How smooth, slow breathing can support your health. Key points Slow breathing can calm your nervous system and regulate emotions, and it's something you can control. Practicing just five minutes a day could yield both immediate and lasting psychological and physical benefits. Nasal breathing has been found to be especially beneficial for cardiovascular, respiratory, and immune health. Slow, smooth breathing is a critical action you can take to voluntarily influence your autonomic nervous system (ANS)—the part of your nervous system that runs in the background, controlling things like your heartbeat, digestion, and blood pressure. The Science: How Breathing Changes Your Body The ANS has two main branches: Sympathetic nervous system: Activates your “fight or flight” response, speeding up your body to handle stress. The sympathetic nervous system triggers the release of adrenaline, increases heart rate and blood pressure, and diverts blood flow to your muscles for quick action (triggering both "jitters" and a stomachache!). Parasympathetic nervous system: Promotes “rest and digest,” slowing things down so you can recover and heal. This lowers your heart rate and blood pressure, stimulates digestion, and supports immune and repair processes throughout the body. Most of the time, these systems work automatically and outside of your conscious control. Smooth slow, smooth breathing is the one thing you can do to consciously shift your body into a state of calm and recovery. Unlike your heartbeat or digestion, you can control your breath at will. This makes it a unique behavior to modulate systems that are usually out of reach of conscious control—like heart rate variability (HRV), the way your heart rate changes with each breath); blood pressure; and stress hormone release. Meta-analyses show: Smooth, slow breathing interventions can reliably reduce stress, anxiety, and depression (Laborde et al., 2022; Zaccaro et al., 2018). Benefits are both immediate—even a single 5-minute session helps—and cumulative, meaning the more days you practice, the bigger the impact (You et al., 2021; Bentley et al., 2023). A global study of 1.8 million HRV biofeedback sessions suggests that the most benefit of smooth slow breathing arises when you are in a state of HRV coherence (Balaji, et al, 2025). This means that your heart rhythms become smooth, regular, and sine wave-like, rather than jagged or erratic (picture your little heart cruising joyfully on a bicycle vs peddling hard and braking at the same time!). HRV coherence occurs when your breathing, heart rate, and blood pressure rhythms synchronize. This synchronization is called “resonance” and is linked to optimal functioning of the autonomic nervous system, and greater long-term health outcomes. The same study found that while six breaths per minute (0.1 Hz) is a common coherence rate, individuals had the highest coherence when they found their own comfortable rhythm near this rate. Importantly, when study subjects were focused on emotions indicating fulfillment (i.e. peace, joy, love) they experienced higher coherence and more stable HRV, while emotions focused on lack (i.e. fear, anger and grief) disrupt this stability. The key takeaway: Let comfort and natural rhythm guide your pace, rather than forcing a preset rate, and turn your attention to the ways you are experiencing need fulfillment. Steps for Establishing an Evidence-Based Breathing Practice Find a comfortable, upright position. Sit upright, feet flat, hands in your lap. Make sure your abdomen is free to move so you use your diaphragm to get a full breath. Set a timer. I advise starting with just five minutes. Inhale gently through your nose. Do this for about five seconds, letting your belly expand naturally and at a pace that feels right. Exhale slowly through your nose. Allow your body to relax as you exhale; see if you can match the length of your inhale (so about five seconds to start). Repeat. Continue this, aiming for a pace of around six breaths per minute, until the timer goes off. Notice how you feel. Pay attention to shifts in your body or mood. Allow yourself to notice and savor feelings of fulfillment of safety, joy and connection. Practice regularly. Aim for once or twice a day. Consistency over a week or more amplifies the benefits. The Benefits of Slow, Smooth Breathing Improved heart rate variability (HRV): Increases flexibility in your nervous system, a marker of resilience. Better vagal tone: The vagus nerve is a key part of the parasympathetic nervous system. The more you practice smooth, slow breathing, the more the vagus nerve is responsive to supporting relaxation and recovery. Increased interoceptive awareness: Heightens your ability to sense internal body signals, aiding emotional regulation. In other words, you may be better able to notice dysregulation higher upstream, when you have more options to respond thoughtfully. Positive brain state: Shifts your brain into relaxed alertness—calm, yet focused. How Often Do I Need to Practice Smooth, Slow Breathing for Benefits? Research suggests that even a single five-minute session at about six breaths per minute can be as effective as longer sessions for increasing vagal tone and HRV (You et al., 2021). This makes the practice highly accessible—no need for lengthy routines. Regular practice can lead to less stress, better mood, and improved heart health (Bentley et al., 2023; Balaji et al., 2025). The more you practice, the more the practice carries forward in your day-to-day life. Over time, slow, smooth breathing is likely to become your body’s default rhythm—shaping how you respond to stress, recover from challenges, and even breathe unconsciously throughout the day. This effect is more than just cumulative: with repetition, your nervous system “learns” this pattern, making calm, regulated breathing your new baseline. Why Nose Breathing? In at least one study, nasal breathing was found to be superior to mouth breathing for several reasons (Watso et al., 2023): Enhances parasympathetic tone: In the study, nasal breathing led to more healthy, calming heart rhythms—as measured by producing higher HRV. Boosts nitric oxide production: Nitric oxide helps relax and widen blood vessels, improving blood flow and lowering blood pressure; it also supports the immune system, and enhances transfer of oxygen from lungs into the bloodstream. Optimizes airway resistance: Nose breathing creates gentle resistance that slows airflow, supporting efficient gas exchange and airway stability. Improves diaphragmatic function: Breathing through the nose encourages deeper, diaphragmatic breaths to pull air in through a narrower airway rather than shallow chest breathing. These mechanisms support cardiovascular, respiratory, and immune health. Nasal breathing acutely lowers diastolic blood pressure and increases parasympathetic activity, providing immediate cardiovascular benefits. Want to go Deeper? If you want to personalize your practice, biofeedback devices can help you find your unique resonance frequency—the exact breathing rate that produces the highest HRV and coherence for your body. Research shows that most people’s optimal rate is close to 6 breaths per minute, but individual differences exist (Balaji et al., 2025). Biofeedback tools measure your heart rhythms in real time, allowing you to adjust your breathing for maximum benefit. This approach can further enhance self-regulation, emotional balance, and stress resilience. Smooth, Slow Breathing is Medicine! Slow, diaphragmatic breathing is safe, free, and accessible anywhere. Its ability to quickly and powerfully affect your body and mind can make it a foundational tool for managing stress and emotions. So why not commit to a practice? Jaimie Lusk, Psy.D.-Blog

