I stepped down into the pool. Cold. Nice. I had a lot on my mind.

I started justI started just focusing on the motions. Up, down, side. “Am I doing this right?” “Do I care?” I thought about my worries. My hopes. People in my life. Back and forth. Thinking. Sending well wishes. Processing. As I left, my mind felt clearer, ready to greet the rest of my clients for the day.

Swimming is a nice mix of strategies. For me, it is exercise, a mindfulness practice, a way to let go of tension, and a way to process. To my knowledge, there is no research investigating this particular application. Still, as a therapist who practices eye movement desensitization and reprocessing (EMDR), I have sometimes wondered if the back-and-forth motions of swimming can mimic the bilateral stimulation (the eye movements, tapping, or other sensory pieces) that facilitates processing EMDR. Who knows. Anecdotally, I can say it helps me out.

Swimming as a Wellness Tool

People have probably used swimming as a wellness tool since we met water. It is naturally relaxing and enjoyable. Research has shown multiple benefits to swimming. A study of 33 children diagnosed with attention deficit hyperactivity disorder found improvements in stress, depression, and selective attention after an eight-week swim program.

Similarly, research investigating an intervention of twelve swim situations of adolescent girls’ self-concept found significantly greater improvement when compared to a control group in multiple areas of self-concept (Tavakolizadeh et al., 2012).

Research has also explored the effects of swimming in natural bodies of water on mental health. A review of 14 studies found repeated positive effects relating to swimming in nature, ranging from improvements in mood to mindful presence (Overbury et al., 2023). Few would argue that swimming, on its own, has some merit as a wellness tool, just like hiking, writing, or dancing.

But what about its use in psychotherapy?

Swimming as an Experiential Therapy

A Confucian proverb states, “What I hear, I forget. What I see, I remember. What I do, I understand.” This is the philosophy of experiential therapy. Experiential therapies integrate activities such as interaction with animals, movement, arts, and ropes courses as a part of intervention. Often, a piece of the intervention is learning through the process.

These types of therapies are common within residential treatment, wilderness programs, and other settings where individuals are receiving intensive therapeutic intervention on an inpatient basis. These are less commonly available on an outpatient basis.

Swimming can be integrated into traditional evidence-based practices, such as cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). For example, it can be used as exposure therapy for someone with a swimming phobia or to enact a metaphor in ACT. I spoke with Rebecca Brand, a licensed clinical professional counselor in Illinois, who has provided this kind of therapy.

Rebecca shares, “It is overcoming a trauma. Mastering a skill. It’s empowering to know the water will keep me up, not to be afraid.” Indeed, trauma expert Van der Kolt shares the need for somatic, experiential intervention in healing trauma in his book, The Body Keeps the Score: Mind, Brain, and Body in the Healing of Trauma. The act of swimming itself is a building of mastery and getting unstuck.

There is also a limited number of structural approaches using swimming in therapy. Among these is aquatic relational experiential therapy (ARET), a therapy utilizing swimming in a multidimensional way to assist in improving one’s relationships with self and others (Garaglass et al., 2022).

In Closing

Swimming can be therapeutic, particularly when combined with other evidence-based practices. While experiential therapies of this kind are most frequently used in residential settings, swimming also has a place in outpatient therapy.

References

Garzaglass, M. R., Garza-Chaves, Y., Williams, M. P., Fauster, L. K., & Freeney, L. G. (2022). The buoyant self: A conceptual journey of aquatic relational experiential therapy. The Humanistic Psychologist, 50(4), 607.

Overbury, K., Conroy, B. W., & Marks, E. M. (2023). Swimming in nature: A scoping review of the mental health and wellbeing benefits of open water swimming. Journal of Environmental Psychology, 102073.

Silva, L. A. D., Doyenart, R., Henrique Salvan, P., Rodrigues, W., Felipe Lopes, J., Gomes, K., & Silveira, P. C. (2020). Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. International journal of environmental health research, 30(5), 584-592.

Tavakolizadeh, J., Abedizadeh, Z., & Panahi, M. (2012). The effect of swimming on self concept’s girl high school students. Procedia-Social and Behavioral Sciences, 69, 1226-1233.

Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

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• So many people are feeling emotionally overwhelmed in the face of world events.
• Finding ways to regulate our nervous systems can be an important first step.
• From there we can more effectively process our emotions and find some sense of personal agency.

If you are struggling deeply with recent world events, you are certainly not alone. I have been alive on this planet for over five decades and somehow these last recent years have felt like some of the most challenging — collectively and on a global scale — that I can remember in my lifetime. As a psychologist I am privy to the inner emotions of many, and with recent world events I know that many people are suffering greatly, trying to grapple with how to cope with fear, helplessness, anger, outrage, and deep loss, among other inner experiences. In the face of all that is around us, I find myself wondering:

• How do we grapple with the enormity of emotions that so many of us are experiencing right now — and that so many have experienced in recent years given world events?
• How do we find a way to keep our hearts open and not be overwhelmed or stuck in grief, outrage, sadness, anger or other emotions?
• How do we not retreat, bury our heads in the sand, or disconnect entirely from what is happening around us, and yet still find a way to move forward and show up most effectively in our lives?

I don’t purport to have all the answers to these big questions, but I can share a few things that have been helpful for me both personally and in my work with patients.

How to keep anchored in the face of difficult world events and our own painful emotions

1. One of the things I try to remind myself of frequently is that a nervous system out of balance and in a state of protection (e.g., “fight, flight or freeze”) does not have access to the same inner resources as a nervous system that is more regulated.

When our bodies (via our autonomic nervous system) become thrown out of balance, it is common to experience anxiety, worry, stress, overwhelm, anger, and outrage, especially in the face of so much personal and collective stress and heartache that so many of us feel. This is not a problem in and of itself to feel this. It is an adaptive and evolutionary response of our bodies to try and fight, flee, or shut down in the service of “protection from threat.” Sometimes this is an inevitable or even necessary response, but when we get stuck there and can’t find our way back to regulation, this can become more problematic and pose challenges for us. When our nervous system is dysregulated, we don’t have as much access to our “social engagement system” and we tend to feel more isolated, experience tunnel vision, feel scattered, stuck, helpless or alone. In contrast, when our nervous system is regulated and in balance, it is easier to experience a sense of connection with others, compassion, care, curiosity, clarity, perspective, and the ability to think more expansively.

