The ability to place a bet—any time and any place—courts ruin for some people. Key points A culture of instant gratification propels online gambling. Young men have several risk factors for developing a gambling addiction. Senior citizens are gambling online in steadily increasing ways. Two fallacies often govern the way gamblers think. We live in a culture that supercharges our wants and desires. We operate under a constant barrage of advertisements and enticements. Most of us are focused on what those pitched products or experiences promise us. Give us our joy, success, and pleasure. We happily concede to our flights of fancy instead of thinking about the likely disappointing or negative consequences. The growth of online betting Those ads and enticements feed an ever-growing hunger for instant gratification. This is becoming apparent with the exponential growth of online betting. A person can place an online bet at any time and from any place on an election outcome, a military action, or when a favorite animal at the zoo will give birth. Sports betting is the easiest and most common form of online betting. It is becoming impossible to escape online sports betting. Whether watching on television or streaming, the odds for a match or game are constantly being shown. In major sporting events such as the Stanley Cup Hockey finals and the NBA finals, spectators were exposed to gambling marketing every 20 seconds. Every shot, every point, every period score, and final score is an opportunity to place a bet. Sports Illustrated has gone so far as to rank the top six online sports betting programs. Never mind discussing the sports themselves; SI now discusses betting on the sports. Easy access to sports betting is creating a world of pain for many people. People no longer need to seek betting opportunities; they can find all sorts of opportunities on their phones. For young people who have grown up with their phones glued to their hands, the temptations may be too hard to ignore. Risk factors for developing a gambling addiction include being male, younger in age, having a family history of gambling problems, certain personality traits, and co-occurring mental health disorders. The phone has never been more dangerous. Older people are also beginning to participate in online gambling to very dangerous effect. Many seniors are now regular users of online gambling platforms that are available at every hour. People who have never gambled to a dangerous effect in the past are losing their retirements, spouses, and well-being. Twin fallacies driving online betting As players place more bets at higher amounts, they become victims of the sunk cost fallacy. The fallacy: I have already spent or lost so much money that I am willing to continue to invest and invest more heavily rather than re-evaluate my circumstances and change my behavior. With a credit card conveniently stored on their phones, many using online betting apps may find themselves gambling more liberally than they would have. Senior citizens may have a very robust line of credit that can be decimated quickly. When people recognize the sunk cost fallacy and try to cut down on or quit these gambling platforms, they are often lured back with enticing offers. There are always workarounds for whatever self-imposed deposit, wager, or time limits a person may put on their account. With gambling available on phones, it is very easy for seniors to hide in plain sight, hunched over their phone right next to younger people doing the same thing. Winning will make some vulnerable to the aptly named gambler’s fallacy, the belief that past events influence future probabilities in independent events, such as thinking that after several losses, a win is due. It does not pertain to the belief that past performance guarantees future results. Combine this with the sunk cost fallacy, and the results can be devastating. In suffering significant losses from gambling, most people will feel deep shame. This may be especially true for people who always see themselves as hard-working and saving responsibly for their retirement. This shame may bring isolation and loneliness. Hiding losses from family members, confronting economic insecurity, and believing yourself to have ruined not only your future but your family’s is devastating. Addictions in their myriad forms can spring from and reinforce loneliness and social isolation. Whether it is a younger person feeling as if he is already behind in his life or a senior whose identity and life have been altered by retirement, loss of a spouse, or adult children who are busy with their own lives, gambling promises excitement and the possibility of a payout. The payout may be small at first, but the jolt of joy accompanying it isn’t. For those who feel lonely, isolated, or simply flat in much of their daily life, that jolt is seductive. Don’t mistake that jolt for joy. That jolt may be the harbinger of shame. Peg O'Connor, Ph.D. - Blog

Why readiness isn't the whole story when kids pull, pick, or bite. Key points Ambivalence about stopping isn't resistance; it means the BFRB is serving a function for the child. Willingness lives on a continuum, and meaningful clinical work can begin wherever a child is on it. Willingness is built through feeling known, capable, less alone, and less ashamed. It's true we can't force another person to be ready to change. But with Body-Focused Repetitive Behaviors (BFRBs), like hair pulling, skin picking, and nail biting, ambivalence about stopping isn't resistance. It's expected because the behavior is serving a function. It may be regulating arousal, soothing a difficult feeling, providing reliable sensory input in an overstimulating day, or meeting a need that nothing else has yet met. When we ignore that function and pressure a child to stop, we often make it harder to understand the behavior and meet the child's needs. Pushing a child to change a behavior that is, on some level, working for them tends to produce a paradoxical effect. The behavior moves underground. Children pull or pick in secret. They may lie about it. Resentment builds. Shame builds. And the parent-child relationship, one of the most protective factors a child has, bends under the weight of a behavior nobody discusses honestly. This is genuinely difficult for parents, because the instinct to protect your child is exactly that, instinctive. The clinical challenge is to honor that parental instinct while meeting the child where they are and joining them with kindness and curiosity. Willingness is a continuum, not a switch Some children arrive with no interest in working on their BFRB. Some are curious but uncommitted. Some are willing to talk about it but not change it. Some will try a strategy if there's a reward attached. And some are quietly ready, and simply need the right clinician and the right invitation. All of those starting points are workable. When a child isn't yet willing to address the behavior directly... There's still substantial, meaningful work to do. Much of it focuses on helping the child to develop a clearer sense of self, discovering what interests them, what they're good at, and what they care about. Children who can articulate their own values have something to anchor to, which matters later when they're asked to tolerate the discomfort of doing things differently. Once those values are identified, the clinician and child can gently look at whether the BFRB gets in the way of any of them. Sometimes the answer surprises a child, and that's often where willingness begins to shift. Therapy also involves helping the child get curious about what's hard in everyday life — not the BFRB itself, but everything around it. This can include friendships that don't quite make sense, a teacher experienced as overwhelming, feelings that arrive too big and too fast, or sensory experiences that other people don't seem to notice. These everyday struggles are often the context driving the BFRB. A significant piece of therapy is building the skills that better meet the needs the BFRB is serving, such as cognitive flexibility, emotion regulation, distress tolerance, and interpersonal effectiveness. If a child's BFRB is, among other things, a strategy for managing overwhelm, developing additional strategies for managing overwhelm doesn't require targeting (for instance) the pulling directly. As the toolkit fills in, the function gets met elsewhere, and the behavior often softens. Self-compassion matters too. A child who has been quietly hating their own hands, scalp, or skin for months or years is carrying a heavy load. Helping them turn toward themselves with kindness changes the internal climate in which the behavior lives. And then there's connection. Shame thrives in isolation, and shame is one of the most powerful forces keeping BFRBs stuck. Books and videos featuring others with BFRBs can be profoundly disarming. So can in-person communities at conferences, retreats, and support groups. Children opposed to working on their BFRB sometimes walk into a room of others who pull or pick and walk out willing to get curious with their therapist. When there is some willingness, rewards and systems can help Family systems become useful here. Bringing parents in to plan for praise and rewards around practice can boost motivation, but it has to be collaborative