Want to live better and longer? Stop searching the internet; talk to your brain. Key points Purpose, whether socially significant or not, can increase the quantity and quality of life. Purpose should contain at least one of three attributes: long-lasting, positive, and filled with surprises. With age, our world shrinks. Purpose can stop the decline. When a friend in her late 80s called and said, “I’m ready to leave,” I understood she wasn’t talking about a place. She had been my graduate advisor, colleague, confidant, and family friend for more than 50 years. Although retired for nearly a decade, she was still regarded as an eminent authority in her field. So why, still healthy, did she say she was ready to die? Aging Is Not for Weaklings How often have you heard or read, “You’re not getting older; you’re getting better.” Really? Statements like these are as silly as classic Vaudeville comedy acts. At 80 years of age, I’m not getting better; I’m getting older. There’s little that I do now that’s better than how I did it when I was 50. Aging is an exercise in subtraction. Yes, I can still run, write, fish, and sculpt, but I run slower than most people walk, and it takes me much longer to write articles today than it did five years ago. Since I fear being swept away by a gentle current because of my Parkinson's, I only fish from river banks, and sculpt wood because I can’t lift even a tiny block of marble. My world—for better or worse—is shrinking. So what’s an older person who still wants to live fully supposed to do? Television and the Internet offer a wide range of solutions guaranteed to reverse aging, clean out my colon, and promote hair growth, along with many other strange claims. And to make the offer even more appealing, I’m told that if I call within the next 30 minutes, the product will be doubled. Not very appealing to someone who tries to base health decisions on data. But there is an answer that doesn’t require me to pay shipping and handling—one based on sociological, psychological, and neurological research: the creation of a purpose-infused life. What Is Purpose? When people read “purpose,” they often conclude that the suggestions will involve achieving lofty goals, such as saving humanity, helping at a food distribution center, assisting disabled runners, or volunteering at a hospice. These are terrific goals, but equally effective for increasing the quantity and quality of life are more personal, selfish activities, such as exercising to lose 10 pounds, learning how to knit, or taking up painting, to mention a few. In looking at the research and reading accounts of what gave purpose to people’s lives, at least one of the following three elements was present: Something that has legs: To say that "something has legs" means that it has the potential to last for a long time. Since we are already old, the length of time doesn’t necessarily have to be very long, but it should not be a goal that can be quickly accomplished. For example, becoming more proficient on a musical instrument can take a lifetime, creating interesting jewelry has no endpoint, and mastering Japanese cooking could take two lifetimes—at least. Positive either in action or completion: It doesn’t require much research to see that we’re more likely to keep doing something positive rather than negative. Engaging in an activity just because you should do it isn’t necessarily positive. The activity you choose should be enjoyable for you, regardless of its social significance. Rhetorically asking “What happens next?”: When a well-known literary agent was asked how he knew if a manuscript was good enough to represent, he said that if he missed his subway stop while reading, that was a book he wanted. Not knowing what happens next is a powerful motivator for continuing to do something. For example, virtually all creative activities involve the uncertainty of how the project will turn out. When I was learning how to make bowls on a lathe, I was never sure how the object would change as I shaved off more wood. The Takeaway We wish we could live forever, but we know that, at least for now, we can’t. Still, research has shown that having purpose in our lives can significantly improve the quality of our lives and even add years to it. Purpose doesn't have to be limited to lofty ambitions. Instead, it just needs three attributes: It’s future-oriented, positive, and includes an element of surprise. Finding a purpose that contains only one attribute is good; two are better, and three is the Holy Grail. And what is my purpose, you may want to ask? It's showing people with Parkinson's that the ease of movement the disease has robbed them of can be relearned through exercise and the application of learning research. I never knew why my dear friend felt she was ready to die, but her death was the inspiration for this article. Stan Goldberg, Ph.D.-Blog, Books

Research-based recommendations for sleeping better in our screen-filled world. Key points Excessive screentime before bed and during the night disrupts sleep. Studies have searched for reasons screentime has this effect. Exposure to blue light, once thought to be responsible, has been found to have little effect. There are steps you can take to reduce the harmful effects of screentime. In previous posts, I have written about how excessive use of smartphones, tablets, and other screens at night is related to insufficient sleep in children and adolescents. In April, I attended an invited address on that topic by Dr. Barbara Galland at the International Pediatric Sleep Association in Florence, Italy. In her presentation, Unravelling the Digital Impact: Screens and Sleep, she summarized many studies that have been conducted in recent years. A 2024 paper in Sleep Medicine Reviews by a group of international pediatric sleep researchers (Bauducco et al., 2024) looked at several possible mechanisms thought to be responsible for the association of screen use with sleep problems. For one mechanism, they wrote that recent research had led them to modify some of their previously held conclusions. Most sleep researchers have assumed that the blue light emitted from screens delays the release of melatonin and consequently causes significant delays in sleep onset and less time asleep. But research has now shown that sleep is delayed by only a few minutes by blue light exposure and is not likely to be a very important factor relating to insufficient sleep. But other factors matter more. Leaving the phone on overnight leads to nighttime interruptions, fragmenting and shortening sleep in a harmful way. One study the researchers reviewed showed that adolescents who experienced frequent interruptions were more than five times as likely to have poor sleep both concurrently and a year later. One suggestion is to put phones on airplane mode when going to bed or using the Do Not Disturb setting, allowing for messages only from particular people to get through. But some do not want to do that for fear of missing out on conversations among their friends. Some adolescents have even reported being reluctant to tell friends that they need to drop out of an individual or group conversation because they want to go to sleep. Companies that sell apps deliberately structure them to keep users on as long as possible. Features such as autoplay and pop-ups are designed to prevent users from leaving. Temptations to watch “just one more video” are hard for some to resist. Since this is the case, avoiding the use of those kinds of apps in bed is beneficial. Parent-set bedtimes, “lights out,” and limitations on both the type and length of activity have proven to be effective in many cases. Finally, the authors suggest that some use of devices near bedtime may actually be helpful in some cases when the goal is to downregulate emotional stress. For example, some might use a meditation app, process concerning events with friends, or try to distract themselves from negative thoughts that may make it difficult to go to sleep. Joseph A. Buckhalt, Ph.D.-Blog