What can we do?

As meditation teacher Susan Morgan says often, once we become aware that our nervous system has been thrown off balance, we can “ground, breathe, calm, settle and soothe.” We can steady and stabilize our nervous system, like a ship at harbor dropping its anchor to keep it from being swept away by the storms.

Last night in the middle of the night, when I woke up with so much heartache and feeling overwhelmed, I found myself instinctually putting one hand on my heart and one hand on my abdomen. I started taking long slow breaths and extending my exhalation. I brought awareness to the sense of support underneath me. I reminded myself that taking time to soothe and steady myself would help me be more effective in my choices and give my body the energy it needs to act in ways consistent with my values.

Sometimes self-soothing might be more active, such as listening to music, taking a warm bath, reaching out to a friend, or going for a walk in nature.

Sometimes, especially for those who may suffer from anxiety or trauma, working with a skilled therapist can be very helpful in learning how to help regulate the nervous system.

2. Once we feel steadier within, we can make some space for our difficult emotions.

This is not always so easy and needs to be done with care, awareness, and some titration (touching into painful emotions only if/when we feel steady enough to handle them and making sure to go back to step one as often as needed). Suppressing or avoiding our unpleasant emotions can have negative physical and psychological effects on our well-being, but being flooded by our emotions is also not helpful. So there is a delicate balance to pay attention to here.

What can we do?

Some ways to make space for our difficult emotions include practicing mindfulness, journaling, reaching out to a friend, or seeking social support in a community setting of some kind. Acknowledging your feelings, meeting yourself where you are (not trying to feel different than you do), and giving your emotions some space to be felt and processed from a grounded nervous system can be helpful.

Additionally, we can invite more expansive emotions (e.g., care, self-compassion, self-kindness, a sense of caring from others) to sit side-by-side with our more difficult emotions, to make them easier to bear (something I write about in my forthcoming book).

3. Find some sense of personal agency, however small.

I am reminded of the quote by Edward Everett Hale: “I am only one, but still I am one. I cannot do everything, but still I can do something; and because I cannot do everything, I will not refuse to do something that I can do.”

What can we do?

While small acts might feel insignificant, doing something matters. And it may matter more than you realize. Some people find personal agency in donating to others in need, volunteering for something they care about, or joining a committee aimed at positive change.

One of the things that we can all do is to commit to spreading compassion in the world on a small scale, (e.g., whether to our family, friends, neighbors, community, or the strangers we meet in our day-to-day interactions). In the face of hatred, heartache and anger, compassion (the desire to, and intention to act to relieve the suffering of another) can help counter a feeling of helplessness and can bring some positive energy into the lives of others and in turn the world.

The post How to Keep Anchored During Difficult World Events appeared first on My Blog.

• In a recent study, 50 patients were interviewed about their experiences with borderline personality disorder.
• More than half of the patients said that BPD symptoms substantially impacted their work or school.
• Extreme mood lability and emotional responses were the symptoms reported to be the most problematic.

“Doctors are men who prescribe medicines of which they know little,

to cure diseasesto cure diseases of which they know less, in human beings of whom they know nothing.”

–Voltaire

Clinicians and researchers are trained to understand, diagnose, and treat illness, but they can’t move inside patients to fully comprehend their suffering. Indeed, most people view illness from the outside. No matter how much empathy you may possess, it is still difficult to fully appreciate what a severe COVID infection, a broken leg, or a persistent psychosis feels like, and which particular symptoms are most disabling, unless you have experienced it. Mental illness, in particular, with all its stigmatization, may be harder to understand for those who haven’t endured it.

A recent study explored the subjective experiences of patients diagnosed and treated for borderline personality disorder.¹ Extensive interviews with 50 patients inquired about qualitative patient perspectives living with BPD. Interviewers also asked which symptoms were most troublesome. This study was larger than those previously reported and, unlike most others, included 24 men.

Most of the patients endorsed most of the nine criteria that are established in defining BPD. Typical quotes describing symptoms were:

• “…just complete unregulation of my emotions.”
• “…really unstable relationships…had some really bad abandonment issues.”
• “…not really feeling as though I have a stable consistent sense of self.”
• “Impulsivity, just like acting before thinking.”
• “I felt empty every day when I woke up.”
• “I would be very impulsive with my anger, the shouting, screaming, cursing…”
• “I would have periods where I would [dissociate] just zone out…”

All 50 patients reported extreme mood changes and intense or unstable relationships. Forty-seven patients (94%) described an unstable self-image. Most patients experienced impulsive, self-destructive behaviors. Chronic feelings of emptiness and intense anger were acknowledged slightly less often. Twelve patients related suicidal ideations. Five patients reported dissociative symptoms.

More than half of the patients said that these BPD symptoms substantially impacted their work or school. Legal, financial, or self-care issues were also affected. Difficulties with relationships had the most effect on these problems. Researchers asked which symptoms were the most personally troublesome and interfered most with daily functioning. Extreme mood lability and emotional responses were the symptoms reported to be the most problematic. The next symptom most bothersome was intense or unstable relationships, followed by anger issues, unstable self-image, chronic feelings of emptiness, and impulsivity. Interestingly, the symptom that was the least interfering—only two patients endorsed it—was suicidal ideation. This finding is particularly striking since suicidal threats and behavior are obviously the symptoms that garner the most attention from clinicians and significant others.

Many current treatment approaches for BPD, such as DBT, follow a specific, manual-based strategy. It is important that therapists not get swallowed by a formal technique, but that they retain flexibility to divine the experiences of their patients. This includes attention to the importance of interpersonal connections and self-image. It is the patient’s goals, not the doctor’s, that determine therapy direction.

References

1. DiBenedetti, D., Kosa, K., Waters, H., & Oberdhan, D. (2023). “Understanding Patients’ Experiences with Borderline Personality Disorder: Qualitative Interviews,” Neuropsychiatric Disease and Treatment.

