes people feel calmer. Find a picture of a scene in nature that makes you feel calm, and bring it up on your computer screen or phone. Set your timer, and spend one minute looking at it. Good sources for these kinds of pictures are National Geographic and the Sierra Club. You might even want to buy a calendar that has natural scenes and look at it for one minute whenever you need to manage your stress levels.

Pictures of Love

Another way to use a picture of peace is to fill your workspace or living space with pictures that remind you of the love in your life. Maybe it’s your child’s art, or perhaps it’s a picture of your family, your pet, or you and your partner on a special day. It may be a picture of the view from a scenic hike you took with your children or a picture of that time you caught a big fish with your dad. Put these pictures in frames on your desk at work or throughout your home. When feeling stressed, set your timer and spend one minute looking at them and picturing yourself surrounded by love.

Visualization

When you don’t have access to pictures that bring you joy and peace, visualization is a good backup plan. Visualizing is a great strategy that can be used for improving performance in many situations. For example, athletes often visualize themselves winning as a way of increasing their confidence. Visualizing calm can help you relax by using your imagination to slow down your body. The first step in this process is to think about a place that puts you at ease. If it’s the beach or the woods, be specific about which beach or which woods so that you have a real place to go in your mind. You can choose a vacation place, your childhood home, or your favorite spa. Wherever it is, think about that place.

Unwanted thoughts are easier to control when rested

It’s not uncommon for unwelcome thoughts to cross a person’s mind now and again. 

According to psychologist Marcus Harrington of the Department of Psychology at the University of York in the United Kingdom, “For most people, thought intrusions pass quickly, but for those [who are experiencing] psychiatric conditions, such as post-traumatic stress disorder (PTSD), they can be repetitive, uncontrollable, and distressing.”

Harrington is the lead author of a new study investigating the effect of sleep deprivation on unwanted thoughts.

The study finds that sleep deprivation increases the frequency of unwanted thoughts and lessens an individual’s ability to control them.

Funded by the Medical Research Council, the research appears in Clinical Psychological Science.

Unwanted thoughts

“In everyday life,” says Harrington, “mundane encounters can remind us of unpleasant experiences. For example, a car driving too fast on the motorway might cause us to retrieve unwanted memories from a car accident many years ago.”

However, for people with some psychiatric disorders, unwelcome thoughts can be a frequent, persistent, and often emotionally destructive intrusion.

“It is clear,” says Harrington, “that the ability to suppress unwanted thoughts varies dramatically between individuals, but, until now, the factors that drive this variability have been mysterious. Our study suggests sleep loss has a considerable impact on our ability to keep unwanted thoughts out of our minds.”

A lack of sleep and the resulting inability to manage unwelcome thoughts may also be self-perpetuating.

“The study also suggests that the onset of intrusive thoughts and emotional disturbances following bouts of poor sleep could create a vicious cycle, whereby upsetting intrusions and emotional distress exacerbate sleep problems, inhibiting the sleep needed to support recovery.”

– Senior author Dr. Scott Cairney

We Are Not Lonely During Social Distancing After All

A new study published in American Psychologist has found that social distancing has not led to more loneliness.

Social distancing has not made us lonely.Source: Everton Vila/Unsplash

For the nationwide study by Florida State University College of Medicine, researchers surveyed more than 2,000 people before and during stay-at-home orders. This was part of a larger study on how we are reacting psychologically to the Covid-19. But because feeling lonely in particular is a known health risk, leading to higher rates of disease or death, the researchers felt it deserved attention.

“There has been a lot of worry that loneliness would increase dramatically because of the social distancing guidelines and restrictions,” said lead author Martina Luchetti, an assistant professor at the College of Medicine in a press release. “Contrary to this fear, we found that overall loneliness did not increase. Instead, people felt more supported by others than before the pandemic.”

That’s surprising at first, but it aligns with some other recent research on how people can meet their social needs even without other people. And virtual eye contact can also give people a genuine sense of connection. But Luchetti felt it may have something to do with a sense of community. “Even while physically isolated, the feeling of increased social support and of being in this together may help limit increases in loneliness,” she said.

Participants reported how lonely they felt.

Study participants were recruited from all over America and were adults between the ages of 18 and 98. The first survey was done in early February before the U.S. was widely considering the coronavirus to be a threat. But once the pandemic arrived, the researchers ran a survey in mid-March during the period of 15-days of social distancing announced by the White House. Then, they ran a second survey in late April, after people had been home for a while and as guidelines were set to expire.

Remarkably, older adults reported less loneliness than younger ones, although they did feel lonely temporarily at the start of stay-at-home. This held true for individuals who lived alone or had a chronic health condition. Perhaps that’s because they already felt lonelier than most people do. But it’s still good news that social distancing did not make it worse.

Prior to the pandemic surveys, studies had found that 35 percent of adults 45 and older reported feeling lonely, and 43 percent of those over age 60 reported feeling lonely. Other research has shown that younger adults are actually lonelier than the older age group.

Nonetheless, people did well when facing social distancing during stay-at-home orders. “Despite a small increase among some individuals, we found overall remarkable resilience in response to COVID-19,” said Angelina Sutin, associate professor of Behavioral Sciences and Social Medicine and senior author in the press release.

When Your “Person” Has Depression

It’s no secret that when depression visits, it’s devastating for the person experiencing it, as well as those who love and rely on them. “When it comes,” writes Andrew Solomon in The Noonday Demon, “it degrades one’s self and ultimately eclipses the capacity to give or receive affection…[It] destroys not only connection to others but also the ability to be peacefully alone with oneself.”

If your person is experiencing depression, you may feel stuck on what to do. You desperately want to help, but your person doesn’t seem to want you around. You may want to “fix” the problem, but when you try it only makes things worse for both of you. And “fixing” is neither in your power nor your role.

So what is your role? What can you do? “Love, though it is no prophylactic against depression, is what cushions the mind and protects it from itself,” says Solomon. You can’t “fix” someone’s depression, but you also needn’t underestimate your potential positive impact through providing soft love and sturdy support on their journey. 

If you’re reading this, I’m guessing it’s not the first resource you’ve come upon. I’m guessing you’ve Googled madly, and scoured some of the great guidance out there like these resources.

Between reading an initial “guide” and perhaps getting support from a specialist yourself, there’s often a desire to consume multiple resources with slightly different perspectives, as you seek the wisdom that “clicks.” I want to commend you for your desire to show up for your “person.” This is not an exhaustive list, but rather a compliment to all the great material out there – because, for a topic so vast, you deserve multiple perspectives. 

I hope in some small way this helps both you and your loved one. The tunnel feels long, but I promise, there’s a light at the end.

Here are 11 ways you can help a loved one who is suffering from depression. This list is ordered with the acronym “HOW TO HELP ME” because it’s informed by things past clients with depression have told me they wish their significant other knew (in addition to broader research).

1. Hold the hope. One symptom of depression is “hopelessness.” Not only do you feel awful, you feel like this is how it will always be. But hope is vital to recovery. If your partner is feeling hopeless, you can still choose hope. You might even say something like, “I know it feels like it will always be this way. And I’ve seen you get through hard things before. I have so much hope you will get through this challenge. We will do it together.”

2. Offer compassion. Compassion = Empathy + Action. Empathy doesn’t mean feeling sorry for someone. It means “being with,” and actively viewing the situation through your loved one’s perspective. This video narrated by Brene Brown gives one of the best overviews of empathy that I’ve seen. Empathy becomes compassion when we also have a willingness to act on behalf of the person we love.

3. Watch out for signs of suicidality. Reducing stigma includes normalizing mental illness, but not neutralizing it. Mental health conditions need to be taken seriously, like any other condition. The vast majority of individuals with depression will not die by suicide, but because mental illness, especially mood disorders elevate the risk, it’s a good practice for loved ones (and everyone, really), to be aware of the signs, and get some basic training and support for how to help. Potential resources include reaching out to suicide prevention lifeline, or taking a training such as  Question, Persuade, Refer(1hour, online option), safeTALK (4 hours), or ASIST (2-Days, digital option available).

4. Talk about treatment options. Depression is a treatable illness. Talk about recognized treatment options such as medication, talk therapy, or group therapy, as well as lifestyle supports such as exercise and healthy sleep. As a partner, your job isn’t to make a diagnosis or treatment plan, but you can share that help is out there. Often the best, most simple place to start is a phone or in-person appointment with a primary care doctor.

5. Offer concrete support. In a depressive episode, even the most capable person can struggle with what could otherwise seem a simple task (like calling a doctor, booking an appointment, and getting to that appointment on time). Someone struggling with depression may not know to answer a broad question like, “How can I help?” Instead, offer specific concrete support such as: Can I just sit here with you quietly? Can I drive you to your doctor’s appointment and wait outside? Would you like to go for a walk?

6. Honor small wins. Someone might be a marathon runner, but in the throes of depression, just getting out the door to work is a worthy achievement. For someone without depression, it can be hard to remember that these mundane, simple tasks may feel like a herculean effort. But small wins add up to big change. Saying something like, “I’m proud of you, I know that took strength” can go a long way.

7. Express care AND concern. People with depression feel pretty badly about themselves. It is helpful to remind them that you love and respect them. Also, it’s ok to share your concerns. Often, what encourages people to therapy for the first time isn’t their own intrinsic desire, but the concern of loved ones. It’s okay to say something like, “I love you, and understand that you can’t get out of bed. I am also concerned that if you don’t get help now, you will lose your job, which is going to make things much worse. Our family needs you. We want you to get help.”

Lockdown Lessons: What Have We Learned about Ourselves?

As the pandemic crept into the nation and then began burning through communities, all of us were being exposed to parts of ourselves that might have surprised us. While we all deal with some level of anxiety or concern during our days, those things may vary widely depending on individual identities. Some of us worry about having enough money to make it to payday. Others worry about being late for the party. Some worry about someone getting the last roll of our “favorite” toilet paper and others worry about running water and enough food to eat. Anxiety is part of the human condition. Most of us know the circumstances that tend to cause us worry. Some of us even go into “panic mode” when a minor hiccough happens on our way to fulfilment.

The pandemic and national lockdown, though, brought a huge number of us to a place we’d never before tread . . . face-to-face with fear of what we couldn’t see, couldn’t predict, and couldn’t control. The uncertainty factor of a virus probably took more than a few of us over the edge into a crisis mode that we might never have experienced before. Faced with an unknowable threat to our lives, our family’s lives, and our economic wellbeing, to boot, we likely were beaten down emotionally by the circumstances without knowing “why” we were feeling so exhausted, or confused, or hypervigilant. After several weeks, the total scope and scale of the pandemic’s power to change our lives in virtually every aspect imaginable began to hit us.

When we face a threat, many of us do so with courage and bravery – we work hard to throw ourselves into the fight. Some of us turn to humor and work hard to make sure we’re keeping our spirits up along with the spirits of those around us. Others retreat and look for safety and security and creature comforts – like comfort foods, trashy television shows, and sweats and pajamas worn 24/7. Others keep going as they have before, not even letting their thoughts turn to the potential risks they may face.

But after several weeks, most of us began to roll into a new phase of response – fatigue and exhaustion. Whatever “crisis response strategy” we tend to utilize, the persistent threat outside our doors – in the form of other people who we may even know and love, soiled doorknobs, tainted delivery bags, etc. – kept us actively engaged with the fight to protect ourselves. So now, as we begin to see the world try to get back to some new way of spinning, we may feel frightened to return to our normal routines. We may feel empty, irritable, tired, and emotionally exhausted. These are all normal responses, and it may take some conscious self-care and talking through these feelings to help us find a sense of wholeness, restoration, and readiness to go back to the lives we used to live.

For our essential workers who never had the luxury of escaping from their posts and curling up under a blanket to escape the outside threat, their “hazard pay” might not mitigate the emotional cost that their hazard duty required. They met others’ basic material needs, but their own psychological needs may need more than a “next day delivery” could provide. They met our medical needs and risked their own health in order to help us maintain our own. We owe them more than what they were compensated for the risks they all took for others. We need to remember this when we’re feeling impatient with others who are doing the best they can and who were there for us when we perhaps were not there for anyone else, at all.

What are some of the lessons that we may have taken from the past few months – during a time when our lives were put on hold and we were put on lockdown to confront, as a united front, a threat that we had never before experienced in this way? Here’s a summary of what people have shared with me:

  1. We are all connected. Social connections are essential to our physical and emotional well-being. Whether we rely on phone calls, video calls, texts, or visiting with masks and 6 feet apart, our lives have value because of the value we have in the lives of others.
  2. This worked as a “wake-up call” to the dependence all of us have on our “essential workers.” Our lives hum because of the labor of healthcare workers, warehouse workers, grocery store employees, truckers, delivery drivers. For those who are “essential” employees, one individual shared that being deemed “essential” means that “I have to be courageous, but it also validates that what I do truly matters.”
  3. Our kids are going to be okay, worrying excessively about them isn’t going to do them any good. There are benefits to having more time to connect with your kids, to talk to them about “real” things, big issues in a way they can understand, and just finding out who they are on their way to growing up.
  4. The government has a great deal of power to shape our daily lives – more than any of us may have ever realized before.
  5. The basics are absolutely enough. The “extras” are sweet, but the basics provide the foundation for everything. We should focus on making memories, not money, for the people we love.
  6. Skin hunger is real – missing the handshakes, the warm hugs, and the pat on the back is hard.
  7. The urgency we feel in daily life really isn’t necessary and it robs us of the peace that we should be finding in each day. We can’t realize the beauty of the natural world when we’re always rushing to move through it, not move within it. We need to slow down and be in the moment – not rushing to get to the next thing.
  8. We can’t “cure” the pandemic or “pick” the lockdown, so just be focused on the present and what you can do, personally and professionally. Turn off the news, stop giving in to “clickbait,” and attend to the things that bring you joy and a feeling of peace – don’t look for reasons to get riled up about things you cannot control.
  9. We can control our controllables. As one person shared, “I am in solo isolation, but I have found that I can be alone, but that doesn’t mean I have to be lonely.” Control those things you can, find solutions for the struggles when you can, and accept when you’ve done all that you can and let yourself off the hook for doing more than is truly possible.

Do You Feel Helplessly Addicted to Your Phone?

We tend to check our phones every 5 minutes. My friend joked the other day that he feels more naked without his phone than without his clothes! Distraction and entertainment through our phones can be one of the most convenient things of our lives, but also can be a silent form of tyranny in itself. How often do you find yourself checking our device compulsively, automatically? Have you ever heard of NOMO (no-mobile-phobia)? It refers to how uncomfortable it feels to be without our phones. It was coined in 2010 by a study in the United Kingdom. Let’s check in:

How do you feel without your phone on you? What about when you can’t find your phone?  Or when someone else is holding it? 

This problem isn’t only you. How do you feel when you get “phubbed“? This is when someone starting messaging or scrolling on their phone when you’re talking to them. Do you normally phub others? How does it change the quality of interaction with them? Is it fueled by FOMO (fear of missing out)? Often it is, but it’s also often automaticity and mindlessness. Have you seen families together where everyone is silently on their phones? How do you feel when you see this?  

If you were addicted to your phone, how exactly would you know? The “digital police” won’t flag you when you’ve met your tech threshold, and there are no age restrictions (only “helicopter parents” for child or teen users). Constant use has become normalized, especially in these times. Of course this is what big tech companies like Apple and Google want, to keep us hooked. No wonder they continue to post increasingly soaring profits.

The increase in popularity & integration of tech in daily life prompts us to ponder their addiction potential. This post begs the question, where is the line from general use to problematic use? Did you know screen, phone, and internet use can trigger the same neurochemical that underlies Cocaine addiction, dopamine (the pleasure chemical)? Self-proclaimed phone-addicts (this is not yet recognized officially as an addiction in the DSM-V) report feeling a pleasurable mood burst or “rush” from simply checking their phone and favorite apps. These feelings of euphoria, even before the actual acting out of the addiction occurs, are linked to brain chemical changes that control our behavior ranging from a seductive psychological pull to full-blown addiction. 

Phone-addicts (perhaps most of us in the industrialized world) become conditioned to compulsively seek, crave, and recreate the sense of elation while off-line or “off-drug.” Whether it’s a few whiskeys, a string of likes an comments on your post, or betting on horse races, dopamine transmits messages to brain’s pleasure centers causing addicts to want to repeat those actions–over and over, even if the “addict” is no longer experiencing the original pleasure and is aware of negative consequences.

So, how can mindfulness help curb our ubiquitous use? 

The answer will look different for all of us. For you, what are your goals? How has it been a problem for you? Hard to sleep? Strain on your eyes? Your child is frustrated with your constant use? You just got a ticket for using your phone while driving? You’re noticing your posture is slumping like a hunchback? You find yourself too distracted by your phone and can’t focus on work? Your partner(s) are angry with you, feeling like they are in constant competition with your phone for your attention? 

Once we have a goal, then we can prioritize tracking and curbing our use using the iPhone screen-time part of the settings app. Then, every time we have an urge to use our phones beyond our desired use, we can plan small meditations, 10 seconds to 3 minutes instead. Yes, they can be short!They don’t have to be sitting. You can do walking or standing meditation too. Before you check your phone, gently ask yourself:

1) How’s my posture and body? I can’t believe how often I find myself slouching on my phone despite my attempts to have a healthy posture. Check in especially with your neck and shoulders. Make sure your whole body is comfortable, especially when you spend a long time on your phone. Hunching can worsen your emotional state too, which can lead to more unnecessary phone use, creating a harmful cycle. Having an erect, upright posture may be the best option. Also check in with your fingers, wrist, and arms. Sometimes if you tune in, you may notice them in more pain. I notice my wrist aches a little and my the skin on my fingers feels raw and irritated after too long on my phone. 

2) Why am I doing it? Before monitoring this, I found myself checking my phone numerous times without actually needing to. I still do from time to time. If it’s not because you need to send an important message, check directions, or another intentional behavior, is it from frustration? Fatigue? overwhelm? discomfort? Listlessness? boredom? Mindfulness can help us become aware of these automatic mini-compulsions and take more effective or wise action. If it is one of the latter, perhaps phone checking isn’t the best option to get your needs met. 

3) How do you feel after having been on your phone for while? Especially after mindlessly scrolling or to kill boredom? It’s vital to notice without beating yourself up. Big tech companies like Apple have created intensely addictive products. The iPhone is the most profitable product of all time. Try to see it as mere data or fodder for later, to help you get to know yourself. Perhaps texting friends is calming, but scrolling Instagram isn’t  

Worried About Alcohol Use During the Pandemic?

Quarantinis. Jokes about happy hour, any hour. Social media is being flooded with memes about increased alcohol use during the pandemic.

The data bear out this trend: alcohol sales are soaring, with a 55 percent increase in a single week as shelter in place orders were issued across the nation.

What’s behind this increase? Why are so many people drinking more during the COVID-19 pandemic? More importantly, should we be worried?

I am a researcher who studies risk for alcohol use problems. I’ve written hundreds of papers on why some people develop problems and others don’t, analyzing data from thousands of research participants.

Here’s what we know: changes in the environment change the likelihood that people will develop problems. Environments that are more permissive or accepting of alcohol use increase the likelihood that people will use.

There’s no question that our environments have changed dramatically as a result of the pandemic. Many of those changes are conducive to higher alcohol use: reduced stigma surrounding drinking at all hours, decreased accountability by co-workers and friends as individuals are isolated in their homes. Alcohol also has anxiety-reducing effects, and let’s be honest, a lot of people are feeling a lot of anxiety right now.

But here’s the part most people don’t realize: the people who are most at risk are the ones who are genetically predisposed to develop problems.

The chance that we will develop any given health problem—including substance use and mental health challenges—is related to the genetic codes we are born with. Some people are more at risk for cardiovascular disease, some people for cancer, and some people for alcohol use disorders. 

Just because you are born with a genetic predisposition doesn’t mean you are destined to develop problems—it just means you have an increased risk. But here’s the kicker: environments that are risk-enhancing—say, for example, a global pandemic—can drastically increase the likelihood that people who are genetically at risk will develop problems.

How do you know if you are at increased risk? 

There’s no genetic test you can take (despite what some websites tell you). Researchers like myself are working hard to find the genetic variations that make people more at risk, but there are likely tens of thousands of them, and so we’re still a far way off from being able to give people accurate genetic risk scores. 

But there are other indicators that can tell you whether you are at an increased risk of developing problems. There are a few different pathways by which our genes can alter our risk for substance use problems. Some genes increase our tendency toward depression or anxiety. People who carry these genetic variants are more likely to use alcohol to cope, which increases their risk of developing alcohol use disorders.

Genes also influence the way our brains are wired to process risk and reward. Some of us are more prone to impulsivity. We’re drawn to immediate rewards—to chasing the fun. We are less likely to pause and think about the long term consequences. “Should I do a Zoom party with friends tonight and drink a pitcher of margaritas? Why not?!”, our impulsive brains tell us… without weighing that 8 am Zoom call with the boss, or thinking ahead to the kiddos that will be waking us at 6 am needing to be entertained all day.

How Are Mindfulness, Stress and Your Well-Being Connected?

Recently I came across two new, unrelated studies that together provide new evidence about the impact of mindfulness practice.  One looked at the potential impact of being “in the moment” when you’re facing stressful problems or challenges that often arise in daily life—perhaps even more so, now, during the pandemic.  Does it really help? Or can it hinder figuring out what you need to do to diminish your stress? The other study also looked at mindfulness, but with a broader focus: how it may affect or impede well-being over time as you deal with change over the years.

Interest in practicing mindfulness has become pretty mainstream in recent years as a way to help you stay focused and centered in the face of distracting emotions and thoughts. Many practice it in their daily lives, and it’s being applied to the workplace and leadership development, as well.

One new study from researchers at North Carolina State University looked specifically at how staying centered and living in the moment helped with daily stress, compared with coping strategies and trying to plan ahead to ward off future sources of stress. Is it more helpful to stay in the moment or better to engage in “proactive coping”?

The researchers found that it’s not either-or. The study consisted of 223 people—half young adults through their late 30s, half between 60 and 90, and they reported their level of mindfulness over time. It found evidence that proactive efforts to reduce the stressful situation were helpful in specific situations—but only when combined with mindfulness. On those days when the participant reported low mindfulness, the proactive strategy lost its apparent usefulness for minimizing the impact of daily stress.

Described in this report, these findings have significance for building resilience and adaptation in the face of disturbing events and emotions. According to one of the researchers, Shevaun Neupert, “Our results show that a combination of proactive coping and high mindfulness results in study participants of all ages being more resilient against daily stressors.” 

Those who are more prone to look down the road at future situations and how to minimize their potential stress that may arise “may be more inclined to think ahead to the future at the expense of remaining in the present.” Of course, a downside there is that looking too much down the road can take your attention away from dealing with stress in the immediate situation. Neupert points out that a greater focus on practicing mindfulness practice may be helpful to people with those tendencies. The study was published in the journal Personality and Individual Differences.

These findings complement, in a way, another recent study that examined several characteristics of mindfulness more broadly: in relation to age and overall well-being. This research, from Flinders University in Australia, defined mindfulness as the ability to be aware of one’s experiences and to pay attention to the present moment in a purposeful, receptive, and non-judgmental way.

The researchers emphasized in this summary that using mindfulness techniques can be instrumental in reducing stress and promoting positive psychological outcomes. Here, they sought to investigate the relationship between aging—from middle age onward—and such capacities as staying attentive to the present moment; being non-judgmental; acceptance of age-related changes; and overall positive emotions.

How to Declutter the Marie Kondo Way

This introduction to Marie Kondo’s decluttering work is powered by Good Housekeeping.

What is the KonMari Method?

The KonMari Method is Marie Kondo’s minimalism-inspired approach to tackling your stuff category-by-category rather than room-by-room. There are six basic rules to get started:

  1. Commit yourself to tidying up.
  2. Imagine your ideal lifestyle.
  3. Finish discarding first. Before getting rid of items, sincerely thank each item for serving its purpose.
  4. Tidy by category, not location.
  5. Follow the right order.
  6. Ask yourself it it sparks joy.

And five categories to tackle:

  1. Clothes
  2. Books
  3. Papers
  4. Komono (a.k.a. Miscellaneous Items)
  5. Sentimental Items

While many people associate her method with tidying, it’s really about discarding items that lack value. To determine what makes the cut, Kondo has you start by removing everything out of your closets and drawers (category one), all the books off your shelves (category two), all the paperwork out of your desk and bins (you get the idea). Once you have a big pile, you’re to go item-by-item and consider if it sparks joy. While Kondo admits that this can feel awkward or unnatural at first, she assures readers and viewers that you’ll get better at recognizing what sparks joy as you go. Once you’ve tossed items in every category, you should have a much smaller set of remaining items that you can return to various closets, drawers, shelves, and boxes. Note that you’re to finish one category before moving onto the next one.

Because you’re actively choosing items that spark joy, and discarding what doesn’t, the intention of the KonMari method is to end up with a clutter-free home that is better able to bring more joy and prosperity to your life. While tidying, she encourages you to visualize the life you want to live — to be less stressed, for example — and what you need to get there. Anything that won’t help on that journey isn’t deserving of your space or you, she says.

Click here to read the full article on Good Housekeeping.


Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

31 Benefits of Gratitude

Here is an excerpt from Happier Human to help you get started today.

Gratitude is simply taking time to think about all the positive things in your life. Rather than ruminating on the negatives. It does not necessarily necessitate actually telling anyone else you are thankful for the things they have done. (although, that helps)

Gratitude may be one of the most overlooked tools for increasing happiness. Research shows it is the single most powerful method of increasing happiness.

Having an attitude of gratitude doesn’t cost any money. It doesn’t take much time. But the benefits of gratitude are enormous. Research reveals gratitude can have these seven benefits:

Positive psychology research has shown that gratitude touches on many aspects of our lives. Our emotions. Personality. Social dynamics. Career success and health. All of these can contribute to increasing our basic happiness.

1. Gratitude makes us happier.

A five-minute daily gratitude journal can increase your long-term well-being by more than 10 percent.a1,a2,a3 That’s the same impact as doubling your income!a4

How can a free five-minute activity compare? Gratitude improves our health, relationships, emotions, personality, and career.

Sure, having more money can be pretty awesome, but because of hedonic adaptation we quickly get used to it and stop having as much fun and happiness as we did at first.

2. Gratitude makes people like us.

Gratitude generates social capital – in two studies with 243 total participants, those who were 10% more grateful than average had 17.5% more social capital.b1

Gratitude makes us nicer, more trusting, more social, and more appreciative. As a result, it helps us make more friends, deepen our existing relationships, and improve our marriage.b2

3. Gratitude makes us healthier.

In case you can’t read the physical benefits opf gratitude image above. the studies show gratitude can decrease pain, reduce bad health symptoms, increase time spent exercising. Increase sleep time. Increase sleep quality. Lower blood pressure. Increase energy and more. There is even reason to believe gratitude can extend your lifespan by a few months or even years.f2,f3,f4

4. Gratitude boosts our career.

Gratitude makes you a more effective manager,c1,c2 helps you network, increases your decision-making capabilities, increases your productivity, and helps you find mentors and proteges.b1 As a result, gratitude helps you achieve your career goals, as well as making your workplace a more friendly and enjoyable place to be.a2, b2

I’m not suggesting that criticism and self-focus don’t have a place in the workplace, but I think we’re overdoing it.

According to one study, 65% of Americans didn’t receive recognition in the workplace last year.c3 A bit more gratitude at work might be nice for us all.

5. Gratitude strengthens our positive emotions.

Gratitude reduces feelings of envy, makes our memories happier, lets us experience good feelings, and helps us bounce back from stress.b2,d1,d2,d3

6. Gratitude develops our personality.

It really does, and in potentially life-changing ways.

Click here to Read More


Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

25 DAILY AFFIRMATIONS TO IMPROVE YOUR MINDSET

Day 6: Write Down Affirmations

Here is an excerpt from The Blissful Mind to help you get started today.

Affirmations are positive reminders or statements that can be used to encourage and motivate yourself or others. Often it’s a lot easier to affirm others than it is ourselves, but we need to remember to encourage ourselves as well.

  1. I create a safe and secure space for myself wherever I am.
  2. I give myself permission to do what is right for me.
  3. I am confident in my ability to [fill in the blank].
  4. I use my time and talents to help others [fill in the blank].
  5. What I love about myself is my ability to [fill in the blank].
  6. I feel proud of myself when I [fill in the blank].
  7. I give myself space to grow and learn.
  8. I allow myself to be who I am without judgment.
  9. I listen to my intuition and trust my inner guide.
  10. I accept my emotions and let them serve their purpose.
  11. I give myself the care and attention that I deserve.
  12. My drive and ambition allow me to achieve my goals.
  13. I share my talents with the world by [fill in the blank].
  14. I am good at helping others to [fill in the blank].
  15. I am always headed in the right direction.
  16. I trust that I am on the right path.
  17. I am creatively inspired by the world around me.
  18. My mind is full of brilliant ideas.
  19. I put my energy into things that matter to me.
  20. I trust myself to make the right decision.
  21. I am becoming closer to my true self every day.
  22. I am grateful to have people in my life who [fill in the blank].
  23. I am learning valuable lessons from myself every day.
  24. I am at peace with who I am as a person.
  25. I make a difference in the world by simply existing in it.

Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

3 Steps to Navigate COVID-19 Anxiety

Medical response centers in Chengdu, China developed an integrative intervention model to address the psychological distress caused by COVID-19 and deliver much needed mental health support1 (Zhang, et al, 2020). This new report utilizes information gathered from natural disasters like earthquakes combined with the current virus outbreak. Overall, they found people need more information, more assessment tools, and more coping methods.

They also advise having and utilizing a Personal Resilience Plan. This must be tailor-made for each of us, by us, since we all respond to stress in different ways through the lens of our unique experiences, values, and expectations. Your resilience plan needs to reflect your values, strengths, and resources. Building this helps ourselves and our families, as well as the communities and organizations we are connected to.

Building your Personal Resilience Plan can take some creativity and self-reflection as well as evaluating your support resources. To get started, I will review the 3 features of resilience that repeatedly emerge in scientific research, 3 types of coping needed to get through challenging times, and offer 3 deeper reflections as an avenue to building personal resilience. I invite you to take a few minutes to answer the reflective questions along the way and write out an emotional emergency preparedness plan with your family that includes outside resources such as community-based support, as well as resilience we nurture within ourselves.

What are 3 common features of resilience?

1) Recovery that is swift and thorough. (Q: What will help me recover from this setback?)

2) Sustainability of purpose in the face of adversity. (Q: What is the purpose that drives me to move forward?)

3) Potential for growth. (Q: What am I learning from this experience?)

What are 3 types of coping?

1) Problem-solving based coping to prepare for or fix things you can.

2) Emotion-based coping to navigate a spectrum of emotions including fear, anger, loneliness, and grief.

3)  Meaning-based coping for events that persist or remain unresolved, that may also spur growth.

But how do I get rid of the anxiety?

During the 1990s HIV/AIDS epidemic, Susan Folkman and colleagues found something profound in their work helping people respond and adapt to the direst of circumstances that included social rejection and stigma along with severe illness and death2-3. They found that life in the face of certain death brings more than sorrow and painful emotions to the heart. People in the worst of situations could experience joyful emotions and engage in positive social interactions. Wellness means much more than the absence of negative emotions (so no need to rid yourself of them before experiencing joy); rather it’s the co-occurance of both troubling and positive emotions. Being able to hold them both closely reflects emotional maturity.

This sentiment is seen in much older communications that we don’t often come across in the scientific literature. A 12th-century German Benedictine abbess, philosopher, and Christian mystic, Hildegard of Bingen, described how we are meant to fly like eagles with two wings: one wing of suffering and one of grace4. We cannot soar with only one of these wings, but need to hold in our awareness the pain along with the glory, simultaneously. This dichotomy is a beautiful albeit challenging tension to hold as we connect deeply with seemingly opposing realities. Some might say we need one to experience the other.

3 Ways to look deeper into your personal resilience:

Here are 3 exercises you might write down on your own or with your family to prepare yourself for the challenges of our current changing situation: 

1)  Recognize what is most difficult for you right now and lean into what you are experiencing. Arguing with your anxiety, escape-avoidance coping (substances, entertainment) and blame will bring temporary relief at best. Reaching out, reaching inward, or upward in new ways will promote flexibility and growth. Share your concerns with others and reflect on what frightens you deeply. Spend time connecting with what is hardest for you right now while also standing into the joy of each breath we are given.

Q: During this crisis, what might you have to let go of? In what ways might you be more connected?

2) Write a story with you as the resilient hero. In what ways are you already resilient? If you experience discomfort thinking of yourself in this way, first start by thinking of someone you know who exhibits openness, flexibility, grit, and adapts to new challenges again and again. Then think back to a difficult time in your life where you persevered, changed course, thought outside the box, and applied skills that brought about positive change. Describe it in detail.

Q: What are the attributes you have that allow you to continue in the face of hardship? How have you already made the world a better place?

3) Take wise and compassionate action. There are some scary knowns and unknowns right now. Move forward with the next right thing and realize this may change from moment to moment. Invite clarity about what the next mindful action you could take is and how it relates to what you value most.  Center yourself in each decision with breath to engage those parts of your rational and compassionate brain. Practice trusting your internal reserves as well as how you might support others.

Q: How would you like to look back on this pandemic years from now? What role did you play?

One thing we can count on: everything is transient. Our security is that everything changes.

Q: How might the current difficulties transform you?

How to Manage the Psychological Effects of Quarantine

(Below is an excerpt from Psychology today. Click Read More at the bottom for access to the full article.)

Psychology, Quarantine, and Consequences

Although social media can mitigate the effects of quarantine for many people, it can’t replace human interaction in physical space. Compound that with being confined to a small area—perhaps a room in an apartment when an infected person needs to isolate from family—and then consider the many worries about the possibility of getting infected, or infecting other people, not to mention the financial consequences. You get a recipe for real psychological distress.

A recent review of the psychological impact of quarantine reports that most studies of quarantined subjects observed effects such as confusion, anger, and post-traumatic stress symptoms, sometimes lasting even three years after the end of the quarantine.

A study from Canada examined the psychological effects of quarantine during the SARS outbreak of 2003. The median duration of quarantine was 10 days. They found a high prevalence of psychological distress symptoms. Twenty-nine percent of participants reported symptoms of post-traumatic stress and 31 percent of respondents reported symptoms of depression. Participants in this study described a sense of isolation and were particularly affected by the lack of social and physical contact with family members.

Being quarantined at home with other family members can be a blessing or a curse. It is an opportunity for families to come together and strengthen their bonds. But being constantly together involuntarily can put considerable stress on relationships. Small children may be overjoyed at the opportunity to be with mom and dad almost all the time; adolescents, on the other hand, may be less enthusiastic, and tensions can arise.

The Mentally Vulnerable, the Elderly, the Hospitalized

People who are particularly vulnerable to suffering psychological distress during and after quarantine are those with a history of psychiatric illnesses.

If a person is already suffering from anxiety, the sense of helplessness and lack of control induced by a forced quarantine can only exacerbate the anxiety. For people who are claustrophobic, being confined to a small space can be extremely stressful. People with suicidal ideation can be particularly at risk under these circumstances.

Another vulnerable population is the elderly, who are confined to their homes or in facilities, where infection can spread easily if not prevented. Because older people are more at risk for mortality, their quarantine must be more complete. And, since they are often dependent on others as it is, their increased helplessness can lead to elevated anxiety and depression.

Also, people who are confined in hospitals, whether because of the coronavirus or for other reasons, can find themselves isolated from their family and friends when hospitals impose restrictions on visitors, which is already happening.

Mitigating the Effects of Quarantine

Research shows that quarantine is better tolerated and compliance improves when people get information about the nature of the disease and the benefits of quarantine.

It is far better to get people to agree to quarantine by convincing them and offering information, than by forcing them. That increases their sense of agency and reduces helplessness as they become active participants in their circumstances. This is an important psychological concept. When faced with external pressures, the feeling of agency enables a person to feel more like a survivor than like a victim—increasing their sense of control.

Keeping people informed about the consequences of breaking the quarantine and explaining how isolation can actually save lives and benefit the community can turn quarantine from a scary nuisance into a truly meaningful act of altruism—a form of self-determination in the face of tremendous pressures.

  • It is critical not to abandon those who are most vulnerable. People who suffer from mental illness need to have access to therapists and medications—with telemedicine if need be. Mental health professionals, community and family members need to be aware of the challenges that isolation presents to the people under their care—or those in the community—and check on them often.
  • Older adults, living alone, need to be contacted often and reassured, while at the same time making sure they are not unduly exposed to the virus, given their health vulnerability. If there aren’t family members around, it becomes the responsibility of the community.
  • Those in nursing homes or hospitals still have access to people who care for them, as long as they are able to understand and interact. Phone, texting, email, even posted letters can make a difference. The act of reaching out is more important than anything that needs to be said. Patients who are isolated need to know that they still count. 

Social distancing could have devastating effect on people with depression

As the coronavirus advances across the country, more Americans are staying in their homes. That sort of “social distancing” is considered essential to slowing the spread of the virus and easing the burden on the beleaguered health infrastructure.

But for those suffering from depression, especially those who struggle with suicidal thoughts, it is definitely not what the doctor ordered.

Any “isolation is so devastating to our own mood because we’re left stuck with our own thoughts,” said Emily Roberts, a Manhattan-based psychotherapist. “If you’re struggling with a mental health disease, if you are relying on therapy which requires you getting out of your house, it’s going to be very hard to motivate yourself to get the help you need.

“The fact that there’s so much of an urgency to disconnect creates a lot of fear with people.”

The potential side effect of the crisis is something mental health professionals are scrambling to address amid the uncertainty of COVID-19, especially as health resources are diverted to the most immediate concerns. The scale of those concerns in turn is precisely what makes this time an unprecedented stressor for even the most well adjusted among us.

“It’s unclear from one day to the next what any local community is going to do in response to the coronavirus, if people are going to have to stay at home, which then has implications on how we work on caring for them,” said Lynn Bufka, associate executive director for research and policy for the American Psychological Association.

“What’s going to be the implication for disruption? Not everyone is going to be able to continue to get the help they need. Clinicians are very much thinking right now about how to do that.”

Meditation Relieves Perceived Stress And Leads To Specific Cerebral Changes

For researchers at IMT School for Advanced Studies Lucca, a study evaluating the effectiveness of Transcendental meditation (TM) among healthy participants led to promising findings.

According to new research, released in the journal Brain and Cognition, Transcendental meditation was linked to reductions in perceived stress. The technique, first developed by Maharishi Mahesh Yogi, involves the use of a mantra practiced with eyes closed, a few times a day.

Researchers studied 34 healthy participants, half of which incorporated Transcendental meditation to their daily routine for 40 minutes per day. The other half carried on without meditation implemented into their normal daily routine.

Before the participants began their routines, psychometric questionnaires were administered to measure levels of anxiety and stress. Additionally, functional magnetic resonance imaging tests were conducted to gain further insight into stress levels at a neuropsychological viewpoint, by measuring brain activity and changes in functional connectivity in certain brain areas. The tests were then initiated again at the conclusion of the study.

“Transcendental Meditation (TM) is defined as a mental process of transcending using a silent mantra. Previous work showed that relatively brief period of TM practice leads to decreases in stress and anxiety,” researchers stated.

It’s Easier to Beat Social Anxiety Than You Think

Researcher Stephen Porges discovered that when we are with other people, we unconsciously exchange signals that influence how safe we feel. Strangers trigger the release of stress hormones which cause the urge to escape. But if the stranger’s body language signals us that they are not a physical threat, what Porges calls the Social Engagement System activates the parasympathetic nervous system (PNS) enough to override the urge to escape.

What about emotional safety? When people are sizing each other up, no signals of emotional safety are being sent or received. In the absence of calming signals, some feel emotionally safe and others do not. A person with a solid history of being accepted does not need signals from others to feel at ease. He or she has what attachment theorist John Bowlby called internal working models of secure relationship. This internal resource signals the PNS to override the negative effect of whatever stress hormones are present.

But a person with a history of being judged and criticized lacks internal working models of security. With insufficient internal emotional support, they are vulnerable to stress hormone effects. They depend on signals from others to feel emotionally safe. Unfortunately, in social situations, signals may be mixed. Or there may be too many people sending signals for the signals to be processed.