Whether physical or psychological, a shutdown needs to be addressed openly. Key points When a partner isn't interested in sex for days or week, it's important to find out why. Is it a matter of "can't" or "won't"? In the case of incapacitation of one partner, both need to discuss options. There may be a time when your partner in a monogamous relationship stops initiating or responding to sexual invitations. It’s important to find out whether it’s a matter of can’t or won’t. It’s certainly common for a woman to say no when she’s angry or him to not respond as expected if he is overtired or preoccupied with other matters. But if your partner has seemingly just shut down, not been interested in sexual activity for days or weeks, it’s time to have a serious conversation. If it’s really a case of “I just don’t want to,” it’s important to the relationship to have an honest discussion. Is your partner dealing with some bodily issues? Is he or she angry, in pain, grieving, or just not feeling it? Is couples counseling a possibility or solo therapy for your partner addressing the reasons for the shutdown? All are helpful if this occurs. Then there are cases where your partner simply is unable to enjoy sexual intercourse anymore, and they are usually physical. He can no longer have erections (sometimes after prostate surgery). She may have a painful vaginal problem that is reoccurring or constant. If the relationships is a monogamous one and the other partner is not willing to give up sex, there is a difficult problem. "If I cant you can't either" is usually not workable. One hopes that the incapacitated one will be gracious enough to be willing to work on an arrangement. Whether the other is free to have sex under certain circumstances: perhaps take a lover, perhaps only casual sex, perhaps an ongoing agreement with a sex worker. It will be up to the couple to decide what’s possible. Over my many years as a therapist, I helped three couples come to agreements on this issue. Oddly enough, they were three different arrangements. In one, he was entitled to go out on Saturday nights. Whether it was with his friends partying or with a lover, she didn't want to know. His sex life was to be kept private. In another case, if she took a lover that she cared for he wanted to meet him. She did, he met him, and he became a family friend invited to all family occasions. In the third case, the couple could not come to an agreement. One of them could not stand the idea of the other having outside sex and the other was not willing to be chaste, so the couple broke up. Whatever the situation, the couple needs to come to an arrangement that suits the needs of both partners, perhaps with the help of a third party. In any case, it is a difficult situation that must be handled with honesty and empathy. Isadora Alman, M.F.T.-Blog, Book

Certain foods reduce anxiety; others make it worse. Key points Some foods reduce anxiety, and other foods make it worse. The Mediterranean diet is the primary diet for reducing anxiety. Using food to reduce anxiety does not take the place of therapy or medications for an anxiety disorder. "Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders ..." (Bandelow, 2015). In addition, people can struggle with anxiety that does not rise to the level of a disorder. For example, some students experience test anxiety. Food can affect anxiety, and choosing foods carefully can be a helpful adjunctive treatment. Some foods can reduce anxiety, and other foods can make it worse. If you or someone you care about has anxiety, you can utilize the information in this post to help reduce anxiety. Foods That Help Reduce Anxiety Research has shown that a Mediterranean diet benefits people with anxiety disorders. "The Mediterranean diet is generally based on the daily intake of fruit and vegetables, whole grains, legumes, nuts, fish, white meats, and olive oil. It may also include moderate consumption of fermented dairy products, a low intake of red meat, and red/white wine during the main course" (Ventriglio, 2021). The Mediterranean diet has been shown to benefit children and teenagers (Camprodon-Boadas, 2025), young adults (Melguizo-Ibanez, 2023), and older adults (Allcock, 2024). Research has also demonstrated its benefits for anxious people who are obese (Menichetti, 2025). Anti-inflammatory and antioxidant foods: Soy products, berries, nuts, seeds, tea, and especially beans (Naidoo, 2023). Micronutrients: Leafy greens such as kale and spinach, whole unprocessed foods, legumes, seafood, meat, dairy, and cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, and cauliflower (Naidoo, 2023). Omega-3 fatty acids: Fish, especially salmon, and other seafood; nuts; and seeds can improve anxiety (Naidoo, 2023). Fiber and fermented foods: Vegetables, legumes, nuts, and seeds add fiber; gut health is supported by fermented foods, such as kimchi, miso, sauerkraut, and yogurt (Naidoo, 2023). Oils: Extra-virgin olive oil for dressings and low-heat cooking; use avocado oil for higher-heat cooking (Naidoo, 2023). Spices and herbs: Turmeric (with a small amount of black pepper), saffron, paprika, oregano, rosemary, mint, parsley, and thyme (Naidoo, 2023). Dark chocolate: 1 1/2 ounces of extra-dark natural chocolate is a healthy treat and dessert (Naidoo, 2023). Water: Drink plenty of water each day (Naidoo, 2023). Foods to Limit or Avoid Completely Sweets and treats: Chips, cookies, sweetened breakfast cereals, and anything with lots of sugar or artificial sweeteners, especially soda. Do not drink energy drinks; their caffeine and other ingredients elevate anxiety (Naidoo, 2023). Coffee: Limit coffee intake. Five or more cups per day can cause panic attacks even in people without a panic disorder (Naidoo, 2023). Alcohol: Limit alcohol use. If you do drink alcohol, red wine is preferred (Naidoo, 2023). Condiments: Limit condiments with a high sugar content, such as ketchup, honey mustard, and BBQ sauce (Naidoo, 2023). High glycemic index (GI) foods: Limit foods with a high GI, such as white bread, potatoes, bagels, and pasta. When you do eat pasta, cool it after cooking because that reduces the GI value. Before eating it, you can reheat it without elevating the GI value (Naidoo, 2023). The GI refers to how quickly carbohydrates raise your blood sugar levels. Red meat: Limit red meat, such as beef. Severely limit or eliminate processed or cured meat, e.g., bacon, sausage, hot dogs, and meat substitutes (Naidoo, 2023). Ultra-processed foods: Eliminate them from your diet (Lane, 2022). Supplements Some supplements have been shown to benefit people with anxiety. Ashwagandha supplements reduce the stress response at a dose of 300-600 mg daily and can reduce anxiety with doses up to 12,000 daily (Akhgarjand, 2022). Omega-3 fatty acid supplements showed improvement at 2 grams per day. It "did not increase adverse events" (Bafkar, 2024). Probiotics have been shown to reduce anxiety and depressive symptoms (Asad, 2025). Several foods contain probiotics, but they can also be obtained in capsule form. The Bottom Line Selecting foods and supplements can be a helpful adjunctive treatment for anxiety. Some foods are beneficial, and others are potentially harmful. Using food as a treatment is not meant to be a substitute for therapy and medications for people with an anxiety disorder. Peter M. Hartmann, MD, DLFAPA-Blog