and child-centered. The child decides how they want their caregiver to help. What's genuinely useful? What's annoying? What would they want a caregiver to say if they noticed the BFRB occurring? What would they prefer a caregiver not say? Putting the child in the driver's seat preserves autonomy, gives the caregiver a welcomed role, and prevents the secrecy-and-resentment cycle. When there's a willingness to talk but not yet to change, the ambivalence itself becomes the work. A child might generate two lists: reasons to work on the BFRB, and reasons to keep it. Both are honest. Sitting with the ambivalence, rather than arguing one side of it, is frequently what makes movement possible. A word on parents and caregivers Sometimes the person in the family who most needs support is the parent or caregiver. When a caregiver is significantly distressed, a caregiver-only session can be invaluable as a place to listen and to share information they may not have heard. This might include the fact that many children and adults live full, healthy lives with a BFRB; that the worst-case narratives found online at two in the morning or in their fearful imagination aren't the typical course; that common myths, like "she's doing this for attention," "something must be deeply wrong," or "a better parent would have prevented this" aren't accurate; and that a less anxious caregiver is a more effective partner in their child's care. When the child is comfortable, caregivers can also be invited in at the end of a session to walk through what was worked on and how they might gently echo that approach at home. Willingness is built, not waited for Left unaddressed, BFRBs can have real physical, emotional, and social consequences. It's understandable that caregivers want intervention now. But intervention doesn't have to mean "making the child stop." It can mean finding a clinician who understands BFRBs, meets a child where they are, treats the whole child, and partners with caregivers in a way that protects both the child's autonomy and the caregiver-child relationship. That isn't waiting. That is treatment — and often, it's the treatment that eventually makes targeted BFRB work possible and effective. Willingness is built. It grows out of feeling known, capable, less alone, and less ashamed. Children don't often arrive at therapy wanting to change. What they can arrive at, with the right support, is wanting to understand themselves and to be who they want to be. That's almost always enough to begin. Marla Deibler, Psy.D., ABPP - Blog

Why teams require professional self-control rather than raw authenticity. Key points Digital communication layers strip away the sensory guardrails that naturally regulate human behavior. Virtual meeting tools offer bad actors plausible deniability for cruel or dismissive behaviors. Evolutionary psychology suggests healthy group disapproval is an essential tool for behavioral regulation. Effective teams do not require complete authenticity; they require a shared standard of best behavior. Remote work was sold as the ultimate escape from the annoyances of sharing a physical space with other people during working hours. No more micromanagers hovering over your shoulder, and no more exhausting watercooler gossip. But there is a dark side to remote work. Remote environments have not cured counterproductive behavior, and they have stripped away some of the social guardrails that keep malicious and destructive colleagues in check. Although a screen makes it easy to temporarily dodge a destructive coworker, avoiding the person also means avoiding the confrontation required to stop them. This has the potential to create an accountability vacuum. Rather than being challenged or corrected, manipulative people can get away with far more when they can hide behind their screens. The Virtual Weaponization of Rudeness In a physical meeting room, human behavior tends to be kept reasonably civil by a shared sensory environment. Bad manners carry an immediate, painful social cost. If a colleague talks over you, ignores you, or rolls their eyes in a physical meeting room, the entire room sees the hostility. People quickly check the reactions of others to understand if their colleagues are seeing the same behavior and interpreting it in the same way. There’s a shared understanding of the social reality that comes across differently in shared physical spaces. Crossing your arms defensively, sighing heavily, or engaging in a blatant side conversation requires a massive amount of overt, aggressive confidence. The physical presence of your peers creates social accountability, forcing people to regulate their impulses. Virtual meetings completely shatter these guardrails. On a video call, rude behavior is compartmentalized and stripped of context when people are in their separate little boxes on screen. When isolated incidents harden into a chronic, unaddressed pattern of undermining others, the technology becomes an ideal camouflage for several distinct types of workplace disrespect. 1. Muted Laughs In a physical room, bursting out laughing while a colleague is speaking is an overt act of social aggression that instantly halts the meeting. On a video call, however, bad actors can actively laugh, smirk, or scoff while hitting the mute button. Because the audio doesn’t interrupt others, the behavior is easily shrugged off as a minor digital distraction. A presenter can be left watching someone visibly mock them in real time, while the rest of the room assumes the person is just reacting to a private message. The technology provides a layer of plausible deniability for cruelty. 2. Digital Interruptions In a physical workspace, interrupting someone repeatedly creates a jarring, uncomfortable social experience that tends to mark the interrupter as aggressive. On a video call, constant interrupting can be disguised by the environment and equipment. Bad actors can cut people off repeatedly, talk over their colleagues, and then casually blame their connection when challenged. Indeed, sometimes people use a poor connection to disrupt conversations and continuously interrupt their colleagues. The tech provides a ready-made excuse for rude or unprofessional behavior. 3. Backchannel Whispers Whispering to a coworker during a live presentation in a physical office is glaringly obvious and universally considered rude. Online, however, the backchannel is a superpower for bullies. Some people use private Slack messages or personal phones to run a live, invisible commentary during a colleague's presentation, undermining a peer in real time while staring directly at the camera with a polite, fake smile. 4. Continuous Partial Attention In a shared space, staring blankly out the window or scrolling on your phone while a colleague is speaking to you is deeply insulting and instantly caught. On a video call, people can completely check out. They open another tab, scroll social media, or answer emails while their team members are speaking, weaponizing the digital screen to completely ignore their peers. To be fair, this is a highly common remote behavior and is rarely malicious if it happens occasionally. Tuning out naturally happens during bloated meetings, at the end of an exhausting day, or when the specific topic under discussion is genuinely irrelevant to that person’s immediate work. The problem is when this behavior bleeds into critical, shared discussion times. Tuning out important, collective information and then later demanding that colleagues backtrack to re-explain everything that was already covered is where the behavior becomes disruptive. It is social loafing, avoiding the cognitive work of a meeting, effectively offloading the burden of paying attention onto the rest of the team. The Avoidance Loop Why don’t we fix this? Because remote work makes it far too easy to choose temporary comfort or avoidance over the difficult task of conflict resolution. Most people naturally default to conflict avoidance when given the chance. In a shared office, if a colleague is setting out to sabotage your work or insult you, there is more pressure to deal with it when avoidance is not an option. Online, you can simply close the laptop, mute their notifications, or decline their calendar invite. For a few days or weeks, you may actually forget how unpleasant they are. But this avoidance allows the behavior to continue unchallenged. Managers avoid the awkwardness of a digital confrontation over behavioral nuances that seem difficult to prove, and the damage is done daily, but not all at once to the same people. The Necessity of Collective Accountability Anyone who has seen the worst behavior in remote environments run unchecked knows exactly how exhausting this dynamic is. Most people who work remotely will have watched a chaotic colleague run roughshod over a virtual meeting, hiding behind the safety of their screen while the rest of the team sits in their separate spaces, virtually checking out. Some aspects of contemporary HR culture love to push the cliché of "bringing your true self to work." But sometimes a person's "true self" is lazy, irritable, or completely self-absorbed. In collective spaces that demand productivity, the team doesn't need your true self, they need your best behavior. Shame gets a bad reputation, but some evolutionary and moral psychologists would argue that it is actually a highly calibrated defense mechanism designed to prevent us from ruining our reputation. Bullying and undermining colleagues are inherently shameful behaviors. When our actions are fully exposed to a physical room, the natural threat of group disapproval triggers this social alarm system, forcing us to self-regulate. Shared physical environments force a necessary level of psychological and physical self-control. They demand that we restrain our petty impulses, monitor our body language, and actively perform the cooperative, professional version of ourselves. Visibility is an important part of working together. Flexibility is a brilliant tool for autonomy, but when we completely remove the physical room, we strip away the shared guardrails that keep human behavior civilized. Ian MacRae - Blog

