Practical strategies for parents and educators to foster confidence and calm. Recognize the signs of anxiety in children, such as school avoidance or stomachaches. Create a supportive and predictable environment in school. Collaborate with teachers and school staff in the process. If your child has anxiety , school can be a daily struggle. Your child or teen may resist getting out of bed, express physical complaints like stomachaches or headaches before bed or in the morning, or struggle to make friends. Some subjects may feel especially challenging, and the noise and activity of the school environment can be overwhelming. The reasons for school-related anxiety can vary, but one thing is clear: when a child is preoccupied with worry, it’s hard for them to focus on academics. Over time, this can lead to a cycle of frustration and fear, with each worry feeding into the next. An anxious child’s inner dialogue might sound something like this: “I can’t focus because I’m worrying about my mom’s safety, so now I missed the math lesson. I don’t know how to solve these problems, but I’m afraid to ask for help. My teacher will be upset with me. Now I have a homework sheet of 20 problems I don’t understand. And I have science and spelling homework, too. Samantha wouldn’t play with me today—did I do something wrong? What did the teacher just say? Was that the bell? Are we going to gym? I can’t do this!” How Can I Help My Anxious Child Succeed in School? Fortunately, there are support plans available that can help. These come in two forms: a 504 Accommodation Plan and an Individualized Education Plan (IEP). 504 Accommodation Plan A 504 Accommodation Plan provides support once a diagnosis is in place. Created by a team including parents, the principal, the school nurse, teachers, and a counselor, this plan offers accommodations that help your child manage their anxiety at school. It’s valid for a year and can be updated annually, though reviewing every three months is often beneficial as a child’s needs can fluctuate throughout the year. Common 504 accommodations for anxiety include: Daily check-ins: Inform the school team—principal, counselor, and teacher—about your child’s challenges so they can help make the morning routine smoother. Arrangements could include a designated staff member to meet your child at drop-off to ease separation and transition. Flexible attendance: If attending a full day is overwhelming, consider a gradual return—starting with a half-day and slowly adding classes as your child adjusts. Staggered entry: Allowing your child to arrive before or after the morning rush can reduce anxiety about crowded hallways. Regular check-ins: Establishing a trusted adult (like a guidance counselor) who meets with your child regularly or on an as-needed basis can provide comfort and support. Individualized Education Plan (IEP) An IEP provides specialized education and additional resources if a child’s anxiety significantly impacts their learning. This program can include in-class support or co-teaching for challenging subjects. It involves a case manager from the Child Study Team (CST) and may include testing by the CST or from a clinical psychologist. For children who have co-existing conditions such as ADHD or specific learning disabilities, the support can be even more comprehensive. Out-of-class resource programs might provide modified curriculum support tailored to their abilities. An IEP can include 504 accommodations along with additional options such as: Reduced workload and homework: Completing only selected problems (e.g., odds or evens) can make assignments feel more manageable. Avoidance of spotlight: Allow your child to volunteer instead of calling on him to avoid added pressure. Breaks as needed: Giving your child permission to take breaks when they feel overwhelmed can help them reset. Safe space: Designate a quiet space in the school where your child can go to decompress. Extended time: Allowing extra time on assignments, tests, and quizzes can ease performance pressure. Quiet testing environment: Permit your child to complete tests or assignments in a quieter setting if needed. The Real Impact of Anxiety on School Life Anxiety can profoundly impact a child’s school experience. For many, holding it together at school means they’re exhausted by the time they get home, leading to emotional outbursts that can be difficult for the family . As a parent, sharing your child’s struggles with teachers, counselors, and the principal can provide much-needed support and reduce your own burden. By involving the school in your child’s daily challenges, you can help them find relief during the school day rather than bearing the weight of their anxiety alone until they come home. Liz Nissim-Matheis, Ph.D., - Website -

Schizoaffective disorder and schizophrenia differ, including in remission rates. Schizoaffective disorder is often mistaken for schizophrenia. Schizophrenia and schizoaffective disorder are distinguished from each other by type of affect. Patients with schizoaffective disorder are more likely to experience remission than those with schizophrenia. Advocating for rights for people with schizophrenia is a tough lifestyle. In fact, there are only a handful of activists in the United States who have successfully executed writing a memoir, starting a YouTube channel, and gathering a following. What is less spoken about is that these activists often do not exactly have a schizophrenia diagnosis in the true sense. Many of us advocating for schizophrenia education have schizoaffective disorder instead. It is easy to conflate the two because both disorders display classic symptoms of psychosis: delusions, word salads, and hallucinations, to name a few. But the two differ primarily on one distinction: Schizoaffective disorder comes with the debilitating effect of extreme moods, and schizophrenia often results in a lack of affect, or mood . Schizoaffective disorder’s mood categorization is based on whether or not the patient is exhibiting either depression episodes or both mania and depression symptoms, resulting in either Schizoaffective Disorder Type I or Type II. A patient will get diagnosed with schizoaffective disorder rather than bipolar disorder with psychotic symptoms when the patient experiences psychotic symptoms outside of the manic and depressive episodes. Psychosis in bipolar is more of an effect of the moods, while psychotic symptoms in schizoaffective disorder are the primary debilitating factor. What the Research Says About Recovery So why does it seem like people with schizoaffective disorder are more public and seemingly better in prognosis than people with schizophrenia? Some studies have looked into this issue. In Italy in 2014, for example, researchers looked into remission and recovery rates in patients with schizophrenia and patients with schizoaffective disorder. Participants included 102 people: 46 diagnosed with schizophrenia and 66 with schizoaffective disorder. What they found was that schizoaffective disorder was more commonly diagnosed in females, while schizophrenia patients were more often male. The percentage of those in remission (which is when symptoms become less severe) was higher in those with schizoaffective disorder than those with schizophrenia. Patients with schizoaffective disorder had a statistically significant rate of 42.4 percent of patients in remission compared to 23.9 percent of individuals with schizophrenia. Recovery was also better for individuals with schizoaffective disorder than for individuals with schizophrenia. Those rates that were statistically significant were 22.7 percent of schizoaffective patients versus 6.5 percent of schizophrenia patients. A similar percentage of patients were placed on the same first-generation antipsychotics (33.3 percent of schizoaffective patients and 34.8 percent of schizoaffective patients), while 73.9 percent of schizophrenia patients and 78.8 percent of schizoaffective patients were put on second-generation antipsychotics (which are thought to be more effective with fewer side effects), which shows many were treated with the same methods. People with schizoaffective disorder were more often prescribed benzodiazepines (like Xanax and Klonopin) and mood stabilizers. The researchers were puzzled about why this was but speculated that schizoaffective patients have more mood components, which could somehow affect prognosis. Additionally, studies conducted in other countries—for instance, in Israel—reported unreliable diagnoses of schizoaffective disorder throughout time. People with schizoaffective disorder were more likely to be misdiagnosed and have their diagnosis changed compared to people who received the diagnosis of schizophrenia. Schizoaffective disorder remains a controversial diagnosis, and because it is commonly misattributed to patients it can be difficult to determine how truly distinct it is as a diagnosis when the patient can easily fit many criteria for other disorders. It is clear that patients who have schizophrenia differ in fundamental ways from those who have schizoaffective disorder. How those differences are explained is currently unknown, but statistical rates of recovery indicate that there are some reasons why people with schizoaffective disorder more frequently recover and experience remission. Sarah An Myers References Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016. Pinna, F., Sanna, L., Perra, V., Randaccio, R. P., Diana, E., Carpiniello, B., & Cagliari Recovery Study Group. (2014). Long-term outcome of schizoaffective disorder. Are there any differences with respect to schizophrenia? Rivista di psichiatria, 49(1), 41-49. Florentin, S., Reuveni, I., Rosca, P., Zwi-Ran, S. R., & Neumark, Y. (2023). Schizophrenia or schizoaffective disorder? A 50-year assessment of diagnostic stability based on a national case registry. Schizophrenia Research, 252, 110-117.