How pressure from society can keep victims from leaving abusive relationships. Key points Survivors often face pressure from family, culture, and faith communities to stay in abusive relationships. These messages can reinforce self-doubt and make it harder for survivors to leave. Leaving abuse often means grieving relationships, identity, community, and the future once imagined We often ask survivors of domestic violence, "Why didn't you leave?" But we rarely ask a more important question: Who told them to stay? Rosa finally tried to leave after enduring years of psychological and physical abuse. When her husband turned his anger toward their younger daughter, she knew she couldn't stay another day. She packed a bag and drove to her mother's home in a neighboring state. But instead of finding safety, she was met with disappointment. When she arrived, her mother was not welcoming. "You can't just leave, you're married. What will people think?" Rosa felt the air leave her lungs. "Marriage is hard," her mom said softly, offering her a glass of iced tea as if a consolation. "But you have to make it work." Rosa drove back to her husband, with nowhere else to go. Rosa's story is not unusual. Many of my patients have described reaching out to loved ones only to be encouraged—sometimes gently, sometimes firmly—to stay. Many have described family and friends who encouraged them to stay in their situations when they opened up about them: “It’ll get better; think of the children.” “Maybe they didn’t mean it that way.” Or “Maybe you should try counseling.” These comments can unintentionally reinforce the self-doubt that abuse has already created. Survivors may begin questioning whether they are overreacting or expecting too much. While survivors of all genders can experience these pressures, women are often socialized to shoulder greater responsibility for preserving relationships, making them especially vulnerable to relationship-based shame. From an early age, many women receive messages that their worth is measured by their ability to keep a relationship together. They are taught to compromise, forgive, nurture, and endure. When a relationship ends, the question often becomes, "What could she have done differently?" Rather than "What happened to her?" Faith and culture alike have long taught women that their value lies in their ability to sustain a relationship. The responsibility for compromise is disproportionately placed on women, and if a relationship ends, the tendency is to wonder how the woman failed to meet expectations. Some of us grew up with parents and extended family who taught us to view separation as a badge of dishonor for a woman, just as they did. As adults, we can now make more educated decisions, but challenging those ingrained belief systems is work, and doing so comes with consequences. The cultural mentality of women in relationships leaves many victims with little to no support from family. When people ask why survivors don't leave abusive relationships, they often focus on the abusive partner. But many survivors are also battling powerful messages from family, culture, religion, and society that tell them leaving is a failure. Many are navigating the anticipated grief of disappointing others and grieving a life they worked incredibly hard to build. Leaving often means grieving not only the relationship, but the future they imagined, the identity they built, the family they hoped to preserve, and sometimes their connection to the people and communities they love most. Until we recognize those pressures, we will continue asking the wrong question. Kaytee Gillis, LCSW-Blog

Build a career that reflects your values, purpose, and well-being. Key points Define career success based on your values, not outdated expectations or external pressure. Sustainable career growth aligns ambition with well-being, purpose and your current season of life. Confidence and strategic visibility help create opportunities before you feel completely ready. Strong boundaries and the right support make long-term career success more achievable. Most women inherit a definition of career success long before they consciously create one for themselves. It often sounds something like this: work hard, keep progressing, say yes to opportunity, be grateful, stay visible enough to be considered, but not so visible that you seem self-promotional. Keep delivering, keep proving, keep moving. For many women, this model works for a while. It can help you build capability, credibility, and experience. But at some point, it can also start to feel limiting. You may be successful on paper, but tired in your body. You may be progressing, but not in a direction that feels meaningful. You may be respected but not fully seen. You may be achieving but still wondering whether the version of success you’re chasing is actually yours. That’s why career success on your own terms matters. It’s not about opting out of ambition. It’s about becoming more intentional with it. It’s about asking what success looks like when it reflects your values, your capacity, your leadership, your life, and the contribution you actually want to make. Here are five things you need to begin creating career success on your own terms. 1. A clearer definition of success The first step is to define what success means for you now. Not five years ago. Not according to your organization. Not according to your family, peers, industry, or younger self. Now, in this current season of your life and career. Your definition of success may include progression, financial growth, influence, or leadership. It may also include flexibility, well-being, autonomy, meaning, or more time for life outside of work. For many women, the challenge is that they keep pursuing goals they never really chose, or goals that made sense in an earlier season but no longer fit. Ask yourself: What does success look like for me in this season of my life and career? What am I still chasing because I think I should? What would I choose if I trusted my own priorities more? You don’t need to have a perfect answer straight away. But you do need to begin the process of separating inherited success from intentional success. 2. A career direction that fits your life, not just your résumé It’s easy to build a career based on the next logical step. A bigger role. A larger team. More responsibility. A higher title. There’s nothing wrong with any of those things if they’re aligned with your goals. But career growth that looks good externally can still feel wrong internally if it doesn’t fit the life you want to live. This is why your career direction needs to be considered in the context of your whole life. Ask yourself: What kind of work energizes me now? What kind of responsibility do I want to hold? What kind of pace is sustainable for me? What do I want my work to make possible in my life? This is not about lowering your goals. It’s about making sure your ambition is pointing in the right direction. You might decide that you do want the promotion, but with better boundaries. You might decide that you want to grow your influence without taking on a role that will consume your life. You might realize that your next step isn’t more, but different. That clarity matters, and it’s worth spending time on. 3. The confidence to back yourself Career success on your own terms requires confidence, but not the kind of confidence that’s loud, performative, or certain all the time. It requires the kind of confidence that helps you make decisions, speak up, advocate for yourself, and take action, even when you don’t feel completely ready. Many women wait for confidence before they move. They wait until they feel more qualified, more certain, more prepared, more legitimate. But confidence often comes through action, not before it. If you’re waiting to feel completely ready, you may wait far longer than you need to. Start by building evidence. Write down the work you’ve done, the outcomes you’ve created, the feedback you’ve received, and the challenges you’ve navigated. When self-doubt shows up, don’t only listen to the feeling. Look at the facts. Then ask: What would I do next if I trusted my capability? Where am I waiting for permission that I may never receive? What is one small step I can take this week to back myself? Confidence is not about never doubting yourself. It’s about not letting doubt make all your decisions. 