Do you need to build an internal working model of a secure relationship that can carry you through the stress of social situations? Here’s how. Think of the people you are physically safe with. From that group, identify a person you feel emotionally safe with. Look for someone who does not judge you. When with a non-judgmental person, you unconsciously receive signals that there is nothing you need to be on guard about. Because of this calming effect, the memory of the person’s presence can activate your PNS and keep you calm in a challenging situation. You simply need to pre-link the person’s presence to the situations you will encounter.

To set up the linking exercise, list the situations to be encountered. One by one, link each situation to the memory of your friend’s face, voice quality, and touch. These are the three areas that convey the signals that activate your PNS. Don’t imagine yourself in the situation. That could cause stress. Instead, imagine a cartoon character in the situation. A cartoon character in a stressful situation is amusing. We don’t take their predicament seriously because, no matter what happens, cartoon characters always find a way out.

1. Link to Their Face

Imagine the cartoon character in that situation. Pretend your friend is holding the cartoon touching their cheek. Keep that in mind for a few seconds to link the cartoon character’s situation to the calming effect of your friend’s face.

2. Link to Their Voice

Pretend you and your friend are looking at the cartoon together. Imagine talking about the situation the cartoon character is in. In a few seconds, that links the situation to the safety signals in your friend’s voice.

3. Link to Their Touch

While talking about it, imagine your friend is giving you an affectionate hug (or whatever touch is appropriate for your relationship). This links the calming signals coming from your friend’s touch to the situation the cartoon character is in.

Continue the linking exercise using a cartoon character as a stand-in for yourself until you have linked each situation to your friend’s face, voice quality, and touch. Linking a stressful situation to a calming person is powerful. The PNS calms us by overriding the effects of stress hormones. It is activated by a person who accepts us completely. We feel our guard let down when our PNS is fully activated by another person’s signals that we are safe in every way.

Having an optimistic partner may stave off cognitive decline

Does your partner see the glass as half full or half empty? Do they tend to expect things to turn out for the best or the worst?

Researchers at Michigan State University in East Lansing have found that by having an optimistic outlook, a person can help the long-term physical and mental health of their partner.

Such is the power of optimism that it can help stave off the risk of various health issues, such as cognitive decline, dementia, and Alzheimer’s disease, as a couple grows old together. 

This is a boon given that most industrialized societies are aging. According to the Population Reference Bureau (PRB), in the United States alone, the number of people aged 65 years and older hit a new high of 52 million in 2018. The PRB predict that this number will nearly double by 2060.

Not only that, but there are 5.8 million people in the U.S. living with Alzheimer’s disease — the most common form of dementia — and someone develops the disease every 65 seconds.

“[M]any industrialized societies are aging at a very fast rate. This presents a lot of unique challenges that we might not be ready for,” said Dr. William Chopik, speaking to Medical News Today

Dr. Chopik is a co-author of the new study, which appears in the Journal of Personality

In addition, he noted that people are living longer than ever, “which translates to a large number of individuals living with cognitive impairment and dementia.” 

“As a result,” he said, “we were motivated to find out what predicts cognitive decline, and we discovered that a lot of it has to do with you, but some of it also has to do with your romantic partner.”

Identifying the link

The study followed 4,457 heterosexual couples from the Health and Retirement Study for up to 8 years.

It showed that there was a potential link between marriage to an optimist and the prevention of cognitive decline.

But how does optimism — the general expectation that good things will happen in the future — in a partner affect long-term mental health?

“Optimists do all sorts of healthy things,” said Chopik. “They are more physically active, maintain healthy diets, and avoid harmful things [such as drugs and alcohol].”

Optimists lead by example, and partners often follow their lead, says Chopik, noting that people typically spend a lot of time with their partner.

Researchers found that in looking at predictors for Alzheimer’s disease or other forms of dementia, a lot revolve around lifestyle choices.

“Compromised health earlier in life, in combination with some genetic factors, is among the largest preventable risk factors for cognitive decline,” said Chopik.

“So, basically, we know that being physically healthier — for example, being more physically active, eating a healthy diet, being more mobile, avoiding major illnesses — is associated with reduced risk for cognitive decline.” 

“But we were most interested in what predicted the healthy living. It turns out being optimistic about the future helps a lot.”

Is It Possible to Program Your Happiness?

Happiness researchers base their work on the fundamental idea that psychology needs a better understanding of the factors that help people feel better. Rather than just focus on psychological disorders or problems, happiness studies use positive psychology as their theoretical basis.

From your own experience, you know that life goes better when you’re happy than when you’re not. You wake up in the morning eager to start your day, focusing on what you’d like to achieve. However, a thought enters your head reminding you that you have some unpleasant tasks ahead of you in the coming hours. Perhaps, instead, you remember an argument you had with a close friend the day before, filling you with regret and disappointment in yourself. Your good mood disappears, and your happiness starts to plummet.

What if you could overcome these detours to your feelings of well-being by shifting your focus away from those negative thoughts? Researchers in positive psychology propose that you can increase your happiness levels by thinking not about what’s going wrong but instead about what could go right.

The “best possible self” intervention is a simple exercise in which you visualize your best possible future. Going one step further, you could also take a few minutes and write down what you would consider your best possible future life. A “hoped-for possible self” is, as the term implies, the sense of who you could be rather than who you are at the moment. On the negative side, a “feared” possible self is one you dread.

According to a new study by Johannes Bodo Heekerens and Michael Eid of the Freie Universität Berlin (2020), there is considerable evidence suggesting that the best possible self-intervention in which you focus on your hoped-for possible self can improve feelings of optimism and positive affect.

However, the German authors note that studies evaluating the long-term benefits haven’t been established. Moreover, studies measuring the impact of this intervention haven’t always defined their outcome measures in precise enough terms, such as distinguishing between momentary changes in affect vs. affect in the past week. Adding to this problem, previous researchers haven’t always distinguished among the more nuanced aspects of positive outcomes such as life satisfaction, optimism, and happiness.

The authors concluded, “inducing an optimistic outlook encourages positive emotions,” a finding in line with the “process” approach to understanding emotions. According to this view, you can regulate your emotions by changing your outlook. Similar to other studies showing the benefits on emotion of such interventions as positive self-affirmations, the best possible self intervention isn’t one that will change your life forever. If done right, though, it could help you feel better for perhaps as long as a week. You will not, however, experience a “lasting change in well-being” (p. 20), as some advocates have claimed about this procedure.

In view of these mixed findings, how can you take advantage of that momentary bump in your happiness that a positive self-intervention can stimulate? In the first place, the authors note that you need to take it seriously and become sufficiently engaged in the activity. Just imagining your life going better when you wake up in the morning and then going about your daily routines without giving the matter further thought isn’t going to alleviate whatever bad mood you happen to be experiencing.

It seems clear that, with these qualifications in mind, there are benefits for your mood in the moment of taking the time to see yourself as able to achieve your goals and overcome your present obstacles. Even if this effect only works for a week, as suggested by the German study, there’s nothing to stop you from engaging in it again after your mood starts to slump downward. That increased positive emotion may also help you become more successful in what you’re trying to achieve even within that brief period of time. Other people will respond more favorably toward you which, in and of itself, can help you feel better about life.

To sum up, it’s important to look carefully at whatever new fads for improving your happiness might seem to offer. In the case of dreaming up your best possible self, the research seems to support its benefits, if not in the long-term, then for your present levels of fulfillment.

9 Ways to Find Your Purpose As You Age

Purpose and Health

In general, surveys show that older people are happier people. But getting older is not a bed of roses either. Eventually, the losses pile up.  Friends, family members, or partners may die.  You may acquire one or more chronic illnesses or become disabled.  You may feel that your choices are narrowing. 

But fortunately there are still ways to find meaning in your life despite these losses.  “Fortunately,” because recent research reveals that living with a sense of purpose—acting in accord with your most cherished values and goals– has numerous benefits for both physical and mental health. For example, feeling that you have a purpose decreases your chance of premature death, according to a study of almost 7000 adults between the ages of 51 and 61.  Amazingly, those without a sense of purpose were almost twice as likely to die in the four years of the study. 

Other studies show that a sense of purpose promotes healthy behaviors and is associated with better physical and mental health outcomes.  A 2019 study by a team of British researchers found that a sense of purpose also promoted happiness and a sense of well-being among adults 50- 90. The same researchers observed that older adults with a sense of purpose were more likely to have close friendships, enjoy the arts, practice healthy habits, and experience less chronic pain and illness.  A recent study of seniors in a retirement community suggests that a sense of purpose might even alleviate loneliness.

According to this NPR article, it doesn’t matter what your purpose is as long as you have one. But where do you look to find your unique purpose as you age?  

Nine Paths to Purpose

For part of the answer, I returned to a favorite book: Viktor Frankl’s Man’s Search for Meaning. In this short, powerful book, Frankl describes his daily experiences and observations while a prisoner in the concentration camps of Nazi Germany. There he developed his beliefs about what can sustain the desire to live even under the most inhumane and desperate circumstances.   

Frankl observed that those inmates who had a sense of purpose were more likely to survive the degrading conditions of the camp. While the rigors of aging in no way compare to life in a concentration camp, they have in common the need to find meaningful goals when life gets rough. 

Below are nine paths to purpose that can be helpful to anyone at any age, but they are especially relevant to older adults.  I’ve drawn on Frankl’s work for #1, #2, and #9.  The ninth path may not strike you as particularly cheerful, but I think you’ll find it bracing and even inspiring in its own way.  By the way, you don’t have to choose just one path. You might find yourself following each of the nine paths in turn, even in just one day.

     1. Work mission. 

Some older adults are able to continue the paid work they love to do. Their motto is: “Never retire.” Other active older adults use retirement as an opportunity to try out a second career.  Still others find employment where they can, because earning an income is either necessary or a source of independence and pride.  Many older adults find meaning in unpaid work such as volunteer work, personal projects, or home improvement. 

One reason Frankl was motivated to survive the daily torment of the camps was because of a book he wanted to finish.  Although he was forced to relinquish his manuscript when he entered the camp, he wrote his key ideas on scraps of paper and stuffed them in his pockets.  After his liberation from the camps, he wrote that book and many others.

If you are no longer motivated by traditional work goals, however, you could find your particular purpose in one of the motivators below.

     2. Love and friendship.  

Finding meaning in the love of another person is an inspiring motivator.  For example, Frankl was able to survive the camps in part by imagining a future reunion with his wife.  Many older people find meaning in relationships with spouses, friends, children, and grandchildren and in taking care of beloved others.

     3. Compassion for others. 

Compassion and concern for others may protect against feelings of meaninglessness, accord to this study.  As one senior said, “If you’re feeling lonely, then go out and do something for somebody else.”  Even making brief connections with relative strangers—acknowledging their presence, wishing them a good day, giving a compliment–can be a source both of meaning and happiness.   Listening to someone with an open mind, reaching out to someone who may be lonely, or sending a card can provide good cheer to someone who is down in the dumps.

4. Small joys and pleasures.  

But what if you don’t have some lofty-sounding “purpose project” in your life? Just learning to appreciate small pleasures is a habit worth cultivating.  Noticing a bird or plant outside your window, having a warming cup of coffee, exchanging hugs—these tiny moments when noticed and absorbed provide a source of satisfaction to both body and brain. 

According to the “Bold School” newsletter of the Washington Post, researchers have studied a population in Okinawa, Japan, where people live longer than anywhere in the world.  Researchers attributed this longevity to the practice of “ikigai:” “This ‘sense of life worth living’ includes looking for joy in small things, being present and creating a harmonious atmosphere.”

     5. Staying strong and healthy.

You won’t be able to accomplish much if you lack energy and strength.  And just staying strong to perform the normal activities of daily living is an accomplishment in itself, because it means that you can still be independent.  Take walks, go to the gym, get a personal trainer, eat right–you know what to do!

     6. Creative projects and play.

Creative activities, humor, and play of all sorts can provide a purpose for many people. Hobbies, sports, and experiences such as art, travel, music, nature, reading, and culture can touch us deeply and enlarge our capacity for empathy.  They may also reduce symptoms of chronic pain and worry by making life more enjoyable, according to PT blogger David Hanscom.  Expressing your identity through art or actions is a way to be happy, a way to affirm who you are, and a way to find purpose.

Click Read More for more Tips.

The Surprising Reason Mindfulness Makes You Happier

Experiencing positive feelings can improve our health and quality of life. However positive emotions are difficult to change because almost half of our happinessseems to be a function of genetic factors. Nevertheless, some practices have been shown to increase positive emotions, including practicing gratitude, spending money on others, doing lovingkindness meditation, and practicing mindfulness. Mindfulness is both a set of skills and an orientation to life that involves maintaining open attention on whatever is happening in the present moment and bringing an attitude of acceptance and openness to whatever is going on internally or externally. Some studies have shown that mindfulness interventions increase positive feelings but we don’t really know why this happens. A recent research study sought to delve deeper into this issue.

Observing your present-moment  experiences

 One facet of practicing mindfulness  involves slowing down and deliberately focusing on different aspects of your experience such as what you feel in your body (e.g.,body temperature, breathing, muscles) your thoughts, emotions, your senses (what you see, hear, taste, feel or smell) or what is happening around you (e.g., listening mindfully to someone who is talking). When your attention wanders, you begin to notice this shift and deliberately bring it back to whatever you have decided to focus on. This deliberate direction of attention is called Monitoring.

Monitoring your ongoing experience may make you feel happier by helping you slow down to appreciate things or to notice more of the happy things that are going on around you. You may begin to pay more attention to the trees and flowers, enjoy the feel of the sun on your skin, or bask in the warmth of your partner’ or child’s  loving gaze.

On the other hand, paying attention to both positive and negative feelings as they arise may also make you more aware of negative feelings and sensations like tension in your body. Some feelings or thoughts may be uncomfortable or difficult to tolerate. Positive feelings may be observed but then quickly replaced by negative ones. Therefore it may take more than Monitoring to help us be happier.

Accepting your Inner Experiences

A second facet of mindfulness is Acceptance. Practicing acceptance means allowing your experiences (e.g., thoughts, feelings, sensations, cravings) to be as they are, viewing them with kindness, gentleness and openness. It is the middle ground between suppressing your feelings or over-identifying with them. When you sit with difficult experiences and give them space they can become less aversive. Acceptance is the opposite of judgment or clinging. Judging and criticizing yourself means not accepting that things are as they are and cannot be changed in this moment. Clinging means not allowing positive experiences to end, forcing ourselves to feel happy when we don’t, or trying to avoid the natural pain and ups and downs of life.  Acceptance can increase positive feelings because it can change the meaning of our stressors, making them more tolerable. By not trying to force our lives or experiences to be a certain way by judging less, we can be more open to the present moment and our naturally arising feelings of contentment, interest, pride, joy, curiosity and so on.

The Study

The researchers compared the effects of two different mindfulness trainings – Monitoring Only (teaching only 1 skill) versus Monitoring + Acceptance (teaching both skills) with a control condition (no treatment or inactive treatment) in two different studies of stressed community adults. One study used in person mindfulness training while the other study taught these skills via smartphone. Both positive and negative emotions were assessed at the end of the day (diaries) and also at 4 random times each day using the smartphone for 3 days before and after the study.

Results showed that while all the active mindfulness interventions (Monitoring Only and Monitoring + Acceptance) reduced negative feelings equally from before to after the study, they differed in their effects on positive feelings. For improving positive feelings the Monitoring + Acceptance group had a significantly stronger effect, compared to Monitoring Only and Control conditions.

These results mean that practicing mindfulness  can make us happier only if we learn to tolerate, make space for, and accept whatever experiences arise, rather than judging them, letting them define us, or running away from them. Perhaps Acceptance leads to a mindset shift in which we can let go and be ok with things as they are, rather than focusing on what we don’t have, what we should have done, or what might happen in the future. Letting go of trying to control everything can make space for you to take a breath and feel the joy of the present moment, whether it’s walking your dog, hugging your child, having lunch with a friend, or doing interesting work. Becoming aware of what you feel, negative thoughts, or the tension in your body (Monitoring) is only part of the work.  You also need to practice allowing those feelings and sensations to be there without trying to force them away, worrying about them, letting yourself be defined by them or judging yourself for having them.

Below is an exercise to help you practice acceptance in your daily life:

Allowing the Feeling In

If you are struggling with feeling something that you don’t want to feel (e.g., anger or sadness), try to make room for that feeling. Start by giving it a name  {e.g., I’m feeling angry) and then notice where you feel it in your body (e.g., your chest). Try to bring curiosity to the experience, letting the anger be there and noticing if it moves in your body, goes down or increases, whether it’s hot or cold, expansive or tight, and other qualities of it. Notice what the anger makes you want to do (e.g., shout and scream) and notice that you have a choice whether to do that or not. You can just watch the impulse to begin with to give yourself more time to process the situation before you act.

3 things you should do every day to improve your memory

In 2009, after Nelson Dellis’s grandmother Josephine passed away from Alzheimer’s disease (which may have a hereditary component), he was inspired to find ways to keep his own brain healthy and sharp.

“I was a good student, but my memory was average,” Dellis, 35, tells CNBC Make It.

Dellis scoured the internet looking for tips to improve his memory and joined a few forums where professional “memory athletes” (people who train their memory skills for high performance) chatted about different memory techniques. Then he listened to “Quantum Memory: Learn to Improve Your Memory with The World Memory Champion,” an audiobook by Dominic O’Brien, a seven-time world memory champion.

“After that, I went off and, through trial and error, figured out what [techniques] worked well for me,” Dellis says.

Today Dellis, author of the book “Remember It” and a four-time USA Memory Champion (an annual competition for elite mental athletes), is a full-time memory coach based in Miami, Florida. He charges $250 an hour for private lessons to the likes CEOs and billionaires, including Mark Cuban and Sara Blakely.

Here are Dellis’ top three tips on improving your memory and staying sharp.

1. Go offline

Dellis says one the easiest memory tips that he’s learned over the years is to take time to totally disconnect from technology — including your smartphone — for at least an hour a day.

That’s because presence is important for memory, says Dellis.

“Your brain is a processing unit,” he says. “If your brain isn’t present to receive [information] (i.e., you’re distracted and not paying attention), how on earth do you think it’s going to be able to remember it? You’ll be surprised how powerful your natural memory is if you just try and pay attention.”

Dellis’s advice is supported by research: According to a 2017 study from the McCombs School of Business at The University of Texas at Austin, researchers found the mere presence of a smartphone reduces cognitive capacity, affecting one’s brain to hold and process data.

2. Think in pictures

“My goal whenever I memorize something is to turn it into a mental picture in my mind,” he says, which is “any mental representation of what you’re trying to memorize, using as many of your senses as possible.” It could be an association, a sound, a feeling — anything that’s “meaningful” to you, Dellis says.

That’s because it’s much easier to remember a picture of something that you are familiar with than words relating to something new and difficult, he says. (Studies in older adults have shown that pictures can help with memory.)

Dellis uses the example of remembering the name chervil (an herb) to buy at the grocery store.

“Most people might not even know what that is. So I might break that word down into what it sounds like: ‘sure-vill.’ So maybe my meaningful image could be, me saying ‘sure!’ enthusiastically to a ’vill’ain. The more context the better. Maybe I’m agreeing with this villain, because if I don’t, he’ll take all the chervil in the world and secretly garnish all the food in the world and ruin the taste of everything,” Dellis says.

The “more over-the-top and bizarre you make the image, the better.”

To practice, Dellis suggests that when you meet someone for the first time, turn their name into mental images, as he did with chervil.

“You’ll have a higher chance of remembering the person’s name, and you’ll be training your brain to get better/quicker at thinking in pictures,” he says.

3. Explore your ‘memory palace’

When you’re thinking in pictures, you need a place to store those images. So most memory athletes use a technique called the “memory palace,” according to Dellis. The technique (which dates back to the ancient Greeks) has to do with remembering things based on location

According to Dellis, a memory palace works like this: Think of a familiar place (like your house, apartment, office, etc.) and imagine a mental pathway through it. To store your images, simply imagine or “stick” each image on a location along the path in your mind. The idea is that later on when you want to retrieve the information, all you have to do is think of your memory palace, walk back through it in your mind and pick up the images you left there.

It sounds a bit crazy, but it works, according to Dellis and it allows top memory athletes to memorize thousands of pieces of information, he says.

“It’s an effective way of stringing together sets of memories because it uses more and various parts of the brain than simply short term recall (visual, emotional, language, imagination and short term memory),” neuroscientist Tara Swart tells CNBC Make It.

To practice, Dellis suggests choosing three familiar places and selecting 10 locations along your mental path through each. Start by storing daily to-do lists and grocery lists there as practice.

How to Maintain Memory as You Age

As we grow older, it is not uncommon for many over a certain age to begin associating these normal lapses in memory with fear of conditions such as Alzheimer’s disease or some other form of dementia. 

While the majority of those diagnosed with dementia tend to be older, our forgetfulness and memory loss don’t necessarily indicate the onset of such devasting diseases like Alzheimer’s. In fact, the Alzheimer’s Association provides resources on its website to differentiate these types of common slip-ups from the early signs and symptoms associated with dementia. 

As we celebrate and promote women aging well this month, here are some integrative approaches to maintaining your memory and cognition as you age.

Herbal Supplements

Herbal remedies have been used in China for more than 2,00 years to boost memory. Some with the most evidence behind them include: 

  • Turmeric: You probably know this herb as a spice, but it’s also used in numerous remedies in Asian medicine. Like all the herbal remedies mentioned here, it has strong antioxidant and anti-inflammatory properties. One study of 1,101 older people without dementia found that those with a high turmeric consumption had better cognitive function than those with lower consumption.
  • Ginseng: Ginseng can help improve learning and memory, potentially protecting against Alzheimer’s disease. One reason could be its ability to protect against amyloid-β and cholinesterase activity, both of which are associated with the development of Alzheimer’s disease. 

Healthy Diet

Maintaining your memory as you age also means embodying a healthy diet to minimize the risk factors associated with diseases like dementia. A diet high in healthy proteins, fruits and vegetables and low in saturated fat, sugar, and processed foods, can go a long way in preventing many health problems, including those connected to Alzheimer’s disease. 

In fact, a systematic review of 12 studies found that participants who strictly followed the Mediterranean diet had a better cognitive function, lower rates of declining cognitive functioning, and a reduced rate of Alzheimer’s disease. 

Yoga or Exercise

The benefits of exercise and yoga are extensive but, specifically, they can be utilized in treating the effects of depression, which can lead to chronic inflammation, especially as we get older. By engaging in any of the various types of exercise to combat depression, you can avoid the “foggy” feeling that limits the ability to concentrate in many depressed people.

Not only can yoga and exercise improve depression and mood, but there is also evidence they can lead to improvements in cognitive function, particularly attention, processing speed, executive function (decision-making) and memory in people with and without depression.

Sleep

The National Sleep Foundation provides the following information on the connection between sleep and memory:

“Healthy sleep puts us in the right state of mind to take in information as we go about the day. Not only that, we need a good night’s sleep to process and retain that information over the long term. Sleep actually triggers changes in the brain that solidify memories—strengthening connections between brain cells and transferring information from one brain region to another.” 

As the medical field continues to take a keen interest in sleep and the importance of getting regular, restful sleep for our overall health, the impact sleep has on our memory will only expand as studies continue to be published. 

Playing Games

And lastly, play games. Playing board games, crosswords, chess, bingo, or cards was found to slow mental decline for those in their 70s. So says a decades-long study of over 1,000 people in Scotland. Those who played games kept memory sharp and improved scores on thinking tests compared to those who didn’t play. It’s great to start early, but even those who increased gameplay in their 70s still benefited as they aged.

For women entering the later stages of their life, memory can serve as a foundational aspect of healthy aging. By embracing the approaches here, you can maintain your memory and cognitive function while also lowering your risk for diseases associated with dementia. Minor episodes of forgetfulness will most likely still occur every so often but your overall memory will hopefully remain in generally good health.  

A Practical Practice to Transform Your Health

Buddha was asked this question: “What have you gained from meditation?”

He replied, “nothing at all.”

“Then Blessed One, what good is it?”

“Let me tell you what I lost through meditation: sickness, anger, depression, insecurity, the burden of old age, the fear of death. That is the good of meditation, which leads to nirvana.”

People everywhere are anxiously working to be happier… and they are trying to buy happiness as evidenced by a quick stroll through the world’s biggest shopping center, Amazon. A search of Amazon inventory for “how to be happier” reveals over 100,000 things you can purchase to be more joyful.

But here, free to all, we are going to give you a valuable tool that is guaranteed to make you happier, and also improve your health. That’s right, nothing to buy. No elixir to take. No equipment to install. This gift comes without batteries and complex instruction manuals.

Meditation—the practice of training your mind to focus on a single point—is like sharpening the blade of a knife. It will sharpen your cognitive and emotional abilities and cut through to your true self. It reduces the noise in your life and provides a clear life signal. With meditation, we aren’t as cluttered or burdened, and we are able to show up as our best selves—full of purpose, enthusiasm, and compassion.

If life feels out of control, meditation is the way to get it back under control.

And here are the well documented scientific benefits:

  • Lowers blood pressure
  • Slows breathing rate
  • Improves rest and sleep
  • Boosts immunity
  • Lessens stress
  • Increases telomere length

Note the last bullet! Meditation increases telomere length.

This is vitally important and scientifically documented. Telomeres are these little endcaps on our chromosomes that serve a protective function so that when cells throughout our bodies replicate they continue to do so free of error. The telomere endcaps keep the gene-copying process happening accurately. Moreover, how robust and long these telomeres are correlates with the length of one’s lifespan. This research earned Elizabeth Blackburn the Nobel Prize in Physiology or Medicine 2009.

Let’s say this again: How robust and long these telomeres are correlates with the length of one’s lifespan. And meditation increases your telomere length – the longer the telomeres, the longer the lifespan.

Research shows that people who are chronically stressed have shortened telomeres. Telomeres are longer in those who regularly exercise. Telomeres are also longer in individuals who meditate.

There are tremendous benefits that accrue over time. In other words, long-time meditators have different brains than everyone else. Harvard researcher Sara Lazar published a groundbreaking study that showed meditation produces measurable differences in the brain as a result of the repeated practice of meditation. What was compelling in this research, however, is that these differences revealed themselves with only two weeks of practice. Yes, only two weeks of practice showed impressive changes.

So how do you meditate?

There are many forms of meditation ranging from Transendental, Buddhist, Vispassana, loving kindness, Taoist, Mindfulness, and Christian. There are also a variety of guided meditation that can be found on apps and YouTube. They are all valuable and worth exploring.

If you are curious to begin, seek out a certified instructor. To get you started, however, we suggest you might experiment with what is known as Mantra meditation adapted from the Chopra Center. Here are six simple steps:

1. Choose your mantra. Select a mantra. This is a short word or phrase—such as peace or love—to repeat to yourself as you meditate. “So Hum” is a popular mantra. It is a Sanscrit, that translates to “I am.”

2. Find a place to sit. Sit comfortably in a quiet place.

3. Gently close your eyes and begin by taking some deep breaths. Try taking a few “cleansing breaths” by inhaling slowly through your nose and then exhaling out your mouth. After a few cleansing breaths, continue breathing at a normal relaxed pace through your nose with your lips gently closed.

4. Begin silently repeating your mantra. For example, if using “So Hum” as your mantra, you could silently repeat “So” on your inhalation and “Hum” on your exhalation. As your meditation continues, allow the breath to follow its own rhythm. The repetition of your mantra should be effortless. Imagine you are listening to your mantra being whispered in your ear.  

5. Importantly, do not try and stop your thoughts or empty your mind.  As you meditate, you will find that your thoughts appear and distract you. This is normal. Whenever you become aware that your attention has drifted away from your mantra to thoughts or any other distractions while meditating, simply return to silently repeating the mantra. This is the practice of your meditation emptying the trash in your mind.

6. After 20-30 minutes, stop repeating the mantra. You have completed your meditation, but be sure to spend a few minutes relaxing with your eyes closed before resuming activity.

You may want to begin by practicing this Mantra meditation for five minutes and then increasing it to ten and continuing to add time to your practice.

It’s quite remarkable! This single, simple practice is guaranteed to transform you into a better version of yourself. Mindfulness and meditation really do make us happier and healthier.

And here’s the most important advice we can give you: Meditate once a day, and if you think you don’t have time to do that you should meditate twice a day.

20 Ways To Be A Happier Person In 2020

Looking to make 2020 your happiest, most fulfilling year yet?

If your mental and emotional wellness took a backseat in 2019, there’s no better time than right now to prioritize it. (If anything, it’ll make the election year just mildly more bearable.) Your mood affects everything in your life ― your relationships, your work, your self-care ― so improving it should be at the top of your goal list.

That might feel like a huge and lofty task, but small, actionable habits can help you get there, according to experts. Below are the most common happiness tips therapists recommend. Maybe they’ll sound challenging or unrealistic (more on that later), but maybe they just might change your life.

1. Conquer one anxiety

Give yourself a motivational benchmark to start conquering your biggest fears this year. 

“Single out the goal of selecting an anxiety that is holding you back, and thoroughly commit yourself to obliterating that fear,” said Forrest Talley, a clinical psychologist. “Hold nothing back in your assault; treat that fear as though it is enemy number one.” 

Perhaps you’ve been worried about signing up for a half marathon. Maybe you’re afraid to reach out to book agents because you don’t want to be rejected. Perhaps you’re fearful of having a difficult conversation with a toxic friend or family member and you’re putting it off. Set the goal, pick a reward you’ll get when you complete it, then get to it.

“The thing to keep in mind is that very often happiness is found just on the other side of a doorway guarded by our anxieties,” Talley said. “And the new year is a great time to start kicking down some doors.”

2. Lock down a sleep schedule that works for you

You may think you’re doing OK on sleep, but take a closer look at your schedule. Are you really getting optimal hours? Are you maintaining relatively the same bed time every night?

“Getting a [consistent] good night’s sleep is vital; chronic sleep deprivation is a huge problem, especially for those who work late or are extremely busy,” said Joanna Konstantopoulou, a psychologist and founder of the Health Psychology Clinic. “It’s not just the 40-hour marathons without sleep which can be detrimental to your psychological health, but simply losing an hour or two on a regular basis can have a significant impact on your mind and well-being.”

That last bit is important. If you’re constantly shaving off an hour here or there ― thinking you can get by on five hours a night ― it’s time to reevaluate that sleep schedule. 

“Start with small steps by giving yourself a sensible and realistic bedtime,” Konstantopoulou said. “Try to go to bed half an hour before your usual bedtime and stick to it. Evaluate this new habit every day by having a journal and writing down your progress.” 

She noted that this new routine will improve your memory, reduce anxiety, and “transport toxins out of the brain” to potentially prevent chronic illnesses.

3. Find one small self-care act that works for you and prioritize it

Pick a you-centric activity and engage in it regularly, said Elena Touroni, co-founder of The Chelsea Psychology Clinic.

“The most impactful mental health goal a person can set is the commitment to balance workload and responsibilities alongside activities that bring them a sense of well-being and enjoyment,” she said. “When there is an imbalance in what we’re giving out to the world, and what we’re taking for ourselves, that’s when our psychological resources get depleted.”

Her suggestions to get you started? Try beginning each day with a five-minute mindfulness meditation session. Want to go further? “Go to therapy to unravel a lifelong pattern, get a personal trainer, or make time for reading,” she said. “This commitment can be broken down into specific and concrete goals, depending on your personal preferences, but it all comes down to making self-care a priority.”

4. Spend 10 minutes a day outside

Go for a walk during your lunch break, spend a few minutes drinking your morning coffee outside or pick up running. It doesn’t even have to be for a long period of time.

“This year, resolve to spend less time inside and more time outdoors in natural settings,” said Michael Brodsky, a psychiatrist. “Research in multiple countries show that spending time in green spaces can lift your mood and relieve anxiety in as little as 10 minutes.”

5. Regularly practice a simple mindfulness exercise

“Many of us spend our days worrying about the future or ruminating about the past, thus, missing a great deal of what is happening in the here-and-now,” said Anna Prudovski, the clinical director of Turning Point Psychological Services.

Making an effort to be more present “increases the sense of well-being, promotes vitality, heightens our awareness, helps train our attention, improves the quality of our work, and enhances interpersonal relationships,” she said. Sounds pretty nice, right? “Be more present” can feel a little vague, so here’s how you can get started:

Each day, spend five minutes noticing your surroundings and how you feel. Do this by naming five things you see, four things you can physically feel, three different sounds you hear, two things you can smell, and one thing you can taste. It’s OK if you point out something far away from you. Then take a second to label how you’re feeling in the moment (like, “I’m frustrated,” “I’m bored,” or “I’m excited”). This is known as a grounding exercise, which experts say helps with anxiety.

6. Say nice things about yourself

Roseann Capanna-Hodge, pediatric mental health expert and psychologist, suggested an adjustment to your everyday vocabulary, both in your thoughts and out loud. 

“Instead of always focusing on the negative, flip your dialogue to only positive outcomes. For example, instead of saying, ‘If I get that job,’ switch it to, ‘When I get that job.’ Those subtle changes in using positive language helps to change your mindset to a glass half full instead of a glass half empty.”

You can also increase your positive thoughts by stating one thing you like about yourself when you look in the mirror each morning. Cheesy, but worth a shot.

7. Give up or cut back on one unhealthy habit

We know when things are bad for us, which can cause stress. You can curb that by reducing them or giving them up entirely, said Sarah C. McEwen, a cognitive psychologist. Think activities like high alcohol consumption or excessive caffeine consumption.

Getting those things in check “will all help to manage stress levels,” McEwen said.

8. Find a physical activity you love

“Exercise plays a large role in mental health,” said physician Jena Sussex-Pizula. “While studies are ongoing, a review article found consistent beneficial effects of exercise on depressive symptoms across multiple studies.”

How often? McEwen suggests 30 minutes a day if you can. “This [amount] has been shown to produce the most benefit for improving mood and reducing stress levels,” she said.

The most important part is finding something you enjoy. It doesn’t matter if it’s pilates, martial arts, spinning, running, dancing or lifting weights ― just make sure the activity is something that excites you.

9. Try meditation

Haven’t jumped on the bandwagon just yet? Now is as good a time as ever. McEwen suggests meditation for those who want to improve their level of stress resilience. 

“A mindfulness meditation practice will have a tremendous positive effect longterm,” she said. “I recommend allocating at least 30 minutes daily, which can be divided into morning and evening.”

Feeling intimidated by the concept? McEwen suggested trying a local class or an app like Headspace, Waking Up or Insight Timer. 

“Research has shown that the regular practice of meditation can actually improve your health because it lowers the negative effects of not only high cortisol, but also high cholesterol and high blood pressure,” she said. “Other great benefits of regular meditation include mental clarity and focus, improvement of memory and overall higher level of mental performance.”

10. Stop negative thoughts in their tracks

“Our thoughts are not always reality,” said Judy Ho, a clinical and forensic neuropsychologist and author of ”Stop Self Sabotage.” “And we need to get into the routine of challenging them and changing our relationships to our thoughts.”

You can do this by asking yourself a simple question when you’re beating yourself up. Next time you have a negative thought, ask yourself: Does this completely and accurately capture what’s going on?” 

Ho said from there, you can transform the thought using one of two tactics. One is called “yes, but” and one is called “labeling.”

“‘Yes, but’ involves recognizing a not so great thing, and [adding] something that is positive or shows progress,” she said. “Example: I did eat three cupcakes while trying to cut down on sugar, but I have been doing a great job with healthy eating and can start fresh tomorrow.” 

And as for labeling, try mentally recognizing or acknowledging that the thought you’re having is toxic. According to Ho, this “takes the wind out of the sails of a negative thought and reminds you that a thought is just a mental event, and nothing more.”

Click Read More for 10 more Mental Health Resolutions.

Finding life’s meaning can keep us healthy as we age

The older people get, the more their lives might change. For example, their friends and relatives may reach the ends of their lives, and people’s careers may begin to wind down.

According to a new study paper appearing in the Journal of Clinical Psychiatry, crossing this threshold reawakens people’s need to find meaning in life.

The study, which researchers at the University of California San Diego School of Medicine conducted, finds a link between having a sense of meaning and positive physical, mental, and cognitive functioning.

“Those with meaning in life are happier and healthier than those without it,” says senior study author Dilip V. Jeste.

A new priority

Although a search for meaning may be on our minds at various times in our lives, the new study suggests that when our lives are full of family, friends, and careers, it tends to fade into the background.

“When you are young, like in your 20s, you are unsure about your career, a life partner, and who you are as a person. You are searching for meaning in life,” says Jeste.

However, “As you start to get into your 30s, 40s, and 50s, you have more established relationships, maybe you are married and have a family, and you are settled in a career. The search decreases and the meaning in life increases.”

Jeste continues: “After age 60, things begin to change. People retire from their job and [may] start to lose their [sense of] identity. They start to develop health issues and some of their friends and family begin to pass away. They start searching for the meaning in life again because the meaning they once had has changed.”

As we become older, there seems to be a pressing need to know what we should be doing with — and what we should be feeling about — our remaining time.

For many people, finding meaning becomes a prerequisite for a happy ending to one’s life story. Without it, suggests the study, our declining years and the difficulties they may involve may be dominated by stress and its physical consequences.

Who participated in the study?

The researchers drew their correlations from 1,042 adults who took part in the Successful Aging Evaluation from January 2013 to June 2014.

The participants were residents of adult communities in San Diego County, CA. They were aged 21–100+.

The researchers performed three evaluations:

  • “A Meaning in Life Questionnaire” captured each participant’s current relationship with meaning, categorized as “Search” or “Presence.” The team asked the participants to identify with different statements, such as, “I am seeking a purpose or mission for my life,” or, “I have discovered a satisfying life purpose.”
  • Each participant self-reported their physical condition and mental status.
  • Each participant took part in a phone interview as a means of assessing their cognitive status.

What the study found

In terms of searching for meaning versus acquiring it, the data showed a striking inverse relationship between the two at age 60: “Presence” reached its highest level at that age, while “Search” hit its lowest.

This suggests that for many people, there was no further need to keep searching for meaning at that point; they had found it by the time they turned 60.

Using statistical models, the researchers found that physical condition correlated negatively with older age but positively with Presence. In fact, the correlation grew even stronger beyond the age of 60.

Mental well-being was positively associated with aging and Presence but negatively with Search. Cognitive function was negatively linked to advancing age and Search.

The study’s conclusion is that finding meaning in one’s life constitutes a sound strategy for thriving in later years — in part because it supports the preservation of a person’s physical and mental well-being.

As first study author Awais Aftab explains, “The medical field is beginning to recognize that meaning in life is a clinically relevant and potentially modifiable factor, which can be targeted to enhance [people’s] well-being and functioning.”

Jeste says, “It’s an exciting time in this field as we are seeking to discover evidence-based answers to some of life’s most profound questions.”

His upcoming research will focus on other personal attributes — including wisdom, loneliness, and compassion — and how they may affect a person’s search for meaning.

“We also want to examine if some biomarkers of stress and aging are associated with searching and finding the meaning in life,” he says.

3 Small Hacks for a Healthy New Year

As another year winds down, are you feeling a little exhausted and worn out?  If you’re nodding your head, know that you are in good company, with less than 20% of people reporting that they’re feeling on top of the world at this time of the year.  So as you head into a new year, how can you find the energy to be at your best for the people you care most about?

“Often we put in so much effort trying to serve others, that we can overlook what we need ourselves,” explained Tom Rath, author of Eat, Move, Sleep, when I interviewed him recently.  “Unfortunately, the reality is that when you’re run down and low in energy, you’re likely to be less effective at work and home.”  

In fact, studies have found that when your energy levels are high, you’re three times more likely to be engaged in your work, and be at your best for others.  The reality is that if you want to make a difference for others, you firstly need to take care of your own health and energy.

So what are the smallest choices that can have the biggest impact?

Research suggests that eating, moving, and sleeping well are the keys to having more physical and emotional energy throughout your day, and can act as buffers against stress.  When you eat, move, and sleep well, you can do more for others.  

Tom pointed out that it’s important to tackle each of these areas simultaneously, as letting one area slip can lead to a negative spiral of energy.  For example, a poor night of sleep can lead to skipping your gym workout and grabbing a high sugar snack from the vending machine later in the day.  On the other hand, doing any one of these things – eating, moving, or sleeping – well can lead to an upward spiral in the other two areas.

The good news is that changing the way you eat, move, and sleep doesn’t necessarily require a grand plan, but can start with the next small choice you make in your day.  Tom suggested trying:

  • Eating Wisely – Making better choices about what you eat can improve your energy and mood.  Foods that are highly processed and include sugars or trans-fatty acids can have a negative impact, whereas when you eat more green leafy vegetables, whole fruits, and whole foods, you’re more likely to feel calmer and happier and have more energy.  Studies also suggest increasing your protein intake while, at the same time, reducing carbohydrates, improves your health over time.