Children's sleep can be affected by what peers do and say. Children and adolescents may experience many kinds of discrimination. These experiences create emotional distress and can lead to disrupted sleep. Parents should be aware that distressing experiences can be a cause of their children's sleep problems. Despite the old saying about sticks and stones, others’ words really can be hurtful. It is an unfortunate aspect of growing up that many children and teens are frequently mean to one another. Ridicule, exclusion, discrimination, and bullying of others are pervasive and can be based on many characteristics, including attractiveness, body shape or size, gender, race and ethnicity , nationality, social class, clothing, religion, politics, language and speech, intelligence and academic ability, or physical ability (did I leave anything out?). These kinds of situations are not new, of course, but the availability of social media has amplified the opportunities and even afforded anonymity in some instances (e.g., the number of “likes”). Rejection by peers can have devastating effects, including emotional distress, anxiety , depression , eating disorders , and self-harm. Do these experiences also influence sleep? Sleep disruptions, including the inability to fall asleep or stay asleep, nightmares, and nocturnal enuresis, are common in children and adolescents , but the research on the relationship between distressing experiences and sleep is relatively sparse. So what has the research revealed? Dr. Tiffany Yip and colleagues have provided an excellent recent review of research in this area. Their focus is on racial/ethnic discrimination and sleep, with discrimination documented in most instances through daily diaries and sleep measured in various ways including self-report and objective measurement with wrist actigraphy. The evidence is clear: Experiencing discrimination and even witnessing others being discriminated against is associated with shorter sleep duration, more difficulty falling asleep, poorer sleep quality, and daytime sleepiness. These effects are even seen in longitudinal designs where sleep can be affected weeks or months later. Sleep is a modifiable behavior, and the authors describe numerous studies that have shown some effective interventions to help children and adolescents sleep better. Improvements in sleep hygiene (e.g., reducing caffeine intake and use of social media in the evenings), cognitive behavioral therapy, and education about sleep are among interventions that have had success. Unfortunately, the authors could find no intervention studies specifically aimed at those who experience discrimination, and they highlight the need for such studies. Interventions by psychological, medical, and educational professionals are beneficial but rarely available to those who might need them. But talking to children daily about their interactions with others at school or on social media is something any parent can do. While it is impossible to shield children from distressing experiences, processing them with a parent or an older sibling can be beneficial. Parents can also take note when their children are not sleeping well and recognize that discrimination can be a cause. Joseph A. Buckhalt, Ph.D., References Yip, T. et al. (2024). Developmental links between ethnic and racial discrimination and sleep. Child Development Perspectives. 24 April 2024.

Discover the keys to healthy giving. Are you "overly nice" and suffering as a result? What I mean by this is that empaths and many caring people often burn themselves out by over-giving and don’t know when to back off. They mean well. But what’s missing is balance and knowing when to give less and replenish themselves. I’ve known people who've sacrificed their last molecule trying to help someone who may not have even wanted their help. Or they've exhausted themselves by trying to fix others. To maximize how your giving can heal others and yourself, learn to remain discerning and balanced. Neuroscience has confirmed numerous ways that healthy giving enhances wellness. For instance, volunteering has been shown to lower stress levels, reduce depression , and lessen your aches and pains. Plus, MRI scans have demonstrated that donating to a worthy cause increases dopamine, the pleasure hormone. Contributing to a community also has been proven to enhance people’s ability to cope with addiction and bereavement. The desire to give flows naturally from having empathy. You care. You want to help. So you offer your time, your knowledge, and your energy. (For me, time is my most valuable gift.) Perhaps you listen to a coworker going through a tough divorce or you do a load of wash for an ailing neighbor. Maybe you simply smile at a stranger. It’s a myth that healthy giving is only unconditional or selfless. Healthy giving may also be conditional. Healthy giving comes from your heart but is also about setting boundaries in situations that warrant it and practicing self-care. One form of giving is showing someone appreciation, whether it’s for taking out the trash, filling in for them at work, or writing a moving novel. Appreciation helps people feel validated and flourish. It can lift you out of a miserable mood so you can think, “Maybe this situation isn’t so bad after all.” I teach my patients, and the UCLA psychiatric residents I supervise, how to give wisely—sometimes a life-or-death concern. It’s a lesson in balancing and conserving energy that many of us overly nice people need to learn. You too can learn to empathize without sacrificing your own well-being. Following are some positive traits of healthy giving: Empathize without feeling drained Practice random acts of kindness Set healthy boundaries, such as saying a positive “no” Prioritize self-care, rest, and alone time to replenish energy Feel nourished by giving Know your own limits Accept support Delegate responsibilities Allow others the dignity of their own path without interfering (Source: The Genius of Empathy) To feel more energized and balanced in your giving, experiment with incorporating these traits into your life. Learning to balance empathy with self-care is a beautiful ongoing healing process. I’m inspired by the 14th Dalai Lama’s prayer about helping others in the book Ethics for the New Millennium, in which he seeks to be “a guide for those who have lost their way” and “a bridge for those with rivers to cross.” In our own unique styles, we can do this too. Judith Orloff, M.D., - Website -

Your anxiety helps to keep your child safe. We are living in an era of escalating tensions, conflicts, and worries. Some call it a "stress epidemic." The Surgeon General has warned that parents are a lot more stressed than others, dangerously stressed in fact. So much is out of your control, but some important things are within your control. Love your child. Accept your anxiety. Be kind to yourself. Reach out for help. Help others. You've got this! Being a parent today means feeling stressed. In fact, the U.S. Surgeon General has issued a “ dangerous stress ” warning to American parents. Knowing that you’re in good company—that most other parents are also super stressed—might give you some comfort, but that’s not enough to help you manage those feelings. To begin with, it’s good to acknowledge that we’re living in a climate of escalating fear, where everyday advertisers, politicians, and experts give us new reasons to worry. And the message is megaphoned up a few notches for parents. On top of everything else, you’re being told that you should also worry about your child’s or adolescent’s behavior, their development, their mental health, your parenting, school shootings, drugs, social media predators, the environment. So much can go so wrong. And in case you’re not anxious enough already, here's one more thing to add to your stress bundle: Your anxiety may be contributing to your child experiencing mental health problems of their own. I am not advocating that you stop worrying altogether; a certain level of anxiety helps keep you safe. It’s important to pay attention to what’s going on for your child and in the world, so that you can do whatever needs doing to keep your family and community strong and healthy. You Can Do This. What I am advocating is that you connect to the love you feel for your child, and do your best to take good care of yourself. Simple, right? Maybe not, but when you’re feeling strong and calm, you’re in the best possible place to give your child what they need, thereby allaying your anxiety and theirs. 