Healing happens when you get out of the way of your nervous system. Key points Thoughts interpret our physiology and are driven by it. Stress physiology creates unpleasant thoughts. Modern self-help processes are ineffective because they keep the body attentive to threat. By calming down and nurturing safety physiology, your body heals on its own. Quit fighting your thoughts; instead, nurture joy. Like the caterpillar, you will wonderfully emerge. The harder you fight your unwanted thoughts, the louder they get. Neuroscience shows us alternatives. Let your body do what it knows how to do – heal. Journalist Benoit Denizet-Lewis1 recently ended a New York Times essay on self-transformation with a cartoon: a butterfly peering down at a caterpillar, dispensing advice with the easy authority of someone who has only recently sprouted wings. "The thing is," the butterfly says, "you have to really want to change." The joke, as Denizet-Lewis points out, is obvious. The caterpillar's transformation has nothing to do with wanting. It becomes what it becomes. Another way to put it is that your body knows how to heal if you can learn to get out of the way. After more than three decades as a spine surgeon, I have watched this same paradox destroy people's chances of getting better. Not because they didn't try hard enough — but because they tried too hard, in exactly the wrong direction. The Invisible Trap Most people I see with chronic mental and physical pain are fighters. They are not passive; they analyze their thoughts, suppress the worst ones, read every book, and try every modality. They do everything the self-improvement industry tells them to do—and they get worse. During the darkest phase of my personal ordeal with pain, I was an “epiphany addict”, on a relentless search for an answer. Only after I was completely broken to the point of suicide did I let go, and I began to heal. You don’t have to endure such a level of suffering to transform, and I have witnessed hundreds of patients experience deep healing, with much less angst. There is no mystery to it; a physiological mechanism is at work. Your body breaks down under sustained stress; it repairs and regenerates only when we feel safe. Constantly searching for a fix and being disappointed doesn’t make you feel safe. Research consistently shows that pursuing happiness produces sadness.2 The more deliberately we chase a positive state, the more the brain scans for the gap between where we are and where we want to be. That scanning is a threat signal. And a nervous system locked in a state of threat cannot heal. The self-help industry rests on the premise that transformation is a product of will — that with the right techniques, enough effort, and sufficient self-awareness, you can think your way to a better life. But that premise misunderstands the most basic fact of human biology: Your body is not waiting for your permission to heal. It is waiting for safety. The Hornet's Nest Think of your brain and nervous system as a hornet's nest. The anxiety, anger, shame spirals, and repetitive unwanted thoughts (RUTs)that keep you awake at 3 a.m. are the hornets. They are automatic survival signals generated by your nervous system, doing exactly what it was designed to do: alert you to a threat. The problem begins when you treat the signals as the problem. Every attempt to suppress, analyze, argue with, or medicate those thoughts sets the hornets off. The hornets become more agitated and swarm. The nervous system registers that reaction as a new threat, generating more signals that provoke further reactions. Talk therapy rehearses the content of unpleasant thoughts. Interventions that urge the hornets to calm down and go back into the nest won’t work. The real answer lies in not continuing to shake the nest. Then the hornets are able to quiet down and re-enter their home. Well-meaning, conscientious people often struggle more with RUTs than others. They care deeply about being well, so they fight harder when the alarm sounds. But fighting the alarm is not the same as addressing the fire. What the Body Already Knows From more than 15 years spent in the abyss of anxiety, anger, and severe obsessive thinking, I learned that the body (including your brain) already knows how to heal. It always has. The human organism regenerates and repairs constantly—but only when it is in a state of safety long enough to do so. There is always some degree of remaining on alert. The nervous system is always engaged in a continuous, largely unconscious scan of the environment for cues of danger or safety3, a process Dr. Stephen Porges, developer of polyvagal theory, dubbed neuroception. When neuroception detects a threat, the body mobilizes. Stress hormones and inflammatory molecules flood the system, stimulating inflammation, to defend against the possibility of infection. Blood flow shifts toward muscles. The thinking brain narrows. This is threat physiology—and it is incompatible with healing. When neuroception registers safety, the opposite occurs. Defensive tone subsides. Blood flows back to the brain's prefrontal cortex. Neuroplasticity—the brain's capacity to physically rewire itself—becomes possible. Healing then happens—not as an act of will but as an emergence. The body does what it was always capable of doing once it is exposed to the right conditions. I watched this in my clinic. Patients who had been in intractable pain for years, who had tried every intervention, would often become symptom-free—not after a new surgery or a better medication but after learning to stop generating threat signals and to start engendering cues of safety. In