Why you can't focus or function when something is pending, ADHD or not. Key points Waiting mode is the inability to function or focus because something uncertain is pending. The pattern is common in ADHD but may also be a trauma response in disguise. Perfectionism and how safe you feel in the world may be at the root of the freeze. The shift begins when you believe you can survive what comes without needing absolute control. Waiting mode describes the inner experience of being unable to do anything because something uncertain, or a future event, is pending. It could be an appointment, an exam result, a medical scan, a conversation that has not happened yet, or a text message that may or may not receive a reply. The pending thing may be hours away or weeks away, significant or routine, but when you are in a waiting mode, that is what takes over your life, your attention, your energy, and your ability to focus. If you have an appointment at four in the afternoon, for the entire morning, you cannot do anything else. If you have an exam on Friday, the whole week is practically gone, and you live in suspension until then. Although rationally you know there is nothing you need to do right now, mentally and emotionally, the unresolved thing clouds everything else. Life feels like it is in suspension. You are going through your day-to-day life, but not quite in it. You cannot relax, or rest, or work, or settle, because something does not feel right, or OK. Even if you resent feeling the way you feel, you cannot stop it. Beyond ADHD Waiting Mode Although not officially included in the DSM, the term waiting mode has, in recent years, gained traction in neurodivergent communities, specifically among people with ADHD. For someone with ADHD, the waiting mode, although by and large unproductive in its overall outcome, serves a well-intentioned function. When a person's internal sense of time is unreliable, when they have a long history of missing appointments or underestimating how long things take, the waiting mode compensates for differences in executive function. The idea is that by suspending all activities and focusing only on what is pending, the brain will not miss it. But waiting mode is not something that happens only with ADHD. The sense of keeping life in suspension whenever there is any pending uncertainty is also deeply familiar to people who have anxiety, particularly those with idealistic and perfectionistic tendencies, and among the emotionally intense and highly conscientious among us. For those who have a tendency to hyper fixate on a future event and keep themselves in a waiting mode, the freeze is not a management device aimed at keeping track of time. There is something compulsive and obsessive in its quality. The mind locks onto the pending thing the way an intrusive thought locks into place: It is persistent, repetitive, and resistant to voluntary redirection. You may know rationally that your preoccupation is disproportionate. And yet you cannot just stop it with willpower, because the fixation is acting at a level deeper than conscious choice, one that involves your entire nervous system. Uncertainty Intolerance and the Waiting Mode Intolerance of uncertainty is a well-documented transdiagnostic factor that cuts across a myriad of depressive and anxiety disorders. People who are highly intolerant of uncertainty interpret ambiguous situations more negatively, show stronger physiological arousal when outcomes are unknown, and find it harder to function when they cannot predict or control what will happen next. The waiting mode and its hyper fixation pattern are likely linked to perfectionistic and idealistic tendencies. Many of the people the term describes might never call themselves perfectionists because when they look at their lives, they mostly see how far things are from perfect. But perfectionism, at its root, is not about achieving real-life "perfection." It is a deep, often unconscious yearning for wholeness, for things to be complete, settled, and in their right place so the person can feel safe. A Trauma Response in Disguise We may also think of waiting mode as a form of a post-traumatic threat response, one that can follow from both complex developmental trauma (C-PTSD) and single-event trauma. In waiting mode, the body has essentially gone into a fight, flight, or fawn state. The mind has identified the pending uncertainty as the one missing piece that will restore safety. Every cognitive and emotional resource gets allocated to monitoring the perceived threat. The origins of this pattern may reach far back into our early history. A child who grew up in a chaotic or unpredictable household, where warmth could be withdrawn without warning and safety was never guaranteed, learns early that the world is only safe when everything is under control. A child who was parentified, or a young person who was disadvantaged, bullied, or made to feel that they did not belong, learns that constant self-improvement and relentless optimization are the only reliable routes to acceptance. The traumatized person learned, as a survival mechanism, to scan for anything that falls outside the smooth and expected pattern, and to treat that deviation as a signal of danger. The trouble is that the mechanism is no longer needed at the same intensity, but it has never been recalibrated. The hypervigilance now treats every open loop, every unresolved situation, as though it were as dangerous and as threatening as early childhood. Another dimension of this pattern is where we place our locus of control when it comes to our sense of safety. For the person prone to waiting mode, it is as though their sense of safety lies not in their own resilience but in other people's appraisal, others' availability, others' love and attention. When those are going fine, they can breathe. When the signals shift or become uncertain, they feel paralyzed. Getting Out of Waiting Mode If you slow down enough to listen to what is actually being believed in the moment of freezing, you may begin to hear the unconscious beliefs that have been quietly running your life. Things like: I need someone's approval to be safe. Or: I need to know the outcome before I am allowed to get on with my day. Or: If people know I screw up, that would be unbearable. These are not thoughts you have consciously chosen, but they have been operating in the background for so long that they no longer feel like beliefs you have adopted, but just the way things are. But ultimately, to free yourself from constant loops of waiting mode may require deeper work than cognitive reframing or practical tips can offer. It is about how safe you feel in the world. The waiting mode loosens its grip when something shifts in your relationship to life's uncertainty and imperfections. The hyper fixation is held in place by a conviction that you cannot afford for things to go wrong, that a bad outcome would not be survivable. The deeper shift is the growing, grudging, hard-won recognition that things can go wrong and you will be OK, that OK and survivable might be good enough, and that not everything needs to be optimized or maximized. The consequences, whatever they turn out to be, will come whether or not you welcome them, and you will deal with them when they do, just as you have many times before. You do not need the world to be settled before you are allowed to live your life. You don't need to be in full control to start living. Perhaps you have always been more able to live on shaky ground than you give yourself credit for. Imi Lo, MA - Blog, Website

