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June 21 2018


Podcast: What Does It Mean to be Transgender?

Gender transitioning has always been a topic that makes many people uncomfortable. And ever since Bruce became Kaitlin, it’s been a frequent topic of conversation. Most of the discomfort comes from unfamiliarity, from presumptions, and (of course) from bigotry. In this episode, two transgender women explain what it means to be transgender, both generally and personally. They talk about their experiences going back more than twenty years. They discuss how transitioning, and the science of it, changed over the decades. And they offer their views on what they believe are the most important things for society to know about it.


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Transgender Show Highlights:

“If you take a look at the statistics for parental support for trans youth – with unsupportive parents, 57% of the individuals will attempt suicide; with supportive parents, 4%. Parental support is huge.” ~ Rev. Emma Chattin

[3:45]   What does it mean to be transgender?

[8:58]   How transitioning is different today vs. 20 years ago.

[14:08] The most difficult aspects of transitioning.

[15:27] How the science has advanced in 20 years.

[19:52] What society should know about being transgender.



About Our Guests

Rev. Emma Chattin currently serves as the Executive Director of the TransGender Education Association of Greater Washington DC, whose mission is to support individuals in transition and the communities into which they are transitioning.   She is a founding co-facilitator of several support and community building groups for the Trans community, including Parents of Trans-youth, Trans & Gender Non Binary Tweens & Teens, as well as Spouses of Those Who Identify as Trans.  Emma is also an ordained minister, currently serving as Pastor of the Metropolitan Community Church of Northern Virginia, a GLBTIQQ affirming community for all people- “No exceptions, No kidding.”  She was recently named one of six OUTstanding Virginians for 2018 by Equality Virginia.  In late 1996, she met Heather James, who has long worked in the technical field, including dish technology, fiber optics, web design, etc. Once it became legal in DC, the couple got married in 2010. As of 2018, they have been together over 21 years. They live in Northern Virginia.

About The Psych Central Show Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. In addition to hosting The Psych Central Show, Gabe is an associate editor for He also runs an online Facebook community, The Positive Depression/Bipolar Happy Place, and invites you to join. To work with Gabe, please visit his website,




Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. In addition to co-hosting The Psych Central Show, Vincent is the author of several award-winning novels and the creator of costumed hero Dynamistress. Visit his websites at and









June 20 2018


The Possible Connection Between Childhood Obesity and Low IQ

Obesity is a global health burden, a serious risk factor for development of metabolic disorders, cardiovascular diseases and many other conditions. But some researchers believe that in addition to affecting physical health, obesity can damage the brain and compromise intelligence.

Brain imaging studies have documented multiple structural and functional abnormalities in the brains of obese individuals, which are already evident in adolescence.

Moreover, research findings indicate that even obesity in childhood is associated with lower intelligence scores. But this is not all. According to some investigations, there is causality in the opposite direction, meaning that lower IQ at childhood results in increased prevalence of obesity in adulthood.

Scientific studies have investigated the association of IQ and obesity in large cohorts. For instance, a group of researchers analyzed data in a prospective, longitudinal study and investigated whether becoming obese is associated with a decline in intelligence from childhood to later life. More than one thousand children were included and tracked until their fourth decade of life. Anthropometric measurements (i.e., body weight and height) were carried out at birth and at 12 occasions later in life, at the ages of 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, 32, and 38. The intelligence quotient (IQ) scores were assessed at the ages of 7, 9, 11, and 38. As the results demonstrated, the participants who became obese had lower IQ scores at adulthood in comparison with the participants whose body mass index (BMI) remained within the normal range. However, the obese participants did not experience a severe decline in their IQ over lifetime, meaning that they had lower IQ scores even in childhood, in comparison with normal weight controls.

Another population-based study followed babies born in the same week of 1950 in the United Kingdom for more than half a century. More than 17 thousand babies were included and their intelligence was assessed at the ages of 7, 11 and 16, while the obesity level and BMI were evaluated at 51. The results indicated negative effects of childhood intelligence on adult BMI and obesity level. In addition, it turned out that more intelligent children had healthier dietary habits and were exercising more frequently as adults.

Considering the negative association between childhood obesity and intelligence, one review study questioned the direction of this causality. After careful examination of longitudinal population based studies, this review study suggested that the direction of causality goes from having low intelligence that results in weight gain and obesity. It also claimed that excess weight gain did not cause a decline in IQ. The study found no strong evidence that obesity impairs cognitive functions or leads to cognitive decline, while it established proof that poor intelligence in childhood leads to weight gain in adulthood.

Still, not all scientists agree with these conclusions. For instance, a group of researchers investigated the impact of obesity on cognitive functions in children with sleep-disordered breathing. They included three groups of children in the study: children with obstructive sleep apnea, children with obstructive sleep apnea and obesity, and children without any of these conditions (normal control). The aim was to assess the total, verbal, and performance IQ scores in these children. The total and performance IQ scores turned out to be significantly lower in the children with obstructive sleep apnea and obesity, in comparison with the other two groups. In addition, BMI negatively influenced the total IQ score in obese children (with obstructive sleep apnea). This study clearly demonstrated that obesity can lead to higher cognitive impairments.

Since childhood IQ and obesity are linked, others investigated whether maternal pre-pregnancy obesity can impact the child’s neurological development. More than 30 thousand women were included; their pre-pregnancy BMI was calculated and the children’s IQ scores were assessed at 7 years of age. The results indicated that women with a BMI of around 20 kg/m2 had children with the highest IQ scores. In contrast, maternal obesity (BMI 30 kg/m2) was associated with lower total and verbal IQ scores. More importantly, excessive weight gain during pregnancy accelerated this association.