The post The BPD Chronicles: New Study Examines Patient Experiences appeared first on My Blog.

We are often inundated by fear. Fear is doled out by politicians to influence people. Advertisers peddle fear to keep people buying their products and services. Some media outlets lead with it to build audiences and sell more ad space. Doomsayers, prognosticators, and conspiracy theorists spread it to gather followers and create audiences for their products and services.

Every day in the media we are exposed to negative news and scary stories that make us anxious or worse including:

Political Fear: government corruption, political division, civil unrest, political violence.

War Fear: nuclear war, biological war, EMP attack (electromagnetic pulse), terrorism, WWIII.

Health Fear: disease, injury, inadequate healthcare, poor access to healthcare, high costs.

Financial Fear: economic collapse, inflation, recession, stock market crash, high-interest rates.

Environmental Fear: air and water pollution, earthquakes, floods, hurricanes, droughts, wildfires.

Employment Fear: layoffs, job loss to automation, not having enough money to pay bills, debt.

Crime Fear: scams, identity theft, home invasion, mugging, carjacking, mass shooting.

The simplest solution is to tune out the fear by turning off your TV and avoiding the news. When you can’t avoid negative news, creativity can help you deal with fear. When you develop your creative thinking skills you may begin to see things in different ways including new paths away from that which is scaring you.

There are six keys to developing your creativity. Each of them is necessary in order to solve problems and generate new ideas. Maybe you will create a new plan to end corruption, a new technique to clean the environment, a new method for increasing prosperity, or a new strategy to keep people safe. Some of these keys are skills while others are habits, but all of them contribute to a creative mind.

6 Keys to Creativity

1. Using curiosity creatively is when your inquisitiveness guides you to look for new connections or when you combine two or more existing concepts into a new idea. Curiosity is wondering what a different world might look like and then thinking about how you might achieve it. Perhaps it’s a world that doesn’t have so many alarming issues in it; where people unite in peaceful consensual exchange instead of engaging in force or fraud.

2. Questioning authority is all about challenging the status quo. Critical thinking is one of the first steps in creativity because it encourages you to question the way things are done. You might ask questions like: “Why do we do things this way?” “Wouldn’t it be better if we tried doing it another way?” Creativity develops your critical thinking skills, so you are less likely to be troubled and bamboozled by charlatans.

3. Trying new things such as exposing yourself to new experiences and different viewpoints. By opening your mind to new stimuli, you literally lay down new neural pathways in your brain. It’s called neuroplasticity, and when you learn or experience something new you create new connections between brain cells and open new channels of thought. Then, when you are confronted by problems (scary or not), you have that extra brainpower and data ready to assist you.

4. Taking risks along with a willingness to break rules can reveal less daunting or more positive probabilities. The people on Maui who were willing to break the rules and drive around the police roadblocks survived the 2023 fire. There is an old proverb that says, “No risk — no reward.” It’s true; the biggest risk is never taking one, because without risk you won’t find alternative options and opportunities.

5. Getting a different perspective by learning to look at things in different ways will enable you to see new ways of doing things. It can take some practice to develop a habit of viewing things from a different perspective. However, until you do, there are dozens of techniques for stimulating it artificially. My favorite is to identify a problem and then ask, “What would I do if the opposite were true?” By changing the paradigm, you abandon old assumptions and methodologies, which then forces you to consider new models and frameworks.

6. Using imagination is the heart of creativity. It is natural to imagine that something can be nicer, faster, stronger, cleaner, tastier, and safer. Imagination enables us to create a better world to live in (or help us solve the problems we are dealing with). It’s also a great way to stop worrying and overcome fear. The trick is to replace negative thinking with positive thinking. Visualize a better outcome and focus on it daily (meditate on it or daydream about it) and then observe what your creative mind does with it.

Developing these skills and habits can liberate you from fear because they empower you to do more and be more.

Creativity Helps You Recognize Alternatives

I’ve noticed lately that news stories of food shortages and other products becoming unavailable have been making people nervous and causing some to start hoarding. Creativity is the best cure for fear of scarcity. Your ingenuity helps you see alternatives. There are always substitutes available if you are open-minded. When you engage your creative brain and look for other options you will be amazed at how resourceful you can be and what you will discover.

I have found that the excitement of getting into the creative process, in and of itself, tends to erase fear. Change doesn’t seem so scary when you realize that it is enhancing your adaptability skills which are extremely important in the digital age. Embracing creativity makes you more mindful; it enables you to live in the present and focus on what you can do right now so that you don’t freak out about the future.

Creativity Builds Self-Confidence

Finally, when you begin to successfully use your creative thinking skills, it will increase your self-confidence. You will know that when a difficult or frightening situation occurs, you will be able to handle it.

References

2023 Chapman University Survey of American Fears https://www.chapman.edu/wilkinson/research-centers/babbie-center/survey…

How Novel Activities Support Neuroplasticity:

1. Vemuri P, Lesnick TG, Przybelski SA, et al. Association of lifetime intellectual enrichment with cognitive decline in the older population. JAMA Neurol. 2014;71(8):1017-24. doi:10.1001/jamaneurol.2014.963

2. Kaczmarek B. Current views on neuroplasticity: What is new and what is old?. Acta Neuropsychologica. 2020;18(1):1-14. doi:10.5604/01.3001.0013.8808

3. Association of Lifetime Intellectual Enrichment with Cognitive Decline in the Older Population. Prashanthi Vemuri, PhD1; Timothy G. Lesnick, MS2; Scott A. Przybelski, BS2; et al Mary Machulda, PhD, LP3; David S. Knopman, MD4; Michelle M. Mielke, PhD2; Rosebud O. Roberts, MB, ChB2,4; Yonas E. Geda, MD3,5,6; Walter A. Rocca, MD, MPH2,4; Ronald C. Petersen, PhD, MD4; Clifford R. Jack Jr, MD1 JAMA Neurol. 2014;71(8):1017-1024. doi:10.1001/jamaneurol.2014.963, August 2014

4. C. Lappe, S.C. Herholz, L.J. Trainor, C. Pantev, J. Neurosci. 28 (2008) 9632–9639.

5. C. Pantev, C. Lappe, S.C. Herholz, L. Trainor, Ann. N. Y. Acad. Sci. 1169 (2009) 143–150.

6. Q. Li, X. Wang, S. Wang, Y. Xie, X. Li, Y. Xie, S. Li, Hum. Brain Mapp. 39 (2018) 2098–2110.

7. https://www.psychologytoday.com/us/basics/neuroplasticity

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Starting a new job entails dealing with much uncertainty regarding the job itself, the people and the culture, so it’s not surprising that in a recent survey, a whopping 87% reported suffering from ‘new job jitters’.