7 Suggestions for Muddling Through Love your child. No matter what else is going on in the world, in your family, and with your child, connect with the loving connection you feel for your child. They feel your love, and need that more than anything you can buy or do for them. This is priority Number One. Acknowledge your anxiety. Let it be okay to be anxious. Anxiety is not only normal and predictable in a chaotic world (and even more so if you’re a parent) but it’s also helpful in keeping yourself and your family and your community safe. Take good care of yourself. Nutrition, sleep, exercise, outdoor time, social time, quiet time—all those good things you try to make sure your child gets enough of are important for you too. You’re a better parent when you’re feeling strong and healthy and happy, so look for ways to make that happen. Ask for help. Parents today feel more alone and isolated than ever. If that describes you, it’s time to put some energy into cultivating your network of social support. Talk to friends, relatives, neighbors, or professionals about what’s troubling you, or just get together for a cup of coffee with someone. Help others. Look for others who might benefit from some help. That can be small-scale, like taking a dozen cookies to your neighbor who’s struggling with toddler twins, or it can be large-scale, like getting politically active because you see a need for change. The neurochemistry of giving to others is potent. When you help someone else, you strengthen your network of social support, and you feel better about yourself and your problems. You're also making the world a better place, and that's ultimately good for your anxiety and your child's future. Be kind. Be patient with yourself and with your child. Do your best to be kind to yourself, and to be present as often as possible to what’s good about this child in this moment. Love your child. At the end of the day, your solid dependable love is what matters most. When you’re showing up with love in your heart, it’s hard to be too anxious, especially if you’re also taking good enough care of yourself. Yes, it’s a time of heightened anxiety for everyone, for a lot of terrible reasons, and a time when parents more than others are feeling completely stressed out. But you won’t be much good to yourself or your child if you let yourself be overwhelmed by that. So, take a deep breath and think about how you can take good care of yourself today. Dona Matthews, Ph.D., - Website - References “Parental Mental Health & Well-Being,” from the Office of the Surgeon General, US Dept of Health and Human Services “The Surgeon General's Advisory on Parental Stress,” by Eugene Beresin “Infographic: Stress in Parents Compared to Other Adults,” American Psychological Association “The Anxious Generation We Should Be Talking About,” by Emily Edlyn “Stressed Parents—Voila, Stressed Kids,” by Janet Hibbs and Anthony Rostain “How to Feel Less Stressed as a Parent,” by Cara Goodwin “Parent Stress Is a Serious Public Health Concern,” by Cara Goodwin “Prepared to Care: The Case for Kindness and Self-Kindness,” by Tracy Dennis-Tiwary

No two people have the exact same depression. What explains these differences? Depression affects 280 million people, but it looks different in everyone. How we define depression plays a huge role. Age, sex, and cultural differences also play a role. Globally, over 280 million people have depression . But if you were to ask a random sample of 1,000 people to describe their depression, you would have a low chance of finding two people who have the exact same experience. Why is that? Defining Depression We first need to define depression to understand why it looks different in everyone. Depression, or a Major Depressive Episode, is a mental health diagnosis that is characterized by nine symptoms: (1) depressed mood ; (2) “anhedonia,” or markedly diminished interest or pleasure; (3) increase or decrease in either weight or appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness or inappropriate guilt; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicidal ideation (American Psychiatric Association, 2022). A diagnosis requires that someone has at least five of these symptoms, one of which must be either depressed mood or anhedonia. These symptoms need to be persistent for at least two weeks and cause significant distress or impairment. Additionally, these symptoms should not be better explained by another factor, like a new medication. So, if we have these defined criteria, why does depression vary so much from person to person? 5 Reasons Why Depression Looks Different in Everyone 1. The criteria are not one-size-fits-all. The definition of depression, itself, invites differences from person to person. Research shows that it is rare that any two individuals will have the exact same combination of symptoms—as you can see in the criteria above, depression is defined by a combination of five out of nine symptoms. One study, led by Eiko Fried and Randolph Nesse (2015), analyzed over 3,000 patients and investigated how often patients share the same symptom experience. Their study revealed that how we define depression can result in over 1,030 unique symptom profiles! The most common symptom profile was only endorsed by 1.8% of the sample. Put simply, there are many, many ways to meet the criteria for depression. 2. Depression is defined by subjective experiences. Depression is a diagnosis that is rooted in subjective experiences like mood, emotions, thoughts, and behaviors. The word “subjective” does not mean someone’s experience is not real—if someone feels sad, then they feel sad. But as a psychologist, I cannot give someone a blood test to assess if they are “happy” or “sad,” nor can I use a brain scan to assess for suicidal thoughts. Even for the physical symptoms, like loss of energy, there is no reliable objective test to determine the severity of someone’s fatigue. To diagnose depression, clinicians must conduct interviews with patients to assess how they feel. And, as we all know, one person’s “sad” looks a lot different than another person’s “sad.” 3. Depression presents differently across age groups. How depression looks can vary across children , teenagers , and adults . Research shows that specific symptoms may show up more frequently in certain age groups. In one study by Rice and colleagues (2019), they analyzed how frequently depression symptoms were endorsed by adolescents and adults. Their study found that “vegetative symptoms”—like appetite and weight change, loss of energy, and insomnia—were more commonly seen in adolescent depression than adult depression. Meanwhile, adult depression was more likely to include symptoms of anhedonia and concentration problems. These findings can help people become more sensitive to noticing signs of depression based on age. 4. Sex differences exist between men and women. Large global studies have consistently found that women are more likely to be diagnosed with depression than men. Among adults in the United States, 10.3% of women—compared to 6.2% of men—met criteria for depression in 2021 (NIMH, 2023). The reasons for these sex differences are complex, driven by an interplay of social, psychological, and biological factors (Eid et al., 2019). It is also possible that how we define depression makes it easier for women to meet the criteria, and men may present with depression differently (Martin et al., 2013). In support of this idea, Cavanagh and colleagues (2017) conducted a large review of studies and found that men with depression were more likely to have difficulties with alcohol use, drug use, and risk-taking/poor impulse control behaviors. Meanwhile, women had a higher frequency and severity of traditional depression criteria, like depressed mood, appetite/weight changes, and sleep difficulties. Recognizing these differences can help both men and women get help for depression. 