All of these findings confirm that there is a link between childhood intelligence and body weight later in life. But what is the mechanism underling this phenomenon?

According to some studies, higher intelligence (IQ) in childhood predicts a better socio-economic status later in life (a higher educational level with a better income). In addition, higher educational attainment seems to reduce the risk of obesity, probably based on better dietary habits (more healthy food choices). This might partly explain how a lower IQ in childhood can lead to weight gain and obesity later in life. When it comes to the impact that excess weight gain has on intelligence, it seems that more research is needed to confirm this association and elucidate the underlying mechanisms. One of the possible explanations for this association is that hormones produced by fat cells may damage brain cells. Another possibility is that excess body weight may jeopardize cerebral blood vessels and, thus, impair brain functions.

Although the cause of obesity-lowered intelligence scores is not entirely clear, it is evident that the link exists. Since obesity is a rising global health concern, its negative effects should also be investigated in terms of its impact on cognitive functions and intelligence. This is especially important when we consider that even pre-pregnancy obesity leads to lower IQ in children.


Belsky, D.W., Caspi, A., Goldman-Mellor, S., Meier, M.H., Ramrakha, S., Poulton, R., Moffitt, T.E. (2013). Is obesity associated with a decline in intelligence quotient during the first half of the life course? American Journal of Epidemiology. 178(9): 1461-1468. doi: 10.1093/aje/kwt135

Kanazawa, S. (2013). Childhood intelligence and adult obesity. Obesity (Silver Spring). 21(3): 434-440. doi: 10.1002/oby.20018

Kanazawa, S. (2014) Intelligence and obesity: which way does the causal direction go? Current Opinion in Endocrinology, Diabetes and Obesity. 21(5): 339-344. doi: 10.1097/MED.0000000000000091

Vitelli, O., Tabarrini, A., Miano, S., Rabasco, J., Pietropaoli , N., Forlani, M., Parisi, P., Villa, M.P. (2015). Impact of obesity on cognitive outcome in children with sleep-disordered breathing. Sleep Med. 2015;16(5): 625-630. doi: 10.1016/j.sleep.2014.12.015

Huang, L., Yu, X., Keim, S., Li, L., Zhang, L., Zhang, J. (2014). Maternal prepregnancy obesity and child neurodevelopment in the Collaborative Perinatal Project. International Journal of Epidemiology. 2014;43(3): 7837-92. doi: 10.1093/ije/dyu030

Chandola, T., Deary, I.J., Blane, D., Batty, G.D. (2006). Childhood IQ in relation to obesity and weight gain in adult life: the National Child Development (1958) Study. International Journal of Obesity. 30(9): 1422-1432. DOI: 10.1038/sj.ijo.0803279

This guest article originally appeared on the award-winning health and science blog and brain-themed community, BrainBlogger: Is Childhood Obesity Linked to Lower IQ?

Omar Dewachi’s Ungovernable Life: Mandatory Medicine and Statecraft in Iraq by Anna Zogas

How to Use Yoga Therapy for Anxiety

Anxiety can stymie our lives in so many ways. Whether it’s a debilitating panic attack, constant worry or an all pervading fear, anxiety is often an unwanted companion that seemingly only wants the worst for us. However with the right help, guidance and support, there are a variety of techniques that can help. Of course it’s important to note that we’re all different, and what works for one person may not be as effective on another, but from personal experience, my own road to recovery led me, thankfully, to yoga therapy.

After years of struggling with depression and anxiety, I moved to to South East Asia and embarked on an intense meditative practice that lasted for three years, training as a yoga teacher and becoming deeply interested in mind-body therapies. During my own personal journey, I learned that one of the challenges that so many people living with anxiety face, is the often extreme physiological response to a threat; regardless of if that threat is real, or simply perceived.

We may rationally understand that there’s nothing inherently dangerous about a given situation, and that our panic and rolling fear is just our brain’s “flight or fight” response misfiring, telling us that we’re in imminent danger — but none of this knowledge makes the fear any less real. In the middle of a panic attack applying any kind of rationality is nearly impossible, and our fear response is incredibly powerful and hard to overcome without support.

While my own recovery led me to yoga therapy, it’s by no means a cure-all. It would be unrealistic to expect to feel constantly blissful all of the time, but both science and individuals have given credence to yoga’s efficacy as a method for reducing and managing anxiety, and with the right guidance, yoga therapy is a tool we can all use as part of a wider strategy to combat our anxiety. However as with most things in life, a little bit of research can go a long way, and there are some areas to consider before exploring yoga therapy further.

Choosing a Yoga Therapist

Yoga is, in and of itself, a therapeutic practice. However, if you suffer from anxiety you may benefit from the specialized advice and teaching that a yoga therapist can offer you. Yoga therapists are trained across a variety of disciplines, blending the wisdom of the Yogic and Buddhist traditions with detailed medical knowledge, neuroscience and psychology.

It’s this foundation and multidisciplinary approach that can be used to successfully apply the principles of yoga therapy to anxiety, but it’s also important you choose a yoga therapist that you feel comfortable with. Typically, a yoga therapist will discuss your unique circumstances with you, and it’s important that you feel an affinity with them. Compassion and empathy are two very important considerations, and as with talking therapy, you may even need to see a few yoga therapists before you find someone you feel is most able to help you.