4. Strategic visibility Hard work matters, but hard work alone is rarely enough. If people don’t understand your contribution, your aspirations or the value you create, you may be overlooked for opportunities you’re ready for. Strategic visibility is not about being everywhere or constantly promoting yourself. It’s about making sure the right people understand the right things about your work. This includes being clear about: What you’re contributing What impact your work is having What you want to be known for What kind of opportunities you’re ready for next Many women feel uncomfortable with visibility because they associate it with bragging. But there’s a difference between performative self-promotion and clear, professional communication. If you’ve led a project, solved a complex problem, improved an outcome, influenced a decision, or supported a major result, that information matters. It helps others understand your leadership and potential. A practical place to start is your next one-to-one conversation. Instead of only updating your manager on tasks, include the impact of your work and what you’re learning about the level at which you want to contribute. For example: “This project has given me the opportunity to work more strategically across stakeholders, and I’d like to build on that in the next quarter.” That isn’t bragging; it’s career leadership, and it can make all the difference to what opportunities open up for you. 5. Boundaries that protect your capacity You can’t build success on your own terms if your time and energy are constantly being consumed by everything and everyone else. Boundaries are essential because they protect the conditions you need to do meaningful work, think strategically, and stay well. For many women, boundaries are difficult because they challenge long-standing patterns of being helpful, available, and accommodating. But without them, your priorities will always be vulnerable to other people’s urgency. Start by looking at where your energy is going: Are you saying yes to work that doesn’t align with your role or goals? Are you attending meetings where you don’t need to be present? Are you doing work that could be delegated, delayed, or redesigned? Are you leaving your own development until last? Boundaries don’t need to be dramatic. They might look like blocking time for strategic work, asking for clearer priorities, declining a meeting that isn’t necessary, or being more honest about capacity. Success on your own terms requires enough space to actually make choices. 6. Support and accountability No woman should have to build her career alone. Yet many women try to do exactly that. They carry the pressure privately, try to figure out the next step alone, and assume they should already know how to navigate confidence, visibility, negotiation, leadership, and change. Support changes what’s possible. That support might come from a mentor, sponsor, peer network, coach, leadership program, or trusted community. You need people and structures that help you think clearly, stay accountable, and keep moving. Career success on your own terms is not only an individual project. It’s supported by the conversations, relationships, and environments you surround yourself with. If you’re serious about the next stage of your career, ask: Who knows what I want next? Who is helping me think bigger? Who can support, challenge, or advocate for me? What structure would help me follow through? Sometimes the most powerful step is allowing yourself to be supported. A final thought Career success on your own terms is not about rejecting ambition. It’s about refining it. It’s about building a career that reflects your values, uses your strengths, supports your well-being and gives you room to grow in a way that feels meaningful. You don’t have to keep following a version of success that leaves you exhausted, unseen, or disconnected from yourself. You can define success differently. You can lead differently. You can make decisions that honor both your career and your life. Megan Dalla-Camina-Blog, Book

New study suggests that some cases of depression are tied to immune dysfunction. Key points Not all depressive patients respond to conventional treatments. Chronic inflammation is gaining traction as a driver of depression. A small clinical trial identified an anti-inflammatory drug that alleviates depression. Rethinking the causes of depression expands treatment options for patients. Everyone gets depressed from time to time. Think about those unpleasant days when you’re sick. You feel depleted and unsociable. You lose interest in everything. You just want to crawl under the covers and rest alone. Scientists call this “sickness behavior” and believe it evolved because it comes with benefits. Someone who isolates themselves from others is less likely to transmit their illness. A tired individual who loses interest in activities is diverting energy to fighting off a virus, or to healing. But for about 332 million people worldwide, the depressive behavior usually reserved for recovering from an illness or injury never lets up, like a dark cloud that won’t vacate the sky. It raises an intriguing question: Could depression, or at least some instances of it, arise when the immune system doesn’t know when to quit? Depression and the monoamine hypothesis The cause of depression has long been mysterious, but astute medical observations in the 1950s suggested that moods are influenced by chemicals coursing through our brains. Doctors noticed that some patients taking a drug called reserpine for high blood pressure developed depressive symptoms. Conversely, tuberculosis patients taking a newly discovered antibiotic called iproniazid reported feelings of euphoria. A decade later, the “monoamine hypothesis” was born. Reserpine and iproniazid were found to alter concentrations of monoamines, including serotonin, norepinephrine, and dopamine in the brain. These findings led to the development of Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine (Prozac). While antidepressive drugs that target monoamine levels have been game changers for many suffering from severe depression, controversy still surrounds how and to what degree they work. For example, there are inconsistencies in monoamine levels and depressive symptoms, and the medications can take weeks to work. Most importantly, about one-third of depressive patients do not respond to this family of drugs. What else could be at play? The link between feeling sick and being depressed In addition to associating brain chemicals with depressive states, researchers have found a strong connection with inflammation as well. Inflammation is a life-saving response when the body is injured or infected. It consists of a complex arsenal of biochemicals released by immune cells to fight off invading