Your Wellbeing Hack: Be A Food Accountant – Most meals contain both good and bad ingredients such as high nutrient content, as well as an excess of sugar, and chances are you may eat some foods that are less than ideal, several times a day.  Try to do some mental accounting based on what you know about the components and ask yourself if what you are about to eat is a net gain or loss.  When you make a choice that does more good than harm, such as opting for a salad over a burger, the resulting net gain gives your body a positive charge.  But deciding to drink a sugary soda instead of water produces a net loss.  As you continue to ask this question, you should become better at making decisions in the moment.

  • Moving Regularly – Not moving well is one of the biggest global public health problems, and this includes not enough physical activity, as well as too much sitting.  When we sit for long periods of time, the electrical activity in our legs shuts off, and that can do more accumulative damage than not getting 30 minutes of cardiovascular activity each day.  Moving regularly, in small bursts of activity, improves your physical energy, and can also help you think better.

Your Wellbeing Hack: Get Moving – Challenge yourself to add a little bit more activity into your everyday routine.  For example, walk around while you’re on the phone, or go out for a brief walk to the second-closest coffee shop to grab your coffee.  And when you start to see the returns on energy from these movements, look for ways to move even more, while you’re getting work done, such as having a treadmill at your desk.  

  • Sleep Well – It’s important to see every hour of sleep as an investment in your future, not an expense.  Unfortunately, many of us have experienced cultures where you get bragging rights for how little sleep you can survive on.  However, losing 90 minutes of sleep can cost up to a third of your productivity the next day, and can reduce your competency and creativity in afternoon meetings.  Over time, a consistent lack of sleep can be dangerous, as the effects are similar to being intoxicated as you go about your work and life.

Your Wellbeing Hack:Create A Bedtime Routine – Create a routine where you minimize bright light from any sources in the hours leading up to your bedtime, and ensure your bedroom is a few degrees cooler than the temperature you are accustomed to throughout the day.  Try to create a culture in your organization where enough sleep is highly valued and sacred, by discouraging late-night emails and having discussions about the effects of lack of sleep.

Cards, Board Games Could Be a Win for Aging Brains

Playing cards and board games like chess, bingo and Scrabble might be the mental workout you need to keep your wits as you age, Scottish researchers suggest.

People in their 70s who regularly play board games score higher on tests of memory and thinking skills than those who don’t. And 70-somethings who step up their game-playing are more likely to maintain thinking skills as they age, researchers say.

“Playing board, card and word games may protect people from cognitive decline, but this study wasn’t an intervention, so we can’t say that for sure,” said lead researcher Drew Altschul, a postdoctoral research fellow at the University of Edinburgh. “But it, at very least, is fun, inexpensive, and it certainly won’t hurt you.”

He doesn’t think it’s the social aspect of these activities that provides this brain-protective effect, but rather the challenge of the games themselves.

Unlike reading, writing, taking classes, visiting museums, libraries or friends and relatives, games appear to more actively engage abilities like memory, thinking speed and reasoning, Altschul said.

“So, this fits with what we call the ‘use it or lose it’ theory, that exercising your mental abilities more keeps them in better shape,” he said.

For the study, Altschul and his colleagues tested the memory, problem-solving, thinking speed and general thinking ability in nearly 1,100 70-year-olds. The tests were repeated every three years until participants reached age 79.

The researchers also asked how often participants played games such as cards, chess, bingo or crossword puzzles.

To isolate the effect of game playing, they took into account results of IQ tests participants took at age 11, as well as their income, education and physical activity levels.

People who played more games as they got older had less decline in mental skills in their 70s, particularly in memory function and thinking speed, researchers found. However, the study only found an association, not a cause-and-effect link.

How the brain changes with this type of activity is unknown, but researchers are working hard to learn more, said Rebecca Edelmayer, director of scientific engagement at the Alzheimer’s Association.

“There’s actually a lot of research that’s happening in this particular area right now focused on cognitive challenge, cognitive engagement and how we can use this as potentially a way to reduce our risk for cognitive decline,” she said.

Just like keeping the body active helps keep heart disease at bay, being mentally active may have the same effect on dementia, Edelmayer said.

“It seems that challenging and complex tasks, or even things like games of strategy, may require multiple cognitive functions that may be most beneficial for individuals as they age,” she said.

Edelmayer predicted that Alzheimer’s and other dementias will one day be treated much like heart disease. “You will see not only medications that are approved to treat dementia, but also ways that we could be changing and modifying our lifestyle to decrease our risk for cognitive decline,” she said.

A large trial is testing whether a combination of social and cognitive engagement, along with healthy nutrition, physical activity and effective management of heart health might help preserve mental function, Edelmayer said.

“Those factors, tested together, can potentially help us understand better what a recipe for beneficial lifestyle intervention would be,” she said.

The Evidence on Giving Thanks

Millions of people will gather with family and friends this week to celebrate what may be one of the most quintessential American holidays – Thanksgiving.

As its name implies, Thanksgiving is all about giving thanks – or showing appreciation or gratitude. It turns out there is a significant body of scientific literature demonstrating that thankfulness.

Alex Wood, Jeffrey Froh and Adam Geraghty conducted a comprehensive review on gratitude. They looked at how gratitude promotes well-being and, further, examined intervention programs that attempt to achieve positive outcomes by promoting gratitude.

The authors note that although we may feel grateful for specific events, gratitude can also be seen as “part of a wider life orientation towards noticing and appreciating the positive in the world.” (You may have heard the expression an “attitude of gratitude”).  Some people are more likely than others to notice and appreciate the positive in life. And this orientation seems to protect people from psychological distress.

Their review shows that gratitude is negatively related to depression. In one study, an attitude of “thankfulness” reduced the risk of disorders, such as major depression, generalized anxiety disorder and drug abuse. Gratitude has also been found to help people adjust to traumatic life events and their aftermath. On the positive side, a dozen studies have found a positive relationship between gratitude and feelings of well-being.

But what is the reason for these correlations? It could be that less depressed people are more likely to be grateful, rather than the opposite. To answer this question, scientists have developed intervention programs to promote feelings of gratitude and rigorously evaluated them. The authors review 12 studies that examined the effects of interventions such as daily listing of reasons to be grateful, thinking or writing more generally about gratitude and expressing gratitude with behaviors, such as writing a thank you note to someone.

The findings are very encouraging, with programs that promote gratefulness resulting in statistically significant increases in positive emotion, and decreases in negative emotion and worrying. A study of adolescents even found an increase in satisfaction with school after a gratitude intervention. More research, of course, needs to be done, but based on this review, promoting gratitude seems to improve well-being.

And more interesting evidence was published in 2017 in a separate review, which found that “the experience of gratitude” was greater in older adults compared to middle-aged and young adults.

An appealing part of the gratitude list idea lies in its simplicity. Anyone can do this – interventions are as straightforward as listing 3 to 5 things for which one is grateful before going to bed.

So as you gather with your family and friends this week, encourage each person to say something they are grateful for before your meal. And as we launch into the busy holiday season, the evidence certainly shows it is worth pausing – on Thanksgiving and every day – to give thanks for what we have.

The Hidden Powers of Gratitude

Scientific findings have revealed that when we make a habit of focusing on and appreciating the positive parts of life, we can enhance our overall well-being.

As one journal review noted gratitude is “related to a variety of clinically relevant phenomena.” These include positive outcomes in mental health (particularly around depression), adaptive personality characteristics, positive social relationships, and improved physical health (especially regarding stress and sleep).

So what are some of the seemingly magical rewards of gratitude? Here, in honor of our most appreciation-oriented month, I will share some of the findings on the exciting rewards of feeling thankful as well as a few tips on how to bring more gratitude into our daily lives.

1. Better Sleep

A good night’s sleep may be a few grateful thoughts away. In 2009, researchers discovered that gratitude predicted greater subjective sleep quality and sleep duration as well as less sleep latency and daytime dysfunction in those studied. The study was noted as being the first to show that a positive trait is related to good sleep quality above the effect of other personality traits. Thus, focusing on more positive thoughts of things we appreciate can be a wise addition to our nightly routine.

2. Lower Stress and Depression

When it comes to our mental health, gratitude can particularly benefit our levels of stress and depression. One 2008 study looked at the relationship between gratitude and perceived social support, stress, and depression during a life transition. What they found is that gratitude seemed to directly foster social support and to protect people from stress and depression.

Similarly, a more recent study from 2018 looked at the interaction between gratitude and depression in university students in China. What they discovered is that gratitude “may not only have a negative influence on depression, but may also counteract the symptoms of depression by enhancing a state of peace of mind and reducing ruminative thinking.” Anyone who’s struggled with depression knows what it’s like to be stuck in rumination. The notion that enhancing gratitude could serve as a tool to help alleviate depression is an optimistic finding worth further exploring.

3. Healthier Eating Habits

Recently, a group of high school students from four different schools was involved in a study in which their goal was to eat healthier. Some of the students were asked to write gratitude letters, as they simultaneously tracked their eating habits. What researchers found is that the students who expressed gratitude reported healthier eating over time. This led the team to conclude that “gratitude-based interventions may facilitate improvements in healthy eating behavior,” a goal that many of us have for our health.

4. Heart Health

When a group of patients suffering from hypertension was enrolled in a 10-week, gratitude-based intervention, they experienced statistically significant decreases in their blood pressure. The role of gratitude in boosting heart health is one that has been researched in many ways. One such study was authored by Paul J. Mills, a professor of family medicine and public health at the University of California, San Diego. After tasking asymptomatic heart failure patients with a “simple gratitude exercise,” Mills wrote:

We found that those patients who kept gratitude journals for those eight weeks showed reductions in circulating levels of several important inflammatory biomarkers, as well as an increase in heart rate variability while they journaled. Improved heart rate variability is considered a measure of reduced cardiac risk. It seems that a more grateful heart is indeed a more healthy heart and that gratitude journaling is an easy way to support cardiac health.

Given the enormous mental and physical benefits of gratitude, here are some suggestions for connecting with our feelings of appreciation:

Take Five to Feel Grateful

We should all aim to designate at least five minutes a day to reflect on what we’re grateful for. Yes, there may have been a maddening amount of traffic that made us late for work. Yes, our kid may have forgotten his bookbag again. Yet, what are some things in our day that we can step back and appreciate? When we’re wrapped up in our day’s tasks, whether it’s getting to the office or flying to another country, it’s easy to take note of and tally up our frustrations. We tend to take what is good for granted, while honing in on anything going wrong.

Yet, taking just minutes to shift our perspective, we may note something as simple as how delicious our morning coffee tasted as we inched along in traffic or how easygoing our partner was about driving our son his backpack at school. Instead of thinking about how long the line to get through airport security is, we may use that queue time to do our daily gratitude practice and marvel at how fortunate we are to be able to travel. These observations can be as small as appreciating a smile from a coworker or as large as connecting with the depth of love we feel for someone close to us. The important thing is simply to carve out that time to reflect.

Keep a Gratitude Journal

Personal stories of the rewards of gratitude journals have been reported by everyone from wellness bloggers to health researchers, from high school students to Oprah. These stories are backed by science showing that keeping a gratitude journal can enhance our happiness and well-being. I like these tips from TinyBuddha.com on how to get started. The most important thing to remember is there is no wrong way to keep this journal as long as we’re using it to connect to anything and everything that ignites our gratitude.

Write a Gratitude Letter

Greater Good Berkeley designed an exercise to write a thank you letter to someone who has offered us something meaningful and to deliver that letter in person. The instructions suggest we think of a particular person we have not yet thanked as well as something specific they have done for us. Doing this exercise helps us connect with our own feelings of gratitude but also encourages us to connect with someone who matters to us in a way we might not otherwise.

Each of these practices is intended to offer us a doorway through which to connect to our gratitude, however, each of us may find our own approach or technique that helps us focus on the positive aspects of our life or even just our day. In addition to making us healthier, this orientation can help connect us more deeply to positive emotions like joy and awe and can bring us closer to the people we care for. In this way, there is really no downside to making thankfulness, not just an annual cause for celebration, but a year-round goal and daily practice.

What connects depression, anxiety, and PTSD?

Mental health disorders, although incredibly prevalent, remain poorly understood.

According to the National Institute of Mental Health, almost 1 in 5 adults in the United States live with a mental illness.

About halfTrusted Source of the U.S. population will experience a mental health condition at some point in their life.

Medication and talking therapies are useful for many people, but understanding the neurological roots of these conditions is proving challenging.

Overlap and comorbidity

Post-traumatic stress disorder (PTSD), anxiety disorders, and mood disorders — such as major depressive disorder and bipolar disorder — have distinct symptoms, but they overlap significantly.

For instance, someone with generalized anxiety disorder might experience depressive symptoms, and someone with major depressive disorder might experience heightened anxiety.

Also, scientists have noted that these conditions often appear together, which they refer to as comorbidity. As the authors of the recent study write:

“Up to 90% of patients with an anxiety disorder meet criteria for a concurrent mood disorder, and as many as 70% of individuals with mood disorders meet criteria for an anxiety disorder during their lifetime.”

9,000 brain scans

This comorbidity and overlap of symptoms infer that there might be neurological similarities between the conditions. A recent study, featuring in JAMA PsychiatryTrusted Source, sets out to identify these shared neural features.

The authors, from various institutions in the U.S., Italy, and Germany, decided to collate and analyze brain scans from previous studies. They hoped to build a clearer picture of what is happening in the brains of people with these disorders.

To investigate, they looked at functional MRI (fMRI) scans from 367 experiments, which included data from 4,507 people with a mental health disorder and 4,755 healthy control participants. In total, they analyzed more than 9,000 brain scans.

These studies all investigated changes in brain activity while participants carried out cognitive tasks.

As far as the authors can identify, this is the largest analysis of its kind to date.

Joint features of multiple conditions

The scientists searched for brain regions that were either more active (hyperactive) or less active (hypoactive) in the participants with mental health conditions than among the control group. As expected, the researchers found that certain features of brain activity were consistent across mood disorders, PTSD, and anxiety disorders.

Perhaps surprisingly, they found the most significant differences between the two groups of participants when they searched for hypoactive regions. The authors outline their primary findings:

“[We] detected statistically robust transdiagnostic clusters of hypoactivation in the inferior prefrontal cortex/insula, the inferior parietal lobule, and the putamen.”

These regions are significant because they are all involved in emotional and cognitive control. Specifically, they play an important role in stopping cognitive and behavioral processes and switching to new ones.

Senior author Dr. Sophia Frangou explains: “These brain imaging findings provide a science-based explanation as to why patients with mood and anxiety disorders seem to be ‘locked in’ to negative mood states. They also corroborate the patients’ experience of being unable to stop and switch away from negative thoughts and feelings.”

The authors also outline how these findings lend support to earlier studies in people with these disorders, which found “deficits of large effect size in stopping and shifting responses in a range of tasks.”

In other words, individuals with these mental health disorders found switching between tasks as difficult as they found switching away from negative thoughts.

The hypoactivity in these regions might explain why the “locked in” states occur in both thoughts and behaviors.

Less hyperactivity

The scientists also identified hyperactivity in some regions of the brain. However, the differences were less pronounced than those that they found in the hypoactive regions.

In particular, the anterior cingulate cortex, left amygdala, and thalamus were more active in people with mood disorders, PTSD, and anxiety disorders. These regions are important in processing emotional thoughts and feelings.

For instance, the cingulate cortex helps regulate emotional experience and appraisal, while the amygdala, among other roles, helps people form and retrieve emotional memories.

Although this study is the largest of its type, there are certain limitations. For instance, as the authors explain, they focused only on adults. The differences in brain activity might not hold true in children or older adults.

The authors hope that, in the future, these brain regions might function as “targets for interventions aiming to improve clinical outcomes and reduce or prevent affective morbidity in the general population.”

Alcohol intake and reduced brain volume

Excessive alcohol consumption carries many risks, including heart and liver problems, a higher risk of cancer, and even brain damage.

Research has suggested that there is an association between high alcohol intake and reduced white and gray matter in the brain.

So far, most specialists have maintained that alcohol consumption leads to this decrease in brain volume, but could that conclusion be wrong?

Recently, a team of investigators from Washington University in St. Louis, MO, and Duke University in Durham, NC, has conducted a study that suggests that alcohol may not be the culprit behind lower brain volume.

Instead, the findings indicate that both reduced brain volume and a predisposition toward consuming higher quantities of alcohol may have the same underlying cause: genetic makeup.

Our results suggest that associations between alcohol consumption and reduced brain volume are attributable to shared genetic factors,” says senior author Ryan Bogdan.

“Lower brain volume in specific regions may predispose a person to greater alcohol consumption,” he goes on to note.

“The study is impressive because it uses a variety of approaches and data analysis techniques to reach findings that all converge on the same conclusion,” Bogdan also adds.

Are genes the underlying cause?

In the study — the findings of which appear in the journal Biological Psychiatry — the researchers analyzed the data from three separate brain imaging studies. These studies included one that recruited twins and non-twin siblings with different alcohol intake behaviors and one that involved children who had not had exposure to alcohol at baseline.

In the third study, the researchers had conducted analyses to determine gene expression in the brain using tissue samples that they had collected postmortem from donated organs.

In total, the investigators had access to data on 2,423 individuals. The three studies that the researchers accessed the data through were: the Duke Neurogenetics Study, the Human Connectome Project, and the Teen Alcohol Outcomes StudyTrusted Source.

“Our study provides convergent evidence that there are genetic factors that lead to both lower gray matter volumes and increased alcohol use,” says lead author David Baranger.

More specifically, the team found that individuals who had a higher alcohol intake had lower gray matter volume in the dorsolateral prefrontal cortex and the insula, which are two brain regions that play key roles in emotion, memory retrieval, reward cycles, and decision-making.

The researchers noted that, according to their analysis, lower gray matter in these two brain regions was actually due to a specific genetic makeup, which, in turn, was also associated with an increased risk of higher alcohol consumption, both in adolescence and in young adulthood.

“These findings don’t discount the hypothesis that alcohol abuse may further reduce gray matter volumes, but it does suggest that brain volumes started out lower to begin with,” Baranger clarifies.

Click Read More for additional details of the study.

Mindfulness at Work

Mindfulness is an age-old practice that has perhaps never been trendier in workplaces across the nation. Massive companies like Google and Intel offer meditation and mindfulness courses for their employees. And research suggests they’re on to something. A study recently published in the Organizational Behavior and Human Decision Processes Journal found that even just a few minutes of mindfulness per day makes employees more efficient and helpful.

But mindfulness at work doesn’t always take the form of a formal class. Plenty of workers—including CEOs—have implemented personal practices in their daily routines. This is good news, since research tells us when a CEO is stressed, the rest of the company feels it. And if those stress levels get too high, employees will likely move on.

Since it’s so critical for CEOs to keep their stress in check, we asked eight of them how mindfulness helps them do that—and what impact it’s had on their leadership:

CLEAR YOUR MIND

Perhaps the most popular form of mindfulness, meditation is a daily ritual for many CEOs—including Bobby Figueroa, who founded Gradient, an intelligent insights platform for Amazon. “As a CEO, you’re under a constant barrage of urgencies, perceived and real. Being mindful is my superpower for making better decisions in those moments,” he says.

Coline Juin tapped into that “superpower” a couple years ago when she launched Moona, a line of sleep products. “A retreat truly helped me experience its impact and tremendously decrease my—and I believe the team’s—stress level,” she says, adding that she’s now made mindfulness part of her corporate culture. “We’re already seeing the fruits in terms of team collaboration and lower stress levels. I’m confident it will be key to the overall success.”

POWER DOWN

“My rule is no screens on Saturdays,” says Nirav Shah, CEO of Sentinel Healthcare, a remote management solution for hypertension. “It allows me to recharge, spend time with family, and come back Monday better rested and with new insights.” She encourages her employees to unplug for the weekend too.

“My team looks to me to set these expectations. Having a healthy work environment—and a team that’s ready to do good, creative work—means taking breaks.”

SWEAT IT OUT

“My way to [practice] mindfulness is playing sports to keep my body active and settle my busy mind,” says Jurgi Camblong, CEO and founder of SOPHiA GENETICS, a biotech company committed to data-driven medicine.

That also does the trick for Scott Smith, the CEO of CloudApp, a cloud-based screen- and video-capture application. “Exercise is generally one of the first areas that’s forgotten when you start to get into a really high-stakes, emergency, or high-effort zone. You need to be able to step back and remember to take care of your physical self,” he says.

Often, he’ll opt for yoga because “it’s so easy to take 10 minutes for yourself, and to practice letting go of any stress and strain you’re holding.”

That exercise can double as your commute, says Sara Raffa, cofounder of Coterie, which sells and delivers curated party kits. She typically walks to work, which takes about half an hour each way. “Not only is it great exercise, but it gives me time to reset and focus at the beginning and end of each workday,” she says, adding that she’ll often use the stroll to catch up on news or call a friend. “Either way, it’s a great opportunity to feel both productive and relaxed, ready to take on the day or evening.”

GET LOST IN A BOOK

Linden Ellis, the other cofounder of Coterie, reads every night. “It’s my way of winding down and giving my brain a break,” she says. “I read novels that have nothing to do with business or leadership so that I can turn my attention to something completely different and get lost in a totally different world, if only for a short while.”

BE HERE, NOW

“For me [mindfulness is] doing an activity that requires my full attention,” says Ryan Napierski, president of Nu Skin, which markets personal-care products. “When I pray and meditate in the morning, I focus on that. When I mountain bike, I focus on the trail so I don’t crash. Or when I’m surfing, I have to use my whole body to push up at the right moment to catch that wave. I can’t be thinking of the next-quarter numbers.”

Practicing focusing on one thing has a real benefit, says Napierski. “These activities force me to have a single focus on what I’m doing right now. . . . So, when I am at the office, I can focus my efforts to be more productive and to be direct and decisive in my work.”

The Problem With Suggesting Exercise For Depression

Terri Cheney, a 59-year-old writer from Beverly Hills, has lived with bipolar disorder for the majority of her life. When a wave of depression hits ― a hallmark symptom of the mental health condition ― she says she feels as if she’s got a bad case of the flu. She wishes she could get up the energy to exercise, but on the days when even shuffling into the kitchen feels difficult, trying to endure an actual workout seems unbearable. 

“There are times when I simply can’t move,“ said Cheney, author of “Manic: A Memoir.” “The exercise advice is what makes me craziest. You know it’s good for you, but it’s a little fraught with danger. If you try and fail, you might feel worse.” 

You don’t have to Google long to learn that exercise is a go-to, expert-backed remedy for managing depression. In fact, physical activity is so beneficial that research shows it can be as effective as antidepressants for some patients ― or, at the very least, it improves symptoms if you’re on medication. A new study published in August also found that hot yoga was associated with reduced depressive symptoms, anxiety and hopelessness.

This boost is likely because exercise releases mood-regulating endorphins and serotonin, as well as prompts the growth of new brain cells and blood vessels that bring more oxygen into your body, said depression researcher Peter J. Carek, professor and chair in the department of community health and family medicine at the University of Florida. 

But despite experts’ enthusiasm for the potential of exercise, there’s often little recognition that the very thing that would make you feel better is really, really hard when you’re depressed. Worse, it may exacerbate the hopeless feeling that comes with depression.

In a small 2017 study in an outpatient mental health clinic, 84% of people acknowledged that physical activity usually helped them feel better ― and the majority wanted to be active ― but 52% blamed their mood as the reason they got less than the U.S. guideline of 150 minutes of moderate-intensity exercise per week. 

It’s true that exercise is one of the best things you can do for your mental health, but we also need to acknowledge that it’s often not as simple as lacing up your sneakers and heading out the door. It’s just not realistic to recommend that someone “go exercise” when getting out of bed seems like the most impossible feat. Advice like “take a walk around the block” or “motivate yourself with a post-workout treat” isn’t cutting it.

We asked experts for a few of their best tips to get moving when it’s the last thing you feel like doing (and also when it’s best to just take a pass). 

Take a shower

Chloe Carmichael, a therapist based in New York, said many of her patients complain that their depression makes it hard to get out of bed in the morning. She recommends they jump into the shower immediately after waking up. 

“For many people, their depression is worse in the morning. So I tell them to start with a very cold or very hot shower … it overwhelms them on a sensory level,” Carmichael said.

The point is to jolt your nervous system, which then may slightly improve how you’re feeling and may make exercise seem a bit more possible or manageable. You can also do this by deep breathing, explained Julianne Schroeder, a mental health counselor in Dallas. 

“You can affect change in your nervous system with breath moving in and out, allowing for physical and emotional release,” Schroeder said.

If you can, start really small

Frank King, a 62-year-old in Eugene, Oregon, who lives with depression, finds motivation by promising himself he only has to do the bare minimum, such as working out on his gym’s elliptical machine for a single minute.

“If I get on and do one minute, I can turn around and go home,” King said. “I make a game out of it. If I don’t want to get off, I say, ’I’ll do 15 minutes and then I can leave.’ If I make it to 15, I’ll say, ‘OK, I’ll do 20,’ and so forth. It’s not always a full workout, but it’s a better one than if I’d never left the house.”

Exercise at home in your pajamas 

Brenna Cliver, who runs health and fitness company Victoriam Performance and has experienced depression from time to time, said that when the idea of leaving the house is overwhelming, she gets moving at home in whatever clothes she happens to be wearing. By eliminating some steps ― dressing, packing, getting to the car, driving to the gym, finding parking ― the actual task of exercising seems easier. 

“I’ll stand up and do a minute of air squats or walking lunges or anything to get my heart rate up enough to feel a little different,” said Cliver, a 28-year-old from Edinburg, Texas. “This doesn’t usually solve the problem, but it slows or stops the sinking and leads to other positives, like showering, drinking water and eating real food.” 

Create or put yourself in a comfortable environment

If your depression is making it absolutely impossible to be in a crowd, find a place that feels less stressful and better suits your mood. 

“Going into the weight room is always a tough one when I’m depressed and self-conscious, and running outside is often too much stimuli, unless it’s away from main roads or sidewalks,” Cliver said. “But I can do the StairMaster in the back of the gym. No one will talk to or look at me. I can listen to music and zone out.”

Others might find nature or swimming to be comforting when they’re experiencing depression symptoms. Research also shows that being near water can have a calming effect.

“Water has a sense of buoyancy that changes the way you’re feeling. Choose the activities that feel good to you,” Carmichael added. 

Enlist social support 

For Jen Ngozi, founder of the networking and dance fitness company NetWerk, she depends on a group of friends to inspire her when she’s depressed. Not only do they provide companionship ― experts warn against isolation ― but they add some much-needed empathy when you’re in a dark place. 

“They will literally show up at my doorstep saying, ‘Get up, girl. It’s time to work out, period!’” said Ngozi, 30, who lives in Roanoke, Virginia. “As women, it’s so important to have a strong community of supporters around us, especially during times of depression.”

Know when it’s OK to cut yourself some slack

Bottom line: Show yourself some compassion. Depression already (unfairly and incorrectly) can make you believe that you’re worthless without piling on exercise guilt.

“It means acknowledging that as a result of being depressed, your motivation and lack of energy aren’t because you aren’t trying hard enough,” Schroeder said. “Your mind and body are affected by a physiological response to depression in an effort to preserve itself.”

That advice resonates with Cheney. If she’s absolutely not able to work out, “that’s when I go and make instant mashed potatoes and curl up and watch TV or sleep,” she said. Knowing her limitations and being kind to herself is one step toward feeling better.

Feeling Insecure? 6 Tips To Quiet Your Inner Critic

But it’s not an objective reporter. It likes to act as critic, judge and jury — especially when it comes to social situations. You know that voice, right? The one that says, “They didn’t text back. They must think I’m uncool/awkward.”

Those negative thoughts can hold you back from making new friends, connecting with colleagues or sharing your brilliant ideas in meetings. Especially for shy or introverted people, it can be a real handicap and even lead to loneliness or isolation. 

“That voice is there for all of us — obviously in varying degrees,” says psychologist and author Andrea Bonior. “With social media, especially, we look at what other people are presenting as, and we assume they are so confident because of how they appear … and we just make ourselves feel worse.”

Bonior is the author of The Friendship Fix and the forthcoming Detox Your Thoughts.

The critical voice in your head can also prompt you to adopt a persona to fit into social situations, says Steven Hayes, a psychologist and professor at the University of Nevada.

“It’s that problem-solving voice that says, ‘You will belong if you are special, and you’ll be cast out if you’re not,’ ” says Hayes, whose new book, A Liberated Mind, aims to help people learn to defuse these thoughts. “You step back and become a little distant, evaluating, listening to the inner chatter — ‘Am I doing this right?’ ” 

If you can turn down the volume on that voice, he says, you might find that you can more easily share the unique gifts you have to offer others.

And it can help you get emotionally closer to the people around you, Hayes continues.

“You’ve got to rein in the dictator within you,” he says. “You’ve got to put that voice on a leash.

“It’s good for paying taxes or fixing your car — that’s when you want that judgmental, problem-solving voice. Your friends are not a math problem.”

For some people, these negative thoughts become debilitating and require professional attention. For the vast majority, though, simple tools can help defang that inner dictator and stop it from holding you back when you want to connect with others.

1. Label the voice.

The voice does not define you; in fact, identify it as an independent entity and give it a name. Call it your unreliable narrator, your negative Nelly or your worry blob — “I’ve seen all kinds of labels,” says Bonior. “What that does is it separates it from yourself.”

“Mine happens to be named George,” says Hayes. “I say, ‘Thanks, George, for the advice. I’ve got this covered, George.’ “

Naming the voice almost turns it into someone else talking. “It’s just one little cognitive strand waving its finger at you,” Hayes says. “You don’t have to do what the dictator says.”

2. Set negative thoughts to music.

Distill your inner negative messages down to a phrase or two. It may help to take a few moments to observe and jot down your most recurrent thoughts. Once you’ve identified them, take the thoughts — “I’m not good enough,” “They’re never going to like me,” etc. — and set them to music, Hayes suggests. 

He recommends an app called Songify by Smule, or just sing it to the tune of “Happy Birthday.” Besides making you laugh, the effect will be to put those thoughts in perspective.

3. Say those thoughts out loud in the voice of your least favorite politician. 

Or say them quietly to yourself, or say them in a silly cartoon voice. “Not to ridicule it,” Hayes says. “Just to remind you, it’s just a voice inside you talking.”

4. Trust that the thought will pass.

It’s just a thought, and it’s just not that important — it’s irrational after all! Don’t waste energy fighting it or dwelling on it, Bonior says. 

“We don’t realize we’re empowering those thoughts, getting into a tug of war with them,” she says. “You can choose to accept its presence in the moment and trust that it will pass.”

5. Slow your breathing to calm your thoughts.

Negative thinking can do a number on your central nervous system, causing you to react physically. Have you ever started getting negative thoughts and suddenly felt physically bad too? Whatever your response — shaky hands, trembly voice, sweaty brow — a slow inhale and a slower exhale will help soothe the central nervous system.

And finding your composure will help you let the thoughts pass.

“You can’t have a calm mind if your body is in hyperdrive,” Bonior explains. “The opposite is true too — you can’t have a calm body if your mind is going in circles.”

6. Remember, you have a lot to give.

Along with taking slower breaths, remind yourself that you have just as much to offer to the conversation as the person you are speaking with. And you can always steer the conversation to topics that put you at ease. 

The people you encounter — whether it’s friends, colleagues or strangers — will like you more than you think, as Gillian Sandstrom, a psychologist and researcher at the University of Essex in the United Kingdom, told NPR’s Life Kit.

“When you talk to someone else, you’re actually going to brighten their day,” Sandstrom says.

Don’t let that voice in your head tell you otherwise.

To Heal from Trauma, You Have to Feel Your Feelings

At any age, in any life stage, you can change. Whether you’re 77 years old or 17, you can learn, grow, adopt new habits, and make new choices to create a life you truly love. It may not always feel that way, though. When childhood emotional wounds tether you to the past, it can feel like you’re being swept away by a fast-moving current; although there are branches on either side of the riverbank to grab onto, something is mentally blocking you from reaching out. That “something” is a tether point, an invisible string holding you back. 

Your tether points originated with emotional injuries or traumas in childhood—experiences that were hurtful and damaging to your sense of self. The same event or experience will affect people differently. School-yard teasing that stays with one person for decades may be brushed off easily by someone else. Genetics, previous events, mindset, and beliefs can all affect which childhood events stay with you and hold you back, and which you shrug off. The social support you received in the wake of the trauma, the trauma’s duration, and the type of injury it is also can affect the tether-creation process. 

Trauma generates emotions, and unless you process these emotions at the time they occur, they can become stuck in your system—negatively affecting you both psychologically and physically. The healthy flow and processing of distressing emotions like anger, sadness, grief, and fear are essential. You will never resolve underlying issues if you deny and run from your feelings. Suppressed emotions don’t just go away; instead, they become toxic. They will keep showing up in your life, in some form of dysfunction or unhappiness, until you resolve them. Throughout life, feeling your feelings is one of the healthiest and most productive things you can do. 

To reach out for that metaphorical branch and pull yourself from the current, you have to find what it is in your inner world that is tethering you to your traumas, restricting your movements and limiting your choices. You have to make conscious what is unconscious so that you can free yourself from your past and grab onto the life you want by making new, more empowering choices. 

To find your tether points, you don’t have to go through every experience you’ve ever had and dredge up old sorrows. Instead, look at what isn’t working well in your life right now. What situations make you feel extra emotional—hair-trigger anger, deep despair, shame? Are there times where you think you should have an emotional reaction, but you feel numb? What do these feelings or lack of feelings tell you about yourself? The act of self-exploration and understanding will help you get to know yourself on a deeper level. It will help you to process and let go of any beliefs, memories, judgments, and regrets that are keeping you bound to the past and unable to fully engage with life in the present. 

To free yourself from what is limiting you and unconsciously driving your actions, you need to observe yourself non-judgmentally. You need to bring your thoughts, feelings, and beliefs into conscious awareness. In doing so, you shift from using the fight-flight-or-freeze part of your brain to the less reactive and more analytical one, which can explore, discover, and create. 

The qualities you’ll need in your self-observation spell the acronym COAL

  • Curiosity
  • Openness
  • Acceptance
  • Love

By using COAL, you create a psychological safe-space where you can let your guard down to reveal the sensations, emotions, and thoughts trapped inside. When you focus on your inner world, you are practicing emotional mindfulness. Self-awareness is fundamental to understanding and being happy with yourself, forming close relationships, and recognizing your motivations so that you can build your life based on what is true for you now, and not a response to past trauma. 

You must feel your feelings; your emotions are helpful companions on the journey of life. You need to make friends with them, learn from them, and interact with them in a loving, not fearful, way.

4 Types of Powerful but Frequently Ignored Habits

When people think about habits, they often think about a narrow and stereotypical range of these, like going to the gym, food choices, teeth brushing, drinking more water, bedtimes, and technology use. To fully harness the power of habits, you need to think more broadly about which habits you could improve, and think about your cognitive-emotional habits as well as your behavior.

As a bonus, making tweaks in other categories of habits is often easier than consistently dragging your butt to the gym every day or passing up cookies.

1. How you habitually react to feeling overwhelmed or self-doubt

Cognitive habits (related to thinking) are just as important as behavioral habits. When people feel overwhelmed or self-doubt in response to a challenge, they either retreat or navigate a way forward. The strategies you habitually use in response to these feelings can have a huge impact on your success in life.

Here are a few examples of strategies I use: 

  • When I get an email that stresses me out, I re-read it with fresh eyes the following day. This helps me not overreact and see situations more clearly. 
  • If I feel overwhelmed, I break down the task into the parts I feel intimidated by and those I feel confident about. This helps me see that it’s not the whole task that’s difficult, just parts of it.
  • I often find that I can’t think clearly about an overwhelming task until I’ve taken a nap or gone for a walk, since those strategies calm me physiologically and allow my brain to think more clearly. 
  • If I’m procrastinating, I make a deal with myself that if I’m going to procrastinate I have to do something instead that’s objectively more important than whatever I’m dragging my heels on.

Challenge:

  • How can you improve the ways you habitually respond to anxiety-related emotions, like feeling overwhelmed and doubt?
  • What strategies help you see those situations as more manageable and navigate a path forward? 

2. How you react to envy and frustration

If you’re an ambitious person, you may find you get annoyed (envious, frustrated, resentful, etc) when you observe someone else who is having the success you would like to have yourself. Having these emotional experiences is no problem whatsoever if you use them correctly. You can use these feelings as a trigger for positive cognitive habits.

For instance, in response to envy, you might: 

  • Check for unhelpful thoughts. Thoughts like “It’s not fair, that person has so many advantages” might be true, but typically aren’t that helpful for moving forward. 
  • Ask yourself: Whatever superstar skills the other person has, have they put more effort and practice into them than you? Is it worth it for you to practice those skills in a more focused way? What’s your plan? What are the small, easy wins you have available to you in terms of improving how well you perform that skill?
  • Identify what that person has that you would like to have. Try answering the question—”That person has the freedom to….. and I would like that.” This question is a useful check against feeling envious about types of success you don’t actually want. For instance, I’d never want to have lots of employees.

Challenge: What are your current habitual ways of responding to envy? What cognitive habits would be more useful?

3. Habits that help maintain your close relationships

Others who write a lot about habits tend to focus on personal self-regulation, but many of the principles for improving self-orientated habits also apply to improving your social behaviors. Your relationship habits are incredibly important to your happiness in life. For instance, we know that how couples handle daily partings and reunions is closely tied to relationship health (typically involving how partners say goodbye on the way to work, and how they say hello again at the end of the day.)

Challenge: If you have a partner, identify what your current habits are when your partner:

  • Asks you to do something.
  • Expresses something they’re unhappy about.
  • Has a success they want to share with you.
  • Has a problem they need emotional support about.

What are your strengths, and where is your behavior ripe for improvement?

4. Whether you have a habit of doing things that are novel and challenging

Creativity often comes from novel experiences: e.g., working with a new collaborator rather than the person you always work with. People who habitually take on projects that are new and challenging are always adding to their skills, resilience, relationships, perspectives, etc. 

If you have this habit, you’ll cumulatively end up in a really good place. If your daily habits are too static (e.g., you’re rigid about always needing 90 minutes a day for the gym), you’ll have less room for novelty in your life.

Challenge: How is your balance between doing things that are familiar versus trying novel approaches and working with new people?

Wrapping Up

The idea that good habits are about being consistent with the same daily rituals and practices is a very limited perspective. Consistent practice at specific behavioral skills is only a small part of what it means to have good habits. Your cognitive habits, your emotional habits (like being emotionally accessible and responsive to your loved ones), and having a habit of curiosity (including an interest in choosing the novel over the familiar) are equally important in terms of healthy habits.

7 Questions Your Therapist Will Probably Ask During Your First Session

So you just made your first therapy appointment. Maybe it’s your first session ever. Or maybe you’ve talked to someone in the past but now you’re about to meet with a new therapist. Even though you know you’re taking a positive step, you may still feel apprehensive.

“It’s OK to be nervous! You’re meeting someone for the first time who is likely going to ask you some very personal and emotionally sensitive questions and you’re expected to be very honest and forthcoming with them,” Gina Delucca, a clinical psychologist in San Francisco, told HuffPost. “It’s a very unnatural and nerve-inducing type of situation, and as therapists, we try to be sensitive to this.”

To ease your pre-appointment jitters, we asked therapists to reveal what they typically bring up with clients during the first session. Below, they share what you need to know to start (or re-start) therapy on the right foot.

Questions You’ll Probably Be Asked

Before your first session, your therapist will likely send over some intake paperwork to fill out. One of those documents will probably be a questionnaire that asks for your medical history (including any medications you’re taking), mental health services you’ve received in the past, current issues or stressors, and what you hope to get out of therapy. The therapist will review your responses and may want you to elaborate on them during your initial session together.

Here are some of the questions you may be asked and why:

1. What prompted you to seek therapy now?

The therapist wants to know if there’s something going on in your life that pushed you to make the appointment when you did. It could be anything from a messy breakup to a conflict with a family member, unmanageable levels of anxiety, a sexual assault or some big life change like becoming a parent or starting a new career.

“We are interested in knowing what event or experience preceded you deciding to get some help to help us understand the nature of the problem and what you are wanting to work on,” said Kate Stoddard, a marriage and family therapist in San Francisco.