Yet, the term ‘jitters’ doesn’t really convey how anxiety-provoking, stressful, scary, and rife with challenges starting a new job actually is, and right from the start:

• Everyone on the team knows how to go about their job better than you.
• Everyone on the team knows each other to various degrees — you don’t know anyone.
• Everyone on the team shares common history — you share none.
• Everyone on the team is familiar with their direct manager’s style, preferences, and pet peeves — you are not.
• Everyone on the team is senior to you regarding performing the job itself — professionally, you start at the bottom.

In fact, it seems that for most people, starting a new job is one of the scarier things they could do. According to 53% of workers in the survey, it’s scarier than a trip to the dentist, it’s scarier than holding a spider or a snake and it’s even scarier than skydiving. Imagine, sitting in an open door, feet dangling, looking down from 10,000 feet, and then actually jumping out of a perfectly good plane, is less scary than starting a new job!

My company (CY), employs people who have been chronically unemployed for many years, and because unemployment impairs mental health, the emotional challenges our new employees face are even more anxiety-provoking and stressful.

Fortunately, we find that veteran team members can provide significant help to all new employees, by reducing their anxiety and hastening the departure of their initial ‘new job jitters’.

5 ways to help new employees feel at home and part of the team quickly

• Empathy warm-up: Think back to a group you joined (not necessarily work related) that initially made you feel unwanted or like an outsider. What behaviors of theirs created those feelings? Then think back to a group you joined that made you feel welcome and wanted from the beginning. Make the first group of behaviors your “to avoid” list and the second group of behaviors your “to do” list.
• Names: the new employee has to remember a lot of new faces and names. Make sure to remember their name and with a smile, remind them of your name every time you interact during the first few days.
• Social inclusion: Make a point of inviting the new employee to sit with you, or join them if they are sitting alone during their first few weeks.
• Pace of learning and expectations: Ask how they are feeling, and feel free to share that when you started it took you a while to reach targets and develop a sense of competency (but only if true). If you happen to notice clear improvement, encourage it — while making sure to not come across as condescending — a simple smile and thumbs up will often suffice.
• Basic Human Caring: Just inquiring every now and then how things are going, and a friendly “let me know if there’s anything I can help with” can go a long way towards helping people feel at home and part of the family.

For the veterans themselves, the effort is well worth their while and can reward them in many ways: It reduces the amount of time needed for the new employee to pull their own weight, making things easier for the rest of the team. It promotes a bottom-up culture of caring which positively affects everyone by creating an improved workplace culture. It enhances team cohesiveness and productivity. And maybe most of all, kindness to others enhances our own well-being and general happiness.

References

Karsten I. Paul, Klaus Moser, Unemployment impairs mental health: Meta-analyses, Journal of Vocational Behavior, Volume 74, Issue 3, 2009, Pages 264-282,

https://learnmore.monster.com/poll-results-new-year-new-career

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Mental health conditions are common. One in five U.S. adults experience a mental illness and global estimates show at least 50 percent of us will experience a mental health condition in our lifetime. Decades of research have documented the relationship between parental mental health and that of their children: The mechanisms are complex and include hereditary factors (genetic and historical trauma, for example) as well as social-environmental factors, such as stress, financial stability, and the neighborhoods we live in. Parenthood is an incredibly important gift. Yet society does not meaningfully support families experiencing mental illnesses. I spoke with three mental-health advocates who are also parents living with mental health conditions. Here is some of the wisdom shared.

Prioritize self-awareness, self-love, and self-care

As parents, we are often bombarded with messages that we must sacrifice endlessly to give our kids the best life possible. This message has been exponentially harmful to women and primary caregivers who often give up careers, health, and relationships to be there for their kids. These actions often leave us depleted, resentful, and not the best version of ourselves. All of the parents I spoke to referred to the importance of learning what kind of “me time” was needed to support their mental health and how this practice of self-love and self-care resulted in better parenting and family relationships.

For Devika Bhushan, a pediatrician, immigrant, and mother who lives openly with bipolar disorder, sleep has to be prioritized. Inadequate sleep is a well-known trigger for mood episodes in bipolar disorder. She and her husband, Ashish, have created a collaborative team approach, in which her husband ensures that he is available for overnight and early morning needs for their toddler. In turn, her husband can take breaks in the evening, while she spends one-on-one bonding time with her toddler; as she says, “Setting things up in this way helps to ensure that I’m my best and healthiest self as much of the time as I can be — and able to be the best parent and partner that I can possibly be.”

Empowering kids by keeping them informed

Parents spoke about being conscious of their children’s chronological and developmental age, both of which can impact their ability to understand the information provided to them. All three advocates said that they have or will inform their children about their mental-health condition and how it impacts their functioning. The decision to disclose such information to a child may be influenced by the severity of the condition and symptoms a parent experiences. For Bhushan, it is important that her toddler understands why he is not allowed to wake mommy up in the morning; he is also aware that his mother takes medication every day and needs it to stay healthy.

Sulman Mirza, a triple-board-certified psychiatrist who is active on social media (@sulmoney), says he has not yet disclosed his diagnosis of Attention Deficit and Hyperactivity Disorder to his four children, but he plans to use his personal narrative to promote their understanding of their own mental-health needs, if they should arise. He acknowledges the impact of mental illness and even intergenerational trauma on how parents raise their children, stating that he wants kids to know that “your parents are human beings who are trying their best, and they have their own struggles, but it (hopefully) does not make them love or care for you less.”