germs and repair damage. But sometimes inflammation gets out of hand. Like friendly fire, overzealous inflammation puts normal healthy tissue in harm’s way. Some people experience sustained, or chronic, inflammation at low levels that, over time, can take a major toll on physical and mental health. Clinical observations have bolstered the idea that mood disorders could be caused by an overreactive immune system, a concept that has been dubbed the “inflammation hypothesis of depression.” People suffering from depression tend to have higher-than-normal inflammatory markers, such as cytokines like interleukin-6 (IL-6) and C-reactive protein (CRP). The reverse is also true: people with chronic inflammatory conditions, such as arthritis or inflammatory bowel diseases, or severe infections, are at significantly higher risk of developing depression. But until recently, hard evidence of mechanisms supporting these correlations has been scarce. An anti-inflammatory medication reduced depression in a small trial A new clinical trial published in May 2026 directly tested the inflammation hypothesis in patients unresponsive to standard antidepressants. Researchers at the University of Bristol administered tocilizumab to 14 of these patients and a placebo to 16 others and monitored their condition for a month. Tocilizumab is a biologic drug typically prescribed for rheumatoid arthritis, an autoimmune disease. It is an antibody therapy that mitigates IL-6 activity, meaning that tocilizumab is an anti-inflammatory that dampens the immune response. The research team’s previous genetic analysis implicated excessive IL-6 as a potential culprit in depression. The findings were striking. Patients who received tocilizumab “generally showed greater improvement over time in several areas, including depression severity, fatigue, anxiety, and overall quality of life.” Even more promising, half of the participants given tocilizumab achieved depression remission. There are some important limitations to this pilot study. The trial consisted of only 30 patients, which makes it difficult to draw firm conclusions about the safety and efficacy of this treatment for depression and whether it works in more diverse patient populations. The trial also treated and monitored patients for only four weeks, so it remains unclear whether the effects would be long-lasting. Nonetheless, the promising preliminary findings warrant expansion of the study to larger patient groups, especially those who do not respond to monoamine drugs and have low-grade inflammatory markers in their blood. What causes the inflammation that might cause depression? If depression is the result of inflammation, as it appears to be in some cases, then the million-dollar question becomes: “What is causing this chronic, low-grade inflammation, and can it be fixed before it spirals into depression?” A 2013 expert editorial reported the primary sources to be: “psychosocial stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability, atopy, dental cares [tooth decay/cavities], sleep and vitamin D deficiency.” More recent studies show that environmental factors such as air pollution also belong on this list. Maintaining a healthy diet and routine exercise, with proper sleep and stress reduction practices, can go a long way in helping to prevent damaging inflammation that could lead to depression and other medical issues. For more than 50 years, our thoughts about depression have largely been limited to what is going on inside the brain. This new study argues we need to expand our scope because the body and mind are inseparable. It may be better to think of depression the way we think about cancer. Instead of having a single cause, depression may have multiple causes, both mental and physical. Such a framework opens new vistas for research and diversifies treatment options for patients. Bill Sullivan, Ph.D.-Blog, Book

The subtle behaviors that reveal trust, vulnerability, and genuine connection. Key points Small, everyday interactions reveal whether someone truly feels safe enough to be themselves around you. Feeling emotionally safe allows people to disagree, ask for support, and recover from conflict. Secure bonds don't require constant entertainment, reassurance, or conversation. People don't wake up one morning and announce, "Congratulations, you've become my safe person." The signs that a secure attachment is beginning to form are often subtle and develop gradually over time. A secure connection doesn't require grand gestures. It's built through hundreds of ordinary interactions that send the message: You can be your true self with me. When people feel emotionally safe, they stop rehearsing every text message, apologizing for having feelings, pretending they're always fine, or worrying that one mistake will send you running. Here are eight signs someone truly feels emotionally safe with you. 1. They Let You See Their Less Polished Side At first, most people present the version of themselves they hope you'll like. Then, over time, they stop pretending they always wake up looking effortlessly attractive. They let you see them in mismatched pajamas, don't cancel on you just because they aren't feeling their best, and admit they're having a terrible week. They confess they accidentally replied all to an email at work, cry during Pixar movies, or tell you about the embarrassing thing they did that still randomly pops into their head before they fall asleep. They share their fears, insecurities, and mistakes without feeling the need to wrap everything in a joke or pretend everything is fine. 2. They Aren't Afraid to Disagree With You People who fear rejection often avoid conflict. They are more likely to agree when they don't mean it or suppress their frustrations. Someone who feels emotionally safe believes the relationship can survive disagreement. They trust that expressing a different opinion won't cost them your affection. Ironically, healthy conflict often signals greater security than constant compliance and agreement. Feeling safe doesn't mean always seeing eye to eye. It means trusting that one disagreement won't threaten the relationship. You stop worrying that every difficult conversation is going to end with someone walking away. 3. They Ask for Comfort Instead of Pretending They're Fine Many people learned early in life that emotional needs were burdensome and therefore have a hard time asking for help. As adults, asking for support can feel uncomfortable or even shameful. When someone begins saying, "I've had a rough day," "Can I talk to you?" or "I just need a hug," they're showing a level of vulnerability that doesn't often come easily. They're trusting that their emotional needs will be met with care rather than criticism, dismissal, or being told they're "too sensitive." 4. They Don't Feel the Need to Constantly Monitor Your Reactions In emotionally unsafe relationships, people often become hypervigilant, constantly assessing the other person's emotional cues. Couples analyze each other's tone, overthink text messages, replay conversations in their head, and wonder whether their partner suddenly became angry or lost interest because they replied with a period instead of an emoji. As emotional safety grows, that constant scanning begins to ease. They become less preoccupied with reading between the lines because your words and actions are consistent. 5. They Tell You Things They Don't Tell Most People Once people feel comfortable in relationships, they begin sharing childhood memories, painful experiences, family dynamics, regrets, dreams, and the stories they've sworn they'll "take to the grave." When people trust that they won't be judged, dismissed, or have their experiences used against them later, opening up becomes much easier, and vulnerability no longer feels dangerous. 