2. How have you been coping with the problem(s) that brought you into therapy?

Delucca asks her new clients this question to learn how they handle stressful situations and difficult emotions. Do they turn to something productive like meditation or spending time outside? Or do they rely on unhealthy habits like excessive drinking or drug use?

“I find it helpful to get a sense of my client’s current coping skills and resources so that we can utilize or build upon them in treatment,” she said. “Second, this allows me to assess whether my client is engaging in any unhealthy coping mechanisms that could be exacerbating the problem and may potentially impact treatment, like avoidance, substance use or self-injury.”

3. Have you ever done therapy before?

If you’ve talked to a therapist in the past, it’s likely this person did some things you liked and others you didn’t. Your current therapist can use this information to help treat you in the most effective way, explained Los Angeles-based marriage and family therapist Danny Gibson.

“If the experience was positive, why was it positive? If not, why was it a negative experience? What would you like to do differently?” he said. “The client drives the therapy session ― I act as the useful guide.”

If you answer no to this question, “the therapist can spend more time orienting you around the structure and process of therapy and how it works,” Stoddard said.

4. What was it like growing up in your family?

Many people enter therapy to gain a better understanding of themselves and how they relate to others. Learning about a client’s childhood and their family dynamics can offer insight into the person they are today, said Zainab Delawalla, a clinical psychologist in Atlanta.

“Although it is not a given that people will repeat the same roles they adopted during childhood, often the pattern of relating that they develop is tied to how they have internalized certain role expectations in the past,” she said.

5. Have you ever thought of harming yourself or ending your life?

For those who have experienced suicidal thoughts or harmed themselves in the past, these types of questions may bring up difficult emotions. But it’s crucial for your therapist to know this information from the get-go.

“Most clinicians will want to know if you’re struggling with thoughts of self-harm from the very first session so they can be sure they are recommending the appropriate level of care,” Delawalla said.

If you answer yes, Delucca said you can expect follow-up questions like: “Are you having current thoughts of suicide?” “Do you have a suicide plan?” “Do you intend to act on these thoughts?” and “Do you have the means to carry out the plan?”

6. How connected do you feel to the people around you?

Loneliness can have serious mental and physical health implications. So your therapist wants to know if you already have a solid support system in place. If not, they can help you work on building one.

“There is lots of research that documents the importance of social support in maintaining psychological well-being,” Delawalla said. “Having a good understanding of your social network will help your therapist know how to best use your social support resources to augment treatment and whether bolstering social support should be part of your treatment goals.”

7. What do you hope to accomplish in therapy?

“It’s helpful to explore this question in more depth during the first session to hear the client’s expectations for therapy and also to help them manage their expectations about how the process of change works through therapy,” Stoddard said.

When setting your therapy goals, be as specific as possible about what these improvements in your life might look like. Instead of just saying you want to be “more self-confident,” think about what some concrete markers of that change would be.

“For example, how would you know if you were more self-confident? What would you be doing differently if you were more self-confident?” Delucca said. “By having more observable and measurable goals, we will be better able to track your progress and know whether therapy is effective.”

Getting goal-ready: how mindfulness can help you tackle anything

Whatever our pursuit of excellence, we each need to show up mentally, not just physically. That’s why this month’s featured collection of exercises has one overarching theme: being at the top of your game in your chosen field.

We can train the body day in, day out, but if we’re not also looking after the mind, then we are not maximizing our highest potential; if we’re not maximizing our highest potential, we’re not truly ready to pursue our goals.

Imagine if you could walk into a competitive arena or a boardroom or a crucial interview, with a mind at ease, in the present, fully focused, not rattled by thoughts, emotions, or surrounding circumstances. Imagine being that mentally strong.

We could all do with being better equipped to be more resilient, more focused, more confident, and more able to handle pressure. Those are just a few reasons why professional athletes are turning to Headspace. It’s also why the app was first utilized as a training tool by Team Great Britain ahead of the 2012 Olympics, and why Headspace now partners with the NBA, the MLS, the LPGA, and U.S. Soccer.

But whatever our skillset — inside or outside of sports — it’s an undeniable truth that a healthy mind is a core element of how we perform in life. And a healthy mind — calmer, clearer, and contented — is less prone to being emotionally reactive during the highs and lows, and the successes and setbacks.

The mind doesn’t respect whether we’re a pro or a first-timer; nor does it respect reputations, popularity, or prestige. At the end of the day, we’re all human. And because we’re all human, we’re all fallible, meaning we will all struggle with the mind at one time or another.

Sobering Truth About Addiction Treatment in America

The crisis is well documented and reported: More people are dying of drug overdose than any other non-natural cause—more than from guns, suicide, and car accidents. Politicians have held press conferences, formed commissions and task forces, and convened town-hall meetings. Vivek Murthy, the Surgeon General under President Obama (fired by Donald Trump), issued an historic report on America’s drug-use and addiction crises. Pharmaceutical companies have been blamed. Drug cartels. Physicians who hand out pain pills like Skittles.

In the meantime, the problem worsens. In 2015, 52,000 people died because of overdose, including 33,000 on OxyContin, heroin, and other opioids. Almost three times that number died of causes related to the most-used mood-altering addictive drug, alcohol. The 2016 and 2017 overdose numbers are predicted to be higher. Currently, fentanyl deaths are skyrocketing.

If not politicians, to whom can we turn to address the crisis? Since addiction is a health problem, the logical answer would be the addiction-treatment system, but it’s in disarray.

Currently most people who enter treatment are subjected to archaic care, some of which does more harm than good. Only about 10 percent of people who need treatment for drug-use disorders get any whatsoever. Of those who do, a majority enter programs with practices that would be considered barbaric if they were common in treatment systems for other diseases.

Many programs reject science and employ one-size-fits-all-addicts treatment. Patients are often subjected to a slipshod patchwork of unproven therapies. They pass talking sticks and bat horses with Nerf noodles. In some programs, patients are subjected to confrontational therapies, which may include the badgering of those who resist engaging in 12-Step programs, participation in which is required in almost every program. These support groups help some people, but alienate others. When compulsory, they can be detrimental.

Patients are routinely kicked out of programs for exhibiting symptoms of their disease (relapse or breaking rules), which is unconscionable. They are denied life-saving medications by practitioners who don’t believe in them—as Richard Rawson, PhD, research professor, UVM Center for Behavior and Health, says, “this is tantamount to a doctor not believing in Coumadin to prevent heart attacks or insulin for diabetes.”

Patients are put in programs for arbitrary periods of time. Three or five days of detox isn’t treatment. Many residential programs last for twenty-eight days, but research has shown that a month is rarely long enough to treat this disease. Some of those who enter residential treatment do get sober, but they relapse soon after they’re discharged, with, as addiction researcher Thomas McLellan, PhD, sums, “a hearty handshake and instructions to go off to a church basement someplace.” As he says, “It just won’t work.” Finally, people afflicted with this disease are almost never assessed and treated for co-occurring psychiatric disorders, in spite of the fact they almost always accompany and underlie life-threatening drug use. If both illnesses aren’t addressed, relapse is likely.

The disastrous state of the system suggests that addiction-medicine specialists don’t know how to treat substance-use disorders (or even if they can be treated). It’s not the case. The National Institute on Drug Abuse (NIDA) and organizations of addiction-care professionals like the American Society of Addiction Medicine (ASAM) and American Association of Addiction Psychiatry (AAAP) have identified effective treatments. There’s no easy cure for many complex diseases, including addiction. However, cognitive-behavior therapy, motivational interviewing, and addiction medications, often used in concert with one another and in concert with assessment and treatment dual diagnoses, are among many proven treatments. However, most patients are never offered these treatments because of a fatal chasm between addiction science and practitioners and programs. 

Fixing the system requires modeling it on the one in place for other serious illnesses. Most people enter the medical system in their primary-care doctors’ offices, health clinics, or emergency rooms. Currently, most doctors in these settings have had little or no education about addiction. A recent ASAM survey of two thirds of U.S. medical schools found that they require an average of less than an hourof training in addiction treatment.article continues after advertisement

Doctors must be taught to recognize substance-use disorders and treat them immediately—the archaic “let them hit bottom” paradigm has been discredited. They should offer or refer for brief interventions. A program called SBIRT (Screening, Brief Intervention and Referral to Treatment), which seeks to identify risky substance use and includes as few as three counseling sessions, has proven effective in many cases, and may be implemented in general healthcare settings.

Primary-care doctors should be trained and certified to prescribe buprenorphine, a medication that decreases craving and prevents overdose on opioids. Currently, there are limitations on the number of patients doctors can treat. Still, in Vermont, for example, almost 50 percent of opioid users in treatment receive care in their doctors’ offices- they don’t have to go to addiction specialists or intensive treatment programs to receive care.

When a patient requires a higher level of care, doctors must refer them to addiction specialists, which excludes many current practitioners whose only qualification to treat addiction is their own experience in recovery. Instead, patients must be seen by psychiatrists and psychologists trained to diagnose and treat the wide range of substance use disorders. There’s a shortage of these doctors; there needs to be a concerted effort to fill the void.

According to Larissa Mooney, MD, director of the UCLA Addiction Medicine Clinic, “Individuals entering treatment should be presented with an informed discussion about treatment options that include effective, research-based interventions.  In our current system, treatment recommendations vary widely and may come with bias; medication treatments are either not offered or may be presented as a less desirable option in the path to recovery. Treatment should be individualized, and if the same form of treatment has been repeated over and over with poor results (i.e. relapse), an alternative or more comprehensive approach should be suggested.”article continues after advertisement

When determining if a patient should be treated in physicians’ offices, intensive-outpatient, or residential setting, doctors should rely on ASAM guidelines, not guesses. The length of treatment must be determined by necessity, not insurance. If a patient relapses, is recalcitrant, or breaks rules, treatment should be reevaluated. They may need a higher level of care, but sick people should never be put out on the street. In addition, all practitioners must reject the archaic proscriptions against medication-assisted treatment; Rawson says that failing to prescribe addiction medications in the case of opioid addiction “should be considered malpractice.” 

Programs must also address the fact that a majority of people with substance-use disorders have interrelated psychiatric illnesses. Patients should undergo clinical evaluation, which may include psychological testing. Those with dual diagnoses must be treated for their co-occurring disorders. Finally, initial treatments must be followed by aftercare that’s monitored by an addiction psychiatrist, psychologist, or physician. In short, the field must adopt gold-standard, research-based best practices.

People blame politicians, drug dealers, and pharmaceutical companies for the overdose crisis. However, that won’t help the millions of addicted Americans who need treatment now. Even the most devoted and skilled addiction professionals must acknowledge that they’re part of a broken system that’s killing people. No one can repair it but them.    

Learn to Breathe

I’m not kidding. Sure, you knew how to breathe as soon as you were pushed out of the womb. But you didn’t learn to breathe right. If you were slapped on the butt by the doctor, you probably learned to breathe too shallow and too fast, maybe even hyperventilate. All that screaming and crying you did after leaving the comfort of the womb taught your brain that stress and anxiety go with rapid, shallow breathing. So when faced with adversity as you got older, your automatic reaction is to breathe too fast and too shallow. This is a case of classical conditioned learning. That kind of learning actually helps sustain stress, because your brain has learned that rapid, shallow, breathing is supposed to go with stress. The brain thinks this is normal.

About a month ago, I was having a large, benign growth on my neck removed by local surgeon. The area was locally anesthetized, but so much tissue was involved that as he had to cut deeper, I felt pain. The nurse said, huffing and puffing with staccato rhythm, “Breathe. Breath in, breath out.” After several such reminders, I blurted, “Is there any other way?” Then, I realized the risk I was taking if my surgeon started to laugh while holding a scalpel to my neck. But my doctor did a great job. And I was reminded that there is a right way and a wrong way to breathe under stressful conditions.

There are three principles to correct breathing for reducing stress:

  1. Breathe deeply. This means abdominally. As you inhale, the abdomen should protrude, filling the lungs better because the diaphragm contraction expands the chest cavity for more lung inflation.
  2. Breathe slowly. Common breathing rates are around 16-20 breaths per minute. This is fine when you are very active physically, but remember that the brain has through decades of conditioning learned to associate rapid breathing with distress. When you are trying to relax, you can shut down stress by slowing down to three to five breaths per minute.
  3. Exhale through the mouth. A good way to automate this method is to slightly open the mouth and move the tip of the tongue behind the front upper teeth during inhalation, then relax the tongue during exhalation.

You can use these principles in two well-known breathing techniques:

  1. The Navy Seal box technique. When they are not raiding a terrorist cell or on another similar stressful mission, Navy Seals train themselves to stay calm by taking a four-step breath cycle of inhale, hold breath, exhale, hold breath, and then repeating the cycle. Each step lasts 4 seconds. This would yield a total breathing rate of about four per minute. With practice, you can make each step last 5 or more seconds. Then you would be breathing like a yogi.
  2. The hum technique. Here, the idea is to make a soft, guttural humming sound throughout each exhalation. You can even do this during the exhale stages in the Navy technique. This may have a similar effect as using a mantra during meditation. Sometimes, people tell me I am humming when I had not been aware of it. I guess I have learned to associate humming with calming down and feeling good. Perhaps it is similar to why cats purr, which they do for two seemingly conflicting purposes: One is that the purring sound has a conditioned association with a calm state. When the cat is calm, it purrs. The other cause of purring is anxiety. In an anxious cat, anxiety acts as a cue that retrieves the memory of associated purring, which then helps to calm the cat.

If you are trying to train yourself to be calm, I recommend that you employ and combine the three principles and the two techniques during mindfulness meditation. All of these principles (deep and slow breathing, and exhaling via the mouth) and techniques (4-step and humming) can be synergistically combined during mindfulness meditation. In such meditation, the idea is to block out all thoughts in order to focus on breathing. You can achieve further synergy by mediating in certain yoga postures, which have their own relaxing effects. If you are like me, you are stiff and sore when you awake in the morning. I deal with this by combining yoga stretches with mindfulness meditation and stress-relieving breathing. It is a great way to start each day.

There is a biological explanation for why all these ideas work, but few scholars explain it. The whole constellation of beneficial effects is attributable to the vagus nerve. The vagus nerve is a huge nerve that supplies most of the visceral organs — lungs, heart, and the entire gastrointestinal tract. Usually, when biology or physiology teachers explain the vagus nerve, they focus on its “motor” effects — initiating secretions, slowing heart rate, lowering blood pressure, and promoting peristaltic movements in the GI tract. What usually gets left out is that the vagus is a mixed nerve; it contains sensory fibers. These sensory fibers are activated by all the breathing functions mentioned above. These impulses signal the part of the anterior hypothalamus that contains the neuronal cell bodies of the so-called parasympathetic nervous system (PNS). The PNS suppresses the “fight or flight” system of the sympathetic nervous system, which is triggered by certain neurons in the posterior hypothalamus. Thus, feedback signals from proper breathing serve to keep the PNS active and in control of a relaxed physical and mental state.

So, CALM DOWN. And TAKE A DEEP BREATH.

How Exercise Lowers the Risk of Alzheimer’s by Changing Your Brain

To find out, for nearly a decade, Ozioma Okonkwo, assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health and his colleagues have studied a unique group of middle-aged people at higher risk of developing Alzheimer’s. Through a series of studies, the team has been building knowledge about which biological processes seem to change with exercise. Okonkwo’s latest findings show that improvements in aerobic fitness mitigated one of the physiological brain changes associated with Alzheimer’s: the slowing down of how neurons breakdown glucose. The research, which has not been published yet, was presented at the annual meeting of the American Psychological Association on Aug. 9.

Okonkwo works with the 1,500 people on the Wisconsin Registry for Alzheimer’s Prevention (WRAP)—all of whom are cognitively normal, but have genes that put them at higher risk of developing Alzheimer’s, or have one or two parents who have been diagnosed with the disease, or both. In the latest study, Okonkwo recruited 23 people from the WRAP population who were not physically active. Eleven were asked to participate in an exercise regimen to improve their aerobic fitness for six months, and 12 served as the control. All had their brains scanned to track Alzheimer’s-related brain changes including differences in how neurons metabolized glucose, since in people with Alzheimer’s glucose breakdown slows. At the end of the study period, the group that exercised more showed higher levels of glucose metabolism and performed better on cognitive-function tests compared to the controls.

“We are carrying our research full circle and beginning to demonstrate some causality,” says Okonkwo about the significance of his findings.

In their previous work, he and his team identified a series of Alzheimer’s-related biological changes that seemed to be affected by exercise by comparing, retrospectively, people who were more physically active to those who were not. In this study, they showed that intervening with an exercise regimen could actually affect these processes. Taken together, his body of research is establishing exactly how physical activity contributes to significant changes in the biological processes that drive Alzheimer’s, and may even reduce the effect of strong risk factors such as age and genes linked to higher risk of neurodegenerative disease.

For example, in their earlier work his group confirmed that as people age, the presence of Alzheimer’s-related brain changes increases—including the buildup of amyloid, slower breakdown of glucose by brain cells, shrinking of the volume of the hippocampus (central to memory), and declines in cognitive function measured in standard recall and recognition tests.

But they found that in people who reported exercising at moderate intensity at least 150 minutes a week, as public health experts recommend, brain scans showed that these changes were significantly reduced and in some cases non-existent compared to people who were not active. “The association between age and Alzheimer’s brain changes was blunted,” says Okonkwo, “Even if [Alzheimer’s] got worse, it didn’t get worse at the same speed or rate among those who are physically active as in those who are inactive.”

In another previous study, they found the benefits of exercise in controlling Alzheimer’s processes even among those with genetic predisposition for the disease. When they divided the participants by fitness levels, based on a treadmill test and their ability to efficiently take in oxygen, they found that being fit nearly negated the effect of the deleterious gene ApoE4. “It’s a remarkable finding because it’s not something that was predicted,” says Okonkwo.

In yet another previous study, Okonkwo and his team also found that people with higher aerobic fitness showed lower amounts of white matter hyperintensities, brain changes that are signs of neuron degeneration and show up as brighter spots on MRI images (hence the name). White matter hyperintensities tend to increase in the brain with age, and are more common in people with dementia or cognitive impairment. They form as neurons degrade and the myelin that surrounds their long-reaching arms—which helps nerves communicate with each other effectively—starts to deteriorate. In people with dementia, that process happens faster than normal, leading to an increase in white matter hyperintensities. Okonwko found that people who were more aerobically fit showed lower amounts of these hyperintensities than people who were less fit.

Given the encouraging results from his latest study of 23 people that showed intervening with exercise can change some of the Alzheimer’s-related brain changes of the disease, he plans to expand his small study to confirm the positive effect that exercise and better fitness can have in slowing the signs of Alzheimer’s. Already, his work has inspired a study launched earlier this year and funded by the National Institutes of Health that includes brain scans to track how physical activity affects biological factors like amyloid and glucose in people at higher risk of developing Alzheimer’s. The cumulative results show that “there may be certain things we are born with, and certain things that we can’t change ]when it comes to Alzheimer’s risk], but a behavior like physical exercise might help us to modify that,” says Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

Instagram Is Not Therapy and I’m Not an Instagram Therapist

Instagram is not therapy. There is no such thing as an Instagram Therapist.

There are brave, generous, trailblazing therapists using social media as a platform to advocate for mental health reform, make information more accessible, and market their services.

Instagram, used by 1 billion people worldwide, was deemed the worst social media for your mental health in 2017. It reportedly leads to negative body image, increased depression and anxiety, and an increase in bullying. Therapists are acutely aware that the information we consume on this platform directly impacts our mental functioning and overall health. Social media’s psychological impact is something that clinicians around the globe contend with in their offices every day. So, it might seem odd that therapists around the world are embracing this controversial medium with open arms.

Is Instagram a viable platform for therapists?

Most mental health professionals are trained to think small and look out for risk everywhere. We are trained to look for symptoms, risk factors, and signs that things aren’t OK. Social media can be a very stressful place for an alert clinician. So, rather than creating more education and opportunities for growth in these realms, we are told to just avoid them all together. We are told it’s just not worth the risk. Many therapists, especially in the most recent cohort of graduates, are rejecting this notion and taking a different approach.

Instagram is being used to take mental health information off the couch and into the mainstream. Therapists with years of training are willingly sharing their knowledge and expertise for free with people who may not be able to access this information otherwise.

The best part? Most of the people sharing information are well informed and have great information. We need these people to keep sharing.

There are risks and benefits.

There have been several articles published about the rise of therapists on Instagram. Most have incorrectly labeled this new phenomenon as “Instagram Therapy,” falsely identifying what therapists are doing on this platform and misleading consumers.

Critiques of therapists using Instagram are also prevalent. Some are based in reality, others in fear. As we move into a new frontier of clinical practice that integrates the use of technology and other media, it’s important that we approach this with curiosity, compassion, and ethical standards.

We must weigh the recent critiques and old standards against the possible benefits, while considering potential pitfalls, solutions, and new ethical guidelines.

Instagram will not replace therapy, but it will help people.

Information presented on Instagram is often generalized and cannot be tailored to the individual. There is no way of knowing exactly how the other person is going to interpret our message. The same risk can be found for blog posts, self-help books, and other forms of media. It is crucial that we inform consumers that what they are reading is generalized advice and often cannot be applied to specific situations.

Research and mental health information are already being shared online, often by those with no credentials, experience, or license to practice. Therapists are a reliable, trained demographic who can provide quality information to the general public. Instagram allows us to share this information in a way that is easy to understand and digestible for the general public. We have to recognize that this is how media is being consumed in 2019, and mental health information needs to follow suit.

Many therapists, journalists, and laypeople have expressed concerns about emergency situations being handled via Instagram. They fear that a therapist will be contacted by someone in crisis. But if you have email, a website, or a phone line, this can also happen. Most therapists have those forms of contact, and clear policies around them. Instagram is not therapy and cannot be used as a substitute for crisis care. Steps have to be taken to ensure that this message is clear to followers. It is also important to have a policy in place about how you will handle potentially dangerous situations. Discouraging therapists from using social media does not solve this concern. It will only lead to people being unaware of their options in a crisis and likely contacting unreliable sources on the internet.

Social media isn’t inherently bad. But the type of information we consume via social media can lead to bad results.

It’s difficult to say that a social media platform is inherently “bad.” It’s often the type of content being consumed that leads to the ill effects described by many young adults who regularly use the app. Most reported that excessive use led to sleep disturbances, poor body image, bullying, and feelings of depression or anxiety.

As therapists, we have the ability to introduce important topics into the mainstream. We have the power to make mental health information more accessible. More information leads to increased awareness; awareness leads to change.

It’s important that we show up in the spaces where our clients live and inform them of their options for healing or treatment. We can do this ethically and with respect for our profession and the people we interact with.

Some guidelines for consuming information therapists share on Instagram or social media:

  • Always filter information through your own worldview. It is OK to question or investigate content. Not every post will be applicable to your life or current situation. It is OK to take what you need and leave the rest.
  • Follow credible accounts. Look for clinicians who are licensed and have a clear title.
  • Remember that this is not a substitute for therapy. Reading information online can help you further understand your situation or learn something new intellectually, but it is not a replacement for formal therapy.
  • Instagram is not a reliable platform to use in a crisis. Please contact the National Suicide Hotline or your local emergency room if you need immediate attention.
  • Therapists on Instagram are not there to provide therapy. Contact a clinician to schedule an appointment if you would like individualized feedback.
  • Remember that confidentiality is not ensured on Instagram. If you choose to leave a comment or share personal information, everything is public on the platform.

Some guidelines for therapists sharing information on Instagram or social media:

  • Develop clear policies for how you will handle comments and direct messages.
  • Create a social media policy for current and future clients that outlines your use of social media and guidelines if they choose to follow you.
  • Create a completely separate professional Instagram page and decide the level of information you will to share on it. Ask yourself every time you share something, “Am I OK with a client or stranger knowing this? Is there therapeutic value to this share?”
  • Clearly label your profession or license in your profile.
  • Tell potential clients how to contact you for appointments.
  • Create a disclaimer that informs clients that your posts are neither therapy nor a substitute for therapy.
  • Create a disclaimer that informs clients of their resources in an emergency.
  • Refrain from using this platform to provide personalized advice or therapy via comments or direct messages.

Physical fitness may help prevent depression, anxiety

Depression and anxiety reduce overall wellbeing and life satisfaction, but they may also increase the risk of cardiovascular disease and increase mortality risk.

Although talking therapies and medication can help in many instances, they do not help everyone.

An issue as substantial as mental health needs an effective public health strategy; stopping mental health issues before they begin would, of course, be ideal.

Researchers are focused on unraveling the myriad of factors that increase the risk of developing mental health conditions. Although it is not possible to alter some of these factors, such as genetics, it is possible to modify some lifestyle factors, including diet and physical activity.

Scientists are keen to identify which modifiable factors might have the most significant impact on mental health. Some researchers are looking to physical fitness.

Fitness and mental health

The authors of a recent study investigated whether cardiorespiratory fitness might be an effective intervention. Cardiorespiratory fitness is a measure of the cardiovascular and respiratory systems’ capacity to supply oxygen to the body during exercise.

They recently published the results of their analysis in the Journal of Affective Disorders.

The authors explain how previous studies “have found that low physical activity is associated with a greater incidence of common mental health disorders.” However, few studies have investigated whether cardiorespiratory fitness is directly related to mental health risk.

Medical News Today spoke with the lead author of the study Aaron Kandola, from University College London in the United Kingdom. We asked him why so few studies have looked at this question.

One reason, he said, is that cardiorespiratory fitness “can be expensive and impractical to measure, particularly in large groups of people.” He explains how it needs to be “measured with structured exercise tests that require the use of specialized equipment in a controlled environment.”

We found that low [cardiorespiratory fitness] and medium [cardiorespiratory fitness] are associated with a 47% and 23% greater risk of […] common mental health disorders, compared with high [cardiorespiratory fitness].”

They also found evidence of a dose-dependent relationship between fitness and common mental health conditions. The authors explain that “[i]ncremental increases in [the cardiorespiratory fitness] group were associated with proportional decreases in associated risk of new onset common mental health disorders.”

The results were in line with the researchers’ expectations. As Kandola told MNT, “exercise is the biggest determinant of cardiorespiratory fitness,” and scientists have already uncovered “the benefits of exercise for common mental health disorders.”

However, he explained that they “were surprised at the lack of research in this area.” He hopes that their study will “help to draw more attention to it.”

The Single Word That Stops Negative Self-Talk

Trying to deny or run away from negativity takes a lot of energy. You might even end up in a mental war with those thoughts, trying to rationalize them away, only to have them come back even stronger. If this has happened to you, here’s another strategy: Apply a good old-fashioned jujitsu move using your awareness. Apply this simple move, and flip negativity on its head.

This mental jujitsu practice, in a single word, is gratitude.

Before you start snoring and clicking away on your mouse, thinking, “Oh, yeah, that’s what my grandmother used to go on and on about and made me yawn,” let’s look at some research that might surprise you. 

One major research project on gratitude showed that a gratitude practice resulted in the following effects on well-being:

  • Higher levels of life satisfaction and more optimism and vitality about life.
  • Better progress toward personal goals and goal attainment.
  • Reduced levels of stress and depressed mood.
  • Greater alertness, enthusiasm, determination, attentiveness and energy in young adults.
  • More prosocial behavior, such as helping and providing emotional support to others.
  • Reduced focus on materialism as a definition of one’s success, as well as fewer feelings of envy toward others.
  • Greater “positive moods, a greater sense of feeling connected to others, more optimistic ratings of one’s life, and better sleep duration and sleep quality,” in adults with neuromuscular disease.

This is really just the tip of the iceberg when describing the benefits of gratitude. In my own practice as a psychotherapist, I’ve seen dramatic shifts in mood and narrative as the result of a simple gratitude intervention.

Let me share the experience of one patient, Jerry (all names are changed), who had a history of family depression that stretched back generations. His grandfather had been in and out of mental hospitals for years, and his mother was diagnosed with acute depression and had trouble functioning. In Jerry’s own words, “I have a genetic history of depression and there’s nothing I can do about it.”

But Jerry had not yet encountered the masterful mind-bending and life-bending power of gratitude. As he explored it, a major shift occurred in his life. He started asking people at work what they had gratitude for. It became a touchstone that transformed his understanding and perception of events—one that represented a very different way of thinking and being in the world. 

Over time, Jerry’s inner narrative changed. I still recall the day he said to me, “I have periods of depression, but I know how to effectively manage them using gratitude and other skills.” That is a much more empowering narrative, isn’t it? And it was made possible in part by gratitude. 

Gratitude Is an Intentional and Selective Attention Practice

Gratitude trains us to use attention in a very specific way. For example, you can focus on what is wrong or missing in your life, and endlessly compare yourself to others. Or, you can turn your awareness toward noticing the good, decent, and beautiful things around you in this moment.

Why does this matter?

By noticing what you could be grateful for, you cultivate a different attitude about your situation. This, in turn, changes not only how you think and behave in the moment, but helps to develop a supportive and life-affirming habit for the future. 

Gratitude Encourages Here and Now Participation

Gratitude is a proactive means of engaging in the here and now. We spend a lot of time as life spectators—watching things on our computer, watching sports and entertainment on TV, and so on. Gratitude catapults us into the present moment because it encourages participation. For example, in order to feel gratitude, you need to be present. You are encouraged to act on your gratitude because you feel more connected and optimistic as a result. Gratitude also helps build resilience, because it gets us looking at the positives, rather than focusing on what’s gone wrong. 

Here are some simple practices for getting started with gratitude. The next time you notice negativity, use the jujitsu gratitude intervention below to turn negativity on its head.

  • Jujitsu Gratitude Move 1: Notice and name one gratitude right now. Write this down, being sure to include WHY you are grateful or thankful. For example, this might look like: “I am grateful for ____ because _____.” Telling why you are grateful deepens the story. 
  • Jujitsu Gratitude Move 2: Keep track of your daily gratitudes. Get a teacup and tape the word “gratitude” on it. For each gratitude you find each day, put a penny in that cup, or write down on a small piece of paper two or three words about that gratitude. At the end of the week, review how many gratitudes you found and experienced. 
  • Jujitsu Gratitude Move 3: Share your daily gratitude with another. This is a wonderful way to make connections on a deeper level with others. Don’t underestimate the importance of this for relationship building, at home or the workplace. 

Do this for a week, and don’t settle for repeating the same gratitude each day. There are many kinds of gratitude to notice.

What is the link between sleep apnea and depression?

Around 20–30% of people with depression and other mood disorders do not get the help they need from existing therapies.

Depression is the “leading cause of disability worldwide.”

For this reason, coming up with effective therapies is paramount.

New research points to obstructive sleep apnea(OSA) as a potential culprit for treatment resistant depression and suggests that screening for and treating the sleep condition may alleviate symptoms of depression.

Dr. William V. McCall — chair of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University — is the first and corresponding author of the study.

He says, “No one is talking about evaluating for [OSA] as a potential cause of treatment resistant depression, which occurs in about 50% of [people] with major depressive disorder.”

He hopes that the team’s new paper — appearing in The Journal of Psychiatric Research — will remedy this.

14% of those with depression had OSA

Dr. McCall and team examined the rate of undiagnosed OSA in a randomized clinical trial of people with major depressive disorder and suicidal tendencies.

They recruited 125 people with depression, originally for the purpose of determining if treating their insomnia would improve their depression symptoms.

The original trial excluded people at risk of OSA, such as those taking sleeping pills, or people with obesity or restless legs syndrome.

The scientists tested the participants with a sleep study and found that 17 out of the 125 (nearly 14%) had OSA.

Dr. McCall and colleagues note that people who had OSA did not present with the usual indicators of OSA severity, such as daytime sleepiness. Also, 6 of the 17 people were non-obese women.

This is contrast with the demographic group usually at risk of OSA: overweight men.

“We were completely caught by surprise,” says Dr. McCall, “that people did not fit the picture of what [OSA] is supposed to look like.”

Also, 52 of the 125 participants had treatment resistant depression; 8 of those with treatment resistant depression also had OSA.

Future treatment options

The researchers point out that underlying conditions — such as hypothyroidism, cancer, and carotid artery disease — may often be the cause of treatment resistant depression.

Therefore, many people with depression undergo a series of invasive and costly tests in an attempt to figure out the cause of depression treatment failure.

Such tests may include an MRI scan or even a spinal tap — but Dr. McCall and team urge for sleep tests first. “I am thinking before we do a spinal tap for treatment resistant depression, we might need to do a sleep test first,” he says.

“We know that [people] with sleep apnea talk about depression symptoms,” he goes on. “We know that if you have [OSA], you are not going to respond well to an antidepressant.”

“We know that if you have sleep apnea and get [a CPAP machine], it gets better and now we know that there are hidden cases of sleep apnea in people who are depressed and [have] suicidal [tendencies].”

Dr. William V. McCall

However, the study authors also acknowledge that other factors — such as the side effects of other medications, including beta-blockers and corticosteroids — may cause treatment resistant depression.

They also point out that suicidal tendencies are also a key factor, and the researchers suggest that a further area of investigation should be the question of whether or not treating sleep apnea will also reduce suicide ideation.

In the United States, suicide is the 10th leading cause of death among people of all ages.

Lifestyle Changes Decrease Genetic Risks of Alzheimer’s

There hasn’t been much good news about Alzheimer’s lately, between the March announcement by Biogen and Esai that a promising trial of a potential drug treatment failed, and the July decision by Novartis and Amgen to stoptheir study of another class of therapies for the neurodegenerative disease.

But in a pair of studies presented at the annual Alzheimer’s Association International Conference on July 14, researchers reported encouraging results from studies of non-drug approaches.

In one, scientists led by Dr. Klodian Dhana at Rush University Medical Center in Chicago followed nearly 2,500 people for almost a decade while tracking several lifestyle factors: their diet, whether they smoked, the amount of leisure physical activity they completed each week, how much alcohol they drank and how much cognitive activity they engaged in. The researchers found that people who reported healthier lifestyles overall—those who stuck to a low-fat diet, did not smoke, exercised at least 150 minutes each week at moderate-to-vigorous levels, drank moderately and engaged in some late-life cognitive activities—had lower levels of Alzheimer’s dementia. In fact, the more healthy activities the people adhered to, the lower their risk. Compared to those who followed none or only one healthy lifestyle behavior, those following two or three of the healthy lifestyle factors reduced their risk of developing Alzheimer’s dementia by 39%, while those who followed four or five of the healthy behaviors reduced their risk by 59%.

Click Read More for the full article.

Don’t Pick up just Any Book this July or August

It’s not surprising that a well-chosen book would aid self-improvement in the general population. But metaanalyses also report bibliotherapy’s effectiveness in helping teens with mild depression or anxiety, as do individual studies of mild depression with young adults, and of mild to moderate depression in older adults.

So here are 12 books that my clients and I have found helpful in self-improvement. Because I’m a career and personal coach, not a psychotherapist, except for one book (The Noonday Demon), these books aim at self-improvement for the general public, not specifically for those with clinical anxiety or depression, although they could be helpful to them as well.

With the exception of the book that’s listed last, I’ve included only books that have stood the test of time both with the public and with me: Even though I read them years ago, they’re still helpful.

ChangePower by fellow Psychology Today blogger, Meg Selig. Despite being a self-help writer myself, I view askance much of such writing, but not this book. It favors the tried-and-true practical over pop-psych nostrums. For example, the book suggests rehearsing your upcoming day:

Conjure up any people or situations that might trigger a lapse and imagine yourself coping successfully. After you’ve made it through the day, have a talk with yourself: How did you do? Jog your thinking by filling in these blanks: “I liked that I _______.  I wish I had ____.  I could strengthen  my plan by ______.

The book’s subtitle, 37 Secrets to Habit Change Success, implies that those tips are atomistic, stand-alone suggestions. In fact, they’re presented in a sequence that could well comprise an overall step-by-step plan for improving your life.

The Seven Habits of Highly Effective People by Stephen Covey. The seven habits reduce to: 1) Have a personal vision that you’d be proud to aim for.  2) Seek first to understand, only then to be understood. 3) Keep learning. Those are obvious but too often not done, so they’re useful reminders, dispensed in plain English.

How to Win Friends and Influence People by Dale Carnegie. I chose not to look back at the book before writing this so that I could mention only what has stuck in my head all these years. In sum, it’s: To get what you want, you have to give people what they want, and what most people want is to feel good about themselves and to get their problem du jour solved. This book written in 1936, has sold more than 15 million copies and today, its Amazon sales rank is still, among self-help books, #13.

How to Stop Worrying and Start Living by Dale Carnegie.  My favorite page is “Part One in a Nutshell” Here’s its essence:

Rule 1: Live in day-tight compartments. Don’t stew about the future. Just live each day.

Rule 2: The next time Trouble with a Capital T backs you into a corner, ask yourself: a) What’s the worst that can happen if I can’t solve my problem. b) Prepare yourself to accept the worst if necessary. c) Calmly try to avoid the worst.

Rule 3: Remind yourself of the exorbitant price to your health that you can pay if you worry excessively.

Three-Minute Therapy by therapist and fellow Psychology Today blogger Michael Edelstein. The book helps readers create a customized three-minute exercise, which if repeated daily, within weeks, often significantly reduces mild to moderate anxiety, depression and substance abuse.

Click Read More for 5 other choices.

6-Plus Ways Heavy Drinking Harms Your Health

The statistics are alarming: More than 15 million Americans struggle with a diagnosable alcohol use disorder. Yet fewer than 8 percent of people who struggle with the disorder get treatment. 

Of drinkers in general, more than 65 million surveyed reported at least one episode of binge drinking (defined as five or more drinks on a single occasion for men, four or more for women) in the past month. One in every six American adults reportedly binge drinks approximately four times a month. Most bingers are not (yet) considered alcohol-dependent, but that may be because binge drinking is most common among young adults ages 18 to 34. Every year, more than 4,300 deaths among those under the age of 21 are attributed to excessive drinking.

Even if excessive alcohol doesn’t kill you on the spot, and even if you’re never diagnosed with an alcohol-related disorder, routine binge drinking has a profound effect over time on almost every part of your body. Some of the more devastating, long-term physical and mental health effects include:

  • Depression and anxiety
  • Learning, memory, and social problems
  • High blood pressure
  • Heart disease
  • Liver disease
  • Cancers of the digestive tract, including the mouth, throat, esophagus, and colon, as well as increased risk of breast cancer in women

Excessive use of alcohol also interferes with reproductive health and sexual functioning, affecting testicular activity and hormone production in men, disrupting the menstrual cycle and increasing the risk of infertility in women, as well as contributing to miscarriage, stillbirth, Fetal Alcohol Spectrum Disorders, and Sudden Infant Death Syndrome in pregnant women who drink alcohol and their babies. 

What can you do? Choose to drink moderately, if at all (no more than one drink a day for women, two for men), and help others around you do the same. Serve less alcohol at parties, and don’t serve alcoholic beverages to anyone who shouldn’t be drinking, such as minors and anyone who has already had too much to drink. And if you know your drinking isn’t reserved for special occasions, or if you just drink too much, too often, or your drinking behavior is risky (or if excessive drinking affects someone you know), speak with your doctor who can help you get over any shame you may feel and determine if further help is necessary from a support group, psychological counseling, medication, or other programs and steps that can lead to reduced cravings for alcohol and, perhaps, ultimately abstinence. 

Commonly prescribed drugs possibly tied to higher dementia risk

A study published in the journal JAMA Internal Medicine on Monday suggests that the link is strongest for certain classes of anticholinergic drugs — particularly antidepressants such as paroxetine or amitriptyline, bladder antimuscarinics such as oxybutynin or tolterodine, antipsychotics such as chlorpromazine or olanzapine and antiepileptic drugs such as oxcarbazepine or carbamazepine.

Researchers wrote in the study that “there was nearly a 50% increased odds of dementia” associated with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which is equivalent to an older adult taking a strong anticholinergic medication daily for at least three years, compared with no exposure.”The study is important because it strengthens a growing body of evidence showing that strong anticholinergic drugs have long term associations with dementia risk,” said Carol Coupland, professor of medical statistics in primary care at the University of Nottingham in the United Kingdom and first author of the study.”It also highlights which types of anticholinergic drugs have the strongest associations. This is important information for physicians to know when considering whether to prescribe these drugs,” she said, adding “this is an observational study so no firm conclusions can be drawn about whether these anticholinergic drugs cause dementia.”She said that people taking these medications are advised not to stop them without consulting with their doctor first, as that could be harmful.

Click Read More to learn about the findings of the study.

High Levels of Internet Use May Alter Brain Function

In a new review, an international team of researchers propose that internet use can produce both acute and prolonged changes in specific areas of cognition, affecting our attentional capacities, memory processes and social interactions.