Building a meaningful life is more motivating than reducing symptoms. Key points Values shift the focus of therapy from reducing suffering to building a meaningful life. Clarifying values can strengthen identity and increase motivation for change. Behaviors are best evaluated by whether they align with your values and goals. When people begin treatment for borderline personality disorder (BPD), the first conversation is often about what's going wrong. Therapists ask about emotional outbursts, impulsive decisions, self-harm, unstable relationships, and any other symptoms that prompted their client to seek treatment. These questions are essential because they help us understand the person's difficulties and determine how to keep them safe. But once that assessment is complete, where should therapy begin? Many evidence-based treatments naturally focus on reducing symptoms. That makes sense. After all, people seek treatment because they are suffering. Yet as a researcher and clinician specializing in BPD, I've found that starting therapy by asking “Who do you want to become?” is a more powerful question than “Who do you want to stop being?” A Different Starting Point BPD Compass (2026) is an evidence-based treatment for BPD that my colleagues and I developed to match treatment to the underlying personality processes driving each person's symptoms rather than assuming everyone needs the same intervention. In clinical trials, participants showed meaningful improvements in BPD symptoms, co-occurring symptoms like depression and anxiety, and the personality traits maintaining their difficulties. One of the features that often surprises clinicians is that we begin treatment with values clarification before introducing any coping skills. It’s not that values are more important than symptom reduction. Rather, values give symptom reduction a purpose. In other words, it’s motivating to envision the person you want to be. Values identification is the process of clarifying the kind of person you want to be and the life you want to create. Rather than focusing on what you want to stop feeling or doing, it asks what you want to move toward. In therapy, this often means exploring the qualities you hope to bring to different areas of your life. “Who do you want to be?” is a big question. So we break it down into important domains of life. For example, what kind of partner do you want to be? What qualities do you hope your friends would use to describe you? What makes work feel meaningful? How do you see spirituality, community service, or wellness showing up in your life? There are no right or wrong answers. The goal isn't to identify what you should value but to clarify what genuinely matters to you. A More Useful Way to Think About Behavior Beginning with values also changes how we evaluate behavior in therapy. I don't believe it’s a therapist’s job to decide whether a behavior is inherently good or bad. Behaviors almost always make sense in context, especially when they developed as ways of coping with overwhelming emotions or difficult life experiences. Instead of asking clients to simply stop engaging in behaviors I think are problematic, we ask, “Does this behavior move you closer to the person you want to be or farther away?" Take something as simple as not answering the phone. For one person, letting the call go to voicemail may be an act of avoidance that pulls them away from their value of maintaining close relationships. For someone else, silencing their phone during family dinner may reflect their value of being fully present with their children. The behavior looks the same, but its function and whether it aligns with that person's values are different. Values Can Help Build a Stronger Sense of Identity One of the defining features of BPD is identity disturbance. Many people describe feeling unsure of who they are or noticing that their sense of self changes dramatically depending on the situation, the emotions they’re experiencing, or the people around them. Values are more stable. Unlike emotions, values don't have to change from one day to the next. You may not always feel confident, but you can consistently value courage. You may not always feel trusting, but you can still value intimacy. You may not always feel patient, but you can value being the kind of parent who responds thoughtfully rather than reactively. Most people, with BPD or not, have never sat down and defined their values. This process is really powerful; most of my clients describe it as difficult, surprising, and enlightening. Moreover, repeatedly acting in line with those values over time helps people develop a more coherent sense of self. Values Make Change Worth the Effort Changing long-standing personality patterns is hard work. Speaking up after years of avoiding conflict feels uncomfortable. Trusting someone after repeated disappointments feels risky. Resisting impulsive urges can feel nearly impossible in the moment. If the goal is simply to stop doing something, it's easy to lose motivation when change becomes difficult. Values provide a reason to persist. They remind us that personality change isn't about becoming someone with “better” traits. It's about becoming more like the person we aspire to be. When treatment begins with that vision, every difficult step has a destination, and every new skill becomes a tool for building the life you want. Shannon Sauer-Zavala, Ph.D. - Blog

Supporting non-sporty boys in a culture that glorifies athleticism. Key points Boys who don't like sports are often marginalized and/or teased by their peer group. There are specific behaviors in school that suggest a boy is having trouble socially because he avoids sports. Non-athletic boys need adults to recognize and validate their non-physical traits and talents. It is important that parents talk about their son's relationship to sports rather than avoid it. Raising non-sporty boys in a culture that prizes athletic talent in males and rewards competitiveness and power playing is no easy feat. After all, it isn’t long before a young boy recognizes that what really matters at the bus stop and on the playground is how far you can throw, how fast you can run, and how often you win. Big, strong, athletically gifted boys have always dominated childhood’s social landscape. Their physical presence alone trumps the clout of smaller, quieter boys, but it’s their love of sports and fierce desire to win anything and everything that really jettisons these boys to the top—especially in America, home of the Marlboro Man and eight-figure pro athlete salaries, and where it is assumed that being faster, stronger, louder, or mightier is always going to be better. All this, however, has created a veritable caste system, leaving many nonathletic boys feeling undervalued and marginalized. While there may not be much we can do about the playground politics surrounding athleticism, there’s a lot we can do in our schools and homes to bolster the self-esteem and confidence of boys whose non-physical talents often go unrecognized and underappreciated. Helping Your Non-Sporty Son Navigate the Social Challenges of Childhood One of the most important issues at hand is recognizing when your child might be experiencing problems in his school or among his peers that is related to his not enjoying or participating in sports. Signs of Nonathletic Boys in Trouble They may complain of bellyaches, headaches, or general “I don’t feel well” on gym days. You might find them hanging along the sidelines of physical activities, or looking uncomfortable in unstructured social situations, such as waiting for assembly, standing outside during a fire drill, or walking from the classroom to the school library. These are boys who will often find ways to stay close to adults during play times or other free, unstructured times; it feels safer, with less risk of being judged. They may go to the bathroom frequently before gym class or recess. Ideas to Implement at School: Parents can encourage their child’s school to provide game activities for kids who don’t like high-exertion activities but who also don’t want to get stuck with only the swings as an alternative. Games like knock hockey, air hockey, and foosball, and an oversized Jenga set offer great alternatives and safe havens for boys who are looking for non-contact, interactive activities or who simply need to be doing something. An industrious parent-teacher association can find secondhand tables through its own parent network, Craigslist, or yard sales. In place of traditional gym activities that favor the naturally athletic boys, schools could adopt short-session modules in which parent or teacher volunteers run programs on introductory fencing, raft making, or boomerang throwing—novel activities that draw on a variety of skill sets. Many schools now include fitness and working out as an alternative to traditional sports, and that’s been a game-changer for many non-sporty boys. Schools can also be encouraged to identify boys a grade or two older who could be responsible for making sure everyone has something to do during recess and other unstructured times (lunch, waiting to be dismissed to the buses). These boys would be the same kids who had been invited to be hallway guards, guides for new students, and the like. With kids so very anxious these days about being left by themselves and thus identified as “losers,” knowing that there’s a safe, older student to even stand around with if necessary provides some measure of relief. Ideas to Implement at Home: Direct your child toward physical activities, games, and sports that will capitalize on his natural strengths. Some boys gravitate toward sports where they have more control over the game itself, such as archery or table tennis, or opt for more solitary activities such as hiking or biking. Some boys just don’t like competing at all or like it only in nonphysical, nonsporting arenas, such as chess or music. Or, maybe they love competing and are really good at their game, but lean toward sports and activities more commonly selected by girls, such as horseback riding or dance or gymnastics. Process sports experiences together with your nonathletic son. If he doesn’t naturally gravitate toward sports and you’re encouraging