In the initial discussion, don’t be afraid to assert your boundaries and explain the full extent of your anxiety. Many of us can feel like we need to put on a public face, even downplaying our symptoms to doctors and healthcare practitioners — but the point of yoga therapy is that it is designed around you. We’re all beautifully complex and unique, and being open and honest about your own challenges is often the first step towards a successful outcome.

Using Yoga Alongside Other Treatment

Complementary and alternative medicine is nothing new, and has been in practice in some parts of the world, such as China and India, for hundreds of years. As a complimentary form of treatment, yoga therapy does not have to be used in isolation — in fact, it works well in conjunction with a variety of other treatments. For example, medication and pharmaceuticals are valuable treatment paths in particular circumstances, and can be especially helpful in extreme situations.

In more recent times you may have also heard the term “Integrative medicine”, a term recently adopted by a number of government and educational organizations, intended to highlight the use of multiple therapy and treatment approaches in order to achieve the best outcomes for mind-body wellbeing. From a very simplistic perspective, this could be viewed as the combination of Eastern and Western medical practices, and both can, and arguably should, be used in tandem whenever necessary.

Who Is Yoga Therapy Suitable For?

Put simply, yoga therapy is suitable for everyone. Yoga therapy is therapeutic in nature, and importantly, designed uniquely for the individual in question. For example, with lower back pain, there are very specific yoga positions and postures for strengthening and supporting the back. Similarly, with post-traumatic stress disorder (PTSD), there are gentle, specialized ways of regulating the nervous system, and in autism spectrum disorders, specific yoga postures can be used to reduce heightened sensory arousal and promote emotional regulation.

For anyone suffering from anxiety, this is an important point. Yoga therapy is never about who’s the strongest or most flexible, but what’s best for you. If that involves sitting in a chair conducting simple yoga postures, then there’s absolutely nothing wrong with that. Everything should be conducted in a supportive and therapeutic environment where compassion and understanding become the core tenants.

Whatever your age, body shape or fitness level, you can apply yoga therapy to your own self-care routine, addressing mind, body and soul in order to help manage and treat the symptoms of anxiety. Recovery from anxiety isn’t an easy task, and we often experience setbacks, but incorporating yoga therapy into our daily lives can give us the tools we need to manage our anxiety — and maybe, one day, overcome it.


The Driving Force Behind Generosity and Selfishness

Generosity results from our feeling content and whole. It is the result of feeling full. Selfishness is the result of feeling empty.

Intuitively this makes sense. Feeling abundant and experiencing our life as abundant is the opposite of feeling a sense of lack and scarcity. When we feel that our “cup runneth over,” we feel more called to share the wealth, as it were. We no longer feel the insecurity that goes along with feeling a sense emptiness and deprivation.

I often hear entrepreneurs and individuals who are trying to take risks and follow their passion wonder, “How can I be generous and bighearted and still pay the bills?”

One answer: generosity.

Generosity is choosing to give. It is not simply saying “yes” when people ask for something. “Yes” is insufficient. To say “yes” is not to mean “yes.”

Do you find yourself saying “yes” to things but are unsure or conflicted about whether you truly mean it? You might be expressing agreement in your words, but not actually making the choice in your heart and in your body.

So why do people say “yes” without actually making the choice? In my experience, it’s frequently stems from the fear of what might happen if I were to say “no” instead. Imagining the loss of relationships, money, influence, success. And oftentimes it’s a lack of presence. I say “yes” without making the choice because I don’t stop to check with my inner Self to ensure it agrees (or even realizes what’s happening). These situations arise from a place of mindlessness as opposed to mindfulness.

The next time you say “yes” notice whether it leaves you feeling empty or panicked about “not enough.” These instances of “generosity” may actually lead to selfishness (and/or broken relationships, business models, etc.).

Try to replace your automatic yes with the discipline of proactively giving what you want to give, when you want to give it, and to whom you want to give it. Make your generosity a choice that comes from within you, rather than a reaction to the desires of others or your ego’s insecurities. The way in which you give becomes your duty, your dharma, your karma, and your destiny. Not your obligation.

Choosing to interact with the world in this way means that you will still give sometimes because someone asks, but you are truly choosing to give, as opposed to simply saying “yes.” This interaction is much more likely to come from a place of fullness. You are far more apt to deliver on your “yes” without resentment and feel even more full afterwards. In this way, generosity may become a virtuous cycle.

  • Think of a time when you said “yes” to something when you actually meant “no.” Were you aware that you were doing this at the time? Why did you choose to say “yes” — what was driving the “yes”?
  • Think of a time when you said “no” to something when you actually meant “yes.” Were you aware that you were doing this at the time you said “no”? Why did you choose to say “no” — what was driving that response?
  • Bring to mind someone you consider to be very generous. How would you characterize him or her? When he or she says “no”, does it change your view of them as generous?

June 19 2018


Are You Addicted to Your Phone?

Excessive cell phone use is a trend that is growing every day. We are consumed with life behind the screen. But why? Because often, in the digital world, flowers are blooming and the sun is always shining.

Many of us seek and gain validation from likes and comments on photos or ideas we post online, and naturally, we crave more of that every day. But when does this craving become obsessive and possibly an addiction? Many individuals form a smartphone addiction because they can’t live without the acceptance and information they have access to on their devices.

We should avoid getting trapped in the infatuation of what we receive from our phones. But it’s hard not to. It has become the norm to automatically check your phone if you’re in the elevator with a stranger or walking down the street on your way somewhere. We do this unintentionally because it’s become a habit for us. It almost feels weird not to check our phones every five minutes. We begin to feel lost, out of place, and even insecure at times.