6. They Recover More Quickly After Conflict Every relationship experiences misunderstandings and disagreements. In secure connection, conflict becomes easier to navigate. Instead of assuming the relationship is ending, people become more willing to reconnect, apologize, listen, and work through the issue together. Rather than viewing misunderstandings as permanent evidence that the relationship is doomed, they trust that most conflicts can be repaired. They no longer feel they have to earn your love by always saying the right thing or never disappointing you. 7. They Can Be Silent Together Silence can feel painfully awkward when people don't feel safe with one another. Secure bonds don't require constant entertainment, reassurance, or conversation. Reading together, driving in silence, sitting on opposite ends of the couch, or simply existing in the same room without feeling responsible for filling every quiet moment are all signs of comfort. No one feels obligated to ask, "So... what are you thinking about?" every 30 seconds. 8. They Start Becoming More Themselves Rather than shrinking themselves to fit what they think you want, they slowly expand into who they already are. They laugh more freely. They become more playful. They share more of their opinions, interests, quirks, and personality without wondering whether they're "too much." In many ways, emotional safety is the foundation of every healthy relationship. It allows people to lower their defenses, speak honestly, recover from conflict, and gradually become more of themselves. After all, there are few greater gifts than creating a relationship where someone feels safe enough to be exactly who they are. Duygu Balan, LPCC-Blog

Is there still a place for punishment in child rearing? Key points Gentle Parenting is a philosophy that is very hard on parents. Children need limits and rules and parents who enforce them. In France, Gentle Parenting is very controversial. Parenting is an exhausting adventure under any circumstances. Most parents have to work and keep up with childcare. But on top of this, there is also Gentle Parenting, and its close cousin, Positive Parenting*. Both of these child-rearing philosophies demand that a parent provide empathy at all times for a child's feelings, put those feelings into words, and negotiate with the child regarding whether or not the child will do something a parent asks. And, if you ask me, this is an unrealistic expectation that requires too much of parents. Both Gentle Parenting and Positive Parenting are outgrowths of something that started in the 1950's when Benjamin Spock wrote his first book, The Common Sense Book of Baby and Child Care. Spock revolutionized parenting practices by urging mothers and fathers to trust their instincts and reject rigid, authoritarian rules. Prior to Spock, parenting tended to be authoritarian and top-down, with parents establishing rules and children being expected to follow them. Harsh punishment for infractions was common. My own mother, for example, born in 1912, had to sit in front of her meal until she ate it all. This sometimes lasted hours, and she was not allowed to get up from the table until she had done what was required. Since my mother's time, expectations of children have done a 180. Child-centered, or child-led parenting, has evolved, and here we are, immersed in Gentle Parenting. Children can do pretty much what they want, and parents are not to raise their voices or punish. They are left on their own to wonder how to get their children out the door in the morning or to get them to bed at night. This subject was discussed in an article in The New York Times entitled, "Did American-Style 'Gentle Parenting' Spoil French Children?" The writer, Madeline Schwartz, reports on what she calls a vitriolic debate within French society about the extent to which children should be catered to and empathized with. She comments that each side of the debate has large groups of professionals behind it. And while this same debate exists in the United States, I would say that there are fewer professionals, and people in general, on the side of setting more limits for children. In France, the center of the debate is psychologist Caroline Goldman, who advocates time-outs for children when they misbehave. She feels that the introduction of Gentle Parenting into French culture has yielded a new generation of parents who do not know how or when or why to set limits. In her book, Go To Your Room, she lists behaviors that should be forbidden. These include complaining and making too much noise. But her detractors say that time-out is a form of psychological violence and that Goldman is encouraging parents to mistreat their children. So what is a parent to do — whether in France or in the US — when even experts disagree? As a psychologist and psychoanalyst with over forty years of experience, you will not be surprised to hear me say that the truth lies somewhere in the middle of the debate. Prior to about 2015, the French were known for having well-behaved children. Pamela Druckerman's book, Bringing Up Bébé: One American Mother Discovers the Wisdom of French Parenting, was a sensation, and many American parents envied the strict French parents she described who seemed to have the secret of how to bring up children while also having time to themselves. Since that time, French parents have begun to adopt Gentle Parenting, and they have also begun to experience the same problems American parents have. So — how do we begin to sort out the issue of which kind of parenting is best for children and which works best for parents? Let's take a broad look at history: For thousands of years, adherence to rules and strict behavioral codes was a matter of survival for children around the globe. After all, if a child felt like running into the meadow when the lioness was hunting, that was the end of the child. Certain rules have existed over time to maintain the safety and survival of children. Now we have the luxury of allowing all sorts of behavior in our children. Parents also have the time to consider their children's feelings. So we now have a choice of whether to impose rules and whether to be strict about them. So — is it best to give your child complete freedom of opinion and expression or is it better to impose some rules and limits and to enforce them, with a time-out or even a small punishment, if necessary? Here is my advice: Treat your child as a real, separate human being with their own thoughts and opinions. Respect their feelings. This is possible to do while also setting limits on certain behaviors. Tell your child what you allow and what you do not. Be consistent. Don't be afraid to raise your voice if necessary to make your point. Time-outs are fine starting at age three. If your child is upset, go in their room with them and help them to calm down. Don't leave the room until they are calm. And if you get angry and yell because your child has done the same misbehavior five times in a row? Don't feel guilty. Children need to understand that what they do has consequences, and if they do the thing you have told them not to, you may get angry. This is the natural consequence of misbehavior. And let me finally talk about one last thing: fear. This is an entirely unpopular subject. To my knowledge, it is not talked about at all. It is your job to prepare your child to live in the world. And in the world, there will be plenty of teachers, coaches, and later, bosses who will not appreciate certain behaviors. We all must live within the hierarchy of society, and the place your child learns about such hierarchies should start at home. You are the parent, and it is OK for your child to be just a little bit afraid of displeasing you and breaking your rules. This is the way children learn what to do and not to do. *Positive parenting is an approach that focuses on building a strong, nurturing parent-child relationship rather than relying on punishment. Corinne Masur, Psy.D.-Blog