5. Cultural differences are real, but more research is needed to understand these differences. Cross-cultural research shows that the expression of positive and negative emotions can vary across countries and cultures. This is important to note because depression—a diagnosis characterized by mood and emotions—is mostly defined from a Westernized perspective. The criteria were not developed and tested in other countries, and thus our estimates of depression around the world may be somewhat biased. For example, a multinational analysis of 116 countries found that countries meaningfully varied in their expression and valuing of emotions (Tay et al., 2011). While the range of emotions if felt universally across cultures, some cultures are more likely to express joy than others, and the same rule of thumb applies for negative emotions (Cordaro et al., 2018). However, a new study by Panaite and Cohen (2024) found some consistency across countries in terms of how emotions were reported among adults with depression, compared to adults without depression. Their study highlighted the need for more cross-cultural research to understand the complexities of how depression is experienced across the world. The Takeaway There is no “one” look to depression. Depression does not have one mascot that represents everyone’s experience. However, by understanding why depression varies from person to person, we are better positioned to provide one-fits-one care and support from person to person. Andrew Devendorf, Ph.D., - Website - References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Cordaro, D. T., Sun, R., Keltner, D., Kamble, S., Huddar, N., & McNeil, G. (2018). Universals and cultural variations in 22 emotional expressions across five cultures. Emotion, 18(1), 75. Eid, R. S., Gobinath, A. R., & Galea, L. A. (2019). Sex differences in depression: Insights from clinical and preclinical studies. Progress in Neurobiology, 176, 86-102. Fried, E. I., & Nesse, R. M. (2015). Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR* D study. Journal of Affective Disorders, 172, 96-102. Haroz, E. E., Ritchey, M., Bass, J. K., Kohrt, B. A., Augustinavicius, J., Michalopoulos, L., ... & Bolton, P. (2017). How is depression experienced around the world? A systematic review of qualitative literature. Social Science & Medicine, 183, 151-162. National Institute of Mental Health (NIMH). (2023). Major Depression. Panaite, V., & Cohen, N. (2023). Does Major Depression Differentially Affect Daily Affect in Adults From Six Middle-Income Countries: China, Ghana, India, Mexico, Russian Federation, and South Africa?. Clinical Psychological Science, 21677026231194601. Rice, F., Riglin, L., Lomax, T., Souter, E., Potter, R., Smith, D. J., ... & Thapar, A. (2019). Adolescent and adult differences in major depression symptom profiles. Journal of Affective Disorders, 243, 175-181. Tay, L., Diener, E., Drasgow, F., & Vermunt, J. K. (2011). Multilevel mixed-measurement IRT analysis: An explication and application to self-reported emotions across the world. Organizational Research Methods, 14(1), 177-207.

Battling blurred lines in your personal and professional relationships Establishing healthy boundaries is how one can take control of unhealthy intrusions, demands, or expectations. Setting healthy boundaries is a great first step, but some people in one's life may challenge or ignore them. It is important to understand the dos and don’ts of maintaining healthy boundaries. We all struggle with some people in our lives ignoring our boundaries, and then we wonder how we can maintain our boundaries in the future and remain focused and connected to our healing and growth while living with hurt feelings. As human beings, we are social animals. We thrive through our social networks throughout our lives. Together, we learn and grow. We define who we are, what we want, how we treat others, and how we wish to be treated. At times, we find it necessary to create healthy boundaries between ourselves and the people in our lives. Healthy personal boundaries work in the same way as a well-constructed and maintained fence. While most of us are familiar with the phrase, “Good fences make good neighbors,” few are familiar with its origin in a 1914 poem by Robert Frost called “ Mending Wall. ” In this poem, the author examines the often-fraught interpersonal dynamics of two neighbors who learn a lot about boundaries through their evolving desire to engage and challenge one another while attempting to respect one another’s property. When we set out to establish healthy boundaries with the people in our lives, what we are essentially doing is correcting unhealthy patterns of over-dependency in relationships and other problematic habits we have identified that no longer serve us and focusing on our self-care and well-being. While we don’t intend to upset friends or family members by appearing aloof or uncaring or wish to be perceived as unprofessional or irresponsible by colleagues and supervisors when we suffer from stress, burnout, and feelings of overwhelm due to a lack of boundaries, we often encounter resistance to our new rules. The purpose of new rules When we create healthy boundaries for ourselves, we are essentially rewriting our rules of engagement. These new rules define our boundaries and protect us from unhealthy and unwelcome intrusions, demands, and expectations. They also enable us to build mutually respectful relationships and manage our finite resources of time and energy. Defining and defending your boundaries Setting healthy boundaries takes a great deal of self-reflection and effort. Then, once our boundaries are set, we need to communicate them to the people in our lives. Though it might be reasonable to assume that once we have set and communicated our boundaries to the people in our lives, all will be well, the reality is that what follows can be a time of great challenge and effort. Especially when we have set boundaries to address the long-term negative impacts of people-pleasing and prioritizing the needs of our friends, family members, and workplaces over our self-care, life tasks, and responsibilities, our new rules are unlikely to go unchallenged. There are, of course, times when it is reasonable to ignore our boundaries and say yes to a colleague or supervisor facing a looming deadline, a friend in crisis, or a family member who needs our help. Managing resistance to change When you establish healthy boundaries that change long-standing dynamics with friends, family members, and colleagues, there are likely to be some people who struggle to understand or accept the changes. There may also be people in your life who challenge your new rules for myriad reasons. Some may not take your efforts seriously. Others—especially those who stand to lose some or all of the benefits of your time, attention, and energy—may find adjusting to your boundaries inconvenient and troublesome. You may find that those who have benefited from your former lack of boundaries often try to challenge your boundaries by engaging in manipulative tactics that seek to appeal to your compassion, concern, and sense of responsibility, and blur the lines you have drawn about your time and energy. The Dos And Don’ts of Maintaining Healthy Boundaries Your healthy boundaries are yours and yours alone. It is up to you to stand your ground and stay committed to defending your boundaries against the people in your life who struggle to accept your new rules of engagement. Don’t personalize the actions, reactions, and choices of other people: Some people in your life may struggle to understand your new rules. Their reactions reflect their struggles rather than your efforts to make changes for your betterment and well-being. Don’t give in to guilt: Guilt is a red flag emotion. When you feel guilty for standing your ground, it is a sign that someone wants something from you that you are not comfortable giving. Do stay aligned and committed to your highest and best: Remember why you established healthy boundaries, and how much these boundaries have helped you reduce stress, create healthier relationships, and manage your time and energy. Pay attention to who challenges your boundaries: Chances are that the people who challenge or ignore your boundaries played a huge part in your decision to create boundaries in the first place. Be prepared for push-back. Have compassion for yourself and others while you adjust to your new rules. Change takes time. Stay connected to your feelings and be patient with those in your life who challenge and resist your new boundaries. This article is brought to you by Psychology Today - Website - Monica Vermani, C. Psych., - Website -