him to get more involved in them, try to keep an open dialogue going on between the two of you about his experiences, and yours. This is especially important if there is any question about your son’s enjoyment of or comfort with sports, or any question about to whom it matters more that he plays—you or him. Give him opportunities to say: “I really don’t want to play this but I feel like if I don’t you’ll be mad at me . . .” Give yourself opportunities to say: “I’ve worried about that, and don’t want you to feel as if you have to do a certain activity in order to win my approval. I just want you to feel that you can join a game of basketball or baseball so that you don’t always wind up on the outside looking in…. But if that sounds like the last thing you’d ever want to do, say so, and we’ll move on to finding activities that you genuinely want to do, and that will be the end of that…” Help your son learn to value his intellect and education. If you discover that being smart or educated is not valued by your child’s peer group at school, then make a point to value it more visibly at home. Keep the matter light, so your kids don’t brace against conversations you might try to start about the books or movies you love, or about interesting current events. Talk about men who are recognized and respected for their diplomacy, intellect, or capacity to appreciate multiple perspectives. Talk about men you know in your family or circle of friends who are impassioned about music, theater, or other art forms. In our sports-crazed culture, a boy who isn’t into sports or is not very good at them needs most of all to know that there are at least some people in his life who value the non-physical traits and developed skills and natural talents that he brings to the table. He’ll also do well to have someone who helps him remain patient through the elementary school years during which non-physical traits earn little social capital, even if appreciated by friends, teachers, and the like. As they grow into men, such boys offer a beautiful counterpoise to our nation’s cacophonous society where, in order to get anyone’s attention, you have to be bigger and brasher than the others — a beautiful expansion of modern masculinity. Janet Sasson Edgette, Psy.D., M.P.H. - Blog

How a hopeful mind lowers inflammation, even when life is hard. Key points Optimism is linked to living four to eight years longer and a lower risk of premature death. Optimism benefits the body by reducing inflammation and strengthening stress resilience. Optimism is a trainable skill, not a fixed personality trait. Three simple habits—gratitude, future visualization, and using your strengths—can boost optimism. Optimism and Longevity Optimism has long been dismissed as little more than positive thinking, but growing evidence suggests it is a powerful biological asset. Large prospective cohort studies and meta-analyses show that people with higher levels of optimism live 5–15 percent longer, have a 13–14 percent lower risk of death from any cause—even after accounting for depression, health behaviors, and chronic illness—and, on average, live four to eight years longer than their less optimistic peers; however, the exact benefit varies across populations. 1 The evidence extends beyond lifespan. A meta-analysis combining data from more than 220,000 people found that optimists were about one-third less likely to develop cardiovascular disease and 14 percent less likely to die during the study period than less optimistic individuals. 2 Remarkably, the protective effect of optimism was comparable to that of many traditional cardiovascular risk factors. A second meta-analysis involving more than 180,000 people reached the same conclusion: people with a more optimistic outlook consistently had a lower risk of premature death. 3 How can something as intangible as optimism affect the body? Scientists believe it works through several interconnected pathways. First, optimists and their partners’ optimism are associated with better cognitive functioning.4 Second, optimists are more likely to engage in healthy behaviors, including regular exercise, nutritious eating, restorative sleep, and avoiding smoking.5 Third, people with a more optimistic outlook tend to have lower levels of chronic inflammation, healthier cholesterol profiles, and a better-balanced autonomic nervous system, which helps the body recover more efficiently from stress. 5,6,7 Fourth, optimists are more likely to cope adaptively with setbacks, cultivate supportive relationships, and remain resilient during adversity. The evidence is compelling enough that the American Heart Association recognizes optimism as a psychological factor linked to better cardiovascular health and greater longevity. Importantly, optimism is not fixed—it can be strengthened through targeted interventions that may benefit both mental and physical health. Some research suggests that reducing pessimism may be just as important as increasing optimism because pessimism itself appears to harm health.9 How to become more optimistic: If you are having a less-than-inspired life right now, being optimistic may seem out of reach. However, there are several ways to boost your optimism. Intervention 1: Optimism doesn't mean pretending your life is perfect or ignoring hardship. It simply means believing that your future can be better than your present.10 At its core, optimism is your brain's ability to generate a positive prediction about what lies ahead.11 One way to strengthen that prediction is to remind yourself that change is possible. Ask yourself: Has anyone who has faced challenges like mine eventually turned their life around? The answer is almost always yes. That gives your brain real-world evidence that difficult circumstances don't have to be permanent. Instead of predicting more of the same, your brain can begin to imagine a different future with the best possible self.12 Intervention 2: Before you go to bed, write down three good things that happened during the day and, just as importantly, why they happened.13 They don't have to be life-changing. Perhaps someone smiled at you, you completed a task you'd been avoiding, or you enjoyed a great cup of coffee. The key is to train your brain to notice what is going right rather than automatically focusing on what is wrong. This simple exercise has surprisingly powerful effects. In a study involving more than 10,000 people across 34 countries, practicing gratitude increased optimism, positive emotions, and life satisfaction.14 Other research has shown that the benefits could last for at least six months. Why does it work? Gratitude gives your brain evidence that good things are happening. Instead of scanning the world for threats or disappointments, your brain begins to recognize patterns of positive experiences.15 Over time, this shifts its predictions. Intervention 3: Take a few minutes to identify four of your greatest character strengths—such as curiosity, kindness, perseverance, creativity, or gratitude.16 Then, over the next week, intentionally use each of those strengths in a new way every day. 17 For example, if kindness is one of your strengths, do something unexpectedly thoughtful for someone else. If curiosity is a strength, learn something new or ask deeper questions in a conversation. Research suggests that regularly using your signature strengths increases happiness, reduces depressive symptoms, and enhances overall psychological well-being. More intensive strengths-based programs have also been shown to increase optimism, suggesting that consistently applying your strengths helps your brain develop a more positive outlook on the future. Srini Pillay, M.D. - Blog, Book

What "panic pouches" get wrong about panic attacks, and what works instead. Key points Many people are using safety objects to help "protect" themselves from their panic attacks. Although it feels good to have a safety object, it can actually make panic disorder worse in the long run. Cognitive behavioral therapists work with people with panic on effectively addressing the roots of the fears. An element of CBT for panic is eliminating reliance on safety objects. Recently, the Wall Street Journal published an article about “panic pouches,” things that people bring with them to feel more comfortable and less anxious. The article highlighted a few people who spoke about the different items in the panic pouch, such as fidget toys, THC gummies, lavender oil, and anti-nausea medication. Although the article did not say that these panic pouches were meant solely to calm panic attacks, let’s discuss why these items can actually make panic disorder worse in the long run, even though they might help with a panic attack in the short term. What Is Panic Disorder? People who struggle with panic disorder tend to have recurring panic attacks, which are sudden rushes of intense anxiety that often reach their peak within minutes. They are characterized by intense physical sensations such as a rapid heartbeat, shortness of breath, and dizziness, and the person might feel like they are dying or losing their mind. People with panic disorder tend to have high levels of anxiety sensitivity—they are fearful of symptoms of anxiety. People with panic disorder also have panic attacks that seem to come out of the blue, and the panic attacks cause