So, how do you know if you have an addiction? Many people wonder this regularly.

There are many signs of smartphone addiction which can be but are not limited to:

  • Feeling extremely anxious if your phone battery dies or if you lose service;
  • Using your phone up until the minute you go to bed and checking it the minute you wake up;
  • Sleeping with your phone on your bed;
  • Reaching for your phone in times of anxiety or depression;
  • Mindlessly passing time by looking at your phone;

Engaging in these activities or experiencing any of these situations could be a possible indication of smartphone addiction. These factors can lead to a multitude of interpersonal and physical ailments, and it can be very hard to break the cycle of feeling dependent on your phone.

The Effects of Cell Phone Addiction

  • “Text Neck” – By consistently looking down, chronic smartphone users can start experiencing something known as text neck. This is usually used to describe neck pain and damage to the neck muscles from always lowering your neck to look downward.
  • Accidents – When you are consumed with what is on your phone, you become unaware of your surroundings. This can lead to accidents, especially car accidents, if you are looking at our phone while driving.
  • Obsessive compulsive disorder – In some cases, smartphone addiction can create OCD patterns or symptoms including: repeated habits (in extreme cases checking your phone over 800 times a day) and sleep disturbances.
  • Relationship issues – If you have to constantly ask your partner to put their phone away, or if you find that you’re out to dinner with friends and can’t seem to stop checking your phone, it can be detrimental to building genuine relationships.

Mental health is completely ignored when you rely on your phone constantly. Stress and anxiety come into play taking away from your happiness, which leads to an attempt to fix that feeling with more cell phone use — and the unhealthy cycle continues.

Let’s start building the conversation of breaking out of smartphone addiction. What can you do to overcome the stress and anxiety of feeling obsessed with your phone? There are so many ways to slowly incorporate habits of not relying on your phone in your everyday life. See below for ways that will help you overcome your addiction:

  1. Placing your phone far away from you. This ensures that temptation is far away. When it’s out of arm’s reach, it’s easier to avoid checking it for no reason.
  2. Remove sound notifications. The little “ding” sound is telling you “check me now”. When in reality, it shouldn’t be a demand. You can decide on your own time when to check a message or a notification.
  3. Putting a timer on your phone use. If you check your phone for one email and then it turns into checking all your social media and an hour goes by, you can monitor this by setting a timer. Set aside only 15 minutes so you don’t go through an hour of scrolling.
  4. Replace the habit. Breaking your addiction isn’t always beneficial. Sometimes, replacing it is the better answer. Pick up a new hobby of painting or a new exercise.

These are all helpful ways to overcome phone addiction. A few simple shifts can relieve stress and tension once you turn them into a habit and consistently follow through. Engage physically with the people you love and care about and put technology lower down on the list of priorities.

Addictions start when there’s a void in your life. So, start tackling these voids early, without the help of your phone. Talk to a friend or a therapist about your what’s missing from life, instead of burying your nose in your phone.


Schools Need to Protect Students Physically – And Mentally

Dealing with increased expectations, social pressures both in-person and online and astronomical education costs, all while simultaneously facing major life choices and changes has led to a dangerous epidemic of mental, emotional and behavioral health issues in America’s youth.

During college, a majority of students are living on their own for the first time, possibly in an entirely new state or area where they don’t know anyone. They spend nearly half of the time that they are awake on classwork, and the school day never really ends until breaks for holidays and in between semesters.

Struggling to keep up with the workload and these significant lifestyle adjustments has become the norm. While they may frequently be surrounded by a lot of people, many students often feel quietly isolated and lack meaningful connection with others.

Compounding the problem, the pressures to succeed and fit in make these feelings hard to express, and life becomes even more confusing and discouraging. This is causing record rates of anxiety and depression that greatly impact students’ quality of life.

As an adolescent or young adult goes through these challenges, parents may write off symptoms of mental disorders as “growing pains” or “going through a phase.” However, when developing mental health disorders are left untreated, they can result in dire consequences that impact the entire family in the long run.

According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death among young people between the ages of 10 to 24. In 2015, the suicide rate among teens reached a 40-year high. In addition, only 20 percent of children with diagnosable mental or behavioral disorders ever receive treatment, which leaves about 12 million who don’t.

Similar research amongst higher education students done by the Center for Collegiate Mental Health revealed that nearly 1 in 5 college students experience anxiety or depression. Others may turn to unhealthy coping mechanisms, leading to problems like drug abuse and addiction or eating disorders.

With mental health issues peaking at alarming rates for the younger generation, there needs to be a serious, concerted effort to curve this epidemic.

Unfortunately, the growing demand for mental health care on campuses is not being met with adequate services. With only about 13 percent of colleges offering full-time, in-house mental health services, students can often go weeks waiting for an initial consultation with a therapist.

Schools across the country are simply struggling to keep up. In Florida, only 10 out of the 12 state schools meet the recommendation of at least one therapist per 1,000 students. That is already an absurd and unsustainable ratio, and we’re failing to meet even that. But Florida’s situation is not an anomaly, it’s the norm and indicative of the widespread lack of access that is keeping students from quality mental health services across the country.

At the same time, corporate America is progressively recognizing the importance of mental wellness in the adult workforce and increasing mental health services, expanding employees’ insurance options to include therapy, and incorporating mental health into their core values.

Colleges and universities should take note and follow suit. This growing emphasis on the value of mental health care should not be looked at as a trend — it is and should be seen as a necessity.