Growing wiser through struggles

The idea of post-traumatic growth helps us understand that struggles can come with wisdom, strength, and power. In the case of experiencing a mental illness, these parents said that their own experiences with missed diagnoses, and their impact on their functioning and overall health have created a helpful level of awareness about their kids’ needs and development, giving them the opportunity to support their children’s mental-health needs holistically, compassionately and as early as possible. Ashley Perkins is a pharmacist, educator, mental health advocate, and co-founder of We Matter Too. She also lives with PTSD, ADHD, and autism. “I think all of this has made me a more compassionate parent given my child is more than likely autistic and has ADHD as well,” she says.

Sharing collective wisdom

Using our lived experience to empower other parents is one way to be a mental health advocate and promote family health. Mirza reminds us, “You’re not alone. Parenting is a hard period, and adding in mental illness makes it harder. But it’s still doable.” He also wants parents to know that “It is not a guarantee that your kids will have the same conditions you have” but your experience gives you the wisdom to engage in prevention efforts and support them if they do develop a condition.

Perkins reminds us: “Sharing parts of your reality, which includes the challenges you go through, is okay because it allows your partner and your child to understand what it is you are dealing with. This allows them to support you. When you explain things to children in a way they understand, they grasp the concepts well. It also invites an environment of acceptance regarding mental health, and they will be more likely to open up to you when they are struggling because they know you understand.”

eamwork, perseverance, and creativity are important ingredients to make all of this work. Bhushan says: “You absolutely can be an incredible parent and partner with a well-managed chronic health condition, such as bipolar disorder. It just means you have to be willing to think creatively and put in constant work to prioritize your well-being so that you can be the best version of yourself, for your loved ones as well as for yourself.”

Teamwork, perseverance, and creativity are important ingredients to make all of this work. Bhushan says: “You absolutely can be an incredible parent and partner with a well-managed chronic health condition, such as bipolar disorder. It just means you have to be willing to think creatively and put in constant work to prioritize your well-being so that you can be the best version of yourself, for your loved ones as well as for yourself.”

Kids are capable of compassion and understanding if we give them the opportunity.

Kids are smart and perceptive. They pick up on changes in their parents’ mood and stress levels. Including them in tough conversations, in a developmentally appropriate way, can be an empowering experience for them to learn about health promotion from an early age. This can foster compassion and kindness, which they can extend to themselves and others around them. Perkins says that sharing about her mental health conditions with her son normalizes the full range of the human experience, ultimately opening up the space for him to share his own worries and struggles. She also notes that being open about her need to prioritize her health helps her son understand that it is not a lack of desire that prevents her from being with him at times, and instead helps him be more understanding about the differing needs of others when navigating meaningful relationships. Perkins’ son, Wyatt, wants other kids to know that “I love my mom no matter what” and that he appreciates being informed about his mom’s struggles. Perkins also reminds us that these conversations are ongoing and can be challenging, so make sure to remind kids that asking questions is always okay.

This post is also published on the TEKU Healing Corner Blog.

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If you practice mindfulness meditation, you probably know that it can lower your stress level, reduce anxiety, and improve low moods. You might also be aware of its health-improving properties. According to the National Institutes of Health, mindfulness meditation may be able to reduce your blood pressure, help you cope with chronic pain, and even make it easier to fall asleep at night. But did you also know that by meditating, you’re also developing cognitive skills that can enhance the benefits of psychotherapy?

When you meditate — and by “meditate” I’m referring to mindfulness meditation, with no disrespect intended toward other forms of meditation — you probably focus on an ongoing, present stimulus such as your breathing. You might choose some other consistent sound in your environment, like street noise, wind through tree branches, or even the hum of an air conditioner. hat these stimuli have in common is that their presence continues from the immediate past into the present moment, and can help you draw your attention to the now. No matter what has distracted you, when you’re meditating and you catch your attention drifting away, you can always return to that ongoing, current stimulus because it’s always there to come back to.

And when you redirect your attention this way, you’ve probably learned to do it nonjudgmentally, with no particular frustration or sense of burden. No matter how many times you get distracted — no matter how often you need to bring your attention back to the present — you’ll need to do it without punishing yourself. This is part of the job of meditation: choosing not to be frustrated with minor diversions, but just catching your thoughts if they’ve wandered, and bringing them back to your focal point once again.

Learning to do this can take patience. It also requires the ability to stand back from your own thoughts and feelings, lest they overcome your intentions and sweep you away from your meditative focus. Perhaps the best analogy might be sitting on the bank of a river as boats and other objects float by. You’re not in the river; you’re watching it flow, just as you can watch your thoughts and feelings drift into, and then out of, your awareness. You know, even as you notice these items coming into view, that the river will soon carry them away again, and that you don’t need to take action at this moment. This sense of distance from your thoughts and feelings, no matter how strong they are, can help you avoid being swept up in the current of emotion caused by a passion or a frustration, or distracted by the thought of a pressing problem. When you notice that your meditative state has been disrupted by one of these ostensibly urgent thoughts or feelings, you simply recognize it and let it float away, down the river.

These skills and abilities — the ability to stay present, to gain distance on your thoughts and feelings, and to correct yourself non-judgmentally — can also accelerate the benefits of psychotherapy. For example, in therapy you may be confronted with difficult memories, turbulent feelings, or perspectives that challenge your outlook. You may be told you’re struggling with chronic, intrusive thoughts or critical self-judgments — possibly the introjected relics of a significant relationship in your past. You might even come to realize that you are contributing more to your own problems than you’ve previously understood. Challenging moments like this can be hard to accept, and difficult to comfortably sit through. But if you’ve developed your ability to stay present, and to tolerate the stimuli that intrude upon the present moment, you may be better at hearing your therapist’s interpretations without rejecting them. This meditation-therapy connection was identified in a 2007 study by Daniel Siegel, who found that the self-observation developed in meditation could change the brain, loosening the connections established by prior learning and allowing new input — that of the present moment — to be integrated in a new way. In other words, as Siegel sees it, being present gives you new tools to understand yourself and helps you to unlearn your prior, potentially mistaken assumptions.