Strategies to heal and cultivate healthier connections after childhood trauma. Lack of attachment or feeling unsafe can make it hard for trauma survivors to build healthy adult connections. Trauma can impact survivors' ability to trust, express emotions, set boundaries, and regulate emotions. Survivors heal and build healthy relationships through self-awareness, boundaries, compassion, and support. Do you often wonder if your partner will be there for you when you need them the most? During conflicts, do you tend to withdraw, push your partner away, or react with an emotional outburst? Do you also have difficulty expressing or asserting your needs in relationships? If you've experienced childhood abuse —whether physical, sexual, or emotional—you may be facing relational challenges. Childhood trauma can have a lasting effect on your ability to form healthy, secure attachment s in adulthood. The quality of our early relationships, particularly with primary caregivers, plays a significant role in how we connect with others as adults, especially in intimate relationships (Silva et al., 2024). Why Childhood Trauma Makes Emotional Connections Challenging In my clinical practice, trauma survivors frequently express dissatisfaction in their relationships. These challenges often stem from core beliefs such as " No one can be trusted, " " I can't express my feelings safely ," or " I am unworthy of love. " These beliefs, common among trauma survivors, can significantly impact the ability to trust others and create difficulties in forming and maintaining healthy connections (Ferrajäo & Elklit, 2020). Secure attachments in childhood help us build trust, feel safe, and regulate emotion—key factors for healthy relationships in adulthood. Conversely, a childhood marked by abuse can result in insecure attachments, leaving lasting emotional scars that carry into adulthood (Bowlby, 1973). If this resonates with your childhood experience, you may struggle with trust, self-confidence, and emotion regulation, which can impact your communication , conflict resolution, and connection with partners (Heller & LaPierre, 2012). How Trauma Impacts Relationships 1. Challenges With Trust and Emotional Intimacy. It’s natural to struggle with trust and vulnerability after experiencing abuse and broken trust in childhood. For trauma survivors, vulnerability can feel unsafe, and expressing emotions might have previously resulted in rejection or harm. As a result, you may have developed coping mechanisms, such as emotional withdrawal or repression. While these mechanisms protect you, they can also create emotional distance in your relationships, leading to misunderstandings and disengagement. If you find yourself doubting whether your partner will be there for you when needed, you may react with jealousy, withdraw, or even try to sabotage the relationship during conflicts. While this is a defense mechanism against further hurt, it prevents deeper connections from forming. 2. Fear of Abandonment or Rejection. Feeling unsupported in childhood and internalizing the belief that you are unworthy of love can create a fear of abandonment by your partner, leading to persistent anxiety. If this resonates with you, reflect on whether you tend to cling to your partner, overanalyze situations for signs of rejection, rely too heavily on them for emotional support, or push them away at the slightest hint of abandonment. These actions can unintentionally create the very situation you fear. 3. Struggles With Boundaries. Childhood abuse often involves blurred or violated boundaries, making it difficult to establish healthy boundaries in adulthood. This might show up in intimate relationships as challenges asserting your needs, respecting your partner's boundaries, or maintaining your sense of self. These struggles lead to resentment, burnout, or emotional exhaustion. 4. Difficulty Regulating Emotions. As children, we learn to regulate emotions through our caregivers' example. However, childhood trauma can leave us without healthy emotional coping skills. Reflect on how you respond to stress or conflict in relationships—do you have intense outbursts, withdraw, or shut down? These signs of emotional dysregulation can create a toxic cycle in relationships, leaving partners feeling overwhelmed, confused, or hurt. As conflicts escalate, this can lead to further disconnection and misunderstanding. 4 Strategies for Healing and Building Healthy Relationships While the effects of childhood trauma on adult relationships can be significant, they are not permanent. Healing is possible. Here are some strategies that can help: 1. Self-Awareness. One of the first steps in healing from childhood trauma is building self-awareness. Recognizing trauma-based patterns and understanding the roots of your fears and insecurities can help you break unhelpful behaviors in relationships. Self-reflection exercises, journaling, and mindfulness practices can all be helpful tools for fostering greater awareness. 2. Communication and Establishing Healthy Boundaries: Effective communication is essential for building trust and intimacy. For those who struggle with vulnerability, taking small steps toward openness can gradually deepen emotional closeness. Approach the conversation with calmness and clarity about your needs. Practicing assertiveness and self-respect is key to breaking the cycle of trauma-related people-pleasing. Set clear, reasonable consequences for when your boundaries are crossed. For example, if your partner tends to ignore you when you speak, use “I feel” statements to express your needs and emotions without blaming them. You might say, “I feel hurt when I’m ignored. If that happens again, I’ll need to speak to a friend who will listen.” 3. Compassion: Healing from trauma is not linear, and it takes time. It’s important to approach both yourself and your partner with compassion. Recognize that trauma affects how we respond to conflicts, which can foster empathy and understanding in your relationship. If you feel you reacted poorly during a conflict, offer yourself the same compassion you would give a friend. Remind yourself of the kind of things you would say to them in that situation. 4. Seeking Support: Establishing a support system is essential for healing. Surround yourself with supportive friends, family, or a therapist who can provide the compassion and nurturing you need. Therapy can be a safe place to reframe unhelpful beliefs about yourself and others, develop helpful coping strategies, and improve communication skills. If you are not ready to work with a therapist, consider support groups or books that can help you process lingering trauma. Copyright by Stacey R Pinatelli, Psy.D. Excerpted in part from my book Hope and Healing for Survivors. Stacey R Pinatelli Psy.D. - Website - References Bowbly. J. (1973). Attachment and Loss. New York: Basic Books. Ferrajão, P. C., & Elklit, A. (2020). World assumptions and posttraumatic stress in a treatment-seeking sample of survivors of childhood sexual abuse: A longitudinal study. Psychology of Violence, 10(5), 501–508. Heller, L., & LaPierre, A. (2012). Healing developmental trauma: how early trauma affects self-regulation, self-image, and the capacity for relationship. North Atlantic Books. Silva, A., Ferreira, S., Silva Pinto, É., Rocha, S. A., & Barbosa-Rocha, N. (2023). The Relationship Between Childhood Abuse and Adult Attachment Styles: The Mediator Role of Sensory Over-Responsivity. Journal of Aggression, Maltreatment & Trauma, 33(2), 236–254.