“The key findings of this report are that high levels of internet use could indeed impact on many functions of the brain,” said study leader Dr. Joseph Firth, Senior Research Fellow at the National Institute of Complementary Medicine (NICM) Health Research Institute, Western Sydney University.

“For example, the limitless stream of prompts and notifications from the internet encourages us towards constantly holding a divided attention — which then in turn may decrease our capacity for maintaining concentration on a single task.”

“Additionally, the online world now presents us with a uniquely large and constantly-accessible resource for facts and information, which is never more than a few taps and swipes away.”

“Given we now have most of the world’s factual information literally at our fingertips, this appears to have the potential to begin changing the ways in which we store, and even value, facts and knowledge in society, and in the brain.”

For the review, the team of researchers from Western Sydney University, Harvard University, Kings College, Oxford University and the University of Manchester investigated the leading hypotheses on how internet use may alter cognitive processes, and further examined the extent to which these hypotheses were supported by recent findings from psychological, psychiatric and neuroimaging research.

The extensive report, published in the journal World Psychiatry, combined the evidence to produce revised models on how the internet could affect the brain’s structure, function and cognitive development.

“The bombardment of stimuli via the internet, and the resultant divided attention commonly experienced, presents a range of concerns,” said Professor Jerome Sarris, Deputy Director and Director of Research at NICM Health Research Institute, Western Sydney University and senior author on the report.

“I believe that this, along with the increasing #Instagramification of society, has the ability to alter both the structure and functioning of the brain, while potentially also altering our social fabric.”

“To minimise the potential adverse effects of high-intensity multi-tasking internet usage, I would suggest mindfulness and focus practice, along with use of ‘internet hygiene’ techniques (e.g., reducing online multitasking, ritualistic ‘checking’ behaviours, and evening online activity, while engaging in more in-person interactions).”

The recent introduction and widespread adoption of online technologies, along with social media, is also of concern to some teachers and parents. The World Health Organization’s 2018 guidelines recommended that young children (aged 2-5) should be exposed to only one hour per day, or less, of screen time.

However, the report also found that the vast majority of research examining the effects of the internet on the brain has been conducted in adults, so more studies are needed to determine the benefits and drawbacks of internet use in young people.

Firth says that avoiding the potential negative effects could be as simple as ensuring that children are not missing out on other crucial developmental activities, such as social interaction and exercise, by spending too much time on digital devices.

“To help with this, there are also now a multitude of apps and software programs available for restricting internet usage and access on smartphones and computers — which parents and carers can use to place some ‘family-friendly’ rules around both the time spent on personal devices, and also the types of content engaged with,” he said.

“Alongside this, speaking to children often about how their online lives affect them is also important — to hopefully identify children at risk of cyberbullying, addictive behaviours, or even exploitation — and so enabling timely intervention to avoid adverse outcomes.”

What is Nonattachment?

What is Nonattachment?

Have you ever spent time in anguish over not getting a job, fixated on an upcoming decision, avoided coming to terms with the fact you’re getting older, or worried that your not as successful as you should be.  In Buddhism, all of these things can be considered attachments.  Attachments are our fixated attempts to control our experience, usually through clinging to what we perceive as desirable or aversion to what we perceive as undesirable.  The problem is, life usually has its own way of unfolding, quite separate from our attempts to control it, no matter how intense or well-intentioned.  Nonattachment, therefore, is what occurs when we can let go of the need to be in dogged control of what is occurring and can reduce our demands on the present moment to be any way in particular.  

Far from being a detached state, nonattachment is something which arises when we are truly present and not caught up in the automatic process of fixating on things being better or worse than what they are at any given moment.  Nonattachment is aligned with psychological maturity and insight into the ever-changing nature of experience and the futility of trying to control it. Nonattachment is not a passive or apathetic quality, it does not require the renunciation of life or moving to a cave in the Himalayas.  Rather, nonattachment involves doing whatever would normally drive you, just without fixation and the accompanied rumination and worry about getting everything right, or adhering to the societal- or self-imposed expectations about what your life should be like.

Our attachments and our dis-ease with the present moment are so ubiquitous, that almost all self-focused thinking involves wanting things to be better, or worrying about things that have happened or will happen. Rarely are they focused on appreciation of the present moment.  For example, we might worry about what we may have said to someone and what they might think about us, thinking things like “what did I say” or “I hope they didn’t think…”  These thoughts are often automatic and can bring up feelings associated with the worst possible scenario e.g., “perhaps they thought I didn’t like them…” or “they must think I’m so boring.”  Although these thoughts and feelings naturally arise, it is our choice to engage with them that can be avoided. This propensity to ruminate and worry about something that has already happened, or when imagining something that may happen, can underlie poor mental health and prevent us from living with a lightness, and sense of ease and flow.  Imagine the freedom involved with letting go of your demands on needing your experience to be any way in particular. 

Research on nonattachment

In 2010, Sahdra, Shaver, & Brown (2010) created the nonattachment scale to capture the quality of nonattachment and investigate how it relates to other aspects of life.  Since then, there has been a growing amount of research in the field of nonattachment, which has found that reducing fixation on the need for experience to be one way or other is extremely healthy.  Not only is it related to reduced symptoms of depression, anxietyand stress (Sahdra et al., 2010), it has shown to relate to increased prosocial behaviours such as empathy and kindness (Sahdra et al., 2015) as well as advanced psychological development outcomes of wisdom and self-actualisation (Whitehead et al., 2018). Numerous studies have also shown it to be a more important quality than mindfulness when explaining positive psychological outcomes (e.g., Lamis & Dvorak, 2014).

This is an interesting question.  Within the Eastern contemplative traditions, the path to building nonattachment involves meditation or a monastic life, and research shows nonattachment is stronger in those that meditate. However, recently, I had the pleasure of interviewing individuals that scored very high (and very low) on nonattachment (see Whitehead et al., 2019) and asked them how they had developed and integrated nonattachment in their life.  Interestingly, the most common theme was the way they worked through their most difficult moments in life.  Almost all of these individuals had moments of intense suffering which had become a catalyst for them to live a different way.  They were able to draw strength from these experiences and realise the futility of living a life burdened by everything they could not change. Most were also able to integrate some form of self-reflective practice, such as psychotherapy or meditation that assisted them in their path towards letting go.

I know it is not the easiest thing to let go of your demands on experience.  Most of our attachments are automatic, have been around a long time and are there because we feel that letting go of them will result in some sort of apathetic quagmire or spiraling loss of control. However, when we can let go of our need for experience to be one way or other, we don ’t cease to make decisions. What occurs is a freedom and a lightness where life unfolds without obstruction, allowing us to be more present, be there for others, take opportunities when they arise and to move on from unhelpful experiences without getting unduly stuck.

Test it for yourself. Remember, life will unfold in its own way whether you try to control it or not.   

Before You Dismiss Mindfulness…

What comes to mind when you think of mindfulness? For many it’s an image of a yogi, a Buddha, or a wellness influencer. Maybe it’s a phone app or a fitness outlet.

For me, it’s science.

Mindfulness has become a buzzword synonymous with self-care and meditation, promising wide-ranging benefits from reducing stress to increasing happiness. It’s now a multi-million-dollar business, with thousands of apps touting the benefits of mindfulness in one way or another. And among all this buzz, I’ve seen a few articles that push back on mindfulness. Often, they’re not wrong to question the claims some apps have made. But as a neuroscientist and physician, I’ve been impressed with the growing amount of evidence in support of the approach.

Like other “hot” topics, mindfulness has been hijacked by hype and misunderstanding. For example, many think that the goal of mindfulness is to clear your head of all thoughts. That’s a hard thing to do, and if you’ve tried mindfulness under that assumption, you’re destined for disappointment.  

Mindfulness is really about paying careful attention to our thoughts and behaviors, not trying to suppress them. When we do this, mindfulness helps us clearly see the cost and benefit of any given situation. It can, for instance, help us overcome cravings and addictions of all kinds. In one pilot study, we found that an evidence-based mindfulness training led to a 48% reduction in anxiety among participants after completing 28 core modules of the program. And we’ve seen this success not only with anxiety, but with overeating, smoking, social media use, and more.

Why might mindfulness be so effective? It starts with neuroscience. Our brains are wired based on the most evolutionarily conserved learning processes – the reward-based learning system. The system is based on a trigger, behavior and reward. Let’s take food as an example: When we get hungry (trigger), we look for food (behavior) and then we eat and feel satisfied (reward). After a while, however, the reward becomes so enticing that we no longer eat only when we’re hungry, but when we’re bored or stressed or tired. Before you know it, overeating becomes a habit that can be incredibly difficult to break.

Mindfulness is the tool we have been given to tap into this system to “hack” and rewire our brains so that we can address unwanted behaviors and overcome even the most difficult habits. When we pay attention to all aspects of our experience, we start to notice the push and pull of cravings in particular. Only then can we really see cravings for what they truly are: simple thoughts and feelings.

One of my favorite examples that shows just how powerful mindfulness can be is smoking cessation. In one study in my lab, smokers were given mindfulness training: They were taught breath awareness and how to pay attention to habit triggers and actions. In response, these smokers reported being more aware of why they smoked, what behaviors to substitute for smoking, and how disgusting cigarette smoke smelled and tasted when they just paid attention. We found that this mindfulness-based training was 5 times more effective than the gold standard treatment in helping people quit smoking. Mindfulness worked: The science speaks for itself.

5 factors affecting happiness and wellbeing

Each one of us has experienced different levels of happiness based on varying life situations. The definition of happiness also varies from person to person. After a lot of study of the behavioral patterns of various individuals, our experts have made a list of things that affects the happiness of most people;

1. Sufficient Sleep

Many people do not realize but sleep is one of the major factors affecting the way you feel the entire day. If you sleep timely and peacefully for the required number of hours, your hormones are balanced and the body is rejuvenated to function perfectly the next day which makes you feel happy. If you do not sleep timely or do not take rest for the required number of hours, it will lead to the increase in the stress hormones named cortisol which is directly related to lowering your metabolism and you feeling heavy the next day. Get your 8 hours of sleep every day to enjoy a healthy life.

2. Family and Friends

Being surrounded by family and friends can change the quality of life which can lead to a much-fulfilled life. The ensured sense of comfort that you have a support system when needed can influence your level of happiness in a big way. Socially involved people are more satisfied in their lives than the ones who live detached from everyone

3. Money Doesn’t Buy Happiness

Many of us associate money with happiness A rich person can answer this concern better. Statistics suggest that rich people have more worries in their lives and find it more difficult to be happy. We are not discouraging you from earning money, work hard to be successful but do not assume you will be happy once you earn more money. It may feel good for some time but money doesn’t significantly make you happy, your mental peace and work-life balance can only help you feel satisfied.

4. Health Worries

A healthy body can lead to a healthy mind as well. If you are suffering from physical issues, you will never be mentally peaceful. Taking care of yourself by maintaining a healthy lifestyle is of utmost importance as you can eliminate any worries related to your health and feel good. Exercise three times a week to keep yourself fit; it will also help in raising the happy hormones hence you will feel good about yourself. Getting in touch with experts from integrativewellnessny.com can help you work towards better health holistically.

5. Stressed Minds

Many of us are so busy with our professional lives most of the day that the work stress haunts us even when we come back home. We need to learn to relax our minds and detach from all thoughts which makes us feel stressed. Practice meditation every day to bring a sense of peace and detachment every day, this will bring you closer to being happy.

Biggest risk factors for developing dementia

The 12 lifestyle choices and conditions which fuel dementia have been identified by the World Health Organisation (WHO) in the most definitive list ever of how to avoid mental decline in later life.

New guidelines based on analysis of decades of research found that physical inactivity, smoking, eating an unhealthy diet and drinking excessive alcohol significantly increased the threat of diseases like Alzheimer’s.

Medical conditions including diabetes, high blood pressure, high cholesterol and obesity also played a role in the development of cognitive decline and full-blown dementia.

WHO Director General, Dr. Tedros Adhanom Ghebreyesu, has warned that in the next 30 years, the number of people with dementia is expected to triple, and added that “we need to do everything we can to reduce our risk of dementia. “The scientific evidence gathered for these guidelines confirm what we have suspected for some time; that what is good for our heart is also good for our brain.” The possible risk factors identified by the WHO team are:

  • Low level of physical activity
  • smoking
  • poor diet
  • alcohol misuse
  • insufficient or impaired cognitive reserve (brain’s ability to compensate for neural problems)
  • lack of social activity
  • unhealthy weight gain
  • hypertension
  • diabetes
  • dyslipidemia (unhealthy cholesterol levels)
  • depression
  • hearing loss.

And health experts also warned of a link between hearing loss and depression.

How Kevin Love Takes Care of His Mental Health

Today, when Kevin Love feels a decline in his mental health, he’s able to deal with it in a number of ways. He goes to therapy and takes medication. He tries to meditate every day. He spends quiet time with his dog, Vestry.

To his opponents on the court, Love comes across as a fearless competitor, regularly sacrificing his body to make a play or change the outcome of a game. Standing 6’10” and 250 pounds, Love is an NBA star known for his physical strength. 

But it took a different type of strength—the courage to be vulnerable—to be able to bounce back after experiencing his first panic attack in front of thousands of people. 

It was just after halftime on November 5th, 2017, at Quicken Loans Arena in Cleveland, where the hometown Cavaliers were playing the Atlanta Hawks. Love had struggled through 18 minutes of playing time, posting a disappointing statline: four points, four rebounds, and four fouls on 1-of-6 shooting. He was pulled from the court with 8:29 left on the clock in the third quarter, leaving fans, teammates, and commentators to speculate on what exactly had knocked the star center out of the game.

“I couldn’t catch my breath,” Love says. “I was sticking my hand down my throat trying to clear my air passage. I thought I was having a heart attack and ended up unconscious on the floor of our head trainer’s office.”

Love remembered thinking that “this could be it”—that he would die at 29 years old at the peak of his professional career as an elite athlete. But what scared Love more than that feeling of helplessness was the idea that other people would find out about the episode. He didn’t want his teammates or coaches or fans to think he was “not reliable.” For months, Love closely guarded a secret that brought him deep shame: that he was struggling with his mental health. 

Despite all this, Love still managed to play well enough that season to land a spot on the All-Star team. And although a broken hand kept him from being able to play in that, Love made the trip to Los Angeles for the All-Star Break in February 2018. It was in L.A. that Love felt compelled to finally open up to the public about his mental health. 

“I didn’t want anyone to tell this story but me,” Love says.

On March 6th, The Players’ Tribune published an essay written by Love titled “Everyone Is Going Through Something.” The essay functioned not only as a confession, but also as a deep exploration of how notions of masculinity have stigmatized men talking openly about mental health and seeking treatment.

“Growing up, you figure out really quickly how a boy is supposed to act. You learn what it takes to be a man It’s like a playbook: Be strong. Don’t talk about your feelings. Get through it on your own. So for 29 years of my life, I followed that playbook. And look, I’m probably not telling you anything new here. These values about men and toughness are so ordinary that they’re everywhere … and invisible at the same time, surrounding us like air or water. They’re a lot like depression or anxiety in that way.”

Since going public with his mental health issues, Love has used his platform to try to lessen that stigma for young men, primarily through his charity The Kevin Love Fund. The charity has partnered with other mental health organizations like the Movember Foundation and Just Keep Livin’, as well as the meditation app Headspace, which provided 850 donation subscriptions to UCLA student athletes. 

“These superheroes that we look at, whether it be somebody in the entertainment industry or an athlete, we also have these layers that we deal with on a daily basis,” Love says. “Know that you’re not alone. You’re not different. You’re not weird. And we can do this stuff together.”

Click Read More to watch Kevin’s video.

Risk of Mental Disorders Higher for People Who Live Alone

That’s the conclusion of new research published this week in the journal PLOS ONE, which used data from three separate surveys in the United Kingdom over the course of nearly two decades.

“In our study, the prevalence of common mental disorders (CMDs) was higher in individuals living alone than in those not living alone in all survey years. Multivariable regression analyses corroborated this findings, as there was a positive and significant association between living alone and CMDs,” said Louis Jacob, first author of the study and member of the faculty of medicine at the University of Versailles Saint-Quentin-en-Yvelines, France.

Researchers looked at survey data from the United Kingdom conducted in 1993, 2000, and 2007, which included more than 20,000 adults.

Between 1993 and 2007, the incidence of adults living alone steadily increased from 8.8 to 10.7 percent, correspondingly, so did the rate of common mental disorders from 14.1 to 16.4 percent.

Regardless of age or sex, CMDs were invariably more prevalent in individuals who lived alone. 

In some cases, those living alone were more than twice as likely as cohabiting individuals to have a mental disorder.

Expanding evidence 

Other studies have associated living alone with CMDs, but this research builds on that work in several ways.

Prior studies have primarily been interested in the effects of living alone on the elderly, but this research helps to expand findings on the relationship between living alone, loneliness, and mental disorders to the adult population in general. The authors also expanded their research to include other disorders like anxiety rather than depression alone.

The findings are consistent with other work on the subject. For example, a study of nearly 5,000 adults living in Finland found a twofold increase of anxiety and depression in people living alone compared with people who were married.

A 2011 study from Singapore of nearly 3,000 adults age 55 and older found that living alone was a contributor to poorer psychological well-being, with loneliness being the cause.

Loneliness is a complex issue, and its association with living alone and mental disorders has become a topic of increasing interest for public health officials and urban planners.

Some researchers have pointed at cities in general as drivers for loneliness and social isolation. While others have noted our increasingly digital world and the influence of social media on feelings of isolation, depression, and anxiety.

Many are also taking note of the effects of loneliness as a legitimate public health concern. Beyond mental health and well-being, the effects can also take a physical toll.

Physical health risks

A 2015 study in the British Medical Journal found that loneliness and isolation were risk factors for both coronary heart disease and stroke.

Jacob said he hopes giving loneliness and social isolation more visibility will ultimately help to bring relief.

“This is important for the identification of vulnerable populations and the establishment of effective strategies to improve population mental health,” said Jacob.

“Based on the findings of the present study, health professionals should be aware that living alone is a risk factor for CMDs, and that this association is largely mediated by loneliness. We believe that reducing levels of loneliness in people living alone is important,” he said.

Indeed, the most important findings from the research may have more to do with how loneliness can be treated.

What you can do

According to Jessy Warner-Cohen, PhD, MPH, a health psychologist at Long Island Jewish Medical Center, “The most robust finding of this study is the effect of social support on those living alone.”

“The takeaway message for me from this study is that those not in cohabiting relationships, whether living with a partner or marriage, need to more actively seeks means of developing social support,” said Warner-Cohen, who wasn’t affiliated with the research.

Social support can take on many different forms and affect people from all walks of life.

It can mean joining clubs related to personal interests, like book clubs or athletic organizations, walking dogs with others in the neighborhood, or cooking together. Involving friends and family more frequently is a great resource for social support.

“Look for meet-up groups related to something you enjoy. This will help with meeting other people with similar interests and provide a natural means of developing social support. Fill your life with fun and exciting things,” said Warner-Cohen.

Mindfulness Meditation Helps with Stress and Therefore Your Love Life

Both sex and meditation involve taking breaks from daily routines and responsibilities. Both include deep diaphragmatic breathing. Both encourage emptying the mind of extraneous thoughts, and focusing attention on the present moment. And both help free the mind from daily hassles.

Meditators accomplish this by sitting quietly and focusing intently on their breath, or on a word or phrase (manta), or on a simple activity (walking, slowly chewing one bite of food). Lovers free their minds by engaging in mutual erotic touch while focusing intently on one another (though they may fantasize about other partners). Both expand spiritual connections—meditators to the world around them, lovers to their partners. And after both, meditators and lovers emerge feeling calm and refreshed, better able to cope with life’s challenges. 

But emptying the mind isn’t easy. During both meditation and lovemaking, random thoughts—some possibly disturbing—inevitably dart in and out of consciousness. Meditation teachers urge students to accept their thoughts without judging them, no matter what the content. They say: “Your thoughts are not you. They’re like dreams. You can’t control them and are not responsible for them. Don’t judge your thoughts. Simply observe them, then let them go as you return to your breath, mantra, or mindfulness activity.” 

Sex therapists concur, encouraging lovers to observe their erotic thoughts and fantasies nonjudgmentally no matter what their content, and then gently let go of them as lovers return to focusing on giving and receiving pleasure. Just as random thoughts during meditation don’t mean anything, neither do the vast majority of thoughts and fantasies during sex.

A Head Full of Ideas 

In Bob Dylan’s song “Maggie’s Farm,” one line goes: “I got a head full of ideas that are driving me insane.” Many people can identify. They have heads full of sexual beliefs that may not exactly drive them crazy, but produce sufficient stress to cause problems. Stress/anxiety/worry trigger the fight-or-flight reflex that constricts the arteries in the central body, limiting blood flow to the gut and genitals and sending it out to the limbs for self-defense or escape. Reduced blood flow through the genitals compromises sexual responsiveness, function, and satisfaction. But deep relaxation, the kind produced by meditation, opens the arteries that supply blood to the genitals and enhances sexual function and pleasure.        

In recent years, several sex researchers, notably Lori Brotto at the University of British Columbia, have harnessed the power of meditation to treat a broad range of sex problems:         

• Child sex abuse. A team led by Brotto enrolled twenty adult survivors of childhood sex trauma in a program shown to aid recovery, cognitive behavioral therapy. CBT helped them reframe their stories away from the horror of abuse toward self-forgiveness and personal empowerment. Half the group also learned mindfulness meditation and practiced it daily. After one month, both groups reported less sexual distress, but the mindfulness group reported greater relief and better sexual functioning.

• Low libido. Another Brotto team recruited 117 low-desire women. Forty-nine were placed on a wait list. The rest participated in three 90-minute classes over six weeks that discussed the causes of low libido and offered instruction in mindfulness meditation. Between classes, the women practiced mindfulness daily at home. After six months, the treatment group reported significantly greater desire, arousal, and lubrication, easier orgasms, and greater satisfaction.        

Investigators at Willamette University in Oregon analyzed eleven studies of mindfulness involving 449 women who complained of low libido and arousal and orgasm difficulties. “All aspects of sexual function and well-being—exhibited significant improvement.”         

• Erectile dysfunction (ED). A third Brotto team enrolled ten men suffering erection difficulties in a four-week mindfulness-based treatment program that included information about ED, counseling, and mindfulness meditation practiced in therapy sessions and daily at home. Most of the men reported significant improvement.         

• Men in distress because of their porn consumption. Creighton University investigators took thirty-eight men convinced they were porn addicts to a rustic retreat center for eight-days. They spent thirty-two hours in cognitive-behavioral therapy. During CBT sessions, the researchers endeavored to correct participants’ sexual misconceptions, such as:

         • Sexual thoughts and fantasies are wrong, harmful, and sinful. 

         • Only bad people masturbate.

         • My porn watching proves I’m evil.

The therapists endeavored to correct those mistaken beliefs:

         • There’s nothing wrong with sexual thoughts and fantasies. Everyone has them. They’re perfectly normal and a key element of great sex.

         • Almost everyone masturbates, particularly men who feel stressed. Unless it interferes with life responsibilities or partner lovemaking, there’s nothing wrong with it, even frequently, even daily. 

         • Virtually every Internet-connected man on Earth has seen porn, many frequently, some daily. Viewing it doesn’t make you evil. Porn is a cartoon version of men’s fantasies of effortless sexual abundance.

The researchers also taught participants mindfulness meditation, which they practiced several times a day. After the retreat, their sexual anxiety and porn viewing decreased significantly.

Breaking Vicious Cycles

Anxiety contributes to many sex problems. That’s why “Am I normal?” is one of the most common questions sex experts get. It’s a leading query on the site I publish, GreatSexGuidance dot com. Many people feel nervous about their fantasies, bodies, libidos, sexual repertoire, and ability to negotiate functional sexual relationships. That nervousness causes stress, which, as mentioned, impairs sexual desire and function. 

When sex experts correct people’s misconceptions, sometimes that’s all that’s necessary to resolve their issues. But quite often, sexual issues cause chronic stress not relieved just by learning the truth. Sometimes, people need the truth plus tools to relieve their sexual stress. That’s where mindfulness and other relaxing activities help: deep breathing, hot baths, massage, yoga, tai chi, dance, hiking, and other exercise. They break the vicious cycle of stress-dysfunction-more-stress-worse dysfunction, and replace it with refreshing calmness.

Sex unfolds most pleasurably when people feel calm, centered, and focused on pleasure—their own and their partners’. Even those free of sex problems can benefit from deep relaxation. For more, search: mindfulness, meditation, or the relaxation response.

What does depression feel like?

It can also cause physical symptoms of pain, appetite changes, and sleep problems.

The Centers for Disease Control and Prevention (CDC) found that nearly 10 percent of adults aged 40 to 59 years had depression between 2009 and 2012. However, despite its prevalence, depression isn’t always easy to identify.

Symptoms and causes of depression can vary widely from person to person. Gender may also play an important role in why a person is affected by depression, and what it feels like to them.

How depression feels

One of the common misunderstandings about depression is that it’s similar to feeling sad or down.

Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to life events.

The symptoms of depression can last for months or years and can make it difficult or impossible to carry on with daily life.

It can disrupt careers, relationships, and daily tasks such as self-care and housework.

Doctors will usually look for symptoms that have lasted at least 2 weeks as possible signs of depression.

Depression may feel like:

  • There’s no pleasure or joy in life. A person with depression may not enjoy things they once loved and may feel like nothing can make them happy.
  • Concentration or focus becomes harder. Making any kind of decisions, reading, or watching television can seem taxing with depression because people can’t think clearly or follow what’s happening.
  • Everything feels hopeless, and there’s no way to feel better. Depression may make a person feel that there’s no way ever to feel good again.
  • Self-esteem is often absent. People with depression may feel like they are worthless or a failure at everything. They may dwell on negative events and experiences and be unable to see positive qualities in themselves.
  • Sleeping may be problematic. Falling asleep at night or staying asleep all night can feel nearly impossible for some people with depression. A person may wake up early and not be able to go back to sleep. Others may sleep excessvely, but still wake up feeling tired or unrefreshed, despite the extra hours of sleep.
  • Energy levels are low to nonexistent. Some people feel like they can’t get out of bed, or feel exhausted all the time even when getting enough sleep. They may feel that they are too tired to do simple daily tasks.
  • Food may not seem appetizing. Some people with depression feel like they don’t want to eat anything, and have to force themselves to eat. This can result in weight loss.
  • Food may be used as a comfort or coping tool. Although some people with depression don’t want to eat, others can overeat and crave unhealthy or comfort foods. This can lead to weight gain.
  • Aches and pains may be present. Some people experience headaches, nausea, body aches, and other pains with depression.

Many people mistakenly believe that being depressed is a choice, or that they need to have a positive attitude. Friends and loved ones often get frustrated or don’t understand why a person can’t “snap out of it.” They may even say that the person has nothing to be depressed about.

Common causes and risk factors

Depression can be caused by a number of factors. Though a single cause cannot always be found, experts recognize the following as possible causes:

  • Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.
  • Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.
  • Hormonal changes: Depression and low mood are often associated with menopause, pregnancy, and premenstrual disorders.
  • Certain illnesses: Anxiety, long-term pain, diabetes, and heart disease may make someone more likely to develop depression. Depression is a symptom of bipolar disorder.
  • Drug and alcohol abuse: In some cases, drug and alcohol abuse may cause depression. Other times, depression may cause a person to start abusing drugs or alcohol.
  • Some medications: Certain prescription medicines may increase the risk of depression. These include some high blood pressure medications, steroids, and some cancer drugs.

Click “Read More” for the full article.

Self-Evaluation and “The Four B’s”

Do you feel that you are a truly worthwhile person?

What do you see when you are genuinely trying to evaluate yourself and you look in the metaphoric mirror of life? That is, when you are wholly truthful with yourself, no masks, no games, no pretense, defensiveness or guile, do you really like (respect, admire, appreciate) that person you see? 

Who are we, really? 

We all experience successes and pleasures in our lives, just as we do disappointment and setbacks. Life can be complicated and pressured. In these circumstances we sometimes question wonder about our personal qualities or worthiness as human beings. We might behave differently in diverse circumstances (work, school, family, recreation), and when we’re with different people and settings. There may be times we worry about how we’re being perceived by others, but we ultimately have to answer to ourselves.

I’ve learned through research studies, clinical work and social relations with people of diverse ages and backgrounds that we all want to be “comfortable in our own skin.” We know that if people have enough to live on and are properly clothed, sheltered and safe (admittedly a big IF), it is not the amount of accumulated material wealth which leads to self-appreciation and ease ‘inside’ their beings. Most people are looking for more substance and meaning in life, and in fact have similar views about what makes them appreciative of their own worthiness.

So, what is it they (we) are all looking for?

The genuine appreciation of our worthiness and our quality depends on whether we achieve four core inner senses, which I call “The Four B’s”—the personal senses of Being, Belonging, Believing and Benevolence.

BEING (Personal): People who have achieved a sense of Being feel grounded and at ease with themselves. They have the sensation of inner peace and self-acceptance. They have insight into themselves and they have a realistic self-image, neither boastful or demeaning of themselves. They are grateful for whom they have become and how they’ve acted with others. They are aware of their strengths and potential, and similarly, of their faults and limitations. They appreciate themselves in spite of mistakes they have made and their emotional scars. They have worked at overcoming their frailties and redeeming themselves for transgressions.

They are empathic and caring, kind and generous to family, friends and strangers, and they’re respectful and tolerant of others. They are responsible and trustworthy, and feel comfortable with who they have become.

BELONGING (Social): People with a sense of Belonging know they are integral members of at least one group or community of people that is very important to them, where they feel comfortable, liked and appreciated, and where they genuinely reciprocate those feelings. These groups could compose a family or close friends, a congregation, a club, gang, team, cast, platoon or a wide range of other possible communities.

Members of these communal groups feel an organic affiliation and comfort with others who share their values and traditions. The members provide support, respect and friendship. These kinds of relationships bestow pleasure and fulfillment. They diminish anxieties and help prevent depression associated with loneliness. The warm glow of belonging contributes to their physical and emotional health, and enhances the quality of their lives.

BELIEVING (Ethical/Spiritual): A sense of Believing refers to having guiding values and principles of one’s behavior. Millions of people around the world venerate (their perception of) a God(s) who gives them comfort and hope, and provides moral rules for their ethical conduct. But one need not believe in a Supreme Being to be an ethical individual, and by the same token, religious followers are not inherently more principled or compassionate than agnostics and atheists. We human beings need to believe in a system of moral principles and civil behavior.  Ideally, we adhere to these overriding tenets in our daily functioning and relationships and we wish to pass these down to our children. When we act according to principles based on religion or other humane social philosophies, our lives become more meaningful during times of both joy and pain. 

Our lives can be at different times and circumstances rewarding, mundane or challenging: We are concerned about ourselves and perhaps even more about our families, wanting to protect and facilitate their navigation through life’s challenges. We are also at times beset with the pressures of finances, responsibilities, health, obligations, social demands, political issues and other aspects of life’s travails. The details and decisions of life can get to us.

Yet when we wonder about issues beyond everyday practicalities and materialism, we can be awed by just how minuscule we are. We are microscopic in our own world, but especially infinitesimal when we consider our own infinite universe and countless other universes. Looking at the photographs taken from the Hubble telescope can be riveting and awe-inspiring. They can transport our thoughts into cosmic or spiritual realms, and help us realize we have but one life to live, and making it fulfilling and meaningful becomes of even more consequence.

BENEVOLENCE (Altruism): A sense of Benevolence refers to the extent to which we have bestowed a caring effect on others. It encompasses how we have positively affected and contributed to people in our lives. This can be in our everyday lives, when we demonstrate seemingly small but important acts of kindness and generosity. The positive effects we have on others linger on in the ‘social atmosphere.’

Benevolence is in a way a culmination of the other B’s. Our personal legacies are best represented by our acts of decency and respect for each other. Notwithstanding humanity’s history of aggression and violence, we humans are also genetically predisposed to be helpful to others. Studies have shown that we can in fact learn to behave with more tolerance and generosity and with less aggression and animosity. The kindness and goodness we bestow on others throughout our lives is the essence of a sense of benevolence.

Nobody is perfect. I know many wonderful people but have yet to meet a veritable saint or tzaddik who is the epitome of perfection in all of his/her personal thoughts and behaviors. While a purely noble existence may be beyond us mere mortals, most of us endeavor to be intrinsically worthwhile: Decent, honest and caring—in other words, a “Mensch.”

When we are evaluating the worthiness of our lives, we aspire to the goals of the Four B’s. These are the foundations for our important core legacies, “Our Emotional Footprint.”

A Sleepless Brain Leads to Emotional Negativity

A sleepless night not only leaves us fatigued and distracted, it also makes us interpret things more negatively and makes us more likely to lose our temper. Moreover, people suffering from a pollen allergy are at a high risk of some form of sleep disruption from the outset. This is the conclusion of a new doctoral thesis from Karolinska Institutet that takes a neuroimaging approach to sleep loss.

“Ultimately, the results can help us understand how chronic sleep problems, sleepiness and tiredness contribute to psychiatric conditions, such as by increasing the risk of depression,” says Sandra Tamm, who has recently defended her doctoral thesis at the Department of Clinical Neuroscience.

Sleep deprivation is already known to potentially affect the way we react to emotional impressions. For her thesis, Sandra Tamm and her colleagues used functional MRI and PET techniques to examine under experimental conditions three emotional functions: emotional contagion (i.e. our natural tendency to mimic other people’s emotions in our facial expressions); empathy for pain (i.e. how we react to other people’s pain); and emotional regulation (i.e. how good we are at consciously controlling our emotional reaction to emotional images).

One study also examined low-grade inflammatory activity in the brain as a possible mechanism for non-specific symptoms such as sleepiness, fatigue and depression in people with severe seasonal allergy. A total of 117 participants were involved in the thesis’s constituent papers.

A negativity bias

The results of these various studies show that experimentally induced sleep loss leads to what the researchers call a negativity bias, which is to say a more negative interpretation of emotional stimuli, negative mood along with impaired emotional regulation. The ability to empathise with other people’s pain, however, was found to be less affected. So, while we might be grumpy in the morning, we still care if our partner happens to scold themselves when making the tea.

Researchers also found that the participants with a pollen allergy had disrupted sleep both during and outside the pollen season, and that the amount of deep sleep they had was higher during the pollen season than at other times of the year.

“Regrettably, we were unable to trace the underlying change mechanisms behind sleep deprivation-induced negativity bias by showing differences in the brain’s emotional system as measured by functional MRI,” says Sandra Tamm. “For people with a pollen allergy, we found signs of inflammation in their blood readings, but not in the brain.”

Mental health can impact memory decades later

Scientists have already shown that depression and other mental health problems can affect a person’s memory in the short term.

For instance, a study that the journal Cognition and Emotion published in 2016 found that individuals with dysphoria — a persistent sense of unhappiness or dissatisfaction that is often a symptom of depression — had poorer working memory than people without any mental health problems.

Now, however, researchers from the University of Sussex in Brighton, U.K. have found evidence that links experiencing mental health problems throughout adulthood to memory problems at the age of 50 years.

The implications, says study author Darya Gaysina, are that “the more episodes of depression people experience in their adulthood, the higher risk of cognitive impairment they have later in life.”

“This finding highlights the importance of effective management of depression to prevent the development of recurrent mental health problems with long-term negative outcomes.”

Darya Gaysina

In the new longitudinal study, the findings of which appear in the British Journal of Psychiatry, researchers analyzed the data of 9,385 people born in the U.K. in 1958, which the National Child Development Study (NCDS) has been collecting.

This new study is the first to look at the long-term relationship between mental and cognitive health.

Mental health problems and memory

To date, the NCDS has followed this cohort for more than 60 years, collecting information about each participant’s health at the ages of 7, 11, 16, 23, 33, 42, 44, 46, 50, and 55 years.

In addition, these participants reported their affective symptoms at the ages of 23, 33, 42, and 50 years and agreed to take memory and other cognitive function tests when they reached 50 years of age.

Gaysina and colleagues looked at how often the participants experienced mental health symptoms throughout the study period and assessed their performance in terms of memory function at age 50.

The researchers used a word-recall test to assess the participants’ memory, and they also evaluated each person’s verbal memory, verbal fluency, information-processing speed, and information-processing accuracy.

The investigators report their findings in the study paper, writing that the “accumulation of affective symptoms across three decades of adulthood (from age 23 to age 50) was associated with poorer cognitive function in midlife,” and, specifically, with poorer memory.

Although experiencing a single episode of depression or another mood disorder did not seem to affect a person’s memory in midlife, the researchers explain that going through depression and anxiety repeatedly throughout adulthood was a good predictor of poorer cognitive function at age 50.

“We knew from previous research that depressive symptoms experienced in mid-adulthood to late-adulthood can predict a decline in brain function in later life, but we were surprised to see just how clearly persistent depressive symptoms across three decades of adulthood are an important predictor of poorer memory function in midlife,” says the study’s first author Amber John.

Why Is It So Hard to Change Bad Habits?

I’ve managed to turn around a lot of my bad habits over the years, like reducing my fast food consumption, spending less time glued to screens, and finding an exercise regimen that I like and works for my life.

But my healthy habit journey isn’t anywhere near completion yet. I’m constantly looking for ways to optimize my energy and improve my life. If you’re reading this article, chances are you too have a few habits you’d like to change. So why is the process of adopting new habits usually so difficult? Because there is not a system in place to help you get the job done (unless you’ve reached the problematic tipping point of developing an addiction or diagnosable disorder.) Even then, the systems that are in place just want to help you stop the bad habit, not give you the tools needed to adopt new, healthier ones.

Why does this happen? Partially because, as a society, we still hold onto a false notion that those struggling with addiction or mental health issues are somehow different than the rest of us “normal” folks. This is not only false, but it’s also extremely dangerous because it ends up exacerbating the shame and stigma for those who are struggling, thus preventing them from seeking help.

The good news is that we do know a lot about how to change people’s behavior before things escalate to a problematic tipping point. Today I’ll be sharing with you four different approaches to change bad habits and the scientifically proven tools that will help you adopt new habits.

1. Behavioral Psychology

When we think, feel, and act in a particular way over a period of time, habits form, not only in our behavior but in our memory systems too.

There are different types of memory classification including semantic memory (knowledge), episodic memory (remembering events), and procedural memory (knowing how to do things) which is considered an implicit form of memory and therefore operating mostly below conscious awareness. It’s this last memory type, procedural memory, that is most important in the formation of habits. Over many decades of research, three primary types of learning emerged in the behavioral psychology domain.

Classical Conditioning

Classical conditioning (also known as Pavlovian conditioning) is learning through association. It was discovered by Russian physiologist Ivan Pavlov, which he discovered in his infamous study of dogs. In simple terms, classical conditioning refers to two stimuli which are linked together to produce a new learned response. 

Operant Conditioning

Operant conditioning refers to behavior that is shaped by either positive or negative reinforcement. It was developed by American Psychologist B.F. Skinner who studied the behavior of rats. He found that he could encourage or discourage behaviors based on a reward or punishment system. 

Observational Learning

Albert Bandura, an American psychologist, believed that people learn behaviors by observing and modelling other people’s behavior, attitudes, or emotions. In particular, he studied babies and young children and found that they imitated the behavior of those around them. This became the foundation of his social learning theory in which he highlighted that any form of learning requires the individual’s attention, retention, reproduction and motivation to imitate the modelled behavior.

2. Neuroscience

Researchers from MIT have identified that if neurons fire at the start and end of a specific behavior, then it becomes a habit. Neurons located in the habit formation region fire at the beginning of a new behavior, subside while the behavior occurs, and then fire again once the behavior is finished. Over time, patterns form, both in behavior and in the brain. This can make it extremely difficult to break a habit. 

In the forebrain, the basal ganglia is known to control voluntary movements and it may also play a crucial role in habit formation (both good and bad) as well as emotional expression. This system is not just concerned with motor (body) movements, but it has a strong effect on the emotional part of the brain. Investigator and Professor at MIT, Ann Graybiel, believes that at its core, the basal ganglia works to help people develop habits, so that they become automatic. This frees up space in your brain and memory to take in all the other things we encounter on a day to day basis. Automatic habits may include riding a bicycle, driving a car or brushing your teeth.

However, it’s the same region that helps people develop unwanted, or unhealthy, habits like eating disorders, anxiety, depressed mood, and addictions.