Similarly, meditation skills can help you cope with the intrusive comments or interruptions posed in therapy by a person other than your therapist: yourself. People who habitually criticize themselves can have trouble hearing alternative interpretations, or thinking about themselves in ways other than the harsh ones they’ve learned. Now consider how much easier it might be to cope with this kind of regular self-criticism if you’ve developed the ability to gain distance on your own thoughts, as you do when you meditate. You’ll have learned to view these habitual, critical “voices” as something separate from yourself, and you’d be better able to protect your own self-esteem by recognizing the intruding thoughts as alien and unwanted, and responding to them in an appropriate, nonjudgmental way. In a 2012 article, Davis & Hayes referred to this process as “metacognitive awareness,” and linked it to improvements in emotion regulation and reductions in perseveration cognition. These changes, Davis & Hayes concluded, can help you build better emotion regulation skills.

I’ve often heard it said that there are three main goals of psychotherapy: to develop insights into yourself, to accept what you learn, and to regulate the emotions that you feel in response. If that’s true, then the skill-building inherent in regular mindfulness meditation practice can help your therapy succeed in all three ways.

References

Davis, D. M. & Hayes, J. A. (2012). What are the benefits of mindfulness. Monitor on Psychology, 43(7), 64-76.

Farb NA, Anderson AK, Mayberg H, Bean J, McKeon D, Segal ZV. (2010). Minding one’s emotions: mindfulness training alters the neural expression of sadness. Emotion. 10(1):25-33.

Ortner, C.N.M., Kilner, S.J. & Zelazo, P.D. (2007). Mindfulness meditation and reduced emotional interference on a cognitive task. Motivation and Emotion, 31, 271–283

Siegel, D. J. (2007). Mindfulness training and neural integration: differentiation of distinct streams of awareness and the cultivation of well-being. Social Cognitive and Affective Neuroscience. 2(4): 259–263.

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There are many good reasons to complain about human foresight. For one thing, we are often lousy at taking a longer view, being guided instead by the prospects of a quick buck, the whims of the daily news cycle, or likes on social media. We persistently predict our projects will be finished within budget and on time, even if our rosy forecasts have often been wrong before. And we tend to expect that negative events, say, falling off a ladder, are less likely to happen to us than they actually are. Much of what comes to pass we do not foresee, and much of what we foresee does not come to pass.

Throughout history, humans have conjured up audacious strategies to help them peek ahead in time. An entire alphabet’s worth of fortune-telling methods abounds, from abacomancy—reading the future in the dirt, sand, smoke, or ashes—to zoomancy—reading it from the behavior of birds, ants, goats, or donkeys. What these “-mancies” have in common, of course, is that they do not work as advertised.

Examples of our failures to foresee remain all around us, and they can have tragic consequences for us individually and also for our planet more broadly. When the inventor Thomas Midgley Jr., for instance, introduced lead to gasoline and chlorofluorocarbon to refrigerators, he failed to foresee that within a few decades, these would turn out to be two of the worst pollutants in history.

We are not clairvoyants, but…

You may well be left wondering how our shoddy forecasting capacities could have possibly evolved. What’s the point of so much miscalculation? In our recent book—The Invention of Tomorrow: A Natural History of Foresight—Jon Redshaw, Adam Bulley, and I argue that—paradoxically—much of the strength of foresight comes from our very awareness of its limits.

Because we know we don’t know exactly what the future holds, this drives us to make contingency plans and to innovate ways to tip fortune in our favor. Though we may all have a Plan A, say for our careers, we also understand that events may turn out differently from what we imagined: Our company could go bust, we might get bored, or we could be hit by a bus. So, we put money aside for a rainy day, keep an eye on other opportunities, and purchase comprehensive life insurance packages. People sign prenups and set up fire extinguishers for when they might be needed, all the while hoping they never will be.

Hedging her bets, Nina holds out two hands to make sure she catches the dropping prize.

Source: Thomas Suddendorf

Considering multiple possibilities is essential to effective foresight

Take a simple psychology experiment from our research group where we drop a marble into a vertical tube with two exits at the bottom, like an upside-down Y, and ask a participant to catch it. To prepare for the drop, 2-year-old children tend to cover only one or the other exit, which means they catch the marble only some of the time. But by age 4, children instantly cover their bases and hold one hand under each of the exits, ensuring they will catch the prize regardless of where it falls. Even preschoolers know that the future is uncertain and prepare for more than one possibility.

When we giveWhen we give this task to chimpanzees, orangutans, and various monkeys, dropping a grape into the forked tube, they act like young toddlers and tend to cover just one exit. They don’t seem to know that their prediction could be wrong. There is as yet no compelling evidence that nonhuman animals, even our closest living great ape relatives, can foresee mutually exclusive possibilities and prepare accordingly.

Because humans can conceive of multiple versions of the future branching from the present, we can compare our options to select the best one. This capacity has far-reaching implications, not just in enabling contingency planning. It gives us our intuitive sense of “free will”—our (some would say fanciful) impression that we are the masters of our destiny. People tend to treasure this notion. Although it’s not always obvious which path is best, it is empowering to think we are the ones behind the wheel.

Foresight has changed the world

Since we realize that our predictions might be wrong, we can also set out to test them—a process that scientists exploit to a powerful effect. Experiments and observations give rise to theories, which lead to predictions that are then tested with further experiments and observations. If the predictions turn out to be wrong, scientists try to devise a better theory to explain the unexpected observations, which then leads to new predictions and tests. And so on. With this simple cycle—essentially an error-correction mechanism—the collaborative scientific endeavor has resulted in giant strides in our understanding of the world and our capacity to predict what lies ahead.

Today, many scientific forecasts indicate that we are facing dramatic challenges—pollution, climate change, and mass extinctions, to name but a few—that will require complex plans and concerted efforts to address.

As presumably the only animal on the planet capable of foreseeing alternative long-term consequences of their actions, we have choices faced by no other creature. Our farsightedness burdens us, and us alone, with responsibility. And unless we want to go the way of the dodo, it will pay to cover our bases.