the most practical sense, they stopped shaking the nest. From Reactive to Creative The shift required is not passive. It is not resignation. It is something more precise: redirecting attention away from the problem and toward the life you want. Neuroplasticity works in both directions. Your brain develops where your attention goes. If your attention is on the symptoms—analyzing, fearing, and fighting them—your neural circuitry deepens around them. The RUTs get deeper. But when you deliberately choose connection, curiosity, creativity, and joy, new circuits form. The old reactive pathways atrophy from disuse. This is not positive thinking. It is biology. The brain you have tomorrow is shaped by what you focus on today. It is formed by repeatedly m aking positive choices. This concept has existed for millennia. Stoic thinking 2,000 years ago is an example.4 Notice what this means in practice: Healing is not a subtraction. You do not get better by removing the bad. You heal by building something else—and by allowing the nervous system to slowly and repeatedly register that the nest is no longer being shaken. The Caterpillar's Lesson The caterpillar does not think its way into becoming a butterfly. It does not try harder. It does not attend more workshops or optimize its transformation strategy. It surrenders to a process already underway, one that was always going to happen under the right conditions. This is what I want patients to understand, and what the self-improvement industry cannot afford to tell them: You cannot fix yourself. But you can create the conditions for your body to heal. Give up fighting the darkness. Turn on the lights. The caterpillar becomes what it will become depending on the dominant state of threat or safety. You must learn to find the switch. David Hanscom, MD-Blog

Current messaging about productivity is worsening burnout for many people. Key points "Hustle culture" makes an already-complicated daily existence busier and less open to mindfulness. Current social media trends promote an unhealthy attachment to productivity. Longstanding norms of hyper-productivity are leading to increased rates of burnout. The irony should not be lost on us: optimizing and maximizing, two words we are hearing more and more in the current life-advice social media zeitgeist, are actually resulting in exhaustion and burnout, virtually defeating their intended purpose of increasing productivity and reaching a state of ultimate effectiveness. From “wellnessmaxxing,” the idea of optimizing self-care, to “biohacking,” the idea of intervening in natural bodily functions (such as sleep) to “hack” or maximize physical functioning, to “habit stacking,” the idea of adding a new habit to an already established one, there are a multitude of buzzy, trendy ways to reach optimal daily functioning. And these trends are to say nothing about longer-standing problematic optimization standards like blurry work boundaries and constant digital connectivity. How 'Hustle Culture' Adds Stress Instead of Relief While we may, in fact, be living in a time of unprecedented daily optimization, the downside of this “hustle culture” is that it can make an already complicated, overwhelming, and stressful daily existence even busier, more outcome-oriented, and less open to mindfulness and presence. American workforce burnout reached an all-time high with nearly 72 percent of U.S. workers reporting moderate to severe levels of workplace burnout in 2025 (Mohr et al., 2025). Three out of every four Americans are feeling tired, overburdened, stretched thin, and burnt out. Our relationships with our jobs are part of the problem, but we might argue that another part is the overarching messaging of “hustle,” “optimize,” “be productive,” and “maximize” that we hear daily, both directly and indirectly. Repeated often enough, a message can be accepted and go unchallenged. But, for the sake of our collective mental health, the message of hyper-productivity that has long been perpetuated by American culture must be challenged and changed. Historical Roots In psychological circles, we might trace some of this messaging back to the early self-improvement literature, which offered titles such as The Laws of Success, How to Win Friends and Influence People, Think and Grow Rich, and The Master Key System. These titles were early precursors to the current culture of optimization—here is how to win, get rich, and be successful. The content of these books was rarely based on psychological theory, and often provided dubious, albeit bestselling blueprints for quick maximization. Social Media and the Unending Push for Life Hacks Many of the most popular optimization-based TikTok reels sound eerily similar to these old book titles: “How to Stop Procrastinating in Two Minutes,” “How to Reset Your Brain,” “How to Win Every Day,” “Leverage Your Mind.” The overarching message is the same: You can hack life by learning how to optimize your existence. This, however, comes with an unspoken caveat: We must be constantly training our brains, learning new hacks, and unlocking new shortcuts—rather than simply living our lives, we are forever striving to make them better, easier, more comfortable, and more monetarily sustainable. Healthy Self-Improvement From Craving-Based Striving Let me make an important distinction: Aiming to improve our lives is, of course, not an inherently bad thing and is, indeed, much of what is focused on in the therapy room. There are healthy, adaptive, and psychologically based ways to do this. The problem is that our culture of optimization presents the goal of improvement as a constant striving. Buddhist