them some distress and interfere with their lives. Many people with panic disorder also have agoraphobia, where they avoid situations they associate with panic attacks. They might also fear doing things that trigger panic-like sensations, such as exercise or caffeine. Carrying safety objects with you, like these “panic pouch” items, is a common behavior in people with panic disorder. You might feel that having these items keeps you safe during a panic attack. Anti-anxiety medications and water are common safety items that I have seen when I have treated panic disorder. Some safety objects can be people, such as a trusted loved one who makes you feel safer. How to Heal From Panic Disorder Cognitive behavioral therapy (CBT) is often cited as the “gold standard” for treating panic disorder, and it is one of the most effective psychological treatments for a mental health diagnosis. CBT treatment is focused on helping you learn that you don’t need to be afraid of the attacks. If you can do that, the attacks usually decrease in intensity and frequency. Here are the typical components of CBT for panic: Cognitive restructuring: This treatment component involves teaching you that your anxious thoughts about your panic attacks are not realistic. Instead, you learn to have more balanced and usually less fearful thoughts about the panic. Interoceptive exposures: CBT also involves retraining the brain to learn that symptoms of anxiety are not dangerous. This aspect of the treatment is often accomplished through interoceptive exposures, in which you perform exercises designed to elicit panic symptoms. In a systematic way, you might practice spinning in a circle, running in place, or purposely hyperventilating. With practice, you learn that these sensations are not to be feared. In vivo exposures: If you are avoiding anything because of panic attack fears, the therapist will work with you on developing an exposure hierarchy, where you practice breaking down feared situations and confronting them. Reducing safety objects: If you are carrying safety objects to protect yourself or to soothe a panic attack, a cognitive behavioral therapist will work with you to eliminate them. The Reasoning Behind Ditching Safety Objects Why do we try to get rid of safety objects when treating panic disorder? If the purpose of therapy is to reduce fear associated with panic attacks, carrying objects “just in case” you have a panic attack may undermine the treatment. The goal is not to fear panic attacks and to know that if they occur, you can handle them. If you need to bring anti-anxiety medication with you (or some other safety object) wherever you go, then you are still in the grips of panic disorder. Think of it this way: someone who doesn’t have panic disorder doesn’t need to bring safety objects with them, just in case of having a panic attack. You ultimately want to become more like this person in this way. I will note that while people are practicing exposures to feared situations, one step in the hierarchy might involve going into a situation with a safety object or a safe person, and then another step up the hierarchy might involve going into that situation without the object. My Social Media Video Reaction I recently made a TikTok video about safety objects, and the reactions were mixed, with some strong negative comments. A couple of people mentioned that they have had panic attacks for decades and that they need to have these things that they can take with them so they can handle their panic attacks. Those comments proved my point: nobody should be suffering from panic disorder for decades when highly effective treatment exists! Unfortunately, access to treatment is often limited for some. Others have been in therapy for panic, but the therapist doesn’t really know how to adequately address the problem. One reason why I love writing for Psychology Today is that it helps increase access to solid, evidence-based information. I also wrote a book, Freedom From Panic: Evidence-Based Techniques to End Avoidance and Stop Panic Before It Stops You, in part to help improve access to information for people who wouldn’t otherwise get it. So, carrying your anti-anxiety meds, water bottle, and sour candies might make you feel armed against panic, but you might just be prolonging the underlying problem. Bonnie Zucker, Ph.D. - Blog, Book

Studies are uncovering the associations between hoarding disorder and suicide. Key points Hoarding disorder involves compulsive accumulation of new items, keeping old ones, and clutter. Those with hoarding disorder report suicidal thoughts and behaviours, and 13 percent have attempted suicide. Hoarding disorder associated with depression and suicidality may be linked to isolation and poor functioning. Approximately 2 to 6 percent of the general population meet criteria for hoarding disorder (HD), with similar rates found in men and women, across developed countries. Hoarding behaviours often emerge in adolescence or early adulthood and tend to worsen over time. This disorder is characterized by difficulty letting go of material possessions, excessive or compulsive accumulation of new items, and disorganization that leads to overwhelming clutter. The disorder is associated with greater social isolation, various medical problems, and significantly lower quality of life. Unfortunately, it is a chronic, progressive condition that can cause significant distress and lead to serious complications, including falls, eviction, self-neglect, malnutrition, food contamination, medication mismanagement, and even death. Hoarding disorder is often misunderstood and overlooked as common over-collecting. However, while collectors focus on acquiring specific items, organizing, and displaying them, individuals with the disorder tend to accumulate a wide variety of things in a disorganized manner, without any clear purpose or system. Hoarding disorder was officially recognized as a stand-alone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013. Before this, it was considered a subtype of obsessive-compulsive disorder, although, due to key differences such as the absence of intrusive, recurring thoughts, it is now classified as a related but distinct disorder. People with it often have varying levels of awareness about the reality of their condition. Most struggle to recognize the impact of their hoarding, even though it causes significant distress. This lack of insight contributes to many individuals not seeking treatment for their symptoms, which can lead to worse outcomes, including increased risk of suicide. A 2025 study conducted by researchers at Stanford University found that these individuals reported suicidal thoughts and behaviours at higher rates than the general U.S. population, with 13 percent of them having a history of suicide attempts, compared to around 0.7 percent of the general adult population. Comorbidity with other mental health conditions is also common, with about 50 percent meeting criteria for major depression. Dariana Gil-Hernandez, lead author, at Yale School of Medicine, explained that the high rates of suicidal thoughts and behaviours in individuals with hoarding disorder may be linked to shared factors like hopelessness, as well as the severity of the illness, its comorbidities, and poorer functioning. The study differentiates between passive and active suicidality to better assess the varying levels of risk. Gil-Hernandez emphasizes that this distinction is crucial because “passive ideation encompasses thoughts about wishing to be dead or not alive anymore, without thinking of wanting to end one’s life by suicide. While active ideation involves thoughts of suicide, with or without details about methods, intent, or a plan.” By making this distinction, researchers and practitioners can more accurately assess the severity of suicidal thoughts, identify individuals at higher risk, and provide more targeted and effective interventions. Hanna McCabe-Bennett, a specialist in treating anxiety disorders, as well as hoarding, explained that hoarding disorder is complex and requires sustained effort to make progress, often taking months or even years. Depression, which frequently co-occurs, can be a major barrier, affecting energy and motivation, creating a vicious cycle that leaves individuals feeling stuck and overwhelmed. McCabe-Bennett points out that hoarding is more common than many realize, and it can feel overwhelming and shameful to discuss. She also stresses the importance of clinicians recognizing the interplay between depression and the core behaviours associated with hoarding disorder, as this relationship is crucial in shaping treatment strategies. “Depression often exacerbates the difficulty these individuals have in discarding items, with feelings of hopelessness or lack of motivation making it even harder to address the clutter, which in turn interferes with the safety and functioning of their homes.” Understanding how depression intertwines with these behaviours is vital, as these factors directly inform the treatment approach. Cognitive-behavioural therapy (CBT) is considered the most evidence-supported intervention for this problem. The approach focuses on challenging unhelpful beliefs about the need to hold onto things, teaching strategies to cope with emotions like guilt, and providing techniques for discarding and organizing. Additionally, it addresses motivation barriers using reinforcement techniques. The goal is to help individuals build confidence in managing intense emotions while reducing the impact of hoarding on their lives. While CBT has proven effective in treating hoarding behaviours, a more tailored approach may be needed for individuals with both hoarding disorder and major depression. Karen Rowa, clinical director of the Anxiety Treatment and Research Clinic at St. Joseph's Healthcare in Hamilton, Canada, states that, “When the symptoms are severe and there are major risks, like the risk of eviction, fire, or homelessness, or when other comorbidities are involved, individuals in these dire situations may not be able to engage in traditional CBT. They need support that is personalized to their risks and circumstances.” Gil-Hernandez believes more research is necessary to understand the role of suicidality in those with hoarding disorder. This will improve the diagnosis and management of the disorder’s symptoms. While managing the condition can be challenging, recovery is possible with the right support and intervention. By recognizing the complexities of the disorder and tailoring treatment to individual needs, meaningful progress can be made. Robert T. Muller, Ph.D. - Blog, Book