The one thing many ADHD woman I've interviewed have in common may surprise you. Key points ADHD often means underperforming despite high intelligence, and that takes a toll on self-worth. Women with ADHD often feel like they haven't lived up to their potential. Late-diagnosed women often spend years haunted by "what could have been." If there's one trap in life that we can all fall into, it's the feeling that we are alone in our suffering. As the old saying goes, there are no unique human experiences, no matter how much your brain would like to trick you into feeling otherwise. Even after years of researching women with attention-deficit/hyperactivity disorder (ADHD), and living the life of a neurodivergent woman myself, I still fall into that trap. So it's always comforting to be reminded that we're not alone. One of the most common experiences of people with ADHD is that they don't live up to their potential and tend to underperform in certain areas, despite often scoring above average in intelligence. Self-esteem comes from "proving" your capabilities to yourself by achieving your goals. When people with ADHD, for one reason or another, don't achieve what they're so capable of, the knock-on effect is a blow to self-esteem. Regret About What Could Have Been The end result is that the one key feature I find in many woman I interview with ADHD is a lack of self-esteem. This is particularly tragic, and it can impact every area of their lives: relationships, career, and even their own sense of peace. As one woman put it, "I always have this nagging feeling at the back of my mind, no matter how well I do, that I've failed, that I've messed up, that I'm just a big failure really." This particular woman was so professional and put together, the type of woman you'd see walking down the street and think, wow, she's really got her sh*t together. It's funny, this theme comes up so often it ended up as the title of my book, How to Get Your Sh*t Together. Put simply, the common thread in how women with ADHD felt as adults was: Why can't I get my sh*t together? And why does it seem like everyone else has theirs together? What I found so fascinating and liberating about my interviews was the realization that we all felt like that. It shattered the illusion that we were alone in our feelings of low self-esteem and revealed the comforting fact that these lingering feelings of "not enough" are so common to the experience of living with an ADHD diagnosis. While most people are bothered to some extent by perceived past failings and wrong turns, people with a late diagnosis of ADHD are particularly haunted by what could have been. If only they'd been diagnosed sooner. If only they'd understood themselves sooner. If only, if only, if only. It's no way to live. It's exactly why I dedicated a whole chapter of my book to forgiving yourself. You're not broken, and you never were. Wouldn't now be a good time to drop the burden of not feeling enough? You have the power to do it today. Enterprise ADHD Institute-Blog

New research highlights the link between weight concern and drug use in women. Key points Many women report using drugs in an effort to lose weight. A recent study of 1,533 women in drug treatment found that 57% were concerned about weight gain in recovery. Substance use treatment centers must address weight concerns as an integral part of recovery when present. Body dissatisfaction and weight concern are rampant in the United States. Research suggests that almost half of American adolescents are dissatisfied with their body. By adulthood, it’s more common for women to be dissatisfied with the way they look than satisfied (National Eating Disorders Association). Weight Loss and Substance Use In addition to being a key feature of many eating disorders, body image disturbance and a desire to lose weight can motivate substance use—both legal and illegal—as women strive to attain a culturally valued low body weight (Robinson, Walter, Deane, & Larance, 2023). For example, in a nationally representative sample of more than 12,000 young adults in the US, losing weight was one of the most common motivations for non-medical use of stimulants for women (Drazdowski et al., 2020). Similarly, in a sample of 131 college students who used substances, 15.3 percent of women reported using drugs for weight control purposes; and those who did mostly used illicit stimulants known for their weight-loss and appetite-suppressing side effects (including amphetamine, cocaine and methamphetamine; Bruening et al., 2018). In fact, women in treatment for substance use treatment often report weight-loss as a primary motivation to start and continue using drugs (Warren et al., 2013, 2026). In a recent study of 1,533 women in drug treatment centers in Nevada, my colleagues and I found that 12.3 percent had a lifetime eating disorder diagnosis and 21 percent reported symptoms of eating pathology without a formal diagnosis (Warren et al., 2026). Additionally, about 44 percent strongly agreed that they started using substances for weight loss purposes, and more than half were concerned about weight gain in recovery (57 percent). Strikingly, women who endorsed using substances for weight loss also reported significantly higher mean levels of body dissatisfaction, binge eating behavior, and general eating pathology than those who did not. Implications for Drug Treatment A 2026 advisory by the Substance Use and Mental Health Administration (SAMHSA, 2026) described the need for evidence-based care for people struggling with drug use, body image concerns, and eating disorder symptoms. Specifically, assessing how body image and weight concerns relate to substance use, treating overlapping symptoms simultaneously, and offering supplemental care in a supportive, nonjudgmental environment with experts who understand drug addiction as well as eating pathology is key to recovery success. One evidence-based program for women in drug treatment is the Healthy Steps to Freedom (HSF; Lindsay et al., 2012, 2026) program. HSF is a 10- to 12-week supplemental program that provides participants in drug treatment information about weight, nutrition, physical activity, body image, and eating behavior. In a recent study of 607 adult women in drug treatment (Lindsay et al., 2026), participation in HSF improved healthy eating and physical activity while thin-ideal internalization, body dissatisfaction, and disordered eating symptoms significantly decreased. These findings suggest that programs like HSF can support women in drug treatment to address weight-related concerns related to nutrition, physical activity, body image, and eating pathology as they relate to substance use. The Naked Truth In Western cultural contexts, women have been using drugs—both legal and illegal—to lose weight for decades. In fact, research increasingly highlights the link between weight dissatisfaction, disordered eating behavior, and drug use. Given that over-the-counter and prescription drugs are increasingly used to treat obesity in an accessible and culturally sanctioned way, addressing body concerns in a culture that increasingly promotes drug use to manage weight is particularly timely. Cortney Warren, Ph.D., ABPP-Blog