tenets present an important differentiation between striving that is based on craving and striving that is based on “right effort.” Craving-based striving might be doing something in order to achieve more status, whereas “right effort” striving might be doing something for our long-term betterment or health (Bodhi, 1994). Unfortunately, many of the optimization and maximization reels that are popular on social media platforms are undeniably craving-based, to wit: “How to Win Every Day.” The Buddhists would argue that craving leads to suffering, and one of the types of suffering we face in our modern world comes in the form of burnout. The Need for Mindfulness Amidst Hustle Culture In my clinical practice, I find myself talking more and more about mindfulness and slowing down. So many clients I see report feeling overwhelmed, burned out, and exhausted by the constant hustle and striving that has become the norm in our society. External messages have a lot of power to influence how we conduct our lives and what habits we adopt. It is important to be willing to challenge some of these messages, particularly those that lead us to negative states like burnout. It is human nature to desire improvement and to want to better our circumstances, but the way we go about trying to achieve this dictates whether it helps or hurts us. Our current culture of optimization is accomplishing the opposite of its intended purpose: Rather than making our lives easier, it is adding more to our plates, which statistics show are already overfilled. Phil Lane, MSW, LCSW- Blog

Kids with chores tend to be more independent, feel happier, and do better. Key points We're in the midst of a worsening crisis in teens' mental health. Public policy and school changes can help, but parents can also use chores to support their troubled kids. Kids who do chores at home tend to be happier, healthier, and more successful at school and beyond. Parents of troubled kids should start small, emphasize the positive, and stay on top of chore completion. There is so much going on for kids as they enter adolescence, starting at age ten or 11 and persisting for the next several years. Their bodies, brains, and place in the world are changing dramatically and quickly. That’s always been true. But today, there are signs that more young people than ever are having increasingly serious social, emotional, and behavioral problems. Arguably, the best way to address these problems is to reduce the stressors kids are increasingly experiencing. That may mean refocusing public policy by investing in social justice, environmental health, and educational equity. On a slightly smaller scale, the U.S. Centers for Disease Control provides recommendations for schools to increase kids’ mental health and resiliency by acquiring mindfulness skills, social skills, emotional awareness, and connectedness. Household Chores: A Vehicle for Connection and Healing It’s great when you get involved in changing public policy or work to change school culture, but in the meantime, you need to address your immediate concerns about your child’s social, emotional, and behavioral development. Sometimes that means getting professional help, but that isn’t usually enough on its own. Troubled tweens and teens often feel disconnected, powerless, and confused about their place in a problem-filled world. Household chores can be a vehicle for increasing your child’s sense of importance in the family, giving them feelings of accomplishment, connection, and value that carry over into other dimensions of their life. Research finds that kids with chores tend to do better than others in a whole lot of important ways. On average, they are happier, healthier, and more successful at school, with friends, and in general. They tend to feel better about themselves and are more connected to their family. So if your tween or teen is difficult or troubled, think seriously about giving them chores. You’ll both benefit. Expect Pushback When Chores Start If your child has reached the age of 8 or so without being responsible for much in the way of household chores, they will almost certainly whine, complain, argue, and explain that they’re far too tired, busy, or otherwise occupied. As far as your adolescent child is concerned, chores are hated for three main reasons: you’re telling them what to do; the chores look like work, not fun; and they see chore-time as a loss of their personal freedom. But that doesn’t mean chores aren’t good for them. They are. Getting Started: How to Implement a Chore Habit Step by Step Explain what you’re doing. When you and your child are both in a good mental space (good-humored, not rushing, no screens), sit down together. Explain that you love them and want to give them the life skills and habits that will serve them well once they’re living on their own. And also, now that they’re 10, 12, or 15 years old, they’re mature enough to contribute to running the household. Make the list. Together—with your child providing most of the suggestions if possible—list all the chores that need to be thought about daily: dishes, table-setting, laundry, bathrooms, sweeping floors, walking the dog, making the next day’s lunches, taking out the garbage, etc. Save the list. You’ll come back to it in a month. Choose one. Ask your child to choose their favorite item on the list, the one chore they’d most like to take responsibility for. Discuss carrots and sticks. What should your child get for successful completion of their daily chore? Maybe points in a point system that’s tied to allowance? Maybe increased screen time? What consequence makes sense