Understand the roots of anger and learn to defuse difficult conversations. Anger often impacts our everyday interactions. Our beliefs lead to irrational, unhealthy anger. Help distressed individuals with empathy, attention, and respect. The middle school's physical education teacher felt like a human punching bag. Once again, an angry parent had called the school, yelling about the "horrible teacher" who made her son participate in gym class when he felt tired and did not want to. According to a recent study by the American Psychological Association, 29% of teachers and 42% of school administrators report incidences of parent aggression. Not surprisingly, 49% of teachers were considering a new line of work. We all have stories of experiencing angry people in stores, cars, workplaces, hospitals, hotels, airports, and meetings. A recent Gallop Global Emotions Report revealed that up to 23% of respondents felt angry every single day. If that includes you, know that you are not alone. We typically believe our anger results from the events that happen around us. Bad drivers and customers make us mad, or so we think. However, the real reason we experience anger is because of what we believe about ourselves and others. We feel the world ought to be as we would like it and that people should treat us fairly. According to the principles of rational emotive behavior therapy (REBT), our unhealthy anger is fueled not by life events but by our inflexible, demanding beliefs. How to Handle Anger Managing anger effectively starts with recognizing the difference between healthy and unhealthy negative emotions. Anger is our response to injustice and boundary violations. If you hear a story of a child being abused, you will likely feel anger. In this instance, anger is a healthy response to the injustice of abuse . Your strong emotion motivates you to protect the innocent. Unhealthy negative emotions do not help us deal with problems of reality—they keep us stuck in self-defeating behaviors, interfere with our ability to reach our goals, distort reality, and make us miserable. In contrast to healthy anger, unhealthy anger is about our blocked personal goals. We want something and get angry when we don't get it. According to Albert Ellis , founder of REBT, there are three core irrational beliefs, each insisting that life must be a certain way. Personal Perfection: I must do well and win others' approval, and I am inadequate and undeserving when I don't do as well as I must. Social Acceptance: Other people should treat me fairly and kindly. If they don't, they are no good and deserve punishment. Comfort and Fairness: I ought to get what I want and not get what I don't want from life. It is terrible if I don't get what I want, and I will be miserable. When these beliefs control our thinking as we experience difficulty, we will be angry with ourselves when we don't measure up and angry with others when they don't give us the recognition and respect, we feel we deserve. What makes a belief irrational? An irrational belief does not correspond with how life actually works. Given that all people are fallible and life is unpredictable, no rules state we or others should be a certain way. We act well at times and poorly at other times. Healthy, rational beliefs express our preference that we perform well and that others treat us well. We do not demand that life be a certain way or insist it is awful when life is not as we would like it to be. How to Handle Angry People We can help our friend who is angry about their latest work assignment, but we struggle to deal with the stranger who explodes for seemingly no reason. The chronically angry person shares the same irrational beliefs as others, but their core beliefs about themselves are different. A chronically angry person may have experienced adverse childhood events where they did not feel safe, accepted, or loved. Belonging and safety are cornerstone developmental experiences and necessary for developing a healthy self-concept and attachment with others. Lack of safety and belonging can leave a person feeling vulnerable to being hurt physically and emotionally. Due to the underlying vulnerability, there can be constant vigilance for the potential threat of rejection, disapproval, or physical harm. The constant feeling of vulnerability creates a perceptual filter that colors how people see the world around them. When a relatively neutral event occurs, such as a receptionist not noticing a new person is standing in line, there is a mistaken assessment of danger (MAD) that is followed by behavior that is aggressive and defensive (BAD). The chronically angry person will immediately assume the receptionist is disrespecting them. Their irrational belief will tell them that others should respect them and that it is terrible that they are being disrespected. As their anger builds, they will behave in ways that make things worse, not better. This defensive behavior then leads directly to negative feedback from the receptionist, which intensifies the mistaken assessment of danger and amplifies the behavior that is aggressive and defensive. If you are in this challenging situation, Bill Eddy, LCSW, suggests three tools for connecting with a distressed, angry person. Empathy: Empathize with the distress the upset person is experiencing. You might say, “I can see how frustrated you are. I want to help.” Attention: Pay attention to the distressed person by making and keeping eye contact, turning toward them, putting down anything in your hands, and nodding your head while you listen. Invite them to talk: “Can you tell me more about what is happening?” Respect: Respect them as a person with concerns. At the core of their distress is a desire to be respected. Point out their strengths: “You have worked hard to solve this problem, and I respect your persistence in seeking answers and solutions.” When that challenging conversation is over, take a deep breath and remind yourself that while you would like to be treated with respect, there is no rule that people will or should treat you well. It is not terrible when you aren’t respected, but it is disappointing—okay, really disappointing. This article was published on Phycology Today - Website - Evan Parks, Psy.D. - Book -

Racquet sports add seven to nine years to your life. Chronic mental and physical illnesses are caused by sustained stress physiology. Racquet sports lower threat chemistry through social connection, exercise, and play. "Working" at getting better is counterproductive. Play causes a healing shift in your body's chemistry. Why not play a racquet sport? The benefits are far greater than many medical interventions. If you want to live a long, healthy life and stay cognitively intact, consider taking up a racquet sport.1 Anyone will do, including ping-pong. Table tennis, tennis, racquetball, and badminton. have all been extensively researched. Studies show they add about seven to nine years to your life, significantly improving cognitive function.2 Tennis seems to have the most impact, but they all have similar benefits. My wife and I started to play ping pong in our backyard about five years ago. We quickly discovered it's relaxing, even for 10-15 minutes. It is also social, and every level of player who grabs the paddle can keep the ball in play. I have played ping-pong since I was 8 years old. My father was a hard-working physician who was not home much. But even when he was dead tired, he would play ping-pong with his four children. It was one of our more enjoyable family activities. About a year ago, we began playing doubles ping-pong with others. At this stage of life, none of us cares whether we win or lose, and we laugh a lot. Most of the data about the benefits of racquet sports come from studies of adults. However, one study focusing on young children caught my attention. It is concluded that a longer tennis experience was associated with better performance in working memory and cognitive flexibility in children between the ages of 8 and 12. Furthermore, tennis experience is positively associated with executive functions. The results of the present study may be of great practical importance for parents and educational settings in designing physical activity programs that target the improvement of cognitive function in children.3 Mental rigidity is a trait that is common to almost all mental health diagnoses.4 Notice the specific mention of improved cognitive flexibility. Physical Health Benefits Table tennis is a highly aerobic activity that improves cardiovascular health, coordination, and reflexes. Aerobic fitness is closely tied to longer life expectancy, and aerobic activities like table tennis, when played regularly, typically contribute to a few extra years of life expectancy. Cognitive and Mental Benefits: Table tennis is especially noted for enhancing cognitive function because it requires quick decision-making, hand-eye coordination, and fast reflexes. Studies on cognitive function and physical activity suggest that engaging in activities that combine physical and cognitive demands (like table tennis) can help prevent age-related cognitive decline, which is linked to overall longer life spans. Racket sports stimulate neuroplasticity of the nervous system by connecting with older and enjoyable learned neurological circuits and stimulating the formation of new ones. Social interaction releases oxytocin, which