As young people and parents begin to recognize the need for and demand these services, universities must offer them in order to keep up and remain competitive. New reports indicate that students are now taking into consideration what mental health service options will be available when choosing a college to attend. In fact, about 28 percent of parents of teenagers are also thinking more about mental health services on campus, when researching schools for their child. For teens who see a therapist in high school, the transition to college can be particularly difficult because it often means losing access to their therapist, in addition to the emotional support of family and friends.

However, there is a devastating shortage of mental health care providers across the country. With the demand for therapy and the number therapists being incompatible, we must turn to alternative options to ensure that everyone gets the help they need.

Relatively new to the scene, telemedicine provides a more flexible and often better solution that can assist students through challenging times. Instead of waiting weeks just to meet a therapist, remote therapy provided through modern technology can provide immediate, yet equally impactful mental health care. Many universities already use mobile apps to allow students to check their grades, contact professors and even see what’s on the menu in the cafeteria. Why not incorporate something as important as mental health services, as well?

Telemedicine also provides a unique means for continuity of care. For the small percentage of students who are able to receive therapy on-site at school, they unfortunately lose access to these local therapists once they leave campus for summer break or to study abroad. But with apps that provide universal, mobile mental health services, students can still reach their therapists anywhere across the country or even the world.

With adolescent suicide and mental illness rates skyrocketing, schools simply cannot afford to wait to address critical mental health needs. To ensure the future of the next generation, we must provide learning environments that are safe for students not only physically, but mentally as well.


Best of Our Blogs: June 19, 2018

In being well (even when you’re sick), author Elana Rosenbaum says freedom and peace from illness can come with acceptance. How do we let go of the “if onlys” of our mind. For example, “If only I wasn’t sick.” “If only I wasn’t overweight.” “If only I found the right one.”

If we can surrender to what is instead of fighting it, we can gain back control in our lives.

As you read our top posts this week, many of which deal with narcissists, control and fathers, see if you can flex your acceptance muscle. What or who in your life are you struggling with accepting?

Surrender and acceptance is not about allowing the narcissistic person in your life to continue to manipulate you. It’s about having the ability to see things as they truly are so you can make healthy changes in your life.

Ask Your Dad These 5 Questions On Fathers Day
(Childhood Emotional Neglect) – This explains your dad’s inability to talk about his feelings. Here’s how to open the door to greater connection now.

Statements Frequently Made by Abusers, Narcissists, or other such Psychopaths
(The Recovery Expert) – If this sounds familiar, you have a toxic person in your life. Here’s what you need to do about it.

Shame Based Parenting: A Narcissist’s Specialty
(The Exhausted Woman) – You were shamed as a child, but you won’t understand the extent of it until you read this.

Abolish Father’s Day? Is Misandry (man hating) Killing Our Men?
(Full Heart, Empty Arms) – Is society’s secret hatred toward men literally killing them?

The 10 Most Toxic Forms of Control in Relationships
(Love Matters) – Unsure if you’re in an unhealthy relationship? If your partner is exhibiting these harmful behaviors, it may be a sign you need to leave.

June 18 2018


10 Questions to Take Your Relationship to a Deeper Level

They might be uncomfortable. But that’s good.

Let’s face it: we all love taking shortcuts. And if we aren’t careful, our relationships are often taken for granted. But too many shortcuts can lead to a lazy, unintentional relationship that merely exists, instead of thrives.

If you want to shed years of emotional baggage, feel loved and cared for, and become your partner’s ultimate partner, then you probably want to keep reading, because with a list of deep questions to ask your boyfriend, you can overcome your intimacy issues.

Maybe you’ve been dating or married for several years. Or maybe you’re just a fan of soul-shaking depth that heals you to the core. Whatever your reason, you find yourself craving the ability to go deeper with your intimate partner.

5 Things That Ruin Physical Intimacy with Your Partner (And How to Overcome Them)

In the day to day of our relationships, a lot of stuff can get swept under the rug. Combine that with the fact that a lot of partners don’t really get to know each other on a deep level at the beginning of their relationships (or at any point) and you could be highly prone to emotionally stepping on your partner’s toes without knowing it.

I recommend asking some of the following questions once every few months, and others on a weekly basis.

For best results, clear all distractions from your environment. Turn off your phones, close the laptops, and switch off the TV. Make sure the kids are asleep and the dog is taken care of. Clear out any and all extraneous things that could potentially ping their way into the space that you are creating and handle them ahead of time.

It’s unbelievable how much even a 30-minute, distraction-free, emotional block-busting session once per week conducted from the comfort of your bed can do for your entire relationship. Don’t believe me? Give it ONE try and see what comes of it. If you don’t like it you never have to do it again. But this exercise could be the exact thing you need to take your relationship from surviving to thriving.

Here are ten questions to ask your boyfriend so both of you can go deep in your intimate relationship.

1. Is there anything I can do for you in this moment to help you feel more comfortable or loved?

Assuming that you are kicking things off right by lying down together in a distraction-free room, it’s always good to ask if your partner needs anything before you start leaning into the heavier stuff. Just like symphony orchestra members tune to each other before they play a concert, you and your partner might need to touch base before you get into the good stuff.

Maybe they want to lie in silence for a minute and breathe deeply. Maybe they want you to hug them and show your love with your eye contact first. Or maybe they need to quickly go and make sure that their cell phone is completely switched off. Whatever they need to settle in, let them settle. It will be worth it.