for omitting to complete the chore? Maybe loss of points or loss of screen time? Make specific plans for doing the chore. Ask your child to describe how and when they plan to complete their chore. Be patient, respectful, and definite that the how and when have to meet your specifications. For example, if they choose table-setting, that might include putting away anything that’s on the table; setting each place with cutlery, napkin, and a drinking glass; and checking to make sure the table looks welcoming. And it needs to be done by a set time, say 6 pm. Emphasize the positive. As your child gets started on a new chore, praise what they get right and help them do better next time. Don’t criticize or micromanage. Be flexible. Negotiate changes as needed. Let your child swap chores with you or other members of the family. Notice and be grateful. Thank your child for their contribution, and point out how what they’re doing is helping everyone in the family. Stay on top of it. This is why you haven’t implemented chores earlier. It really is an annoying, time-consuming hassle to supervise a resistant child as they acquire the habit of contributing to the family. But, like putting money aside in a savings account, it’s very much worth doing. You’d rather spend your time and energy elsewhere, but someday you and your child will be glad you invested in giving your child the habit of taking responsibility for chores. Have a one-month check-in. One month later—to the day, if you can make that happen—sit down with your child again, this time with snacks. Discuss the implementation process of the first chore. What went well? What obstacles did either one of you experience? Choose the next chore. Review the list. What other chores should be added? Ask the child what their next most favorite (least despised) chore is. Discuss the practical details of how and when to do it. If one or both of you have been slack about doing or monitoring Chore #1, then you need to get better at the chore habit. Continue with Chore #1 and delay implementation of Chore #2 until the following month. Although your troubled adolescent might be working hard to push you away and resist your demands, they urgently need to feel loved, respected, and valued by you. As counterintuitive as it might seem, giving them chores and insisting they be completed can help make that happen. Dona Matthews, Ph.D.- Blog, Book

Your relationship struggles may be tied to the stories you tell yourself. Key points The signal is the emotions and physiology you experience when you perceive a situation as a threat. The story is what you tell yourself to reduce uncertainty, even if the story is more painful. Focus on the signal and avoid telling the story to help change how you handle life situations. How often have you heard this from people explaining their relationship challenges: “I have anxious attachment?” Attachment theory has become part of what I call the “Relationship-Industrial Complex” and is an essential term in our relationship vocabulary. It suggests that relationships demonstrate one of three patterns: anxious, avoidant, or secure. It’s used as both an explanation and an excuse for struggling relationships and other difficulties we often face in our lives. And sometimes it’s accurate; many people do experience anxious attachment in even the most loving relationships. But just as often, what people are experiencing isn’t that readily explainable because attachment isn’t a dichotomous style (or a label); rather, it lies along a continuum of how we connect with others. And one location along that spectrum is what I call “signal/story attachment.” It is a very human process in which the mind confuses two different internal experiences: signal and story. Understanding the difference can immediately reduce distress and improve how you respond to difficult relationship moments. Signal: What Is Real and Immediate When something unsettling happens, your body reacts first. A delayed text. A change in tone. A moment of distance. Your nervous system registers a potential threat. This is not pathology. It’s basic biology. It’s your survival instinct kicking in. Emotions such as anxiety, sadness, frustration, or anger are signals that something meaningful is happening. From an evolutionary perspective, these emotional responses are designed to orient you toward potential threats and mobilize attention and action to remove the threat. The key point is this: The signal is tied to the present moment. It reflects what is happening right now and how your system is interpreting it. Though a clearly unpleasant emotional and physiological experience, it is nonetheless normal, healthy, and often positive information that you should listen to. The Purpose of the Signal Emotional signals are not problems to eliminate. They serve specific, important functions. They invite awareness. Emotions direct your attention toward something that matters. They slow you down. When you feel something strongly, your system is trying to interrupt automatic or impulsive behavior. They prompt care. Signals often indicate a need for support, patience, or self-regulation. Research on emotion regulation consistently shows that acknowledging emotions, rather than suppressing them, leads to better psychological outcomes. In short, the signal is an ally that should be attended to, not the enemy that should be avoided at all costs. The problem is that when we feel some sort of pain, including emotional pain, our evolutionarily developed reaction is to do everything we can to not feel that pain. That’s where the story comes in. The Story: What the Mind Adds Very