is a social bonding hormone. It is also highly anti-inflammatory.5 Comparisons to Tennis: Specific data on lifespan increases from table tennis are limited. Due to differences in intensity, the effect on lifespan might be similar, though potentially slightly smaller, than sports like tennis. Table tennis shares many of the benefits that tennis does, particularly social and mental engagement, and is generally considered lower-impact. A family activity Almost every family I worked with that had a member suffering from chronic pain was experiencing a lot of internal chaos. About 50% of parents in this modern era feel stressed.6 Stress increases pain, which in turn aggravates internal family dysfunction. Play is the antithesis of pain and creates a profound physiological shift from threat to safety, which heals. One woman whom I have gotten to know through my coaching practice had an interesting experience with her teenage daughter after she learned about the benefits of racquet sports. Her daughter was in a bad mood about school, and they had slipped into an unpleasant conversational routine. She suggested that they play badminton, which was not initially well-received. However, within a few minutes, not only did everyone's mood change, but the mood shift also began redefining their relationship. They were able to laugh. The same scenario happened the next week She is excited to see where the activity leads. Think of the energy you have spent in chaos and looking for answers. Why not take a few moments and head to the garage to play some ping-pong? It won’t solve your problems, as an isolated intervention, but it is a significant low-risk step. 7 Aging Ping-pong is accessible to anyone at any age. Our ping-pong group has 11 seniors. One of the better players is 80. Another, closing in on 70, was a candidate for the Chinese national team in his teens. We are all well aware that when he wants a point, he gets it. If you are older, especially if you are alone, find a way to engage in a racquet sport. It is an easy way to relax, have fun, deter aging, and meet people. Grab your paddle, and let’s go! David Hanscom - Website - References 1. Schnorr P, et al. Various Leisure-Time Physical Activities Associated With Widely Divergent Life Expectancies: The Copenhagen City Heart Study. (2018); 93: 1775-1785. doi: 10.1016/j.mayocp.2018.06.025. 2. Oja P, et al. Br J Sports Med. (2017) 51:812-817. doi: 10.1136/bjsports-2016-096822.Epub 2016 Nov 28. 3. Xu Y, Zhang W, Zhang H, Wang L, Luo Y and Ni G. Association between tennis training experience and executive function in children aged 8–12. Front. Hum. Neurosci. (2022) 16:924809. Doi: 10.3389/fnhum.2022.924809 4. Giommi F, et al. The (in)flexible self: Psychopathology, mindfulness, and neuroscience. International Journal of Clinical and Health Psychology (2023); 23:100381. 5. Carter SC. Sex, love, and oxytocin: Two metaphors and a molecule. 104948 Neuroscience and Biobehavioral Reviews 143 (2022) 104948. 6. Murthy VC. Parents under Pressure: The U.S. Surgeon General’s Advisory on the Mental Health and Well-Being of Parents. 7. Biz C, et al. Epidemiology and Risk Factors of Table-Tennis-Related Injuries: Findings from a Scoping Review of the Literature. Medicina (Kaunas). (2022); 58(5): 572. doi: 10.3390/medicina58050572

Get rid of clutter and your brain will function better. Clutter reduces the efficiency of the brain. Clutter can be external or internal. Both are detrimental. Clutter can be reduced or eliminated quickly and easily. How often have you looked at a pile of laundry in the living room, dirty plates in the kitchen, or unpaid bills on your desk and thought, “I’ll take care of them later; they’re unimportant.” Maybe to you, but not to the giant vacuum cleaner between your ears: your brain. You may have read that the brain contains more neurons than all the sand grains on Earth’s beaches. “Quite impressive,” you say, patting your head until you remember it allowed you to write $1200 on a check instead of $12.00 while you watched a rerun of Law and Order. Although there may be many reasons for your error, clutter is the primary suspect. Clutter—multitasking in this example—diverted the concentration you needed to be accurate. Some argue that a disorganized mind produces clutter, while others believe cluttering causes disorganization. Regardless of the outcome of this "Which comes first?" debate, you can begin 14 methods today that will reduce or prevent clutter. What Is Clutter? When we think of “clutter,” images of a hoarder saving 1960s newspapers appear. But cluttering takes many shapes. Clutter is simply the accumulation of “stuff,” from a few used plastic cups to dumpster quantities of old magazines. It can consist of useless objects as well as persistent memories. How Does Clutter Affect Processing? It’s been estimated that the brain takes in about 11 million pieces of information per second. But here’s the kicker: It can only process 40 to 50 bits per second. How does it “choose” the bits it will process? One theory is that it selects what’s most prominent. Another is that it finds disorder and tries to impose order on it to run more efficiently. Regardless of which explanation applies, clutter—regardless of its size—asks the brain to sacrifice some of its precious 40 to 50 bits per second needed to understand what you are reading when a pile of dirty laundry enters your visual field against the background of Saturday Night Live blasting from the TV. What many people don’t realize is that the effects of cluttering can be outside of their awareness, either because it is subtle or hidden. It's like a pebble in your shoe. It may not be so annoying that you will remove it before you start hiking; you may not even be aware of it. But after a few miles, it will make your outing less than pleasant. There are two types of clutter that can affect processing: external and internal. External Clutter External clutter is stuff outside of your body that can gum up the workings of the brain. An example is the two-month-old pile of unopened bills on your desk. It can be just a few utility bills or so many that they look like the Leaning Tower of Pisa. It’s not the size of the clutter that gives it importance but rather the effect it has on your thinking. That two-day unopened letter from the IRS may have a greater effect on your ability to drive than the mountain of three-month-old utility bills that cover your kitchen table. 6 Suggestions for Getting Rid of External Clutter It’s usually best with any change program to start with what’s easiest. Your choice. Keep the environment orderly. Bills in one place, magazines in another, etc. Touch it once. When clothes come out of the dryer, they go directly into drawers. Keep what you don’t need out of sight. Place what you don’t immediately need out of your visual field. Finish one uncompleted project a day. Start with the easiest one to perform. Don’t start a new project until at least one old one is completed. Complete a project regardless of how simple it is. Spend only a limited amount of time each day reducing clutter. Start with 5 minutes and build up to 30 minutes. Internal Clutter Internal clutter involves experiences or projections that roll around in your mind and result in you doing something regrettable. For example, after receiving an “if I was you...” criticism, you substitute a half-cup of salt for sugar in a recipe you have used for 20 years. Some of the issues causing internal clutter are long-standing and may require the guidance of a professional counselor. But most are the result of the normal, everyday consequences of living, such as being annoyed you forgot your marketing list, thinking of what you could have said differently in an argument with a friend, etc. In my counseling, I’ve found internal clutter more difficult to trim down than external clutter. And, yes, some clutter—like that IRS letter—can be both. 8 Suggestions for Getting Rid of Internal Clutter Take a physical break between different cognitive activities. Walk, run, bike, or play a musical instrument. Divide long or difficult cognitive activities into separate units. Take a physical or meditation break between units. Meditate. Any form of meditation done every day for 5 to 10 minutes will reduce clutter. Get adequate sleep, nutrition, and hydration. Think of your brain as a muscle. Become more accepting of differences. Be less judgmental. Avoid music while performing cognitive tasks. Music, for most people, interferes with cognitive tasks. If you need music while writing, reading, etc., keep the volume low. Perform cognitive tasks in a quiet environment. When reading, try to find the quietest place possible. Identify a distracting issue and deal with it. If you can't resolve emotional issues on your own, seek the help of a counselor. The Takeaway: The brain doesn’t attach a “social value” to clutter or its most exaggerated form, "hoarding." That's the province of the "mind." Your brain operates in accord with its hardwiring. Reduce or eliminate clutter, and it will thank you by functioning more efficiently. Stan Goldberg, Ph.D., - Website - References Goldberg, S. (2023). Preventing Senior Disorders: How to Stay Alert Into Your 90s and beyond. Lanham, MD: Roman and Littlefield. Understanding Unconscious Bias. NPR. July 15, 2020. GYÖRGY BUZSÁKI. How the Brain ‘Constructs’ the Outside World. Scientific American. June 1, 2022.