2. How can I better support you in your life?

Ahhh, the all-encompassing dream/mission/passion supporter. Sometimes this question will spark something for your partner, and sometimes it won’t and that’s OK.

Maybe it will come out as something as simple as “Could you please kiss me in the mornings before you get out of bed… even if you haven’t brushed your teeth? It really affects my day for the better if you kiss me before getting up and getting dressed.” Or it could be something as large as “I’m about to take on a really huge project at work and I really don’t know how much mental bandwidth I’ll have by the time that I get home. Would you mind making dinner for the next week and I promise I’ll make it up to you after this particular work sprint dies down?”

Whatever favor they ask of you, you aren’t contractually obligated to comply. But simply by asking the question and letting them voice their honest thoughts, you will be engaging in the dance of intentional intimacy.

3. Is there anything I have done in the past week that may have unknowingly hurt you?

Alright, brace yourself…this is where we start to head into the emotionally uprooting territory of this exercise. While I don’t believe that you need to shine a light on absolutely everything in the dark subconscious of your mind in order to have a healthy relationship, it is good to uproot the major things that get swept under the rug.

Whether it was something that you thought was insignificant or an argument that you had that you thought was thoroughly squashed, your partner’s answer to this question might surprise you.

Receive it lovingly, with patience, and let them tell their entire side of the story without interrupting. Truly listen to them. Recognize that, even if you didn’t mean to hurt them in the slightest, it takes real vulnerability and courage for your partner to voice frustration/resentment/discomfort with something that occurred between the two of you.

Sincerely thank them for sharing their thoughts with you (it’s not an easy thing to do for most people), and follow up by apologizing for the incident, or asking what you can do or say to help them feel more complete about the event.

4. When you come home from work, what can I do or say that will make you feel the most loved?

Depending on what kind of job your partner has and how they are as an individual, they might want something entirely different than what you expect as their preferred method of being greeted.

They might want to have as little communication as possible for the first few minutes as they settle into their new environment. Or perhaps diving right into physical affection is more their way of relating. Whatever they need, all it takes is one simple question in order for you to better understand your partner and to go deeper in your relationship.

5. Is there any kind of physical touch that I can engage in more that helps you to feel loved?

This question refers to non-sexual touch. Is there any kind of physical intimacy that they feel is lacking? Do they want to hold hands more? Do they love it when you play with their hair? Do they adore when you come up behind them and wrap your arms around them?

Ask, get clear on what would make them feel more loved, and then incorporate that kind of touch into your daily schedule to the best of your ability.

6. Do you think you will need more closeness or more alone time over the next couple of days?

Our individual needs for independence and intimacy vary greatly from day to day. Maybe your partner has been having an emotionally charged week and they need an extra large dose of words of affirmation, physical intimacy, and compliments. Or maybe they are charging full steam ahead in their career and they need a bit more space as they grab their life’s steering wheel for a little while.

A greater need for independence and alone time doesn’t mean that they love you any less, nor does a greater need for intimacy mean that they are needy. People simply have emotional needs that fluctuate depending on a huge variety of elements in their ever-changing lives. And the more you can accommodate your partner, while still being conscious of your own mental and emotional needs, the better.

People in the Strongest Relationships Share These 5 Types of Intimacy

7. Is there any argument that we had this past week that you feel incomplete about?

Similar to the third question in that this one directly brings up potential wounds from the previous week. By asking this in a different context, your partner gets to consider whether they thought your arguments felt complete.

You might have a gut-level resistance to asking this one (“But if I ask this, won’t they remember that they were mad and then get mad at me again!?”), but working through this uncomfortable moment together will make it so that the unspoken, underlying tension is allowed to dissipate.

Have you ever heard the expression “Saying no hurts for a moment, but saying yes hurts for months”? It basically says that when we are assertive and direct with our desires, it can be uncomfortable. But if we don’t, the trade off would be the low-lying anxiety that we feel by not being true to ourselves.

This question works much in the same way. It’s so easy to ignore the difficult moments from the past week. What takes courage and strength is intentionally working through it so that the dirt between you isn’t given the chance to grow into resentment. So be proactive… your relationship will thank you.

8. How do you feel about our sex life lately?

One of the main differences between your intimate partner and every other relationship in your life is that you (hopefully) have sex with your partner. And yet, along with money, what is ranked as the most common topic that couples cite as the most stressful thing that they don’t discuss that break them up? You guessed it: sex.

Ask your partner about their level of satisfaction with your recent sex life. Ask them if there’s anything they would like more of, less of, or even different sex acts than you’ve been having. This question will be easier to answer the longer you’ve been in the relationship, so have some patience if you’re a new item.

9. What are the main stressors currently in your life, and is there any way I can alleviate that stress for you, if only a small amount?

An open-ended question that gets people to dig deep and show their soft underbelly. This question is the easiest way to get a window into your partner’s mind by directly asking them what they’re currently struggling with.

As with any of the questions mentioned, feel free to calibrate the wording to how you naturally speak. Anything that gets across the subtext of “How can I lighten your load?” is a surefire way to increase the feelings of depth and connectedness in your relationship.

10. When do you find speaking difficult and how can I best support you through those moments?

This one is one of the questions that you can ask every few months or so, and boy is it powerful. Everyone has different emotional triggers that make them feel vulnerable in a variety of different situations.

Maybe your partner feels easily attacked when you do something that they interpret as criticizing them publicly. Maybe your partner tends to shut down when you argue about certain emotionally charged topics like sex, finances, or the in-laws. Or maybe something could happen in the bedroom that makes them feel inadequate or embarrassed.