quickly, the mind begins to interpret the signal. It creates a story around that signal with the intention of easing our pain. “I’m screwed.” “I’ll never be successful.” “They’re losing interest.” “I’m falling behind everyone else.” “I don’t know who I am without this.” “They’ll come back to me, I’m sure of it.” “I’ll show them!” These are the stories we tell ourselves. Some are short stories, even one-liners. Other stories are elaborate fantasies that extend far into the future. Some are incredibly negative, simply affirming definitively what we believe in the moment. Other stories are the exact opposite. They are triumphal tales of the relationship working out, getting the job in the end, or getting a better one. Unfortunately, though these stories provide temporary emotional relief, they make things worse in the end because they anesthetize us against the signals we don’t want to, but really need to, listen to. The story is not the event itself. It is the meaning you assign to the event. And the mind is wired to generate meaning rapidly, often with incomplete information. From a cognitive perspective, this reflects automatic thought patterns and predictive processing. The brain is constantly trying to reduce uncertainty by constructing narratives about what is happening and what will happen next. How the Story Amplifies Suffering The real pain is not the initial emotional signal (though it is certainly unpleasant). It is what the story does to it; the story intensifies the signal. It stretches a present-moment reaction into an imagined catastrophic future. It converts uncertainty into painful certainty. The paradox here is that, from an evolutionary perspective, we would rather know that something bad is going to happen than not know what the future portends. Most importantly, it shifts the threat from the situation to the self. A delayed reply becomes “I’m not wanted.” A setback becomes “I’m a failure.” This shift is critical. What began as a manageable emotional response to an immediate concern becomes a broader psychological threat to our very value as people. This pattern aligns with what cognitive models describe as catastrophizing and overgeneralization, both of which are strongly associated with anxiety and distress. Separating Signal From Story The goal is not to eliminate the emotions in any particular moment. It is to separate the signal from the story. Start by allowing the emotional signal without resistance. If you feel anxious, acknowledge that anxiety is present. Then notice when your thinking shifts from what hurts (the signal) to what it means (the story). That transition is the moment where signal becomes story. It’s also the moment when the pain of the situation becomes the excruciating pain of self-judgment and failure. Even when the story feels helpful or protective (yes, it does dull the pain in the short term), it often adds unnecessary suffering in the long run. Instead of resolving uncertainty, it ultimately amplifies it. And, in doing so, the “volume” of the pain gets much louder too. Grounding Back in the Signal A more effective response is to return to what is real, present, and actionable. In other words, what you are feeling in the moment (the signal). Name the emotion without interpretation: “This is anxiety.” “This is sadness.” Acknowledge that it hurts, but also realize that it will pass if you allow it to. Bring your attention back to what you can control now, for example, work, family and friends, self-care. When you feel the pull toward telling a story, remind yourself that a story will only make it worse. Now, here’s the hard part. Choose not to tell yourself the story. Redirect your attention, immerse your mind in something (e.g., a book, music, time with friends, exercise), or do something you enjoy. All of these not only distract you from creating a story, but they also generate positive emotions and physiology that ease the signal. Overall, let the larger meaning of the current situation reveal itself over time, rather than constructing a narrative prematurely that will likely not turn out to be true. This approach is consistent with mindfulness-based interventions, which emphasize present-moment awareness and nonjudgmental observation of thoughts and emotions. A Different Way to Understand Yourself Before concluding that something is fundamentally wrong with you and assigning a label, anxious attachment, that may not accurately reflect your state of mind, consider a simpler explanation: Maybe you don’t have anxious attachment. As a result, you aren’t doomed to a life of loneliness (talk about catastrophizing!). You may simply be experiencing a normal emotional signal that you are in a situation that isn’t healthy for you (no matter how much you wish it were otherwise) and then telling yourself a story that will make things much harder than they are now. If you stop the story, you not only ease your pain, but you also begin to rewire your brain so that, with enough practice, you no longer have to resist telling yourself a story, but rather can just sit with the signal until it passes (and I assure you it will). Learning to distinguish between signal and story doesn’t eliminate emotional pain or failed relationships. But it prevents you from adding insult to injury in an already challenging moment. And, in some cases, it also may just salvage the situation you are in or enable you to move on more quickly to a life situation that is healthy and fulfilling. And that shift alone can change how you experience relationships, performance, and life. Jim Taylor, Ph.D.-Blog, Book

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