This article was adapted from The Invention of Tomorrow: A Natural History of Foresight by Thomas Suddendorf, Jonathan Redshaw, and Adam Bulley.

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Lately, it’s been hard for Jack Innanen, a 22-year-old TikTok star from Toronto, to create content. “I feel like I’m tapping a keg that’s been empty for a year,” he said.

Spending hours shooting, editing, storyboarding, engaging with fans, setting up brand deals and balancing the many other responsibilities that come with being a successful content creator have taken a toll. Mr. Innanen, like so many Gen Z influencers who found fame in the last year, is burned out.

“I get to the point where I’m like, ‘I have to make a video today,’ and I spend the entire day dreading the process,” he said.

He’s hardly the only one. “This app used to be so fun,” a TikTok creator known as Sha Crow said in a video from February, “and now your favorite creator is depressed.” He went on to explain how his friends are struggling with mental health problems and the stresses of public life.

The video went viral, and in the comments, dozens of creators echoed his sentiment. “Say it louder bro,” wrote one with 1.7 million followers. “Mood,” commented another creator with nearly five million followers.

As people collectively process the devastation of the pandemic, burnout has plagued nearly every corner of the work force. White-collar workers are spontaneously quitting jobs; parents are at a breaking point; hourly and service employees are overworked; and health care professionals are coping with the exhaustion and trauma of being on the front lines of the pandemic.

According to a recent report by the venture firm SignalFire, more than 50 million people consider themselves creators (also known as influencers), and the industry is the fastest-growing small-business segment, thanks in part to a year where life migrated online and many found themselves stuck at home or out of work. Throughout 2020, social media minted a new generation of young stars.

Now, however, many of them say they have reached a breaking point. In March, Charli D’Amelio, TikTok’s biggest star with more than 117 million followers, said that she had “lost the passion” for posting content. Last month, Spencewuah, a 19-year-old TikTok star with nearly 10 million followers, announced he’d be stepping back from the platform after a spat with BTS fans.

“A lot of older TikTokers don’t post as much, and a lot of younger TikTokers have ducked off,” said Devron Harris, 20, a TikTok creator in Tampa, Fla. “They just stopped doing content. When creators do try to speak out on being bullied or burned out or not being treated as human, the comments all say, ‘You’re an influencer, get over it.’”

What Goes Up, Comes Down

Burnout has affected generations of social media creators. In 2017, Instagram influencers began leaving the platform, saying they were feeling depressed and discouraged. “No one seems to be having any fun anymore on Instagram,” a contributor to the blog This Is Glamorous wrote at the time.

In 2018, Josh Ostrovsky, an Instagram creator known as The Fat Jew, who had also spoken about burnout, echoed those sentiments. “Eventually there will be too many influencers, the market will be too saturated,” Mr. Ostrovsky said.

That same year, many large YouTube creators began stepping away from the platform, citing mental health issues. Their critiques centered on YouTube’s algorithm, which favored longer videos and those who posted on a near-daily basis, a pace that creators said was almost impossible to meet. YouTube product managers and executives addressed creators’ concerns and promised a solution.

But problems with burnout in the creator community are endemic. “If you slow down, you might disappear,” the YouTuber Olga Kay told Fast Company in 2014.

When a fresh crop of young stars began building audiences on TikTok in late 2019 and early 2020, many were hopeful that this time would be different. They’d grown up watching YouTubers speak frankly about these issues. “When it comes to Gen Z creators, we talk so much about mental health and caring for yourself,” said Courtney Nwokedi, 23, a YouTube star in Los Angeles. “We’ve seen a bunch of creators talk about burnout in the past.”

Still, they weren’t prepared for the draining work of building, maintaining and monetizing an audience during a pandemic. “It’s exhausting,” said Jose Damas, 22, a TikTok creator in Los Angeles. “It feels like there aren’t enough hours in the day.”

“TikTok is just as demanding as YouTube,” said Gohar Khan, 22, a TikTok creator in Seymour, Conn.

Thanks to the app’s algorithmically generated “For You” page, TikTok delivers fame faster than any other platform; it’s possible to amass millions of followers within a matter of weeks. But as quickly as creators rise, they can fall.

“It almost feels like I’m getting a taste of celebrity, but it’s never consistent and as soon as you get it, it’s gone and you’re constantly trying to get it back,” said Lauren Stasyna, 22, a TikTok creator in Toronto. “It feels like I’m trying to capture this prize, but I don’t know what the prize even is.”

The volatility can be rattling. “When your views are down, it affects your financial stability and puts your career at risk,” said Luis Capecchi, a 23-year-old TikTok creator in Los Angeles. “It’s like getting demoted at a job with no warning.”

Creators have encountered all kinds of problems, including bullying, harassment and discrimination. “Some creators get their content stolen too, so someone else will go viral off their content then they get all the press,” Mr. Harris said. Not to mention, fan communities and internet commentators can be vicious. “You can’t just film what you want to film,” Mr. Harris said. “They’ll make fun of you if your views drop.”

“I do worry about my longevity on social media,” said Zach Jelks, 21, a TikTok creator in Los Angeles. “People just throw one creator away because they’re tired of them,” he said.

‘Next, Next, Next’

No one has benefited from the creator boom more than the technology industry. After over a decade of largely snubbing influencers, in the past year, high-profile investors have done an about-face. Venture capitalists in Silicon Valley are now pouring money into creator-focused start-ups, and platforms themselves have begun to compete for talent.

“The over-saturation and this push for everyone to be a creator seems disingenuous,” Mr. Innanen said. “It seems like a cash grab. It makes me feel very disposable, which maybe I am. It’s just next, next, next.”

Creators also operate without the type of traditional employment protections and benefits that come with many salaried jobs. Some leaders in the creator economy, such as Li Jin, whose venture firm invests in the industry, have called for more sustainable monetization paths for creators of all sizes. But most are left to fend for themselves or risk potentially exploitative management agreements.

“You’re completely self-employed, and it’s not like you can continuously make the same work,” Mr. Innanen said. “You have to evolve and adapt.”

“I feel like I can become washed up any second by an algorithm,” he added.