Whatever the reason may be, there’s always a way around it that could make your partner feel a lot more cared for and loved.

I’m not suggesting that you become co-dependently obsessed with solving all of your partner’s troubles around the clock. And nor does every topic need to be talked to death. Some of these questions will speak to you more than others and that’s just fine. This exercise is merely meant to start the conversation that very few couples ever have with each other.

A lot of things tend to get swept under the rug in intimate relationships. The questions outlined above are simply a tool that you can use to lift up the rug, sweep out the accumulated muck, and get on your with awesome lives as a happily connected couple.

This guest article originally appeared on If You Want To Go Deeper In Your Relationship, Ask Him These 10 Qs.


Exercise and Brain Health in the Aging Population

Studies have shown that exercise is good for us in so many ways. It keeps our bodies and our minds healthy and has even been shown to have a positive effect on our immune systems.

But just how much, and what type, of exercise will keep cognitive decline at bay in older adults?

study published on May 30, 2018, in the journal Neurology: Clinical Practice gives us some insight and answers beyond “exercise is good for your brain.” Joyce Gomes-Osman, a clinical neuroscientist at the University of Miami Miller School of Medicine and the lead author of the study, concluded that all types of exercise — aerobic, resistance (strength) training, mind-body exercises, or a combination of all three – have cognitive benefits for older adults. Walking, running, swimming, weight training, yoga and tai chi are all good ways to keep your brain young.

What’s particularly interesting about this study is it showed that what’s more important than the type of exercise you do is the amount of time spent doing it. Dr. Gomes-Osman reported that exercising for an average of 52 hours over a six-month period was linked to specific cognitive improvements in adults both with and without cognitive impairment. This exercise can be broken up into an hour here or there, but there is no set formula, as long as you reach that 52-hour goal.

Another interesting aspect of the study, which included the examination of previous studies on exercise and cognition as well, is that participant’s cognitive gains were found in specific areas of thinking that included planning and initiation of tasks, as well as processing speed and executive function (the ability to focus and manage tasks). Memory improvement was not as clear-cut, as it was only seen in around half of those analyzed.

So much about medicine is precise. We take specific doses of medications at particular times of the day, for a given amount of time. We have an exact number of physical therapy sessions, chemo treatments, and countless other medical interventions. But exercise recommendations for optimal brain health have always been vague. This is especially unfortunate as there are currently no medications available specifically for age-related cognitive decline. Exercise is all we have.

Instead of primary care doctors telling their older patients that they should exercise to keep their brains sharp, they can now “prescribe” something more specific, and possibly even work with their patients to develop an exercise plan. I think there is a greater possibility of success if someone is told exactly how much he or she needs to move in order to notice a difference in cognitive ability as opposed to just being told to exercise.

The results of this research are promising, and we are likely to see more studies on exercise and brain health, given the fact that our older population continues to grow. Perhaps one of the most important things to take away from this study is that older adults should find some type of exercise they enjoy and make it part of their every-day life. Just keep moving — and the physical and mental benefits will follow.


Ep 14: A Bipolar, a Schizophrenic, and Their Mothers

Our mothers are incredibly naive when it comes to what it’s like to live with bipolar and schizophrenia — or are they? In this episode, Gabe interviewed Susan Hammer and Michelle interviewed Susan Howard about their child’s illness.

Each mother was asked the same five questions and given the opportunity to answer in their own words. Then our hosts came together and quizzed each other about how they thought their mothers replied.

Is Michelle’s mother the detached woman Michelle fears? Is Gabe’s mother as clueless and he often says she is? Find out all this and more when our mothers are put on the hot seat!

Subscribe to Our Show: The Psych Central Show Podcast iTunes Google Play The Psych Central Show And Please Share & Review!


“Michelle, are you telling me your mom knows your diagnosis, and you don’t?”
– Gabe Howard


Highlights From ‘We Called Each others Moms’ Episode

[1:50] Question #1: At what age did you suspect Michelle/Gabe was mentally ill?

[5:30] Question #2: When you learned that Michelle/Gabe was sick, what did you first think?

[9:50] Question #3: What is your definition of recovery from schizophrenia/bipolar and does Michelle/Gabe meet your definition?

[13:25] Question #4: In your own words, what is your understanding of Michelle’s/Gabe’s schizophrenia/bipolar?

[18:30] Question #5: When considering all of Michelle’s/Gabe’s accomplishments, as they pertains to mental health advocacy, which one are you the proudest of and why?

[22:30] Gabe and Michelle talk about their moms and their answers to the questions.

A bipolar, A schizophrenic, and a Podcast

Meet The Hosts of #BSPodcast

GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit


MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC.


June 17 2018


Can’t Find Your Passion? Ask Yourself These Questions

Like many Millennials, I was told I could become whatever I wanted to be when I grew up. Before the age of ten I cycled through dreams of acting, singing, and becoming a veterinary pharmacist (true story).

Trying to find my passion was a near-obsession that followed me into adulthood. Ironically, all along I ignored what was naturally good at, including my knack for empathy, my love for writing, and an incurable curiosity about human behavior.

They say hindsight is 20/20, so today I clearly see how these strengths shaped my career. But for a long time, I searched for my passion as if it was a lost treasure chest that I simply needed a map to find.

Why Finding Your Passion Is a Myth

Despite what we’re told, passion is something that unfolds over time. It’s discovered through life experiences. Your “dream job” isn’t an exact destination, either. It’s constantly evolving. The ideal career when you’re in your early 30s may eventually become a poor fit, even by the time you turn 40.