Exploring the psychological costs of nutritionism. Key points Nutritionism reduces food to nutrients, overlooking the broader context of health. Social media and wellness marketing often fuel anxiety by promoting nutritional optimization. Rigid food rules can contribute to anxiety, obsessive-compulsive disorder (OCD), and eating disorders. Psychological flexibility around food is an important part of overall health. Most of us have heard the message that food is medicine. Research has consistently shown that eating patterns can influence health. But somewhere along the way, many of us stopped seeing food as something that nourishes, satisfies, connects us with others, and brings pleasure. Instead, food has increasingly become a collection of protein grams, fiber targets, antioxidants, and micronutrients to optimize. This way of thinking has a name: nutritionism. Coined by Australian sociologist Gyorgy Scrinis and later popularized by journalist Michael Pollan, nutritionism describes the tendency to reduce food to its individual nutrients while overlooking the complexity of how people actually eat and live. Health becomes something we believe we can achieve by optimizing nutrients rather than considering the whole picture. While nutrition science can absolutely inform our understanding of health, nutritionism often strips that science of context. The Illusion of Control Health is determined by much more than what appears on our plates. Sleep, stress, genetics, relationships, movement, financial resources, access to healthcare, and emotional health all influence how we feel and function. Yet nutrition marketing often suggests that if we simply eat the right foods, avoid the wrong ingredients, and optimize every meal, we can control our health and eliminate uncertainty. That message is appealing because certainty feels reassuring. The wellness industry often capitalizes on that anxiety. There is always another nutrient to optimize, another ingredient to fear, another supplement to buy, or another eating strategy promising better health. Social media only amplifies these messages. Nutrition myths frequently oversimplify complex biological processes or present rigid habits as universal truths. Algorithms reward certainty, not nuance. "Never eat after 7 p.m." or "This food causes inflammation" spreads much faster than "The answer depends." When Healthy Eating Starts Hurting Mental Health As a psychotherapist specializing in eating disorders, I rarely see people whose struggles begin with a desire to become unhealthy. More often than not, they begin by wanting to eat "better." Over time, those intentions can become increasingly rigid. Meals are carefully calculated. Food labels are scrutinized. Entire food groups are eliminated. Eating out becomes stressful. Social events are avoided because the food feels unpredictable. Thoughts about eating can consume hours of the day. For some people, these patterns become intertwined with anxiety, obsessive-compulsive disorder (OCD), or eating disorders. The problem is not nutrition knowledge itself. The problem is when nutrition becomes a source of fear, self-worth, or perceived control. Context Matters More Than the Food The same nutrition recommendation can have very different effects depending on the person receiving it. A recommendation that is neutral or even helpful for one person may reinforce fear, rigidity, or compulsive behaviors in someone struggling with an eating disorder, obsessive-compulsive disorder (OCD), or health anxiety. The context in which it is given matters. For example, someone might choose to eat a simple rather than a complex carbohydrate before a workout because it is digested more quickly and provides readily available energy. On its own, that is simply a nutrition choice. The picture changes when food choices are driven primarily by fear. If someone is terrified of weight gain, rigidly follows food rules, eliminates entire food groups, carefully tracks macronutrients and micronutrients, or feels compelled to optimize every eating decision, the nutritional rationale may be serving a psychological function rather than a nutritional one. Nutrition science can become a way to justify restriction, reduce anxiety, reinforce compulsive behaviors, or create a sense of certainty and control. There is a particular irony here. Someone may become intensely focused on optimizing nutrition to build muscle, improve athletic performance, or maximize health while simultaneously becoming so fearful of weight gain that eating becomes increasingly rigid and consuming. Hunger and satisfaction are ignored in favor of numbers. Meals are judged by whether they are "optimal" rather than whether they are nourishing or satisfying. Food becomes something to manage rather than something to enjoy. At that point, the pursuit of "optimal" nutrition has moved far away from health. Health Includes Psychological Flexibility Ironically, the relentless pursuit of perfect nutrition can undermine both mental and physical health. Chronic anxiety around food, social isolation, rigid restriction, and constant self-monitoring all carry consequences of their own. For most people, good health does not require micromanaging every macro- and micronutrient or eating with mathematical precision. Consistently following a varied and flexible pattern of eating is supported by far more evidence than striving for nutritional perfection. As a therapist, I often remind people that a healthy relationship with food includes flexibility. It leaves room for enjoyment, culture, connection, and trust in our bodies. Health isn't defined by how perfectly we eat. It's reflected in whether food supports our lives rather than consumes them. Carolyn Karoll, LCSW-C, CEDS-S - Blog

Your body, your environment, or your future could be the source of suffering. Key points Chronic illness is considered the number-one predictor of depression. The people and places that surround you can cause depression. If you expect bad things to come, you can become depressed. Suffering is hard enough to deal with, but not knowing why you’re suffering is even harder. Depression can feel like an unpredictable storm of hopelessness, but just like the weather, there are patterns that shape when and why your depression comes. There are three major categories of triggers that can cause you to feel depressed: your body, your environment, and your expectations of the future. It’s important to understand all three so that you can best prevent future depressive episodes. 1. Your Body According to the World Health Organization, chronic illness is the number-one risk factor for becoming depressed. This is because depression and being sick share an important trait: They cause your body to have an immune system response. Depressed people tend to have more inflammation, lower levels of iron, and a slightly higher body temperature than people who aren’t depressed. There are hundreds of research studies examining this mind-body connection (like this one), but the important part for you to know is that when something negatively impacts your body, it can negatively impact your mind. If your body is sick, chronically malnourished, or routinely sleep-deprived, then your chances of feeling depressed increase. Longer-term stressors like postpartum health issues or autoimmune disorders make depression even more likely. Your genetics play a large role in what chronic diseases you might inherit. They also significantly impact your depression, accounting for approximately 60 percent of the reason you may develop depression. The other 40 percent are part of the next two causes of depression. 