How can you prevent social media from stealing sleep hours? Social media is used by children and adolescents before bed and during the night. The use of social media is often arousing and incompatible with going to sleep and staying asleep. While limiting social media use at night is challenging, we should keep trying. There is widespread consensus among sleep experts, pediatricians, and parents that most children and adolescents are not getting sufficient sleep to allow them to function optimally during the day. Poor sleep has been linked to academic underachievement, poor socioemotional regulation, and health problems. While the research linking poor sleep to these problems has been accumulating and getting stronger, there have been few solutions that have been proven to result in better sleep. Remedies for Poor Sleep in Children and Adolescents One remedy that I have written extensively about is the movement to have middle and high schools start later to allow more morning sleep for adolescents who stay up late at night. A considerable number of school districts have changed to later start times, and the evidence so far shows that there are many positive benefits. That said, more research is needed, particularly long-term studies that determine whether the positive results are long-lasting. Another remedy has been to encourage better sleep hygiene in youth. Sleep hygiene refers to all of the factors that facilitate sleep, such as maintaining a bedtime early enough that allows for sufficient sleep, having that bedtime be consistent during the week including weekends, establishing a good sleep environment of temperature, noise, and light, avoiding late meals and late exercise, and numerous others. One suggestion that has been frequently suggested is limiting the nighttime use of devices with screens, including televisions, gaming consoles, personal computers, tablets, and smartphones. Parents are advised to monitor and regulate the use of these devices, but compliance for those who are willing and able to try has been hard to establish and continue. The problems that screen usage at night create are primarily twofold. One is that exposure to blue light from the screens may suppress the release of natural melatonin necessary for falling asleep. The biggest culprit, though, is that excessive cognitive and emotional stimulation is counterproductive for getting to sleep and staying asleep. Scrolling through social media, reading posts, making comments replying to posts, “liking” posts, and so on takes time and energy at times when it is best to be settling down for sleep. Most of the apps are designed to keep your attention longer and longer. Some information read and seen on social media may be emotionally arousing in both positive and negative directions. Adolescents increasingly want to be connected via their social media during all waking hours to follow their friends’ activities and messages, and many leave their smartphones on while they are sleeping, and wake when messages come in during the middle of the night. Fear of missing out is often mentioned as a reason smartphones are left on during the night. For a recent review of the effects of social media on youths’ sleep see Alonzo et al. (2021) in Sleep Medicine Reviews. The problems created by smartphone usage at night for children and adolescents are an example of unintended consequences created by the developers and marketers of these devices. Either or both of the two possibilities occur to me. One, they did not consider that the use of the products would cause this kind of harm, and two, it was considered at some point during the years of development and was deemed unimportant and a hindrance to selling the devices and software that runs them. Given the power of marketing and the appeal of smartphones, surveys indicate that around 95 percent of teenagers own one. I’ve tried to thinkd of ways to help adolescents and their parents manage nighttime usage better. Bear in mind that these suggestions require compliance, and in many cases, there will not be an inclination to follow them. How to Help Adolescents Manage Nighttime Smartphone Usage Many commercial devices are now available at a reasonable price to track sleep. Many of the devices allow measurement of the time it takes to fall asleep, overall sleep duration, and the number and length of nighttime awakenings. Users can be encouraged to keep track of these metrics and work to improve them (longer sleep, falling asleep faster, fewer and shorter awakenings). Goals and rewards may be set to motivate compliance. The smartphones themselves have features that report the number of minutes and hours the smartphone is used for categories of use. Daily data could be tracked to reduce the hours used for social media. Again, goals and rewards could be set. For both of the suggestions, “buy-in” by adolescents is crucial. There are many ways of changing behavior, but unless an individual wants to change, non-coercive methods will be ineffective. I seriously doubt that adolescents would be persuaded by scientific research showing harm. Demonstrable harm such as failing grades, emotional and health problems pointed out by parents, or self-realized might be effective in some instances. If somehow an adolescent’s circle of friends would decide to all cut down on nighttime usage, a competition could be arranged by them with goals and rewards. Since attachment to, and approval from friends and peers, is of great importance in adolescence, this could be an activity that works. Having them decide for themselves, rather than being told to do so by adults is key for this idea to work. If at least one of a circle of friends can convince themselves that this is a good idea, they may recruit others. As has been pointed out before, sleep is one leg of a three-legged stool for health with the other two being diet and exercise. Changing unhealthy diet and exercise patterns is very difficult for persons of all ages. Habits related to sleep quality are equally hard to change. But the difficulty of the task in these domains should not keep us from continuing to try. Joseph A. Buckhalt, Ph.D., References Alonzo, R., Hussain, J., Stranges, S., & Anderson, K.K. (2021). Interplay between social media use, sleep quality, and mental health in youth: A systematic review. Sleep Medicine Reviews, 56.