Research in this field, that focuses on the neurons in the basal ganglia, may lead to new psychological and drug treatments in mental health disorders and addiction.

3. Self-help Tools

The self-help industry claims to want to help you develop better habits. Before newer technologies, self-help mainly came in the form of physical books, but these days you can access information from home through eBooks, online courses, apps, and podcasts.

What Else Is Important?

Two factors that effectively help people achieve the behavior change they desire are incentives and accountability.

The American Society of Training and Development (ASTD) have released data from their study on accountability and the results were very interesting! What did they find? If you are held accountable to someone else, by committing to someone that you will achieve a goal, then your chance of success is up to 95 percent.

Accountability is the most important factor in habit formation or habit changing. This means that the likelihood that you will reduce your alcohol or lose weight will go up if you share your goal with friends, family or your community, either in person or online.

Though the above-mentioned tools are proven to work, physicians and therapists typically don’t employ them that often because they don’t think they are relevant to mental health issues and compulsive behaviors.

So, when people become “addicted” or “depressed” we just tell them they should stop without rerouting those “bad habits” and then wonder why it doesn’t work. Why? Because we are bad at stopping ourselves from doing something, especially if it’s already a habit.

Click Read More for the rest of the article.

Take Control Of Your Happiness

If you are relying on anyone or anything else for your happiness, stop that right now. If you feel like you’re not quite doing what you want to be doing and you’re not quite the person you want to be, let reading this be the sign that you have a change to make.

There are those who take control of their life and there are those who are life’s victims. Which do you want to be? The type who confidently assesses their own worth or the type that complains about feeling undervalued? No one can ‘make’ you feel anything. Happy or sad. every emotion you feel you can be in charge of. Giving away control of your feelings? Sort it out.

Here are 6 ways to create and control your own happiness:

Make a change

If you always do what you’ve always done, you’ll always get what you’ve always got. If you always avoid difficult conversations, you’ll always work with a team that isn’t up to scratch. If you always blame others, you’ll never take ownership and you’ll never be the best you can be.

Everything that happens is a cyclical process that will continue until you make an intervention – a change that puts you on a new course. Happy where every part of your life is going? Great! Go you! More of the same. Feel like you’re missing something? Make a change – somewhere. If what you’re putting out there isn’t working, or isn’t manifesting the results you want, it’s only you that can get you back on the way to happy.

Evaluate yourself

Be prepared to give yourself honest and ruthless feedback and don’t forget to learn each time you mess up. If you’ve already assessed and addressed your own weaknesses, what can anyone else’s opinion matter?! Get comfortable with your strengths – look for opportunities to use them. Nothing you hear in a formal appraisal or passing comment should surprise you. Don’t rely on others to point out your shortcomings.

Stop comparing

It happens all the time. You’re happy with your job until you hear about someone else’s and it sounds much better. You’re happy with the growth of your business until you hear of someone else’s growing faster. You feel like things are going pretty well until a peer does something you’d love to do. If you compare your life to anything other than a former version of itself, you’re asking for unhappiness. Even some of the most successful and inspiring people I know have moments where they want to swap places with someone else. It’s madness. Sure, there are other things you could be doing, but choosing to do them would mean forgoing your current path. Keep forgoing your current path and you’ll end up flitting around with no agenda, copying the last success story you read on the internet. Make comparisons with no one but your former self.

Define happiness

Ever seen the BBC show Saturday Kitchen? In each episode, James Martin, the presenter, cooks one of two dishes for the special guest – their food heaven or their food hell. My food hell is a seafood linguine with some kind of pea, mint and fennel sauce. Every part of that dish absolutely disgusts me. Yuck. I know, however, that the dish I’ve described will be someone else’s food heaven. Life and work are the same. The choices you make and the reality you live will be someone else’s version of hell, and vice versa. The happiness you seek has to be based on your version of happiness and not someone else’s. Definitely not based on TV adverts, celebrity Instagram pictures or the lives of friends and relatives.

Keep your lips sealed

Work out your own plan before you ask for comment. Be sure of your next move before you open up to receive advice. Recognise that every time you share your intentions you leave yourself susceptible to be influenced. Get clear on your plan, put the work in, then share the results, not the journey.

Design your life

In the 4 Hour Work Week, by Tim Ferriss, he advises an exercise where you take a piece of paper and write down: every day, every other day, every week, every month, every quarter, every year. You then write down the things you’d like to do in those frequencies. They could be ‘go for a walk’ every day. ‘Have a meal with friends’ every week, ‘go to Disneyland’ every year. Anything you like! Try it out – write them all down and use that piece of paper as a blueprint for living a life full of your favourite things.

5 Steps to Reduce Stigma About Mental Illness

If you tune into any conversation about mental illness and addiction, it won’t be long until the term “stigma” comes up. Stigma has various definitions, but they all refer to negative attitudes, beliefs, descriptions, language or behavior. In other words, stigma can translate into disrespectful, unfair, or discriminatory patterns in how we think, feel, talk and behave towards individuals experiencing a mental illness.

Where stigma comes from is a complicated question. It’s almost like asking where differences in racial prejudice, political views, religious preference, or sports team allegiances come from. Turns out we are influenced (all too easily) by family, friends, the media, our culture and environment, inaccurate stereotypes, and a host of factors. It’s really difficult to tease all this apart.

Rather than figure out where stigma begins, it’s easier to become more aware of what it isand when it occurs. Then we can do our best to educate others about how to reduce stigma and work toward ultimately eliminating it.

How do we become more aware of stigma? It’s usually easier to take a look at ourselves first before we try to change the rest of the world. 

Here are 5 simple steps you can do as a new stigma fighter:

1. Don’t label people who have a mental illness.

Don’t say, “He’s bipolar” or “She’s schizophrenic.” People are people, not diagnoses. Instead, say, “He has a bipolar disorder” or “She has schizophrenia.” And say “has a mental illness” instead of “is mentally ill.” This is known as “person-first” language, and it’s far more respectful, for it recognizes that the illness doesn’t define the person.

2. Don’t be afraid of people with mental illness.

Yes, they may sometimes display unusual behaviors when their illness is more severe, but people with mental illness aren’t more likely to be violent than the general population. In fact, they are more likely to be victims of violence. Don’t fall prey to other inaccurate stereotypes from movies, such as that of the disturbed killer or the weird co-worker.

3. Don’t use disrespectful terms for people with mental illness.

In a research study with British 14-year-olds, teens came up with over 250 terms to describe mental illness, and the majority were negative. These terms are far too common in our everyday conversations. Also, be careful about casually using “diagnostic” terms to describe everyday behavior, like “That’s my OCD,” or, “She’s so borderline.” Given that 1 in 4 adults experience a mental illness, you quite likely may be offending someone and not be aware of it.

4. Don’t be insensitive or blame people with mental illness.

It would be silly to tell someone to just “buckle down” and “get over” cancer. The same applies to mental illness. Also, don’t assume that someone is okay just because they look or act okay or sometimes smile or laugh. Depression, anxiety, and other mental illnesses can often be hidden, but the person can still be in considerable internal distress. Provide support and reassurance when you know someone is having difficulty managing their illness.

5. Be a role model.

Stigma is often fueled by lack of awareness and inaccurate information. Model these stigma-reducing strategies through your own comments and behavior and politely teach them to your friends, family, co-workers and others in your sphere of influence. Spread the word that treatment works and recovery is possible. Changing attitudes takes time, but repetition is the key, so keep getting the word out to bring about a positive shift in how we treat others.

Former President Bill Clinton said it very well: “Mental illness is nothing to be ashamed of, but stigma and bias shame us all.” Take the next step. Adopt these simple tools and you can help move the needle in the direction of getting rid of stigma once and for all.

The Healing Power of Telling Your Trauma Story

However, our trauma memoriescan continue to haunt us, even—or especially—if we try to avoid them. The more we push away the memory, the more the thoughts tend to intrude on our minds, as many research studies have shown.  

If and how we decide to share our trauma memories is a very personal choice, and we have to choose carefully those we entrust with this part of ourselves. When we do choose to tell our story to someone we trust, the following benefits may await. (Please note that additional considerations are often necessary for those with severe and prolonged experiences of trauma or abuse, as noted below.)

Feelings of shame subside. 

Keeping trauma a secret can reinforce the feeling that there’s something shameful about what happened—or even about oneself on a more fundamental level. We might believe that others will think less of us if we tell them about our traumatic experience.

When we tell our story and find support instead of shame or criticism, we discover we having nothing to hide. You might even notice a shift in your posture over time—that thinking about or describing your trauma no longer makes you feel like cowering physically and emotionally. Instead, you can hold your head high, both literally and figuratively. 

Unhelpful beliefs about the event are corrected.

Many people experience shifts in their beliefs about themselves, other people, and the world following a traumatic event. For example, a person might think they’re weak because of what happened, or that other people can never be trusted. When we keep the story inside, we tend to focus on the parts that are most frightening or that make us feel self-critical. 

I’ve often been struck during my work with trauma survivors by the power of simply telling one’s story to shift these unhelpful beliefs. These shifts typically don’t require heavy lifting by the therapist to help the trauma survivor recognize the distorted beliefs. Instead, there’s something about opening the book of one’s trauma memory and reading it aloud, “from cover to cover,” that exposes false beliefs.

For example, a person who was assaulted might believe they were targeted because they look like easy prey; through recounting what actually happened, they may come to see that it was due to situational factors (“wrong place, wrong time”) rather than something personal and enduring about themselves. 

Telling the trauma story to a supportive therapist is one of the key components of Cognitive Behavioral Therapy (CBT), which is one of the most effective treatments for posttraumatic stress disorder (PTSD). I recently explored the latest findings on PTSD treatment research with psychologist Dr. Mark Powers, Director of Trauma Research at Baylor Scott and White Health. As we discussed, effective CBT typically doesn’t require an intensive examination of the survivor’s beliefs and evidence for those beliefs, as is often done in CBT for other conditions. Instead, insights about the truth of what happened emerge just through talking about what happened and what it means. 

The memory becomes less triggering. 

Revisiting a trauma memory can be very upsetting, triggering strong emotional and physical reactions and even flashbacks to the event. Those reactions can stay in place for years if we have unprocessed trauma memories, especially when we’re trying to avoid thinking about the trauma.

Through retelling the story of what happened, we find that our distress about it goes down. The first time it’s likely to be very upsetting, even overwhelming, and we might think we’ll never be able to tolerate the memory. With repeated retelling to people who love and care about us, though, we find the opposite—that the memory no longer grips us. As Dr. Powers noted, we find that the memory no longer controls us. It will never be a pleasant memory, of course, but it won’t have the same raw intensity that it once had. 

You find a sense of mastery.

As we talk about our trauma, we find that we’re not broken. In fact, as Dr. Powers pointed out, we can come to see that our reactions to trauma actually make sense. For example, it’s understandable that our nervous systems are on high alert, since they’re working to protect us from similar danger in the future. 

Many trauma survivors I’ve worked with described the strength they found as they faced their trauma and told their story. They said they felt like they could face anything as they saw their fear lessen and found greater freedom in their lives. It takes courage to tell your story, and witnessing your own courage shows you that you’re not only strong but whole.

How chronic stress fuels cancer

Scientists say they now have a better understanding of how chronic (long-term, sustained) stress can accelerate the growth of cancer cells, and how this damage could be avoided.

While the correlation between stress and health issues – such as gut health, heart problems and cognitive impairment – is well-established, researchers have now located a key mechanism, which chronic stress triggers, that fuels the growth of cancer stem cells that tumours originate from.

The report, published in The Journal of Clinical Investigation, is one of the first to link chronic stress specifically with the growth of breast cancer stem cells in mice.

Principal investigator Quentin Liu, from the Institute of Cancer Stem Cell at Dalian Medical University told Medical News Today that while the direct signalling network between stress pathways and a cancer propagating system still remains “almost completely unknown”, a better understanding of the biochemistry that causes stress to increase the growth of cancer cells “could lead us toward targeted drug interventions”.

In these findings, researchers found the hormone epinephrine was responsible for the tumour growth, not cortisol. This hormone, when binding with ADRB2 cells, boosted levels of lactate dehydrogenase, an enzyme that normally gives muscles an “injection” of energy in a danger situation as part of a fight or flight mechanism. As a result, this led to an energy boost in the production of lactate, which feeds the harmful cancer cells and allows them to acquire more energy.

This means a person with chronic stress will have too much lactate dehydrogenase in the system which in turn will activate genes related to cancer growth and allow those cancer cells to thrive.

“When most people think of stress they think it’s cortisol that’s suppressing the immune system,” says Keith kelley, the co-author of the report. However cortisol was actually lower after a month of stress, while epinephrine was much higher, he notes.

Researchers confirmed these results by studying the blood epinephrine levels in 83 people with breast cancer, and found people with higher levels of the stress hormone also had higher levels of lactate dehydrogenase in cancer tumours and were more likely to have poorer outcomes following treatment.

Researchers also considered how they could block epinephrine’s effect on the system and found vitamin C to be the most promising substance. When tested on mice, scientists found stressed mice injected with vitamin C experienced tumour shrinkage.

Meditation can help treat PTSD

Studies have shown that meditation practices can have a significant, positive effect on mental health and how well our bodies respond to stress.

Existing research has also found that different types of meditation can even help boost a person’s emotional intelligence.

Interest in meditation’s potential as a tool for coping with various mental health symptoms has risen in recent years, and now, a new study suggests that one type of meditation — called transcendental meditation — can successfully counteract PTSD and lower depression.

The researchers, who hail from various academic institutions across the world, including Norwich University in Northfield, VT and the Maharishi Institute in Johannesburg, South Africa, have worked with students from the Maharishi Institute and the University of Johannesburg who had all received diagnoses of PTSD and depression.

The investigators’ findings, which appear in the journal Psychological Reports, indicate that participants who started practicing transcendental meditation saw notable improvements in their symptoms.

Symptoms recede after 3.5 months

The researchers worked with 34 students at the Maharishi Institute who had PTSD and depression. These students agreed to practice transcendental meditation, a type of meditation that involves chanting and focusing on mantras to achieve serenity.

Additionally, the team recruited a further 34 University of Johannesburg students with the same diagnoses who neither received any treatments nor took part in meditation for the duration of the study. These students acted as the control group.

At the beginning of the study period, which lasted 3.5 months, all of the participants scored 44 or over on the PCL-C test, which assesses PTSD symptoms. These scores signify that PTSD is very likely. Moreover, mental health professionals had also diagnosed PTSD in each of the participants.

At the end of the study, most of the participants from the transcendental meditation group had PCL-C scores below 34, which is the threshold for a PTSD diagnosis, indicating that their symptoms had altogether receded.

These participants also reported improvements in their depression symptoms.

In contrast, the participants in the control group, who did not take part in the meditation sessions and did not receive any other treatment, did not see any improvements.

‘A way to effectively deal with this problem’

Some of the PTSD symptoms that the participants reported at the beginning of the study included nightmares, flashbacks to traumatic events, a sense of anxiety or fear, and a state of hypervigilance.

At that point in time, many of these students were also experiencing emotional numbness, states of anger, violent outbursts, and misuse of alcohol and drugs.

“A high percentage of young people in South Africa, especially those living in the townships, suffer from PTSD,” explains study author Michael Dillbeck, from the Institute for Science, Technology, and Public Policy at the Maharishi University of Management in Fairfield, IA.

This issue extends beyond South Africa, however. In recent worldwide survey data that the World Health Organization (WHO) collected, 70.4 percent of the respondents reported experiencing trauma, and many of these individuals may have PTSD as a result.

“To become successful students and productive members of society, they absolutely need help dealing with the symptoms of post-traumatic stress disorder,” Dillbeck points out, noting that a tool as simple as meditation could make an important difference to people’s lives.

“Our study shows that after 3 months of meditation, [the meditation] group, on average, was out of PTSD. It offers a way for others to effectively deal with this problem.”

Michael Dillbeck

Can social media really cause depression?

The supposed effects of social media on young people sound drastic enough to make anyone switch off their cell phone.

Some studies have indicated that young people can develop an addiction to social media.

Meanwhile, other studies have linked this with poor sleep, poor self-esteem, and potentially poor mental health.

However, new research has now dispelled the belief that social media use can bring about depression.

Previous studies have made this claim based on measurements from a single point in time, but this new study took a long-term approach.

“You have to follow the same people over time in order to draw the conclusion that social media use predicts greater depressive symptoms,” says lead study author Taylor Heffer, of Brock University in St. Catharine’s, Canada.

“By using two large longitudinal samples, we were able to empirically test that assumption.”

The real effect on mental health

The study focused on two separate groups of participants. One was made up of 594 adolescents in the sixth, seventh, or eighth grade in Ontario, Canada. The other comprised 1,132 undergraduate students.

The team surveyed the younger group once per year for 2 years. They surveyed the older students annually for a total of 6 years, starting in their first year of university.

The questions focused on how much time they spent on social media on weekdays and weekends, as well as how much time they spent on activities such as watching TV, exercising, and doing homework.

They also looked at symptoms of depression. For the undergraduate students, they measured such symptoms using the Center for Epidemiological Studies Depression Scale. They used a similar but more age-appropriate version for the younger participants.

Next, the researchers analyzed the data, separating it into age and sex. The findings — which now appear in the journal Clinical Psychological Science — revealed that social media use did not lead to depressive symptoms later on. This held true in both groups of participants.

The scientists also found that in adolescent females, higher depression symptoms predicted later social media use. Heffer points out that females of this age “who are feeling down may turn to social media to try and make themselves feel better.”

Reducing social media fear

These findings suggest that overuse of social media does not lead to depression. More importantly, this may go some way toward dissuading public fear over the impacts of the technology.

As Heffer explains, “When parents read media headlines such as ‘Facebook Depression,’ there is an inherent assumption that social media use leads to depression. Policymakers also have recently been debating ways to tackle the effects of social media use on mental health.”

It is likely that differences in factors such as personality play a part in how social media can impact mental well-being. For example, some young people might choose to use social media negatively as a comparison tool, while others may simply use it to stay in touch with friends.

Scientists will now need to further examine motivations such as these to help authorities, medical experts, and parents figure out the best path forward.

Decision-Making for Sound Mental Health: 3 Useful Principles

A useful distinction to consider when thinking about decision-making in the mental health space is between principles and rules. A principle is a fundamental proposition that guides a system of belief or behavior. A rule, on the other hand, is a prescribed dictate for action within a particular activity or sphere. Parental authority is a principle; bedtime at 8:00 is a rule.

Principles tend to be broad and more abstract, and they may apply across contexts. Rules tend to be narrow and context-specific. Principles tend to regard general processes, and often represent internal convictions. Rules tend to regard specific content, and are often imposed on us externally. Principles invite contemplation, and need to be applied thoughtfully. Rules demand obedience and can be followed thoughtlessly. “Is it right?” is a question about principles. “Is it legal?” is a question about rules. Principles allow for flexibility and agency, but may generate confusion regarding how they should be applied. Rules are useful in that they clarify proper conduct, but they also limit flexibility and personal agency.

Principles and rules are not unrelated, of course. In fact, a system’s rules are often derived from—and function to uphold—its principles. If “customer service above all” is a company principle, then the company may devise a rule that, “all customers must be greeted within 5 seconds of walking into the store.” Many rules may be subsumed under one principle, and so novel situations usually beget new rules, rather than new principles. For example, upholding the ‘right to privacy’ principle in the new digital environment will require devising new privacy-related rules. This is one reason rules tend to multiply over time. Before long, they may begin to obscure, and even undermine, the principles they ostensibly serve. This is, in essence, the paradox of bureaucracies: designed to advance the worthy principles of organizational efficiency, rationality, and objectivity, their convoluted rules often end up undermining all three.

Our culture prizes both those who follow the rules and those who are principled. But in general, the latter is more highly regarded than the former. If you break a rule in the name of principle, you’ll be often regarded positively. If you obey a rule in betrayal of principles, you’d be perceived negatively. In Lawrence Kohlberg’s famous moral reasoning theory, a rule-based moralityis considered ‘conventional,’ and is located lower on the developmental ladder than a principle-based, ‘post conventional’ morality. Yet rules can be helpful in putting principles into practice. A transportation system that includes highways may be considered better developed that one that relies on country roads. But a truly developed system needs both.

Most of the systems that govern human conduct and decision makinginclude both principles and rules, yet systems may differ in which of these they lean more heavily on. For example, American football is a game of rules. Every nuance of the game is closely measured, officiated, prescribed, and addressed in preset ways. Soccer is a game of principles: Move the ball into the opponent’s net without using your hands or breaking other players’ shins. That’s more or less it. American football is heavy on equipment and technology; it involves many more referees than soccer, and many more stops, consultations, and rule-related controversies (Deflategate, etc.). Soccer flows. It is known as ‘the beautiful game.’

The work of psychotherapy concerns itself with principles and rules quite regularly. For therapy clients, I find, focusing on principles is often more productive than focusing on rules. Now granted, therapy is not a one-size-fits-all proposition. What works for one client may not work for another. At the same time, people are people, and commonalities exist. For example, when it comes to parenting, clients often find that they do well to behave in ways that satisfy the principles of generosity, fairness, and responsibility. Giving your kids no treats ever may be fair and responsible, but ungenerous. Giving one child more treats than the other may be generous and responsible, but unfair. Giving each child fifty treats to eat at once may be fair and generous, but not responsible. You get the idea.

Clients often benefit from figuring out general principles of thinking and decision making that work well across content areas in the mental health space. Here are three useful go-to principles of sound mental process:

Flexibility over Rigidity

This principle is based on the fact that cognitive flexibility is a hallmark of cognitive health. Cognitive flexibility refers to our ability to adapt our cognitive processing strategies to novel or unexpected environmental conditions. As such, cognitive flexibility implies a capacity for learning from experience. It also involves the ability to apply and adjust problem-solving strategies by exploring potential solutions inside a given problem space. It therefore is best thought of as a facility with complexity.

Life, as you may have noticed, is, if nothing else, complex. In such an environment, rigid, narrow, and simplistic thinking will not suffice. All-or-nothing perfectionism, for example, is rigid thinking. It is ill fitted to handle real life, which is much more likely to involve more-or-less propositions. Perfectionism distorts our analysis by turning life’s nuanced continua into crude dichotomies. Striving for excellence, on the other hand, affords the requisite flexibility. For the difference to become clear, think about someone in your life whom you love and admire: are they perfect or excellent?

One obstacle to the development of cognitive flexibility is the cache our culture attaches to dogged determination. Many successful people attribute their success to ‘not giving up,’ and to their stubborn insistence on pursuing a dream against the odds. Narratives of success against the odds are heralded and often compelling, but they are also misleading. In principle, it is better to go with the odds rather than against them (see under: Las Vegas). For example, if you want to become financially secure, you can play the lottery doggedly every day, or you can get an education and a good job. Some of those who choose the former strategy may be successful. And they will attribute their success to their stubbornness. But their good fortune doesn’t validate the strategy, because most of those who choose it will fail. Put differently: the fact that Steve Jobs succeeded after dropping out of college and starting a business doesn’t mean that dropping out of college to start a business is a sound strategy for success. The error illustrated by these examples is known in the literature as survivor bias. Those who succeed by beating the odds succeed despite, not because of, their strategy.

This is why much received wisdom, such as “Follow your dream and never give up,” constitutes poor life advice. Better to follow only those dreams for which you have aptitude and good success odds, and give up on the rest. Most successful people have given up on many dreams and goals along the way. Adaptive flexibility predicts success better than rigid stubbornness.

Compassion over Cruelty

This principle appears self-evident: Of course it is better to treat others with kindness rather than cruelty. Yet somehow this self-evident truth becomes less so when applied inward. Somehow, treating yourself with cruelty and lack of kindness doesn’t evoke the same moral outrage as seeing someone else treated this way, or experiencing yourself treated this way by someone else. Yet a fair evaluative system cannot accept an arbitrary double standard. If we accept and respect others who are imperfect, but fail to accept and respect ourselves on account of our imperfections, then we are creating a unique, and uniquely harsh, measurement system just for us, an unjustified double standard.

Click Read More to Continue

Hearing loss and cognitive decline: Study probes link

After analyzing 8 years of data from a health study of more than 10,000 men, scientists at Brigham and Women’s Hospital and Harvard Medical School, both in Boston, MA, found that hearing loss is tied to an appreciably higher risk of subjective cognitive decline.

In addition, the analysis revealed that the size of the risk went up in line with the severity of hearing loss.

The risk of subjective cognitive decline was 30 percent higher among men with mild hearing loss, compared with those with no hearing loss.

For men with moderate or severe hearing loss, the risk of subjective cognitive decline was between 42 and 54 percent higher.

Subjective cognitive decline refers to changes in memory and thinking that people notice in themselves. Such changes can be an early indication of cognitive decline that objective performance tests do not pick up on.

“Our findings,” says lead study author Dr. Sharon Curhan, who works as a physician and epidemiologist, “show that hearing loss is associated with new onset of subjective cognitive concerns which may be indicative of early-stage changes in cognition.”

They could also “help identify individuals at greater risk of cognitive decline,” she adds.

Dementia and early diagnosis

The World Health Organization (WHO) have identified dementia as a public health priority that requires more research, especially into causes and modifiable risk factors.

Today, there are around 50 million people living with dementia worldwide, and this figure is set to rise to 75 million by 2030.

There are currently no effective treatments that prevent or reverse the course of the disease.

However, early diagnosis can do much to improve the quality of life for people with dementia and those who care for them.

Identifying early decline in memory and thinking capacity could also help develop treatments that are more effective than those that target later stages of dementia, note the authors.

They go on to explain that subjective cognitive decline, that is, the changes in memory and thinking skills that people notice in themselves, can indicate “subtle features” of cognitive decline that do not show up in objective tests of performance.

This is borne out by imaging studies that have linked subjective cognitive function to brain changes that precede dementia.

Such findings support the notion that subjective cognitive function lies on a spectrum that includes mild cognitive impairment and predementia.

Hearing loss and cognitive decline

In the United States, a national survey has estimated that around 23 percent of those aged 12 or older have some level of hearing loss.

The majority of individuals affected have mild hearing loss. However, in those aged 80 or older, moderate loss is more common than mild loss.

Hearing loss and cognitive decline have some features in common. Their causes involve several factors and, in many cases, both get worse over time.

Dr. Curhan and colleagues remark that these common features likely point to a buildup of “auditory and neurodegenerative damage” over the lifespan.

For their investigation, they analyzed data from the Health Professionals Follow-Up Study (HPFS).

The HPFS recruited 51,529 men from health professions who were aged between 40 and 75 years when the study began in 1986. Their professions ranged from podiatry and dentistry to veterinary medicine and optometry.

Following enrolment, the men completed questionnaires about lifestyle, medication use, diet, and medical history every 2 years.

Click Read More for the results of the analysis.

Learn As You Go

I was recently asked about my top five inner practices for 2019, and here they are:

  • Drop the stone
  • Let it flow
  • Learn as you go
  • “Us” all “thems”
  • Open into awe

You can click the links above to see the first two. By “learn as you go,” I mean that each day is an opportunity to take in the good: to help useful or enjoyable experiences sink in and become a part of you. Then when you go to sleep, you’ll be a little stronger, a little more resilient, a little wiser, a little more loving, a little happier than you were when you woke up in the morning.

This kind of learning is not memorizing a multiplication table. It’s emotional learning, somatic learning. It’s becoming more skillful with the world around you and the world inside you. It’s social learning, motivational learning, even spiritual learning. It’s healing from the past and growing strengths for the future. It’s becoming more compassionate, confident, patient, capable, and joyful. This is the learning that matters most. If things fall apart, what’s already inside you is what you can really count on.

I grew up in a stable and loving home, but for a variety of reasons I was still very unhappy, awkward, and messed up inside. I didn’t know what to do and it seemed hopeless. Then about age 15, there was a big turning point when I realized that no matter what things were like at the present time, I could always look for ways to learn and grow from there – to get more skillful, to heal, to grow. I didn’t need to despair because it was in my power to develop myself in some way each day. To learn how to talk with other kids or not be so irritated by my parents or deal with my crazy thoughts. To learn how to make my way in the world. And that was full of hope.

We can’t do anything about the past but – to quote Captain Kirk in Star Trek – the future is an undiscovered country. It’s full of possibility, including the possibilities in who you are becoming. No one can stop you from learning. And no one can do it for you – which makes the results authentic, and yours to own.

How?

We’re having experiences all day long, but what actually sinks in? Usually it’s the moments of stress and sorrow, anxiety and anger, hurt and resentment. Meanwhile, all the many experiences of gratitude, accomplishment, friendliness, feeling cared about, wholesome pleasure, insight, and commitment pass through us like water through a sieve. This is due to the brain’s evolved negativity bias, which makes it like Velcro for bad experiences but Teflon for good ones.

To beat the negativity bias and grow more of the good inside yourself, there are just two steps – but you have to do both of them.

Two Steps
First, you need to experience whatever you want to grow. Such as an insight, intention, skill, satisfaction, calming, easing, soothing, or vitalizing. Second, that experience must leave a lasting physical trace behind in neural structure or function. Otherwise there is no lasting value, no healing, no growth, no learning.

The first step is usually easy. Most people are having many mildly pleasant or useful experiences each day and just have to notice them. And we can also create beneficial experiences, such as calling up the feeling of compassion or determination, or remembering what it feels like to be with someone who cares about you.

Second, once the “song” of that experience is playing in your inner iPod, turn on the recorder. This is the step that people routinely skip in everyday life, and that therapists and coaches and teachers (including myself) can fail to do when working with others. But if we miss this step, we’ve wasted the experience on the brain.

There are lots of ways to use the power of “experience-dependent neuroplasticity” (that’s a mouthful) to turn passing experiences into grit and gratitude and other inner strengths hardwired into your nervous system. (For a summary, check out my book Resilient.) Try one of these, or all three of them:

  • Stay with the experience for a breath or two or longer. There’s a famous saying: “Neurons that fire together, wire together.” The longer you keep them firing, the more they will tend to connect together.
  • Feel it in your body as much as possible. This is not about remembering specific events in your life, but about receiving the residues of lived experience into yourself.
  • Focus on what is enjoyable or meaningful about it. As the sense of reward in an experience increases, dopamine and norepinephrine activity in the brain tends to increase as well. This flags experiences as “keepers” and prioritizes them for long-term storage.

You might take these two steps only a few times a day, usually less than a minute at a time. But bit by bit, synapse by synapse, you’ll be growing happiness, love, and wisdom inside yourself.

Some Profound Implications
This practice is simple, down-to-earth, and natural. It’s also profound in a couple of ways.

First, experiences are continually changing; as Francis Bacon wrote: “We have only this moment, sparkling like a star in our hand – and melting like a snowflake.” Yet you can help them leave enduring tracks behind as they pass through consciousness. Remarkably, you can get lasting value from the melting moment even as you let go of it.

Second, as you take in the good over time, you feel increasingly filled up from the inside out. Then it feels like there is an enoughness of needs met already, even as you cope with challenges. This reduces our biologically rooted tendencies toward “craving” based on a sense of something missing, something wrong. As we grow an unshakable core of resilient well-being, there is less push inside to fight pain or chase pleasure or cling to other people.

Then our footprint on the world and others becomes lighter, and we also become harder to manipulate with fear or greed or “us against them” grievances and rivalries. We should certainly act to improve conditions in the world. But that is not sufficient – as we can see in the example of many privileged and affluent people who still see threats around every corner, can’t stop piling up more wealth no matter the cost, and dehumanize and bully others. The sense of enoughness must land in the heart and take root – and if it does in the hearts of enough people, that will change the course of human history.

6 Strategies to Overcome Insomnia

Do you occasionally find yourself up in the middle of the night, ruminating and unable to go back to sleep? Or do you sometimes have a hard time falling sleep because you have too much on your mind?

Part of the problem may be related to natural sleep patterns and waking/sleeping behavior, and another part of the problem may be how we deal with wakefulness. Here are strategies to address those problems and overcome insomnia.

1.     Understanding Sleep Patterns. A great deal of the worry associated with insomnia may be related to our misconceptions about sleep timing. Many of us adhere to the 8-hours-of-uninterrupted-sleep notion. This is the belief that sleeping straight through for 8 hours is “normal.” However, sleep research suggests that the normal pattern may be what is called “segmented sleep.” This is the idea that our natural rhythm is to sleep for 3-4 hours, followed by a 1-2 hour awake period, and a second 2-4 hour sleep. Historical evidence suggests that segmented sleep was once common, and our ancestors used the mid-night waking period to visit with neighbors, have a snack, or have sex.

2.     Cognitive Reframing. Occasional insomnia may occur because of our belief system about sleep. We may worry about our lack of uninterrupted sleep, or too few hours of sleep per night, and this anxiety often keeps us awake. By cognitive reframing—thinking differently about our sleep patterns—we may alleviate some of our insomnia. An obvious strategy is to assure ourselves that segmented sleep is ok, and a few nights of poor sleep will not lead to lasting damage.

3.     Benign Reflection. Wakefulness, right after we hit the sack or in the middle of the night, offers an opportunity to put negative thinking on hold, count our blessings, and reflect on the many positive things in our lives. By moving our thought patterns from negative to positive, it may become easier to fall asleep.

4.     The To-Do List. Sometimes insomnia is caused by the many things that we have to do the next morning, and we ruminate about them and can’t get back to sleep. This is the time to make a mental to-do list or have a pen and paper next to your bed and write it all down. Very often, once we make the list, we realize that there wasn’t all that much to do in the first place.

5.     Wrestle Your Demons. Perhaps wakefulness is not a bad thing, but an opportunity to reflect and solve problems. We can often cognitively put our demons to rest by thinking through problems and issues. And, coupled with benign reflection, we might satisfy our cognitive musings and return to peaceful sleep.

6.     Be Productive. Take advantage of wakeful time and get something done. It was mid-night insomnia, and the reflection it provided, that led to this blog post. (In fact, I got up way too early in the morning to write it down). Taking advantage of segmented sleep might lead you to accomplish tasks, and it may even tire you out so that you can get a restful, “second” sleep.

Why Exercise Is Good for Your Brain

As JPM Healthcare week kicks off in San Francisco, the conversation around healthcare turns clairvoyant as experts weigh in on their predictions for the big trends in the coming year. One of the main topics: Will this be the year we finally see a successful drug for Alzheimer’s disease?

But rather than play a guessing game, why don’t we look at what we know actually prevents dementia—improving your lifestyle. This article is the first in a five-part series focused on evidence-based methods to prevent dementia through lifestyle. Let’s begin with exercise.

Healthy Body, Healthy Mind

The Federal Government first published the Physical Activity Guidelines for Americans1 in 2008. Using science-based advice, these guidelines provide an overview of how much exercise Americans should perform each week (i.e., at least two days of muscle strengthening activity combined with at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise). These guidelines address both healthy individuals and those at increased risk of chronic disease, stressing how exercise can prevent the effects of certain chronic diseases, including dementia.

An updated edition of the Physical Activity Guidelines was released in late-2018. The primary update was a section dedicated to the relationship between physical activity and brain health. This section explains the benefits of exercise for cognition, sleep, depression, anxiety, and overall quality of life. The government’s recognition of brain health finally publicizes its integral role in overall health and highlights how exercise benefits not just your body, but also your mind.

How Exercise Improves Brain Health

There are many ways exercise improves cognitive health. Aerobic exercise (also known as cardio) raises your heart rate and increases blood flow to your brain. Your increased heart rate is accompanied by harder and faster breathing depending on the intensity of your workout. As your increased breathing pumps more oxygen into your bloodstream, more oxygen is delivered to your brain. This leads to neurogenesis—or the production of neurons—in certain parts of your brain that control memory and thinking.  Neurogenesis increases brain volume, and this cognitive reserve is believed to help buffer against the effects of dementia.

Another factor mediating the link between cognition and exercise is neurotrophins, which are proteins that aid neuron survival and function. It has been noted that exercise promotes the production of neurotrophins, leading to greater brain plasticity, and therefore, better memory and learning. In addition to neurotrophins, exercise also results in an increase in neurotransmitters in the brain, specifically serotonin and norepinephrine, which boost information processing and mood.

Exercise’s Lasting Effects on Cognition

In 2017, the Lancet released its landmark research commission on dementia prevention, intervention, and care that demonstrated that 35 percent of risk factors for developing dementia can be attributed to modifiable lifestyle traits. A significant component: exercise.

In a longitudinal study conducted by Dr. Zhu from the University of Minnesota, exercise tests were administered to a group of participants to determine their fitness levels. Those who were the most active in 1985 tended to still be on the fit side of the spectrum decades later. That same “fit” cohort also performed better on cognitive tests decades later.

Furthermore, exercise gives hope to people with a rare genetic mutation that programs them for early-onset Alzheimer’s disease. Although exercise cannot completely counteract their genetic predisposition, people who exercised for at least 150 minutes per week had better cognitive outcomes compared to those who did not.

Incredibly, exercise could potentially delay their dementia onset by up to 15 years.

Does Workout Type Matter?

Both the type of workout and method of staying fit are important to whether or not you experience cognitive benefits. It’s not enough to just count calories to stay thin, you still need to exercise. In fact, there is a term in medicine for people who are not healthy overall but manage to stay thin: TOFI (Thin Outside Fat Inside). Rather than exhibiting fat externally and appearing overweight, these individuals carry weight viscerally, around their internal organs. This is harmful to overall health—including brain health.

Between three sets of people—individuals who lost weight through restrictive eating, people who lost weight through exercise, and a group that used a combination of the two—only the groups who had exercise as part of their weight loss regimen noted an improvement in cognition.

It’s most important to concentrate on the type of exercise you perform if your goal is to maximize your cognitive health. A multi-component routine focused on balance, flexibility, and aerobic fitness is better than focusing on just one type of exercise. For example, tai chi has been heralded as an example of an all-encompassing exercise routine that significantly enhances cognition. A meta-analysis of research on tai chi and cognition found tai chi exhibited a greater effect on cognitive function than other types of exercise.

However, any exercise is better for your brain than none at all.

So, pick your exercise of choice! Go walking, running, swimming, hiking, or biking. Enjoy the fresh air. Get in touch with nature. And reap the many health benefits of exercise—both physical and mental.

The Science of Creating New Year’s Resolutions That Work

Research shows that people tend to make big life decisions at the first of the year, which gives us New Year Resolutions. This is the right time for changes both large and small.

Instead of following some of the usual folksy advice about how to make and keep New Year’s resolutions, you could, instead, use brain and behavioral science to craft New Year’s resolutions that will actually work.

Here are some ideas on how to do that.

1. Pick small, concrete actions. “Get more exercise” is not small. “Eat healthier” is not small. This is one reason New Year’s resolutions don’t work.

A lot of New Year’s resolutions are about habits — eating healthier, exercising more, drinking less, quitting smoking, texting less, spending more time “unplugged” or any number of other “automatic” behaviors. Habits are automatic, “conditioned” responses.

If it’s a habit, and you want a new one, it must be something really small and specific. For example, instead of “Get more exercise,” choose “Walk for at least 20 minutes at least four times a week” or “Have a smoothie every morning with kale or spinach in it.”

2. Use visual and/or auditory cues. Want to go for that walk everyday? Set up a place in your home where your walking shoes are. Don’t put them away in a closet. Put them in a place where you will see them when you get home from work or first thing in the morning. The shoes will act as a visual cue. And/or set an alarm on your phone called “Go for a walk” and have the alarm go off every morning at 7:30 a.m. People become conditioned to auditory and visual cues and that makes it easier for an action to become a habit.

3. Decide what you want, not what you DON’T want. Instead of setting a resolution of “I’m not going to check my email 10 times a day,” set it for what you ARE going to do: “I’m going to use “batching and check my email only twice a day.” Instead of “I’m going to drink less soda,” set the resolution as “I’m going to replace drinking a soda with drinking water.” Although this may seem not that different, it’s important. It’s easier for your brain networks to work on an intention stated in the “affirmative” than it is stated in the “negative.”

4. Write a new self-story. The best (and some would say the only) way to get large and long-term behavior change, is by changing your self-story.

Everyone has stories about themselves that drive their behavior. You have an idea of who you are and what’s important to you. Essentially you have a “story” operating about yourself at all times. These self-stories have a powerful influence on decisions and actions.

Whether you realize it or not, you make decisions based on staying true to your self-stories. Most of this decision-making based on self-stories happens unconsciously. You strive to be consistent. You want to make decisions that match your idea of who you are. When you make a decision or act in a way that fits your self-story, the decision or action will feel right. When you make a decision or act in a way that doesn’t fit your self-story you feel uncomfortable.