“There is a dark side to it,” said Jake Browne, 30, founder of the Go House, a content house in Los Angeles. “There’s all these investors and platforms, and they need creators to create content on a mass scale. It’s sort of, let’s get everyone to do it and we don’t care about them. The top 10 percent will make us money.”

That pressure will soon feel familiar to more people who shun low-wage or unreliable work to pursue careers in the creator economy. Platforms like Substack and OnlyFans have arisen to sell the dream of entrepreneurship and independence to more people, many of whom have lost faith in more traditional sectors of the economy.

“The influencer industry is simply the logical endpoint of American individualism, which leaves all of us jostling for identity and attention but never getting enough,” Rebecca Jennings wrote recently in Vox.

It likely won’t change soon. “I feel like social media is built to burn people out,” Mr. Jelks said.

To cope with depression, many TikTok creators have sought therapy and life coaching, or tried to be more open with their fans and friends about their struggles.

“When I’m depressed, I talk to the people around me,” said Tatayanna Mitchell, 22, a YouTube and TikTok creator in Los Angeles. “I make posts on my stories and share those quotes that are like, ‘It’s OK to talk to people if you need help.’” Last September, Ms. Mitchell announced she was “quitting TikTok,” citing toxicity and harassment. However, she rejoined shortly after. “I was just sad,” she said.

Walid Mohammed, 21, a manager for Gen Z creators who lives with Ms. Mitchell and several other social media stars, said that being in proximity to one another has helped them. “As a house we have meetings every morning at 10 a.m. to talk about this stuff,” he said. “We talk about stress and how we have to keep working, but that it’s important to take breaks, you just have to stay consistent. We try to cheer each other up.”

Mr. Innanen said that representatives from TikTok have been supportive when he has used the platform to speak out about mental health challenges and invited him to participate in a panel on the issue with other creators.

“We care deeply about our creators’ wellbeing, and take their concerns seriously,” a TikTok spokesperson wrote in an email statement. “We’re focused on understanding their individual content goals and experiences, and our teams continue to work to provide resources, support, and an open door for feedback.”

But even the most helpful platforms can’t alleviate the precarity that’s inherent to a creator’s job, or the pressure many creators put on themselves. “It feels like I personally am failing and may never recover if a video flops,” he said.

A version of this article appears in print on June 13, 2021, Section ST, Page 4 of the New York edition with the headline: Content Creators Burn Out and Break Down.

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As of 2023, the United States has almost 250 million social media users. That number climbs to nearly 5 billion people worldwide and is expected to reach 6 billion by 2027. The average person spends an astonishing two and half hours of their time on social media each day. To put that into perspective, if you started using social media at age 10 and continued till age 80, you’d have spent over seven years of your life on these apps.

With statistics like these, we all need to be asking about the long-term risks to our health, including our mental health. But what does the science actually tell us about the links between mental health and social media use? Here’s the latest science, and steps we should all consider taking today.

Google “social media” and “mental health,” and you’re sure to get a lot of hits. Prominent themes in news stories include higher rates of depression, anxiety, and stress especially in younger people. Yet the actual scientific research tends to be more split on the topic. So what does the research say? Let’s review some of the largest analyses looking at the links between social media use and mental health published in the last few years:

• Problematic social media use in youth is linked to higher levels of depression, anxiety, and stress (2022 systematic review and meta-analysis)
• Problematic social media use is correlated with worse well-being and higher distress, as well as more loneliness and depression (2020 meta-analysis)
• Screen time does not appear to be linked to worse mental health outcomes including smartphones and social media time (2022 meta-analysis)
• Social media can create community, but when used excessively, it’s linked to depression and other mental health disorders (2022 meta-analysis of countries across the world)
• Social media use correlations with worse mental health in youth are described by some studies as “small to moderate,” while others looking at the same data reported the associations as “serious, substantial or detrimental,” suggesting disagreement in the interpretation of the data (2022 umbrella review of data)
• Young adults with higher social media use may feel more socially isolated (observational data, 2017)
• Older adults who use social media may experience “enhanced communication with family and friends, greater independence and self-efficacy, creation of online communities, positive associations with well-being and life satisfaction and decreased depressive symptoms.” (2021 scoping review)

As you can probably tell, even the most comprehensive journal articles on this topic have rather conflicting messages. Yet there are some key stable themes that we can extract from all this work that can help guide us towards safer social media use for our brain health.

1. Our digital devices, especially our smartphones, are packed with technology and apps designed to capture our attention. Companies behind these products are largely incentivized to keep us looking at the screen, not necessarily happy.
2. Children and youth may be at higher risk for negative mental health outcomes from social media use than adults.
3. Problematic (unhealthy) social media use is emerging as a clear risk factor for worse mental health, but the definition of this term is unclear. Usually, it’s something similar to characteristics of addiction (e.g., preoccupation, compulsion, withdrawal).
4. Social comparison that occurs due to social media exposure may increase the risk for worse mental health outcomes, and this may be more of an issue for young women.
5. Social media can provide meaningful connections to people who might not have access to strong in-person networks specific to their interests or needs.

What does this mean for how we might approach social media use?

With most people on Earth participating in at least one social media platform, it’s unlikely that the social media genie is headed back into the bottle anytime soon. Some have argued for large-scale restrictions on social media use for children and adolescents while others propose an outright ban. How and when a person engages with social media will always be unique to the individual, but when looking at a personal approach to use, most will benefit from asking if their use passes the test of T.I.M.E. (adapted from Brain Wash).

T: Time-restricted

Is your time spent on social media time restricted? If not, can you set a time limit that you feel comfortable dedicating to social media?

I: Intentional

Is your social media use intentional, or are you falling prey to doomscrolling, social comparison, or the plans of the app developer that’s trying to steal your attention?

M: Mindful

Is your social media time mindful or mindless? Do you find yourself losing large chunks of your day to scrolling? If so, consider reevaluating your use.

E: Enriching

Does your social media use enrich your life? Does it educate you? Connect you with others? Provide an opportunity to grow your business. If it’s hard to answer yes, it’s likely that your apps are extracting more from you than you’re getting in return.

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