2. Your Environment The second cause of depression is your environment. That can be your physical environment or your social environment. If you live next to a chemical waste plant, your chances of depression increase (see the previous paragraph). Being around a toxic place can impact you just as much as being around toxic people. If you’re surrounded by people who bully you, abuse you, or consistently make you feel ashamed, your chances of being depressed increase. This is true of one-on-one interactions, but it’s also true for more macro interactions. Being a minority and living in poverty are more likely to cause depression, too, due to the way people around you are treating you or because of the way you know society perceives you. Your body can’t always tell the difference between psychological and physical stressors, so negative interpersonal experiences also trigger an immune system response. You have felt this connection before. When you hear bad news about a friend and feel sick to your stomach. When your relationship ends, and you feel heartbroken. Or when you feel the lethargy that comes with grief. These are factors in your psychological environment that impact how you feel. The worse the situation, and the longer it continues, the more likely it is to cause depression. 3. The Future and Your Expectations The third cause of depression is your future and your expectations of your future. You could be completely healthy, live in a beautiful place, and have a life full of great relationships, but if you’re getting sentenced to 20 years in prison tomorrow, your chances of being depressed are high. It doesn’t even have to be that extreme. If the general trajectory of your life feels like it’s going downward, you can strip away joy from any moment and become depressed. If you get promoted but you’re worried you’ll get overwhelmed by your responsibilities and disappoint everyone, you can start to feel depressed. If you finally found a great partner, but you’re constantly nervous that they’ll stop liking you, cheat on you, leave you, or die, then this great relationship can inadvertently become a cause of your depression. These are somewhat easier predictions to manage—the assumption that your life might go from good to bad. It can be harder to stop your mind from worrying when your life goes from bad to worse. If you lose your job and get dumped in the same week, then it’s easy to see why you would become depressed. It might even seem logical to expect some other bad thing to happen. That’s how the expression goes: When it rains, it pours. But sometimes, it only rains an inch. It’s important to remember that your predictions are just guesses until the future happens. Your future should be innocent until proven guilty. Trying to protect yourself from being hurt by assuming something bad will happen might sound like a logical idea, but your attempts at predicting tomorrow may be causing your depression today. Fortunately, most things in life follow a pattern. When you learned about how water cycles through the world, with that classic school infographic, you grasped an extremely complex concept that you can now explain to a toddler if you wanted to. Now that you know the three major causes of depression, you can take the mystery away from how and when your depressive episodes occur and tell other people. Depression can no longer catch you by surprise, and you can start to figure out what causes depression for you and share that pattern. While all three causes can interact with each other, it will become easier to understand over time if your depression tends to happen after you get sick, after you interact with certain people or places, or after you spend a lot of time alone thinking about what might happen in your future. Simply live your life and then look back to see which cause matches your life best. Myron Nelson, LCPC - Blog

The emotional breaking point that changes how people define hope and loss. Key points Fertility treatment can shift over time, as does hope. The emotional weight starts to build quietly. Stopping is not giving up but recognizing your limits. I have to confess, the idea for this blog post was inspired by a song playing on the radio. I stopped to listen, as it happened to be one of my favorite bands, Fleetwood Mac. I know the song well, "Never Going Back Again." This is where I began. The Pattern Beneath the Words The line is simple: “Been down one time, been down two times / I’m never going back again.” On the surface, it is about the unraveling of the relationship between Lindsey Buckingham and Stevie Nicks. But beyond that, it speaks to a very specific kind of experience. One that is familiar and repetitive. One where we question why we are doing what we are doing, yet continue anyway, perhaps against the odds, even when part of us already knows what is coming. The Rhythm of Fertility Treatment If you have been through fertility treatment, you know this rhythm. You gather hope, allow yourself to imagine, and that propels you forward despite the uncertainty. Then something happens that you were not quite prepared for. The cycle fails. A loss happens. While devastating, you gather yourself back together. Your support system shores you up, and you keep going. At first, this repetition can feel like determination. But what happens when it is your third, fourth, or fifth try? The emotional repetition wears you down. When Your System Starts to Learn the Outcome There comes a point where you begin approaching things with a muted mix of hope and caution. Hesitation replaces the instinct to jump right in. Allowing yourself to go through this again comes with a cost you already understand. This is not pessimism. It is learning. When Hope Begins to Carry Risk Hope becomes a double-edged sword. It is no longer just something that supports you. It becomes something that exposes you in an anxiety-provoking way. It becomes mercurial. It can carry you into the clinic and collapse on the drive home. It shifts with every symptom, every scan, every stray comment from someone who means well. It can feel like a very bad co-dependent relationship with treatment. What do people even do at this point? Some people notice they begin pulling away from hope altogether. They stop letting themselves picture a due date, a name, or the moment of telling family. Imagining feels too risky, but they keep their fingers crossed. Others move between intense optimism and emotional shutdown. They are all in the week before a test, then emotionally close that door 'til the results are in. Others use distraction. The people around them are not always sure which version they are going to get. But all of these ways of trying to manage risk. The Question That Changes Everything At some point, a different question begins to emerge. Can I keep going? It slowly becomes: What will this cost me if I do? What shifts at this point can be difficult to recognize in the moment, but it is vital. It is the moment you step back into the picture. Not just the outcome. Not just the possibility of success. But the impact of the process on you as a person. The Moment of “Never Going Back Again” It happens because you are intimately familiar with loneliness, exhaustion, shame, disconnection, and the looping thoughts that return night after night. From within this shell-shocked state, something begins to emerge. You start to recognize something that was always there, but often pushed aside in the process: Your Self and your well-being that has been put on hold. For some, this moment arrives suddenly, as a final and unmistakable feeling. For others, it builds slowly over time. But when it comes, it is often clear. The emotional cost of continuing has become too high, and stopping brings an unexpected sense of relief. What surfaces is often a quiet recognition: I finally accept what this is doing to me, and I need to pay attention to that. This Is Not Failure “You don’t know what it means to win.” In the song, there is a line: “You don’t know what it means to win.” Its meaning becomes clearer over time, not as a statement about success, but rather as something earned through experience. It reflects the kind of understanding that comes from having been through something enough times to know what it costs you. And that is where it starts to matter. Reaching a point of stopping is not failure. It is not a lack of strength, commitment, or caring. It is the result of having been through something enough times to understand a new truth: you matter. And while there is one kind of strength in continuing treatment, there is a different kind of strength in recognizing when to stop. One does not invalidate the other. In a world where success is measured by outcomes, it can be difficult to accept that internal shifts, like recognizing your emotional limits, are also a form of success. But this is where the meaning of that lyric deepens. It is not about winning in the way we usually define it through external outcomes. It is about the kind of experience that changes how you define winning altogether. A definition that includes both your desires and the acceptance of finally including yourself in the cost of it all. What does that look like in practice? Often, it is small. Noticing the toll on your body and no longer waving it away. Naming what the two-week wait has done to your relationship. Allowing yourself to want something other than a baby, even briefly, without the guilt that usually rushes in. These are quiet acts of revolution and inclusion. They are how you stop being only the means and become part of what matters again. There are multiple valid truths, including the ones that do not result in babies. Fenella Das Gupta, Ph.D., MFT - Blog