If you want to change your behavior and make the change stick, then you need to first change the underlying self-story that is operating. Do you want to be more optimistic? Then you’d better have an operating self-story that says you are an optimistic person. Want to join your local community band? Then you’ll need a self-story where you are outgoing and musical.

New Study Looks into Concussions and Suicide Risk

An assessment of cohort, cross-sectional, and case-control studies involving more than 7 million individuals has found an association between concussions, mild traumatic brain injury (TBI), and risk of suicide.

The analysis, led by Michael Fralick, MD, SM, of the Department of Epidemiology at Harvard TH Chan School of Public Health, reiterates a clinical trend reported as recently as this summer. In August, a Denmark-based study of a similar patient population size reported that those who suffer from concussions and/or TBI face a nearly two-fold greater risk of suicide.

This newest assessment involved a systematic search of studies reported from 1963 to May 1, 2017. Investigators included 17 analyses which featured 718,572 patients diagnosed with concussion and/or mild TBI, and 6,974,124 individuals not diagnosed with either neurological condition.

Among the 17 studies, 14 included patients in North America, 2 included patients in Scandinavian countries, and 1 was conducted in Australia. Military personnel—a subpopulation popularly associated with both TBI and suicide risk—were included in 7 studies, while children from the general population were included in 3 studies.

Investigators found there to be a more than two-fold greater risk of suicide in people to be diagnosed with at least 1 concussion and/or mild TBI compared to those not diagnosed with either (RR= 2.03 [95% CI: 1.47 – 2.80] P < .001). A majority of studies also reported a heightened risk of suicide attempt following a concussion and/or mild TBI. Additionally, all 8 studies to assess risk of suicidal ideation had reported a heightened risk following concussion and/or mild TBI diagnosis.

In separate, stratified analyses comparing military personnel to civilian populations, investigators reported a higher combined estimate for studies of nonmilitary populations (RR 2.36 [95% CI: 1.64 – 3.40] P < .01) than the combined estimate for studies of military populations (RR 1.46 [95% CI: 0.80 – 2.58] P < .01).

Despite there being a heightened risk of suicide in this patient population, investigators observed that “nearly all patients diagnosed with concussion and/or mild TBI did not die by suicide.” They theorized that abnormal activity on functional magnetic resonance imaging (MRI) as well as abnormal structural connectivity in the brain regions necessary for cognitive and emotional processing—trends noted in recent meta-analyses of mild TBI neuroimaging studies—could explain this trend of depression in individuals exposed to more TBI.

“In addition, multiple neuropathological models have been proposed for how neurobehavioral impairment may occur in the short term and long term after concussion and/or mild TBI,” investigators noted.

The most notable of these—chronic traumatic encephalopathy (CTE)—has been associated with contact sports, concussions and/or mild TBI, and symptoms of depression, anxiety and impulsivity. That said, it’s also been reported in athletes without any history of concussion or mild TBI.

“The lack of a prior documented concussion and/or mild TBI might be because of underreporting of these conditions, but this also raises the possibility that subconcussive events could be sufficient to cause (CTE),” Fralick and colleagues explained.

Making reference to notable former National Football League (NFL) players Junior Seau and Mike Webster—both of whom had previously suffered from concussions in their playing days and subsequently died from suicide years after—as well as to the prevalence of concussions and/or TBI and suicide in military personnel, investigators stressed the significance of their assessment.

“Although there has been anecdotal evidence reported in newspaper reports, movies, and documentaries suggesting a link between concussion and/or mild TBI and subsequent suicide, past studies on the topic have been limited by small sample sizes and conflicting results,” investigators noted.

They also emphasized the high prevalence of both concussions, which occur approximately 4 million times in the US annually—with up to 25% of patients experiencing chronic neuropsychiatric symptoms including anxiety and depression for years after injury.

“Evaluating the potential association between concussion and/or mild TBI and suicide is important, because concussion and mild TBI are common, affect individuals of every age, and are often preventable,” Fralick and colleagues wrote. “Furthermore, even if the absolute risk of suicide is low, evidence of an association between concussion and mild TBI and suicide across a range of populations is important because of the seriousness of the outcome.”

In an essay accompanying the meta-analysis, Donald A. Redelmeier, MD, MSHR, and Junaid A. Bhatti, MBBS, MSc, PhD, of the Departments of Medicine and of Surgery at the University of Toronto, noted the accumulated findings do not prove causality over correlation.

“Patients who receive a diagnosis of a concussion might have already had a latent psychiatric illness that contributed to the incident and the outcome,” the pair argued. “For example, one shared factor could be alcohol use, which is often poorly identified in medical data. Disentangling such factors is difficult because it is unethical to randomize patients to receive a concussion.”

That said, they added that Fralick and colleagues’ greatest contribution is by creating a comprehensive review of medical science suggesting a significant association between TBI and subsequent suicide risk. Consequently, they advise clinicals use proper terminology and etiquette when diagnosing concussion-like symptoms, and neurologists should be keen to suicide risk and the additional factors involved in suicidality.

After all, they conclude, concussions can be lethal in their own way.

“The major implication of this meta-analysis is to highlight that an acute concussion might add to long-term neuropsychiatric illness,” Redelmeier and Bhatti prose. “Health care needs to focus on the prevention of concussions, although the cost-effectiveness of specific tactics that are based on engineering, education, equipment, or regulation is uncertain.”

The study, “Association of Concussion With the Risk of Suicide,” was published online in JAMA this week.

What Kind of Happiness Do People Value Most?

Sure, everyone wants to be happy. But what kind of happiness do people want? Is it happiness experienced moment-to-moment? Or is it being able to look back and remember a time as happy? Nobel Prize winner Daniel Kahneman described this distinction as “being happy in your life” versus “being happy about your life.”  Take a moment to ask yourself, which happiness are you seeking?

This might seem like a needless delineation; after all, a time experienced as happy is often also remembered as happy. An evening spent with good friends over good food and wine will be experienced and remembered happily. Similarly, an interesting project staffed with one’s favorite colleagues will be fun to work on and look back on.

But the two don’t always go hand in hand. A weekend spent relaxing in front of the TV will be experienced as happy in the moment, but that time won’t be memorable and may even usher feelings of guilt in hindsight. A day at the zoo with one’s young children may involve many frustrating moments, but a singular moment of delight will make that day a happy memory. A week of late nights stuck at the office, while not fun exactly, will make one feel satisfied in hindsight, if it results in a major achievement.

While happiness scholars have long grappled with which form of happiness should be measured and pursued, nobody has simply asked people which version of happiness they seek. But if we want to find ways to be happy, it may help to understand what type of happiness we truly want.

In a series of studies, recently published in The Journal of Positive Psychology, we directly asked thousands of people (ages 18 to 81) about their preference between experienced and remembered happiness. We found that people’s preferences differed according to the length of time they were considering — and according to their culture. For Westerners, the happiness most people said they wanted for the next day was different from the happiness they said they wanted for their lifetime, even though one’s days add up to one’s life. We found this interesting; if people make decisions by the hour, they may end up with a different version of happiness than what they say they want for their life.

In one study, we asked 1,145 Americans to choose between experienced happiness (“where you experience happiness on a moment-to-moment basis”) and remembered happiness (“where afterwards you will reflect back and feel happy”) for either a longer timeframe (i.e., their life overall or next year) or a shorter timeframe (i.e., their next day or hour). The majority of participants chose experienced happiness over remembered happiness when choosing for their life (79%) or their next year (65%). By contrast, there was a roughly even split of participants who chose experienced happiness and remembered happiness when choosing what they wanted for their next hour (49%) or day (48%).  This pattern of results was not affected by individuals’ overall happiness, impulsivity, age, household income, marital status, or parental status.

After participants made their choices, we asked them to write a short paragraph explaining why. We found that those who favored experienced happiness mostly expressed a belief in carpe diem: a philosophy that one should seize the present moment because the future is uncertain and life is short. On the other hand, participants’ explanations for choosing remembered happiness ranged from a desire for a longer lasting happiness, to a nostalgic treasuring of memories, to the motivation to achieve in order to feel productive and proud.

Social Media: Why Does it Make Us Feel More Lonely?

Findings from a recently released study[i] demonstrate that social media use can directly impact our mental health, causing increased levels of depressive symptoms and loneliness. In an experimental study, researchers at University of Pennsylvania followed college students over the course of three weeks, asking them to send nightly screen shots of their battery usage (which reveals how much time they spent on social media per day). The experimental group was asked to limit their social media usage of Facebook, Instagram, and Snapchat to 10 minutes per platform per day (no more than 30 minutes per day total). The control group was told to continue social media use as usual. Researchers found that all students in the study showed decreased anxiety and “fear of missing out” (FOMO) scores over baseline, presumably due to self-monitoring throughout the three weeks. It seems that just being aware of how much you are using social media each day helps you use less and actually feel better in terms of worries over missing out on what others are doing. But interestingly, the experimental group (students who limited their social media use to only 30 minutes per day) had significantly lower depressive symptoms and loneliness than did the control group by the end of the three weeks.

This finding is eye opening in that many studies have shown a correlation between social media use and negative mental health symptoms— including depression, anxiety, loneliness, and even suicide-related outcomes[ii]. The relationship between negative mental health and social media use is strongest for those whose people whose usage patterns are the heaviest. While researchers continue to amass data indicating this connection, the actual direction of the relationship remained unclear: Is it that depressed and lonely people are more likely to seek out social media and use it more often than others, or does social media use directly contribute to people’s experience of more negative mental health symptoms? This study gives us initial evidence about the direction of the relationship.

Why Would Social Media Make Us Lonely?

In exploring the somewhat puzzling finding that social media use leads to negative mental health outcomes, particularly depression and associated loneliness, the question becomes, “Why? Why would social media use lead to increased depressive symptoms? Isn’t the purpose of using social media to be social, to increase and enhance our connections with others?” Looking at the pervasive use of social media in our current culture, there is no doubt that we are definitely more “connected”, but these online connections just don’t seem to be emotionally satisfying. When using social media for multiple hours per day to the neglect of face-to-face interactions, people report feeling less fulfilled and even more isolated. As people mindlessly scroll through their feeds, they compare themselves to others, which can create envy, feelings of rejection, and contribute to a “fear of missing out” on the great time everyone else seems to be having. Even more concerning, for younger users who are in the process of developing an identity, their development of an authentic sense of self can be impaired when they “live for likes” and measure their worth by the number of friends and followers they can accumulate. Further, when they are heavily immersed in social media, they are also likely to be sacrificing active participation in non-screen activities that are known to boost mental health and well-being. Finally, many users report that social media use contributes to decreased hours of sleep, and sleep deprivation also contributes to poor mental health.

Strategies for Social Media Resilience

While these findings seem like bad news for parents of teens (the heaviest users of social media), young adults, and actually any individual who is a heavy user of social media, the results of this particular study can be seen as encouraging in some ways— you don’t need to go cold turkey and put down your phone forever in order to feel better. An abstinence approach is simply unrealistic in current culture, particularly for younger people. The study demonstrates that people should become more mindful of their usage patterns (and that this practice alone will help curb our usage) and that they should put limits in place if they don’t want their social media experience to lead to increased depression and loneliness. How to start? Here are eight ideas to promote your social media resilience:

  1. Be intentional about Social Media Visits. Instead of considering social media as a 24-hour, ever-present experience in which you remain immersed, think about your platforms as simply a place to “visit”. Intentionally decide when to open your social media apps, decide how long you intend to visit, and when you intend to leave. While the highlighted study suggests that people who reduced their use to 30 minutes per day had more positive benefits than those who used more than 30 minutes, this might not be the right number for everyone. The point is to pay attention to your urge to look at social media, be mindful of how long you want to spend there, enjoy your brief visit, and then move on to something else in your life.
  2. Turn off Notifications and Close the Apps. Once you have closed your social media app/site, try not to think about it again until the next time you decide to visit. This is almost impossible if you receive notifications every few seconds about what you are missing out on by not checking your app. One way to help you do this is to change your notification settings so that you do not receive notifications about new posts, etc. If you are on a computer, close the window so you will not continue to receive notifications and messages as you try to do something else on your device.  It is exceedingly difficult to fully concentrate on other tasks (or on face-to-face conversations with real people) if you are constantly interrupted by a series of pings that draw you back into your feed.
  3. Become an Active Participant rather than a Passive Scroller. There is some research evidence to suggest that people who passively scroll through their feeds are more negatively impacted by social media than those who actively participate on others’ posts as they scroll (e.g., making comments, clicking “likes”, sharing stories). Try to intentionally interact with others’ posts when you visit your social media pages.
  4. Limit Social Media Platforms. Some research suggests that the more social media platforms you use, the more likely you are to experience depression and anxiety. In fact, in one study, the total number of media platforms that participants used was more strongly associated with depression and anxiety than was the total amount of time they spent on social media[iii].
  5. Put the Device Away at Least an Hour Before Bedtime. Social media use is associated with sleep deprivation, which can contribute to poor mental health. This occurs for two reasons: one, because the light emitted from your phone (or device) tends to suppress the production of melatonin, a naturally occurring hormone that your body produces in order to induce sleep. So using your phone or device at bedtime makes it harder for you to fall asleep. Second, many people report using social media at bedtime and then using it far longer than they intended, losing valuable hours of sleep. This is particularly detrimental for teens who sleep with their phones at night and whose sleep is continually disrupted by notifications and checking social media throughout the night. It is far better for teens to turn their phones in at night to an agreed upon charging area (not in their bedrooms) so that they can actually obtain much needed quality sleep[iv].

Click “Read More” for additional tips.

Why You Can’t Think Straight When You’re Sleep Deprived

After a bad night of sleep, we all typically feel distracted and off our mental game. But do you really know all the ways a lack of sleep interferes with your cognitive performance? Most of my patients are surprised to learn just how broadly it affects their ability to think at their best.

It’s difficult to identify a cognitive skill that isn’t affected by sleep and compromised by sleep deprivation. That’s how pervasive the effects of insufficient sleep are on the brain.

Thanks to recent research, we know that sleep deprivation interferes with brain function at a cellular level. A study by scientists at UCLA found that sleep deprivation interferes with the ability of some brain cells to function and communicate with one another. We’ve got billions of neuralcells working on our behalf, enabling us to make decisions, process information, focus on important information—and remember it down the road. Sleep deprivation slows that work down, compromising our mental performance.

Less robust brain-cell activity isn’t the only way poor sleep hampers our ability to think. Other recent discoveries have told us more about how lack of sleep changes brain function and cognitive performance.

Sleep deprivation…

disrupts levels of chemicals, including serotonin, dopamine, and cortisol, that affect thought, mood, and energy.
leaves key areas of the brain in an “always on” state of activation.
activates genes that interfere with optimal brain activity.
Because genetic makeup is different from one person to the next, the effects of sleep deprivation on brain function can be, as well—so, some people will experience the negative cognitive and mood effects of sleep deprivation more than others.

We’ve still got much to learn about the full effects of poor and insufficient sleep on cognitive performance and health. But as you’re about to see, what we know already offers many compelling reasons to make getting plenty of sleep a top priority.

You can’t focus well.

Attention is especially sensitive to the effects of sleep deprivation. You know this through experience when you have trouble focusing on tasks after a night of poor sleep. Unfortunately, “a night of poor sleep” is often a series of nights of poor sleep, leading to chronic sleep debt and continually compromised attention.

New research suggests that as many as 75 percent of people with ADHDmay have a chronic, underlying sleep problem stemming from a disruption to their circadian rhythms.

Attention is about focus and concentration—your ability to stay with tasks long enough to make meaningful progress. For most of us, focus is key to both our performance and our sense of purpose, in and away from work. Sleep deprivation makes focus harder to achieve.

Your reaction time slows down.

Attention isn’t only about focusing on big, thought-intensive tasks. It’s also about focusing on—and making sense of—what’s important right now. Remember those sluggish brain cells that result from being sleep deprived? Scientists in that recent study found that sleep deprivation slowed down neural cells’ ability to absorb visual information and translate that visual data into conscious thought. Research shows reaction times are dulled as much by sleeplessness as they are by alcohol.

Reacting to changing circumstances around us is a critical skill that helps keep us—and others—safe. And it can be significantly compromised by sleep deprivation.

You have trouble making—and storing—memories.

Research shows just how important sleep during middle age can be to memory and cognitive health in later years. A new study found that disrupted sleep during middle age, including insomnia, is connected to cognitive decline a decade or more later. (It isn’t just sleeping too little during middle age that is linked to greater risk for cognitive decline later on—the study found sleeping 9 or more hours a night was also associated with later-in-life cognitive problems.)

We know sleep is deeply critical to memory in all its phases—from acquiring memories, to storing them, to recalling them. All phases of memory are complex and involve multiple areas of the brain that are affected by lack of sleep.

Alzheimer’s: Artificial intelligence predicts onset

The team responsible suggests that, after further validation, the tool could greatly assist the early detection of Alzheimer’s, giving treatments time to slow the disease more effectively.

The researchers, from the University of California in San Francisco, used positron-emission tomography (PET) images of 1,002 people’s brains to train the deep learning algorithm.

They used 90 percent of the images to teach the algorithm how to spot features of Alzheimer’s disease and the remaining 10 percent to verify its performance.

They then tested the algorithm on PET images of the brains of another 40 people. From these, the algorithm accurately predicted which individuals would receive a final diagnosis of Alzheimer’s. On average, the diagnosis came more than 6 years after the scans.

In a paper on the findings, which the Radiology journal has recently published, the team describes how the algorithm “achieved 82 percent specificity at 100 percent sensitivity, an average of 75.8 months prior to the final diagnosis.”

“We were very pleased,” says co-author Dr. Jae Ho Sohn, who works in the university’s radiology and biomedical imaging department, “with the algorithm’s performance.”

“It was able to predict every single case that advanced to Alzheimer’s disease,” he adds.

Alzheimer’s disease and PET imaging

The Alzheimer’s Association estimate that around 5.7 million people live with Alzheimer’s disease in the United States and that this figure is likely to rise to almost 14 million by 2050.

Earlier and more accurate diagnosis would not only benefit those affected, but it could also collectively save about $7.9 trillion in medical care and related costs over time.

As Alzheimer’s disease progresses, it changes how brain cells use glucose. This alteration in glucose metabolism shows up in a type of PET imaging that tracks the uptake of a radioactive form of glucose called 18F-fluorodeoxyglucose (FDG).

By giving instructions about what to look for, the scientists were able to train the deep learning algorithm to assess the FDG PET images for early signs of Alzheimer’s.

We Need to Talk More About Mental Health at Work

Alyssa Mastromonaco is no stranger to tough conversations: she served as White House deputy chief of staff for operations under President Obama, was an executive at Vice and A&E, and is Senior Advisor and spokesperson at NARAL Pro-Choice America. So when Mastromonaco switched to a new antidepressant, she decided to tell her boss.

“I told the CEO that I was on Zoloft and was transitioning to Wellbutrin,” Mastromonaco said. “I can react strongly to meds, so I was worried switching would shift my mood and wanted her to know why. I talked about it like it was the most normal thing in the world —it is!”

Her boss was supportive. “You got it,” she said.

When Mastromonaco goes to work, she and her mental health struggles do not part ways at the door. “You want me,” she said, “you get all of me.” Mastromonaco brings tremendous talent to her workplace — but she also brings her anxiety. The same is true for high-performing employees everywhere: one in fouradults experiences mental illness each year and an estimated 18% of the US adult population have an anxiety disorder. And yet we’re loath to talk about mental health at work. If we’re feeling emotional at work, our impulse is to conceal it — to hide in the bathroom when we’re upset, or book a fake meeting if we need alone time during the day. We’re hesitant to ask for what we need — flex time, or a day working from home — until we experience a major life event, like a new baby or the illness of a parent. We would more likely engage in a trust fall with our boss than admit that we have anxiety.

Mental illness is a challenge, but it is not a weakness. Understanding your psyche can be the key to unleashing your strengths — whether it’s using your sensitivity to empathize with clients, your anxiety to be a more thoughtful boss, or your need for space to forge new and interesting paths. When we acknowledge our mental health, we get to know ourselves better, and are more authentic people, employees, and leaders. Research has found that feeling authentic and open at work leads to better performance, engagement, employee retention, and overall wellbeing.

Still, less than one third of people with mental illness get the treatment they need, and this comes at a cost — to people and to companies. Failure to acknowledge an employee’s mental health can hurt productivity, professional relationships, and the bottom line: $17-$44 billion is lost to depression each year, whereas $4 is returned to the economy for every $1 spent caring for people with mental health issues.

So what needs to change? In the twenty-first century, human capital is the most valuable resource in our economy. And though much has been done (rightly) to promote diversity at work, there’s a giant hole when it comes to understanding how temperament and sentiment play into the trajectory of success. As we recognize neurological and emotional diversity in all of its forms, workplace cultures need to make room for the wide range of emotions we experience. Professional support needs to get better. We need to have the option to ask for help, and feel safe doing so (depression screenings are free under the Affordable Care Act, and some companies offer an Employee Assistance Program). In short, we need more flexibility, sensitivity, and open-mindedness from employers. The same treatment and attention they’d give to a broken bone or maternity leave. We’re not there yet, but some companies are trying to bring conversations about mental health to the forefront.

EY (formerly Ernst and Young) launched a We Care program two years ago to educate employees about mental health issues, encourage them to seek help if they need it, and be a support to colleagues who might be struggling with mental illness or addiction. They started the program out of a demonstrated need. “Our Employee Assistance Program was starting to hear more conversations about anxiety,” said Carolyn Slaski, EY Americas Vice Chair of Talent. “They told us that it was very taboo — something that people don’t normally talk about — but they were seeing more activity, so we decided to schedule a session to talk about anxiety. Just talk about it and see what would happen.”

Since the advent of the We Care program, 2000 EY employees have attended these sessions, which always have a senior-level sponsor and a mental health professional on hand. Someone in leadership kicks it off by sharing their story. This sends the message that anxiety is not toxic and attendance is not a career-dampener.

The company also has an employee assistance hotline that offers confidential support — calls related to anxiety have increased 30% over the last two years. “You have to notice first if someone is struggling,” said Slaski, “and ask them if they’re okay. Learn how to listen to their concerns, and then act. Our company has 47,000 US employees, and 250,000 globally. If I can get my team comfortable just noticing when someone has an issue, then there is so much more we can do for them. These are people reaching out for help. We want to help. We don’t want to have a stigma around it.”

Other companies, like Michigan-based furniture store, Herman Miller, offer free onsite counseling sessions to employees and their families, and courses on mental health first aid that teach them how to recognize signs of mental illness in others. The goal is to empower people to achieve their optimal state of well-being.

What organizations like EY and Herman Miller realize is that, given the right support, employees who struggle with their mental health can do great work. Most people who suffer from chronic anxiety or depression are excellent at faking wellness. We put on our makeup, get dressed, and show up on time. But we never know when an attack might be around the corner. This is why a work environment that is open and understanding is so important. Anxiety is a lingering expectation that something bad is going to happen, and if we don’t talk about it, it’s harder to recognize our triggers and learn healthy ways to cope. But when we do talk about it, we can actually teach ourselves to harness it in ways that play to our strengths.

What’s the Best Way to Treat a First Bout of Depression?

In the midst of these difficulties, a person faces an important decision: What is the best way to treat my depression? Options include talking with close friends and family members, self-help books and apps, over-the-counter remedies, psychotherapy, and prescription medication, among others. Many people find these choices overwhelming and are not sure where to begin, especially because it’s their first time dealing with depression.

Thankfully many people have thought really carefully about this decision, and none more than psychologist Robert J. DeRubeis of the University of Pennsylvania. I recently interviewed Rob to discuss the current state of the science in depression treatment research.

Do I Have a Chemical Imbalance?

First, let’s think about what causes depression, which may affect choice of treatment. An explanation that seems to have saturated popular culture is that depression is caused by a “chemical imbalance.” Most often the imbalance is said to involve too little serotonin—with the understanding that a drug is needed to fix it. I asked Rob for his perspective on this theory:

Seth J. Gillihan: What causes depression? Is it a chemical imbalance?

Robert J. DeRubeis: The chemical imbalance theories that came around in the 1950s were quite intriguing and they captured the imagination of the profession. There’s no doubt that whenever we are in a particular mood or when we come out of that mood, there are associated events in the brain. That’s a given and we all understand that.

But theories that led some to talk about a ‘chemical imbalance’ as a rather simple matter have really not panned out. There’s nothing simple about the neurotransmitters and their relation to depression. The brain’s a very complicated organ, and current thinking is more focused on the regulatory systems in the brain that are more active in some people than in others.

SJG: And yet that simple account of a chemical imbalance has been surprisingly persistent given how little data there have been to support it.

RJD: Yes, and of course it’s connected to the predominant treatments in the US and many other Western countries for people with mood difficulties—that is, the antidepressant medications. And so there are some kind of interesting links between what we think the antidepressant medications are doing and what we know about what happens at the synapses in certain areas of the brain, but the connections are not very tight, strong, or well understood. And indeed as I’ve read these literatures and contributed a bit to them, it’s common enough that what we find about a given neurotransmitter system is the opposite of what was first proposed.”

Can Psychotherapy Really Help with Severe Depression?

The lack of evidence for a chemical imbalance in depression might call into question whether the condition requires a chemical solution. I asked Rob about existing research comparing the effectiveness of meds and psychotherapy, particularly for severe cases of depression.

SJG: When I started in my doctoral program at Penn in 2001, the idea was that medication was like a key that fit in the lock of your chemical imbalance, which fed the idea that the real treatment for real depression was medication. Someone I interviewed with at Penn actually predicted that in a study you were doing at the time, ‘the meds were going to beat up on the therapy’ in the head-to-head comparison of CBT and an SSRI. So I wanted to get your perspective on why it was widely assumed that medication was better than the best therapy for treating severe depression.

RJD: In the 1970s and ’80s, the possibility that we could correct a simple imbalance was very exciting, and the medications that were being used were more effective than placebo pills, on average, for people with substantial depression. So the idea was that ‘Here we have a real and serious treatment for depression.’

Then along came a relatively small study—but an intriguing one—that found that cognitive therapy outperformed medication in that randomized trial. This was surprising to many who believed that ‘real’ depression needs a ‘real,’ physical treatment, and there were many skeptics, as there should have been. But then a couple of other studies showed very similar kinds of effects that were encouraging about the benefits of cognitive therapy in comparison to medication.

And then in what was thought to be a large study comparing medications with cognitive behavioral therapy, there were reports that medications outperformed CBT for those with the most severe symptoms [Elkin et al., 1989—a study that’s been cited over 3200 times]. This finding confirmed preexisting notions among the psychiatric community, and also spread to the public. The belief was that ‘now that we’ve done the real study and we’ve looked at more severe depression, we can see that we were too optimistic to think that CBT could work as well as meds.'”

This 1989 study did indeed seem to have a lot of sway over the depression treatment field; it was frequently cited as evidence for the superiority of medication over psychotherapy. But as Rob explains, the implications of that study’s findings appear to have been overblown.

RJD: It turns out that in that study, the comparison that everyone was excited about and took very seriously was a comparison of 27 patients in each group. Now, that’s not nothing, and it certainly is data that one needs to take into account. In the 1999 paper we wrote, those 27 patients who got medication in that trial did significantly better than those in cognitive therapy, but it turned out that study was unusual in that regard. Clinical science is a larger enterprise than one study, and when we were able to look across several studies, there was no advantage of the medications at all in the short run. Cognitive therapy and medications, on average, performed essentially exactly the same.

Does Medication Work Faster Than Psychotherapy?

While CBT and medication appear to be equivalent in their short-term effectiveness, some have suggested that medication works faster, and thus can lead to quicker relief.

SJG: One of the other common arguments for giving antidepressant medications right away is that they work faster than psychotherapy. Is that the case?

RJD: They don’t. And this belief again somehow meets up with preconceptions, but in the analyses we’ve done, there really isn’t a difference in speed of the effects, and if there are any, they’re really slight. Of course, it’s going to depend a bit on what the medication is and how active and directive and potent the psychotherapy is. But if you’re talking about an effective antidepressant and an effective cognitive behavioral therapy, the rates of change are pretty much on top of each other, on average.

What You Need To Know About Poor Sleep And Alzheimer’s Risks

I work every day at keeping my brain in good shape. I read, I play games with my kids (Words with Friends, anyone?), take supplements, you name it. I eat a diet that emphasizes brain food—including those omega 3s I wrote about recently. I also make sure to get plenty of sleep.

I’m working hard today so that my cognitive abilities stay strong decades down the road.

But living a healthful lifestyle doesn’t keep us free from worry about the long-term risks for cognitive decline and neurodegenerative diseases like dementia. Many of my patients who are moving through middle age talk with me about their fears of losing memory, mental clarity, and cognitive functions with age—and of their concerns about Alzheimer’s in particular.

There’s new research out about the link between sleep and Alzheimer’s I want to share with you, research that deepens our understanding of how poor sleep and Alzheimer’s disease are connected. Most of us probably know, or know of, someone who has been affected by Alzheimer’s. Unfortunately, the numbers bear that out. According to the Alzheimer’s Association, someone in the US develops Alzheimer’s disease every 65 seconds. Today, there are 5.7 million Americans living with this neurodegenerative disease—the most common form of dementia. By 2050, estimates predict that number will rise to 14 million.

What causes Alzheimer’s disease?

The tough answer is, we don’t yet know. Scientists are working hard to identify Alzheimer’s underlying causes. Though we don’t yet know why, what we do know is that the disease causes fundamental problems in the way brain cells operate.

Billions of neurons in our brains are constantly at work, keeping us alive and functioning. They enable us to think and make decisions, store and retrieve memory and learning, experience the world around us through our senses, feel our whole range of emotions, and express ourselves in language and behavior.

Scientists think there are several types of protein deposits that cause the degradation of brain cells, leading to the progressively more serious problems with memory, learning, mood and behavior– the hallmark symptoms of Alzheimer’s. Two of those proteins are:

Beta amyloid proteins, that build up to form plaques around brain cells.

Tau proteins, that develop into fiber-like knots—known as tangles—within brain cells.

Scientists are still working to understand how plaques and tangles contribute to Alzheimer’s disease and its symptoms. With age, it’s common for people to develop some of these build ups in the brain. But people with Alzheimer’s develop plaques and tangles in significantly greater amounts—especially in areas of the brain related to memory and other complex cognitive functions.

There’s a growing body of research that indicates poor quality sleep and not getting enough sleep are linked to greater amounts of beta amyloid and tau proteins in the brain. One study released in 2017 found that in healthy, middle-aged adults, disruptions to slow wave sleep were associated with increased levels of beta amyloid proteins.

Daytime sleepiness is linked to Alzheimer’s-related protein deposits in the brain

A just-released study shows that excessive daytime sleepiness is linked to higher amounts of beta amyloid protein brain deposits in otherwise healthy older adults. Scientists at the Mayo Clinic set out in their study to answer a big question about causality: does build-up of beta amyloid protein contribute to poor sleep, or does disrupted sleep lead to the accumulation of these proteins?

The Mayo Clinic already had in progress a long-term study about the cognitive changes associated with aging. From that already-running study, scientists selected 283 people, who were over age 70 and did not have dementia, to investigate the relationship between their sleep patterns and their beta amyloid protein activity.

At the beginning of the study, nearly one-quarter—a little more than 22 percent—of the adults in the group reported that they experienced excessive daytime sleepiness. Being excessively sleepy during the day is, of course, a prime indicator you’re not getting enough sleep at night—and it’s a symptom associated with common sleep disorders, including insomnia.

Over a seven-year period, scientists looked at patients’ beta amyloid activity using PET scans. They found:

People with excessive daytime sleepiness at the beginning of the study were more likely to have higher levels of beta amyloid over time

In these sleep-deprived people, a significant amount of beta amyloid build-up occurred in two particular areas of the brain: the anterior cingulate and the cingulate precuneus. In people with Alzheimer’s, these two areas of the brain tend to show high levels of beta amyloid build up.

This study doesn’t provide a definitive answer to the question of whether it is poor sleep that’s driving amyloid protein build up, or the amyloid deposits that are causing sleep problems—or some of both. But it does suggest that excessive sleepiness during the day may be one early warning sign of Alzheimer’s disease.

The Mayo Clinic study lines up with more recent research that looked at the relationship between poor sleep and Alzheimer’s risk. Scientists at the University of Wisconsin, Madison investigated the possible links between sleep quality and several important markers for Alzheimer’s, found in spinal fluid, including markers for beta amyloid proteins and the tau proteins that lead to nerve-cell strangling tangles.

In this study, the scientists tested people without Alzheimer’s or dementia—but they specifically chose individuals who were at higher risk for the disease, either because they had a parent with Alzheimer’s or because they carried a specific gene (the apolipoprotein E gene), which is linked to the disease.

Like their counterparts at Mayo, the Madison researchers found that people who experienced excessive daytime sleepiness showed more markers for beta amyloid protein. They also found daytime sleepiness linked to more markers for tau proteins. And people who reported sleeping poorly and who had greater numbers of sleep problems showed more of both the Alzheimer’s biomarkers than their sound-sleeping counterparts.

The brain cleans itself of Alzheimer’s-related proteins during sleep

It was just a few years ago that scientists discovered a previously un-identified system in the brain that clears waste, including the beta-amyloid proteins associated with Alzheimer’s. (The University of Rochester Medical Center scientists who made this discovery named it the “glymphatic system,” because it functions a lot like the body’s lymphatic system in removing waste from the body, and is operated by the brain’s glial cells.) Scientists didn’t just identify the glymphatic system—a groundbreaking discovery in and of itself. They also found that the glymphatic system goes into overdrive during sleep.

When we sleep, the scientists discovered, the glymphatic system becomes 10 times more active in clearing waste from the brain.

This is some of the most compelling research yet to show the importance of healthy sleep to long-term brain health. When you sleep, scientists now think, your glymphatic system steps up its activity to remove potentially harmful debris that has collected over your waking day. If you sleep poorly or go without sufficient sleep on a regular basis, you risk missing out on the full effects of this cleansing process.

Irregular sleep wake cycles linked to Alzheimer’s

Another possible sleep-related early warning sign of Alzheimer’s? Disrupted sleep patterns, according to new research. Scientists at Washington University School of Medicine tracked the circadian rhythms and sleep-wake cycles of nearly 200 older adults (average age, 66), and tested them all for very early, pre-clinical signs of Alzheimer’s.

In the 50 patients who showed pre-clinical signs of Alzheimer’s, all of them had disrupted sleep-wake cycles. That meant their bodies weren’t adhering to a reliable pattern of nighttime sleep and daytime activity. They were able to sleep less at night, and inclined to sleep more during the day.

One important thing to note here: The people in the study who had disrupted sleep-wake cycles weren’t all sleep deprived. They were getting enough sleep—but they were accumulating sleep in a more fragmented pattern over the 24-hour day.

This study suggests that disrupted circadian rhythms may be a very early biomarker for Alzheimer’s, even in the absence of sleep deprivation.

When my patients share with me their worry about their long-term cognitive health, and their fears of Alzheimer’s, I understand. I’ll tell you what I tell them: the best thing you can do is to translate your worry into preventative action, and take care of yourself today, with the goal of lowering your risk for cognitive decline and dementia in mind. Looking at all that we know, it’s clear that getting plentiful, high-quality sleep is an important part of that action plan.

Dementia – six diet and lifestyle changes to lower Alzheimer’s disease risk at home

Dementia affects about 850,000 people in the UK, according to the NHS.

It’s the name given to a group of symptoms linked to an ongoing decline in brain function.

Common dementia symptoms include memory loss, difficulty concentrating and mood changes.

But, you could lower your risk of dementia – including Alzheimer’s disease – by making these six lifestyle swaps.

Boost nutrition
Certain foods could help to lower your risk of dementia, according to Cytoplan’s nutritional therapist, Clare Daley.

Eat more foods that are low in sugar, but moderate in starchy carbohydrates, including sweet potato, carrots and leafy greens.

Be sure to eat plenty of vegetables, and foods that contain healthy fats, including avocados and nuts.

“Nutrition is essential for cognitive health,” said Daley. “Eating foods that are low in sugar can prevent the development of insulin resistance.

“The brain is very susceptible to damage by ‘free radicals’ and antioxidants provide protection from these.”

Improve gut health
Having bad gut health causes inflammation, which is one of the many chronic health conditions linked to cognitive decline, said the nutritional therapist.

Improve your gut health by eating more green leafy vegetables, chicory, apples, olive oil, and dark chocolate.

“To improve gut health, remove specific foods from your diet that may trigger gut symptoms,” she said.

“Add in nutrients and fibre to support gut health.”

Get rid of stress
Feeling persistently stressed can actually kill brain cells, and increase the risk of cognitive decline.

Some stress-relieving exercises could help you to feel more relaxed when at work or at home.

“In order to effectively manage stress, it is important to focus on stress reduction activities that work for you.

“These could include yoga, meditation, mindfulness, massage, breathing techniques, gardening, reading, listening to music or keeping a happiness and gratitude journal.

“When we learn to effectively manage our stress, we see an improvement in our sleep, energy, patience, resilience, focus and memory.”

Sleep well
The health of your brain relies on getting a good night’s sleep, warned Daley.

“Sleep is vital for optimal brain health as during sleep our brain cells detoxify and cleanse,” she said.

“Melatonin is the hormone responsible for restful sleep, however as we age we produce less, and therefore older individuals often experience more trouble sleeping.

“Whilst eight hours of uninterrupted sleep is possibly a dream for many of us, it’s important to find sleep strategies that work for you.”

Try sticking to a regular bedtime routine to boost your chances of falling asleep faster. Eating well, regular exercise and avoiding bright digital screens could also help you get a good night’s sleep.

13 Things Confident People Don’t Do

Self-confident people know what they value and what they want. They share common habits and thought patterns that help them achieve their goals. Here are 13 things self-confident people don’t do, so you can be one of them.

1.   They don’t believe they are worth less than others. One of the fundamental beliefs underlying confidence is, “My worth as a person is equal to everyone else’s.” That doesn’t mean you don’t have to work for what you want, and it certainly doesn’t mean life divides up its rewards evenly. But it does mean you have the same right as anyone else to stand up for yourself, pursue your dreams, enjoy your life, and make a difference in the way that’s most meaningful to you.

2.  They don’t fear self-doubt. Confident people realize that not all self-doubt is a bad thing. Sometimes fear is a signal that you haven’t prepared enough for the big presentation, the recital or the interview. Practicing what you plan to say and do will give your mind something to fall back on when the pressure is high. The voice of self-doubt may also be saying you need to get more information, move in a different direction, or take a break.

3.  They don’t hesitate too much. The flip side of #2 is that once you’ve put in the hours of practice, you should be able to take action without obsessing over what might go wrong.

4.   They don’t wait for the “big” move. When you envision a confident person, you might think of someone who takes big, bold actions, like running for office or making a marriage proposal on the Jumbotron. But there can be boldness and bravery in small steps. Those incremental changes build on themselves, both through your own feelings of accomplishment and reinforcement from others.

5.  They don’t confuse confidence with arrogance. Some people fear confidence because they don’t want to start stepping on other people’s toes, taking up too much space or just plain being a jerk. But confidence isn’t the same as arrogance or narcissism. In fact, when you feel confident in yourself, you often become less self-absorbed. When you stop worrying so much about how you’re coming across, you can pay more attention to those around you.

6.  They don’t fear feedback or conflict. A confident person can accept helpful feedback and act on it without getting defensive. When your sense of self-worth is no longer on the table, you can handle criticism or even outright rejection without allowing it to break you. By the same token, confidence doesn’t mean you mow other people down when a conflict arises. It’s possible to speak your mind with conviction and still make room to listen to someone else’s point of view and even reach a compromise.

7.   They don’t fear failure. Confidence doesn’t mean you won’t fail. It doesn’t mean you’re always smiling or that you never experience anxiety or self-doubt (see #2). Instead, it means you know you can handle those feelings and push through them to conquer the next challenge.

8.  They don’t have to make things perfect.  Perfectionism is a form of faulty thinking that contributes to low self-confidence. If you believe you have to have something all figured out before you take action, those thoughts can keep you from doing the things you value.

A Real Dietary Treatment for Depression

I’m often asked in my work with patients about various diets and supplements that get promoted in books and blogs as miracle cures for everything from anxiety to autism.  As someone who tries to be very careful about medications, I want to be encouraging about nonpharmacological treatments, but at the same time, it’s important to base medical advice on real science, rather than hype. After all, pharmaceutical companies aren’t the only ones prone to making grandiose and exaggerated claims about their products. Supplement makers and fad diet promoters do the same thing, but for some reason, there is less public outrage and skepticism about these “natural” interventions.

What often happens is that particular diets or supplements often sound scientific and even make physiological sense as to why they theoretically might be useful for certain mental health problems, but nobody seems to have the time (or maybe the guts) to put rubber to the road and actually rigorously test the product in a real human clinical trial.

This is why I was excited to read about an actual randomized trial in Australia from respected dietary researcher Felice Jacka and colleagues of a specific diet designed to help adults with major depressive disorder. The official name of the study was SMILES, which stands for Supporting the Modification of Lifestyle in Lowered Emotional States. (All clinical trials that want to be important and groundbreaking now need to come up with these rather forced acronyms.)

Perhaps not unexpectedly, the dietary treatment was not some flashy new supplement or bizarre new approach, but rather a general healthy Mediterranean-inspired diet that urged people to increase consumption of fruits, vegetables, lean protein, and whole grains while decreasing consumption of carbohydrates, sweets, and heavily processed foods. Importantly, participants were also allowed to continue the depression treatments that they were already doing, which was mainly psychotherapy, antidepressant medications, or some combination.  In this way, the study really was testing the added benefit of dietary modification rather than looking at what happens when diet is used as the primary intervention.

The 67 subjects in this study suffered from major depression that was rated as being in the moderate to severe range.  They also had baseline diets that were not particularly healthy in the first place.  Half of the sample was randomized to social support (basically friendly chats with a research assistant), while the other half received 7 sessions of personalized nutritional counseling and motivational support to a “ModiMedDiet” that emphasized more healthy food choices as described above.  The counselors also focused on curbing alcohol use beyond 2 glasses of wine per day.

The results were very encouraging. Subjects in the dietary modification group generally did improve their eating habits and this, in turn, appeared to reduce their depressive symptoms. On their main instrument that tracked depression severity, subjects in the dietary modification group improved significantly more than those in the control condition.  In terms of raw scores, the mean depression score for the dietary modification group dropped from 26 to 15 over 12 weeks, while for the control group it fell from 25 to about 20.  This would be considered to be a fairly large effect that is comparable to—and even surpasses—some studies of antidepressant “augmentation” with other medications, such as antipsychotic agents, which carry with them the potential of some serious side effects.  By the end of the study, about a third of the subjects in the dietary group were rated as being “in remission” from their depression compared to only 8% in the control group. Anxiety scores also improved with the dietary intervention.  Improvement in depression was found to be independent of changes in weight.

The authors acknowledge that they can’t be sure exactly how a better diet improves depression, but they do note other research that suggests pathways related to decreased inflammation, antioxidant effects, and changes in one’s gut bacteria can affect the brain. One aspect of the study that does muddy the waters a bit is their focus not only on diet but alcohol use as well, which can worsen depression.  I’d honestly be a little more confident in their conclusions had they demonstrated that the improvement occurred independently on any changes in alcohol consumption.

Also worth noting is that the subjects were obviously aware of what group they were in rather than being “blinded” as in the case of an active drug versus placebo trial.  Finally, the authors acknowledge that their sample size was relatively small and, indeed, smaller than they had hoped, perhaps reflecting how challenging it can be to get people to want to make substantive changes in how they eat.  Nevertheless, this is an important advance as the first (and long overdue) real randomized clinical trial that demonstrates how changing one’s diet and positively improve mental health.

Harvard Psychology Professor Discusses How Trauma Affects Memory

ARI SHAPIRO, HOST:

Soon after Christine Blasey Ford went public with her story about Brett Kavanaugh, critics began to question her memory. Ford says Kavanaugh and a friend assaulted her at a house party when they were teenagers. They are both in their 50s now. Ford has recalled the attack in gripping detail to The Washington Post. But she can’t say whose house they were in or exactly how they ended up there. To shed light on how trauma affects memory, let’s bring in Harvard psychology professor Richard McNally.

Welcome.

RICHARD MCNALLY: Thank you. Thank you for having me.

SHAPIRO: We know that memory in general is not entirely reliable and it can be difficult to precisely recall events from long ago. Does that change when we are talking about trauma and traumatic events?

MCNALLY: Yes. In fact, the stress hormones that are released during a terrifying experience tend to render the central features of that experience vivid and memorable. That said, the process does not operate like a videotape machine. So for example, it doesn’t infallibly encode every detail of the experience. Nevertheless, the central features are typically retained – often all too well, as the case of post-traumatic stress disorder exemplifies, and sometimes at the expense of the peripheral details.

SHAPIRO: Do you find that these kinds of memories change over time the farther people get from the event?

MCNALLY: No, not necessarily. With traumatic events, they’re fairly stable. I mean, memory is – it’s a dynamic process. That’s true. But to the extent that you’ve experienced the intense emotion at the encoding of the memories, it tends to render the central features of them quite stable. So you find this with war veterans, rape victims, victims of torture or natural disaster. They don’t forget these things. They tend to be recalled quite vividly.

SHAPIRO: So you say the central event may remain vivid while peripheral details may not. That seems to come to bear in the Ford case, where she is saying she remembers the alleged incident very clearly but can’t say for certain whose house she was at.

MCNALLY: Exactly. Right. Yeah, so the central features are those that the person’s attending to. They’re are often the most threatening, the most terrifying features of the experience; where the day in which it happened or the house or a dress or the day of the week it happened – these things may get scrambled up, forgotten because they’re not really the ones that you are attending to at the very moment of terror.

SHAPIRO: Brett Kavanaugh categorically denies that anything like this assault ever happened. And he has suggested to Senator Orrin Hatch, Republican of Utah, that maybe this is a case of mistaken identity. Does it seem plausible to you that Ford may be remembering this traumatic incident correctly but not the cast of characters?

MCNALLY: That’s possible. That’s certainly possible that there’s a mistaken identity. I really don’t know. I don’t know enough about the case, quite frankly. But eyewitness testimony is sometimes fallible. But the memory of the actual (inaudible) that a person might experience is unlikely to be garbled up to that extent.

SHAPIRO: Another variable here is alcohol. Ford told The Washington Post that Kavanaugh was stumbling drunk during this alleged incident. How does alcohol affect recall?

MCNALLY: Well, alcohol can sometimes impair the encoding and, therefore, the memory of experiences. The most dramatic examples are alcoholic blackouts, where the person is behaving and acting and so forth but has consumed so much alcohol that they have no memory of it at all. I’m not saying that’s necessarily the case here, but alcohol does not improve memory. If anything, it tends to impair it.

SHAPIRO: Richard McNally is a clinical psychologist who teaches at Harvard University.

Thanks for joining us today.

MCNALLY: Thank you for having me.

How to Take a Break From Your Phone — and Why You Should Do It More Often

It’s rare but it happens. You forget your phone — whether you’re engrossed in conversation with friends, fail to check notifications after a peaceful yoga class, or simply leave the device across the room for a few hours. Shockingly, for a brief period of time, it’s as if your phone didn’t exist.

Today, people constantly look at, think about, and remain physically close to their screens. To be so intensely focused on a task that text messages go unread for hours is unusual. To be so engrossed in a task or activity that all distraction evaporates seems inconceivable.

In fact, such freedom is attainable. A phenomenon called flow state constitutes total absorption in an experience, such as surfing, writing, dancing, playing jazz, or painting. Once a person has achieved immersive focus in one task, they describe flow as a sustained period of cognitive clarity, self-confidence, joy, ecstasy, and unobstructed consciousness. Psychologist Mihaly Csikszentmihalyi coined the phrase in 1990.

Since then, everyone from professional athletes to special ops military has studied flow. Being in “the zone” can lead to peak performance, for instance, 12 three-pointers in one basketball game. It has informed innovations in game learning, where immersive design and achievable goals teach players new skills. Flow can be therapeutic, productive, educational, and downright spiritual.

So why can’t we flow all the time? Like animals, the human brain is wired to perceive distractions.

“Our ancestors had to watch out for snakes, saber-toothed tigers, and enemy tribes all the time — and if they did not, they stopped surviving,” said Csikszentmihalyi.

Unfortunately, the brain that evolved to sense distractions (and keep early humans alive) can’t be turned off so easily. Enter the mobile alert, the Slack message, the Instagram like. Each tiny communication signals a dopamine hit to the brain, hence why our phones are so addictive. But over time, the constant competition for our attention from all these apps and pings become less gratifying and more overwhelming. For Csikszentmihalyi, consumer technology presents a sinister picture: the business of commodifying the human mind.

“If we are always open to interruptions from the outside through the use of mobile devices, we risk giving up control of our lives to external agents who don’t really care about our lives, but only for how to gain our support—financial, political, or whatever,” he said.

“Honestly, have we abdicated our purpose just because of these insistent micro asks?” Jamie Wheal, director of the Flow Genome Project, told The New York Times. “Have we just completely ceded our center, completely ceded clarity, and it was all just based on 20-something bro-grammers trying to crack our attention spans?”

The numbers aren’t great. The average human attention span now hovers around eight seconds, shorter than a goldfish and down from 12 seconds in the year 2000. Americans devote more than 10 hours per day to screens, according to a 2016 Nielsen report.

But that doesn’t mean people don’t or can’t achieve the bliss that comes with flow. Perhaps you’ve even experienced it a time or two, since flow feels different for everybody. Teammates of Kobe Bryant say he goes silent when he’s flowing, but after he scored 81 points in one game, Bryant remained perplexed. “It’s tough to explain … To sit here and say I grasp what happened, that would be lying.”

How to Break Free

Today, one clue you may have reached flow is forgetting your phone. It makes sense since, according to Csikszentmihalyi, it’s easier to flow away from devices. He suggests setting aside one hour of free time per day to allow screens to “shape our minds,” then turning them off.

Find a task or hobby that won’t challenge your skill level too highly but which demands close focus. Most importantly, you should love it. That way you’ll be inclined to sustain the activity, repeat it, and increase your skill level over time. (Many people don’t reach a “runner’s high” until several miles in, or don’t trance until the sixth or seventh EDM song.) Look for activities where you either can’t reach for your phone or aren’t inclined to, such as mountain biking or knitting. Finally, make conscious choices to keep technological distractions at bay even when your phone is handy; for example, don’t buy Wi-Fi on your next flight.

“The information we carry in our brains will determine the content and quality of our lives,” said Csikszentmihalyi.

If the information that’s arriving to us is not information we choose, but rather in the form of interruptions, we have little control over it. Make deliberate choices in how you spend your time and develop your skills. You’ll focus. You’ll drop in. You’ll flow. And you will, blissfully, forget your phone ever existed.

How to Get Bad Sleep Back on Track

If you’ve ever lain in bed staring at the ceiling for what feels like forever, you know the pain of insomnia. The missed opportunity for sleep is bad enough, not to mention the worry about what it will mean for your performance the next day.

I’ve written elsewhere about the best way to treat chronic insomnia, which involves cognitive behavioral therapy for insomnia (CBT-I). If you’ve battled insomnia for years and have tried everything else, give CBT-I a try; if you’ve never tried treatment for your insomnia, CBT-I is a great place to start.

But how can we prevent chronic insomnia in the first place? To answer this question I spoke with Dr. Michael Perlis, a psychologist and sleep specialist at the University of Pennsylvania. Dr. Perlis works at the frontier of sleep medicine, and has played a key role in developing CBT-I; he’s the first author on a therapist guide for CBT-I entitled Cognitive Behavioral Treatment of Insomnia: A Session-by-Session Guide.

Let’s start by distinguishing between two different types of insomnia.

What Is Acute Insomnia?
Insomnia means trouble sleeping, whether it happens at the beginning, middle, or end of the night. As Dr. Perlis explains, “Insomnia includes not being able to fall asleep or stay asleep, or waking up too early in the morning.” Those difficulties can last a short time (acute) or a long time (chronic), and the distinction matters. So what is acute insomnia?

Michael L. Perlis: Somewhere between a few days and two weeks of three or more days per week is often considered the threshold of acute insomnia. Some people go as much as a few days to three months before they call it “chronic,” so everything before three months is considered acute insomnia.

Acute Insomnia Is Very Common—and Most People Recover
Most of us have experienced acute episodes of insomnia, as you’ve probably heard the people you know describe from time to time. New research is confirming just how common acute insomnia is, and how likely it is that people recover before it becomes chronic.

MLP: We just finished a study of a national sample of about 1500 people who started as good sleepers. They completed questionnaires for us quite frequently: daily sleep diaries, weekly measures of insomnia. And we just watched. And it was astounding—in confirmed good sleepers, around thirty percent had acute insomnia in one year. In England the same study was done with a colleague of mine and he found fifty percent. That’s a lot of people. The interesting thing is, ninety percent of people who have acute insomnia recover.

Unlike Chronic Insomnia, Acute Insomnia Is Unrelated to Age
Acute insomnia is relatively “equal opportunity,” meaning it doesn’t discriminate by age—which raises important questions about its function.

MLP: There is a belief—and it’s true—that as we get older decade by decade, the rate of chronic insomnia goes up. One of the things I’m working on in the data set is to see if this humongous incidence of acute insomnia varies by age, but so far it doesn’t—which is really telling you something. If a humongous percentage of the population has acute insomnia now and again, like once every three or four years, and it doesn’t differ by age the way chronic insomnia does, which gets more and more prevalent with each passing decade—how “abnormal” is that? Popularity is not a great way to define normal, but it is a way, and if something is highly prevalent and doesn’t vary the way the chronic form of it does, you start to wonder if this is normal. And then you start to wonder, How could that be?

Acute Insomnia Is Usually Linked to Stress
So what causes acute insomnia? Many factors can be involved, and most of them involve stress. The stress may be related to physical pain, illness, worry, or that argument you had with your sibling earlier in the day. As Dr. Perlis points out, it makes sense that our bodies at times make sleep a lower priority. As the late Dr. Art Spielman, another major figure in the insomnia treatment, said, “Sleep is adaptively deferred when the lion is at the mouth of the cave.”

MLP: There has to be an override when there is perceived or real threat, to disable the normal governance of sleep, so that you can stay awake and run or fight. So acute insomnia is part of the fight-or-flight response, such that if you are under siege and at mortal threat, don’t sleep. And that’s a good thing.

But why would our brains override the sleep drive when stress is more psychological, like having big deadlines at work? Is that just a function of our stress response, which doesn’t distinguish between physical danger and psychological distress?

MLP: You can argue, “Maybe for the caveman living on the savannah, evolutionarily speaking, that was important….But now it’s not adaptive at all, it’s just bad. We’re responding with inappropriate levels of fight/flight response, of being adrenalized, because I’m worried about work? Because I’ve got some financial problems? Those are not life threatening. I shouldn’t lose sleep over that.” And I hear that, and maybe this is vestigial, or maybe it’s not. Maybe insomnia is what you’re begging for when you’re under stress. What is insomnia but the gift of more time? It’s what you’re begging God for—”If only I had a 40-hour day, I could get all this stuff done!” You asked, you got it. So maybe it’s still adaptive in its acute form

Why It’s Important to Get to the Root of Your Emotions

We are all born with needs that are felt and expressed as emotions. Although we all experience the feelings of desire, fear, attachment, and despair, new research shows how these feelings are connected to our basic needs.

  • We need to engage with the world. This is felt as curiosity.
  • We need sexual partners. This is felt as lust.
  • We need to escape dangerous situations. This is fear.
  • We need to destroy those people and things that come between us and satisfaction. This is rage.
  • We need to attach to those who look after us. Separation from those who look after us can feel like panic and despair.

Developing healthy ways to meet these needs results in a feeling of well-being.  When these are unmet it can result in attempts to meet them in out-moded ways that worked when we were children but are now faulty and unproductive as adults. This can lead to suffering in our current lives, relationships, and at work.

Research demonstrates that psychoanalytic psychotherapy can help achieve better control over our emotions, more successful relationships, and a more fruitful professional life. In other words, psychoanalytic psychotherapy allows us to unlearn reactions that negatively affect our lives and to learn productive ones.

Unbearable emotions are caused by unmet needs 

Imagine a baby. When his parents steps out of the room the baby doesn’t have the capacity to know that they will be back.  All he knows is that he needs them. This need is expressed through a feeling of love when they are present and through the feeling of despair when they are gone. He has not yet acquired the capacity to understand that they will be back or the ability to self-soothe. When all goes well developmentally, the baby eventually learns that when his parents leave the room they always come back. But if the parents remain unreliable or neglectful the fear that they won’t come back is reinforced.

As this boy becomes a toddler and a teenager his parents continues to be unreliable, and he copes with this rejection by distancing and convincing himself that he does not need them.

Now let’s fast-forward. The boy is 40-years-old and finds that he cannot sustain a romantic relationship which brings him into therapy. As the therapy progresses, it emerges that whenever he starts to feel dependent on a significant other, he experiences intense panic and distances himself. This distancing behavior, designed to protect him from the despair, eventually leads to a break-up.

The challenge is to unlearn that default reaction with the mind of an adult. The adult mind does have the capacity to understand things that a small child can’t grasp. This is where psychoanalytic psychotherapy comes in. It is designed to address and help patients learn to tolerate painful feelings as they arise. The therapist and patient follow these feelings to their beginnings, where they were originally learned.

In this example, the need to distance from an important person goes back to the need for and the fear of losing his parents. To avoid that happening, he leaves the relationship before any real dependency can take place.  Gradually, the patient unlearns the automatic response of flight from dependency. This is achieved through repetition.

How does psychoanalytic therapy work?

Research has established that psychoanalytic psychotherapy is just as effective as cognitive behavior therapy (CBT) in the short term. However, psychoanalytic psychotherapy shows an increase in its effects after termination of treatment. In other words, people who go through psychoanalytic psychotherapy continue to benefit and grow from the treatment long after it has ended.

In the above example, the therapist encourages the patient to share his pain and recognize its origins. He reviews with the therapist his usual coping mechanism of distancing and detachment. The therapist addresses both the underlying feelings and the patient’s attempts to avoid them.

Unlike other psychotherapeutic methods that seek to lessen the intensity of the feelings, the psychoanalytic therapist helps the patient to stay with and tolerate these feelings over and over again. Eventually this repetition allows the patient to let go of the original reaction and to practice new options of feeling and coping.

Psychoanalytic psychotherapy allows the patient to gain access to unmet needs which are experienced as painful emotions and to learn to regulate them and become increasingly liberated from their oppressive and demanding grasp on our lives. This leads to an increased capacity to live a richer, fuller life.

Building the Perfect Day

We start every day hoping it’ll be great, maybe even perfect. But then, after snoozing, commuting, sitting in meetings, and grabbing junk food, we realize that, once again, we haven’t exercised, engaged with family and friends, or knocked much of anything off our to-do list. Staying up late, hoping to be productive, we manage only to watch TV and check Facebook before collapsing—and then starting all over again.

We can do better.

Believe it or not, most of us have the opportunity to get more done. We actually spend more time on leisure than ever before, according to the federal Bureau of Labor Statistics, dedicating about five hours and 16 minutes a day to pursuits we perceive as pleasurable, like socializing and watching TV (although research finds no correlation between the latter and feelings of satisfaction).

But we increasingly experience our free time in small, scattered chunks, says Geoffrey Godbey, professor emeritus of leisure science at Pennsylvania State University—nibbled half-hours on Netflix vs. restorative weekends away.

The foundation of any perfect or even half-decent day is adequate rest. As you can imagine, most of us start out behind. Our bodies run on an internal 24-hour chronobiological clock; when the retina captures light, a message sent to the brain suggests to this clock what time of day the body should think it is. It’s a system that has served us well for most of human history. “But over the last couple of generations, these natural rhythms have been gravely disrupted,” says Michael Grandner, the assistant director of the Behavioral Sleep Medicine Program at the University of Pennsylvania. Our near-constant exposure to artificial light has made nighttime effectively optional, leaving our bodies and brains struggling to do tasks that feel off schedule.

Can we fix our day? Absolutely. When Ken Wright, the director of the Sleep and Chronobiology Laboratory at the University of Colorado, took eight people camping for a week in the Rockies with no electronic devices or man-made lights, the group was exposed to about four times more natural light than usual. “We were able to shift everyone’s internal clock two hours to become in sync with nature within a week,” Wright reports, and his campers began waking up less groggy.

So there’s hope. Researchers in sleep health, nutrition, cognition, fitness, and productivity are working to identify where our modern schedules have gone wrong and how to better set ourselves up for success. We now know that with a handful of hacks, both large and small, and some changes to preconceived notions—wake-up sex and bedtime baths?—we can reconstruct our 16 waking hours to maximize productivity, leisure, and connection, while restoring alignment with our core chronobiological instincts.

You don’t need to follow this suggested schedule to the minute, but its consistency and healthier routines can bring you a lot closer to a more perfect day:

6:00 a.m. WAKE UP
No universal wake-up time will fit everyone, Wright says, but it’s ideal to rise when your body is best prepared—at the conclusion of REM sleep. We experience our longest nightly period of REM right before we naturally wake up. When is that? It’s so rare to wake without an alarm that many of us don’t know, but the amount you sleep on vacation should give you a good idea. Then track backward: If you need 7.5 hours of sleep to feel your best; need to be at work by 8 a.m.; need an hour to get ready; and have a one-hour commute, then a bedtime of 10:30 p.m., with a wake-up time of 6 a.m. might be best. If you can rise without an alarm, all the better, because when you hit the snooze button, you coax your brain to rewind to the beginning of the sleep cycle, making it that much harder to wake feeling refreshed, according to research by Edward Stepanski of Chicago’s Rush-Presbyterian-St. Luke’s Medical Center.

6:10 a.m. SEX
Surprise: Our level of testosterone—the hormone that spurs desire, our energy to perform, and even our generation of fantasies—is highest in the morning, for both men and women, says clinical sexologist Kathleen Van Kirk of the Institute for the Advanced Study of Human Sexuality in San Francisco. We also get an immediate boost in circulation in the morning, further fostering energy and arousal. Sexual activity is a pleasurable way to launch the day, not least because it causes a release of mood-elevating, stress-reducing hormones. Research on oxytocin has demonstrated that the hormone surge we get from intimacy can significantly reduce our level of the stress hormone cortisol and markedly boost positive communication between partners.

7:00 a.m. BREAKFAST
Eat within one to two hours of waking, says psychologist and dietitian Ellen Albertson. It may be 10 to 12 hours since your last meal, and your brain needs fuel. “Your brain is only about 2 percent of your body weight, but it consumes up to one-fifth of your body’s energy intake,” she says. “When you raise blood-sugar levels with breakfast, you increase your energy and improve mood.” Bonus: Your metabolism is at its peak in the morning, so your body efficiently uses most of what you consume, depositing less in fat stores, says Matthew Edlund, M.D., the director of the Center for Circadian Medicine in Sarasota, Florida.

7:45 a.m.  GET OUTSIDE
The best time to go outdoors and get moving is within two hours of waking up, says Jacqueline Olds, an associate clinical professor of psychiatry at Harvard Medical School. “The UV component of sunlight is low,” she says, “but the bright light sets you on a good course of wakefulness.”

The morning is a great time for a workout at your gym as well. Brigham Young University researcher James LeCheminant found that 45 minutes of moderate-to-vigorous morning exercise reduces the urge to eat throughout the day, but if that’s not possible, he suggests that you fit it in whenever your daytime schedule allows, because it still provides cognitive benefits and fosters restful sleep. “Pick the time when there are the fewest barriers,” he says, noting that this is often in the morning because the day’s events haven’t interfered yet.

8:45 a.m.  SEND EMAILS
Messages sent between 6 and 10 a.m. are much more likely to be read promptly than those sent between 10 a.m.  and noon, when people are more focused on work, says Dan Zarrella, the author of The Science of Marketing.

The average person spends 28 percent of the work week managing email, one reason 26 percent of us label ourselves chronic procrastinators. Limiting temptation by quitting your email app when you’re not using it can be instrumental in reclaiming your day. Start establishing two times during the workday to review messages—one here, one later in the afternoon.

9:30 a.m.  COFFEE
You may be used to pouring your first cup much earlier, but it will do more for you if you wait until later in the morning. “Our circadian clock controls the release of cortisol, a hormone that makes us feel alert and awake,” Albertson says. “Production is usually highest between 8 and 9 a.m., when most of us drink coffee,” negating the usefulness of the caffeine. This may be why regular coffee drinkers have an average of 3.1 cups a day—the first doesn’t help much. “Drinking caffeine too early can lead to too much cortisol, which can disturb our natural circadian rhythms,” Albertson adds. “It’s much better to drink caffeine between 9:30 and 11:30 when you actually need it.”

Are You Having a Bad Day? Exactly What to Do and Not to Do

Have you had one of those days? A day when you felt small, or like a bad parent, like a bad wife, like a bad everything? Or perhaps you had a day where you were publicly humiliated? Or just in a bad mood for absolutely no reason? Chances are you did!

How do you typically deal with such days? Go ahead and check as many as applies!

1) You had an internal conversation full of negativity and self-hate. “I do suck”, “I am a loser”, “I am a complete failure”, “I am a …”

2) You rationalized how much you suck by giving yourself examples and finding evidence for why you are indeed a failure:

“How could I be so stupid to push reply all instead of just reply” “I deserve this because I do …” “I deserve this because I don’t…”

3) You projected this onto others

Told your husband “you suck”, told your child “you are a failure”, gave the finger to someone who did not even cut you off! Who do you usually project feelings of insecurity onto?

4) You stopped feeling, thinking, but completely withdrew. You went to sleepand hoped that it would all end by the time you woke up. Or, tried to self medicate by taking painkillers, drugs, or overeating. How do you self medicate?

5) You firmly believed that these ugly feelings are forever, and if anything things would get worse. “There is no hope, I am a stupid person”, “I will never get this”, “I will never …”

Here is what you should do instead when you feel vulnerable:

1) Honor any feeling you have, even if negative. But, be kind to yourself and show self-compassion.

2) Speak to yourself with dignity and respect. Don’t allow any thoughts of self-disrespect to invade your soul.

3) Do one kind act towards someone, anyone. This will demonstrate to your injured soul that you can help someone feel better, and therefore you can make yourself feel better. Doing a kind act gives immediate gratification and makes the world a better place. Imagine if that person is also having a bad day and you shocked them with your kindness? Chances are, someone might shock you with their kindness.

4) Connect, connect and connect. Connect with someone who is trustworthy and who loves you because of your vulnerabilities. Do not do it by texting them, pick up the phone and call them. Or, ask someone who is worthy of your love to meet for coffee and just talk and vent about your day. Chances are you will feel so much better after venting. We are social beings and most of our problems and their solutions require social bonding. Do NOT connect with negative people; your soul is too raw to handle their acidity on such days. Do not just connect with anyone.

5) Self-medicate with exercise and indulge in nature. Go for a walk on the beach. Have a conversation with the ocean; oceans are never judgmental! But, don’t listen to sad music while taking a walk, not on those days. Sad music will intensify your negative feelings. Walking and exercising in general release feel-good chemicals.

6) Tell yourself “Nothing is forever, this too will pass”. Some days are bad, really bad, just allow them to pass.

We all have unprovoked bad days, they are almost mandatory! Sometimes, it is completely out of our control, but what we do about them is completely within our control. Every time, a bad day does not destroy you, your brainkeeps track of this as a small victory. Then the next time you have a bad day, your brain reminds you that you survived the last ten times that happened. It then predicts that you will survive this one too.  As a result, your self-esteem, self-confidence and self-worth escape uninjured from such days.

Have a great day or a manageable so-so day!

Depression in the United States—an Update

How common is depression? This is one of the fundamental questions Deborah Hasin and colleagues addressed in a recent epidemiological studyabout Major Depressive Disorder (MDD) in the United States.

The study analyzed data collected in 2012 and 2013 to provide an update on similar research from over a decade ago. Over 36,000 individuals age 18 and older were interviewed by trained personnel as part of the National Epidemiologic Survey on Alcohol and Related Conditions III. The analysis utilized the most current diagnostic criteria found in DSM-5. Participants were evaluated for depressive episodes and other psychiatricconditions that occurred during the previous 12 months as well as over their lifetimes.

Over 10 percent of the individuals in this study experienced function-impairing depression during the previous 12 months, and about 20 percent had experienced depression during their lifetimes. The prevalence was almost twice as high in women compared to men. During the previous year, reported depression was less common in those 65 and older than in those younger than 65. In fact, the prevalence of depression was 5.4 percent in the older group, considerably lower than the average.

About 13 percent of depressive episodes occurred shortly after the death of a loved one and lasted less than two months. In previous years, these episodes would have been diagnosed as bereavement, but the new diagnostic manual has eliminated bereavement as a separate diagnosis.

An interesting subtype of depression, called depression with mixed features, accounted for about 15 percent of the depressive episodes experienced by participants during their lifetimes. Mixed features include symptoms that might be expected in persons with bipolar disorder but do not reach the diagnostic threshold for bipolar I or bipolar II disorders. Among those are expansive or elevated mood, inflated self-esteem, rapid speech, racing thoughts, and increased energy. Thus, some individuals with moderate to severe depression demonstrate brief periods of elevated mood; it is uncertain whether these individuals go on to exhibit a diagnosable form of bipolar disorder.

How many depressed individuals consider suicide? Suicidal thoughts and suicide attempts occur in depressed persons. In this study, 39 percent of people with a history of depression had “thought a lot about suicide” and more than 13 percent had attempted suicide.

On average, how long do depressive episodes last? It has become increasingly clear that depression can be a chronic illness for some people. Results from this study indicate that during their lifetimes, 44 percent of individuals experienced episodes that lasted a year or longer and 30 percent had episodes lasting two years or longer.

Are other psychiatric illnesses associated with depression? The investigators found that co-morbid substance use disorders, anxiety disorders, and borderline personality disorder were common in persons with depression. Fifty-eight percent of people with lifetime major depressive disorder had a substance abuse disorder during their lifetime (including alcohol and nicotine use disorders as well as other drug use disorders), 37 percent an anxiety disorder, and 27 percent borderline personality disorder.

How many depressed individuals receive treatment? Interestingly, almost 70 percent of those who had experienced depression at some point during their lifetimes had received treatment. More than 50 percent had received medications and more than 60 percent had received counseling from a professional therapist. The percentages were lower for those who had experienced depression during the previous 12 months: about 50 percent had received some sort of treatment, 37 percent with medications and 44 percent with professional talk therapy. The intensity of treatment was not defined, however, and other research suggests that many who receive treatment do not receive adequate amounts of it.

The rates of depression found in this recent study are at least 50 percent higher than rates from the study performed a decade earlier. Whether this increase is a result of methodological differences or reflects a true increase in the prevalence of the illness is unclear. However, the authors point out that an increase in prevalence is supported by other studies demonstrating increases in indicators of depression and suicidality. Even if some of the observed increase is related to differences in methodology, it appears that an increasing number of people are suffering from this disorder.

Depression is one of the most disabling of all illnesses. We must do more to understand its various causes in order to develop better strategies for prevention and treatment.

7 Habits That Can Drag Down Cognitive Performance

This month brought a few studies showing some interesting connections between our everyday habits and cognition—dehydration, digital devices, and (potentially) neckties may all apparently sap cognitive bandwidth. The good news is that these habits are easily fixable (although device use may be trickier), which points to how delicate, and how responsive to its surroundings, the human brain can be. The three new studies are outlined below, along with four longer-term habits that may also deplete or replenish brain power. Again, some are easier to address than others, but the ones that take a little more commitment are definitely worth it, considering what’s at stake.

Dehydration  

As mentioned, a study earlier this month found that being just a bit dehydrated can affect cognition. The researchers analyzed previous studies, arriving at a final pool of 33 that looked at how being dehydrated at various levels can affect cognitive performance. Generally, the team found that people started making some errors during attentional tasks earlier during dehydration, and the errors became more pronounced the more significant the dehydration. In addition to the more innocuous initial errors, higher-level capacities like math and logic also fell off with dehydration over 2% of one’s body mass (which could occur after working out for a few hours without drinking).

“The simplest reaction time tasks were least impacted, even as dehydration got worse, but tasks that require attention were quite impacted,” said study author Mindy Millard-Stafford in a statement. Being dehydrated could well affect the kinds of attention and executive functions that’s required in work, school, or leisure. “Maintaining focus in a long meeting, driving a car, a monotonous job in a hot factory that requires you to stay alert are some of them,” said Millard-Stafford.

People working in hot places who need to make technical decisions would probably by the most affected—but for people who are feeling a little groggy, thinking back on whether you’ve gone a big chunk of the day without hydrating may be wise.

Neckties

Another study this month found that wearing a necktie can cut off the circulation to your brain—not fully, of course, but by about 7%. The team, wishing to study “socially desirable strangulation,” had men don neckties or go without, and then undergo MRI scans to measure cerebral blood flow. Men whose ties were tightened had a significant loss of the blood flow to their brains compared to others.

Whether this loss of blood flow would be enough to affect cognition isn’t totally clear. But for men who are concerned about the possibility, it may not be the worst idea to wear your tie a bit looser.

Devices in the classroom

Cell phones are likely the bane of many teachers’ existence these days, and now they have a true scientific study to support banning them. Researchers at Rutgers University allowed half of the study’s participants—funnily enough, 118 Rutgers cognitive psychology students—to use cell phones, tablets, and laptops in the classroom, and banned their use for the other half. The team correlated the students’ grades throughout the semester with their use of devices, and found that the kids for whom devices were banned had final grades that were about half a grade (or 5%) higher than the kids who got to use them.

“These findings should alert the many dedicated students and instructors that dividing attention is having an insidious effect that is impairing their exam performance and final grade,” said Arnold Glass. “To help manage the use of devices in the classroom, teachers should explain to students the damaging effect of distractions on retention – not only for themselves, but for the whole class.”

Others have suggested that gadgets are “making us dumb” for a variety of reasons, but this is the first to show a causal connection between their use and academic performance. The same connection is very likely true for devices in the office—and at home, when you’re trying to have some quality time with your family.

Sleep

Another habit worth mentioning, given its potentially significant effects on cognition, is one that most people don’t get enough of, acutely or chronically: Sleep. Losing sleep on a chronic level can affect cognition, but so can just a night or two of poor sleep.

A study last year looked at brain cells and cognition in real time: It found that during a night of lost sleep, participants’ brain cells became slower to respond during a cognitive task, and when they did respond, their activity was sloppier than normal. And sleep loss over the long-term has been shown to affect our cognition and our ability to form memories.

Sleep isn’t just an indulgence, but a necessary habit during which the brain is doing a lot of heavy work—pruning unnecessary connections and strengthening the needed ones. Most people know from their own anecdotal evidence that lost sleep can seriously affect how well we think and make decisions, but the scientific evidence certainly backs that up as well.

Chronic Stress

Like sleep loss, stress affects just about every system in our bodies; and chronic stress is well-knownto affect our mental prowess. Likely due to the stress hormone cortisol and its inflammatory effects, stress has been shown to affect everything from memory formation to decision-making to hand-eye coordination to brain volume. While we may not be able to control every variable that presents stress in our lives, we can at least control our relationship to the stress and how we respond. Taking care of ourselves, using tools like meditation, yoga, and therapy are good ways to reduce the effects that stress is known to have.

Lack of Social Connection

Social connection—and its doppelganger, loneliness—has been shown again and again to have major impacts on our health and mental health. In fact, social connectivity keeps showing up in the research as perhaps the number one variable affecting long-term health. And loneliness has been linked to poorer cognition, especially in older people. A study a few years ago showed that loneliness and social isolation were linked to a greater risk of cognitive decline in the future. It’s not totally clear why this is, but it may be the intellectual and emotional stimulation, not to mention stress reduction, which social interaction provides.

Sugar

Finally, sugar is one “food” that’s been shown to have ill effects on our neurological and cognitive health (“sugar coma” is a pretty well-known phenomenon, and there’s some logic to it). Not only does sugar seem to function somewhat like a drug, but it’s been shown to sap mental resources: A study a few years ago found that rats who were given sugar-water instead of plain water performed more poorly on a memory task (interestingly, those who were given omega-3s in addition to sugar water performed fine, suggesting that omegas may counter the effects of sugar). And it’s not just rodents: A study earlier this year found that people who consumed either glucose or sucrose performed worse on cognitive tests than those who consumed fructose or placebo—which isn’t surprising given the known connection between sugar and Alzheimer’s disease.

Luxurious Lifestyles Are Hurting Us

Inequality and climate change go hand in hand. Most of us know that poor countries and poor people in rich countries suffer the most from extreme weather, rising sea levels, and pollution. However you may not be aware that the carbon footprint of the rich is enormous as the rich live luxurious lifestyles with homes around the world, private jets, large yachts, exotic vacations, and closets full of things they don’t use. America’s 1 Percent emits 15 times more greenhouse gas emissions per person than the average American and fifty times more than the average person worldwide (World Resources Institute). The rich pollute the most and suffer the least from pollution.

What do the rich achieve with their extravagant consumption? Not much from a happiness or social welfare viewpoint, as Buddhist economics explains. While a person shows off their self-importance, they are still wanting more because another rich person has an even longer yacht or bigger house. The valuation of consumption rests on comparing ourselves to one another. Thorstein Veblen, the 20th Century economist who coined the terms “conspicuous consumption” and “invidious comparisons,” pointed out how individuals use luxury goods to show off their status. Veblen observed that people were living on treadmills of wealth accumulation, competing incessantly with others but rarely increasing their own well-being. This means that when inequality increases, we all feel less well-off even if our income has not gone down. When the rich get even richer and the rest of us don’t get more, our stagnant income and lifestyles seem diminished. Over the past four decades, economic growth has mostly gone to the top 5% of households, and this growth begets more inequality, without increasing social welfare as it exacerbates invidious comparisons. Yet inequality continues to increase in the U.S., with the top 1% grabbing 95% of income growth and the bottom 90% experiencing declining incomes even  as the economy recovered (2009 to 2012) (Atkinson, Piketty, and Saez, JEL, 49 (1), 2011, 3-71).

Feelings of social discontent and anxiety rise with growing inequality. People struggle to maintain their social position even as those at the top aren’t feeling more satisfaction with their fancier lifestyles. With rising incomes comes frivolous spending, which itself drives ever more needless consumption, all so we can try to maintain our relative standing. This treadmill of wealth accumulation leads us to spend our incomes on status or luxury goods that tend to pollute the earth. Yet even though America’s top ten percenters emit six times the tCO2e of the bottom 50% of households (50 vs 8.5 tCO2e per person yearly; Oxfam), even the bottom 50% have an average carbon footprint that is four times the Paris Climate Accord goal of 2.1 tCO2e per person per year by 2050. The task to reduce CO2 for the United States with 16.4 tCO2 is much greater than for the European Union with 6.7 tCO2. India and Indonesia will increase their carbon emissions as their living standards improve. Their people have very low emissions, below the 2.1 benchmark (Girod, Env Research Letter, 2013). Though there are improvements to be made across income groups and countries, the global rich need to lead the way in reducing their carbon footprint.

Rich countries are not the only ones vulnerable to this destructive story. The developing world faces enormous environmental degradation as the standard of living increases, and the professional class imitates the lifestyle of the Western world based on subsidized fossil fuel energy. Countries such as China and India are already suffering the consequences of a burgeoning middle and upper class that consumes increasingly more. These populations are not only trying to keep up with the rich within their own countries but the global rich as well—this is evident when nearly all Chinese provinces and cities’ per capita carbon footprints increased  from 2007 to 2010 (Shao et al. 2018). In India, poor urban slums (poorer areas) have lower carbon footprints than the richer non-slum areas (Adnan et al. 2018).

How to Choose a Therapist

Psychology is a field made up of fragments. We are far from having a unified theory of the mind and, in my opinion, that will come only with advances in neuroscience and that will come only with advances in technology. Meanwhile there is a plethora of therapies from which to choose and they are based mostly in the experiences of their founders and practitioners.

Psychotherapy is still more of an art than a science. In fact, research has confirmed that it does not matter so much what brand of therapy one practices as does the relationship between client and therapist.1 These are known as often known as the common factors.2

That is, these are aspects of therapy that cut across professed schools and mostly have to do with the quality of the relationship. We all know that feeling when we meet someone and just “click” with them. It is that click that a prospective client should be looking for in choosing a therapist. Interviewing three potential therapists is often recommended before choosing one.

While the quality of the relationship, affect and empathy can override the specific technique, it does not cancel it out. For example, Freudianapproaches will want to treat the unconscious, while Cognitive Behavioralthe conscious ideas and behaviors. Gestalt therapy s