So what do you do if you have no idea what your passion or life calling is?

First, don’t panic. Finding your purpose doesn’t happen overnight. It’s a messy, iterative undertaking that takes time, patience, and a healthy dose of self-reflection. You’ll get there, but you have to start by taking small steps.

That starts by asking yourself some key questions about how your past experiences, struggles, and triumphs have shaped you.

Powerful Questions to Uncover Your Purpose

For each of the prompts below, write for a minimum of five minutes. Don’t censor yourself. Write freely. Jot down whatever comes to mind, no matter how silly it seems.

  • Name the top 3 peak experiences in your life. What do they have in
    common? What does this tell you about yourself?
  • If money weren’t a problem, what would you spend your every day doing?
  • What dreams have you given up on? Why? Did fear play a role? Did your values change? How can you rekindle forgotten interests?
  • What is the hardest thing you have ever had to overcome? How did this influence you?
  • What activity are you doing when it feels like time flies by?

These powerful questions can help you strip away limiting beliefs to find your true calling — work you find deeply meaningful. That doesn’t mean it’ll be easy, but it will be rewarding.

At the end of the day, introspection isn’t enough. You have to take consistent action to make your dreams a reality. But when you take the time to look inward, you may be surprised by what you find. Your passion might have been waiting there all along, just waiting for you to light the spark.


When You Feel Defective and Deficient for Struggling with Anxiety

You’re struggling with anxiety. Maybe you had your first panic attack when you were in high school while taking a final. Maybe you had a panic attack in college while driving or grocery shopping. Maybe since then you’ve been having panic attacks regularly.

Maybe it’s not panic attacks at all. Instead you’re constantly on edge. If they gave out medals for worrying, you’d no doubt take first place. Everything makes you anxious and uncomfortable. And it’s absolutely exhausting.

Whatever the specific circumstances surrounding your anxiety and how it manifests, you feel like a complete and utter loser. You feel like there’s absolutely something wrong with you. There must be.

Many of Kira Hoffman’s clients assume their coworkers and friends don’t struggle with anxiety (or feelings of inadequacy). They also believe they should be able “to get over” or “push through” their anxiety. They believe they should be able to work harder and to cope better. Which is precisely what they think others do—and do with very little effort, said Hoffman, Psy.D, a licensed psychologist who provides psychotherapy services for young professionals in San Francisco.

Lisa Richberg’s clients who have high anxiety, especially panic attacks, tell her that they feel embarrassed and ashamed. They also worry that they’ll be “found out as a fraud,” or seen as “out of control,” said Richberg, who specializes in co-morbid eating disorders and addictions, anxiety and depression in Miami. They yearn to be “normal,” to be like people who don’t sit with anxiety every single day.

But here’s the truth: You’re not alone.

For starters, “anxiety disorders are more common than any other mental health issues,” said Richberg. According to the Anxiety and Depression Association of America, anxiety disorders affect 40 million adults in the U.S., or 18.1 percent of the population every year.

Also, anxiety in general (and feelings of deficiency) is part of the shared human experience, Hoffman said. “To suffer is to be human,” so, again, you are not alone—just like you’re not alone in your grief or sadness (or excitement or joy).

Knowing you’re not alone is important. But it can be hard to dissipate our thoughts of deficiency. Sometimes, it seems like they’re simply part of who we are. I am anxious, and I am inadequate.  

But you can slowly chip away at your negative, hurtful self-perception, and adopt a more compassionate perspective. Below, Hoffman and Richberg share some tips on how.

Share your heart with someone. Tell someone you trust that you’re struggling with anxiety. When Hoffman’s clients have had these discussions with loved ones they’ve reported feeling heard, understood and validated. You might even find out that the other person is struggling or has struggled, too.

However, it’s OK if you’re not ready yet to share. If that’s the case, Hoffman suggested seeing a therapist that you feel is a good fit. In fact, seeing a therapist for your anxiety can be tremendously helpful. As Richberg noted, “Anxiety issues are highly treatable.” 

Turn to caring phrases. For many of us speaking to ourselves with kindness feels foreign and false. But you can create a phrase that feels “as authentic, genuine, and true to yourself as possible,” Hoffman said. For instance, you might use: “Everyone feels anxious sometimes,” or “It’s OK, you’re just having a really hard time today.”

You also can create a phrase based on your responses to these questions from Hoffman: “What am I feeling in this moment? What isn’t helpful? What do I need?” You might come up with: “I can be gentle with myself, and provide myself with the comfort I need right now…I think I’ll take a walk to get some fresh air.”

Address your inner critic. Even though it feels like the opposite, our inner critics actually have good intentions. They yearn to protect us and keep us safe. The problem is that they run on fear, and lash out.

Sometimes, it can help to talk directly to your inner critic. For instance, Hoffman suggested saying something like: “I know you are trying to be helpful by motivating me to do better next time, but you are really just hurting me.” 

Recognize when your anxiety is talking. “Most of the time, the negative messages we tell ourselves are totally bogus,” Richberg said. That is, our critical thoughts are actually creations of our anxiety.

In order to tell whether a thought is simply your anxiety is talking, Richberg suggested jotting down the negative messages as they arise, and reflecting on these questions:

  • Are you catastrophizing? That is, are you creating a catastrophe out of a current or future situation?
  • Are you stuck in all-or-nothing, black-and-white thinking?
  • What are the reasons for and against these thoughts?
  • Would others you know and respect agree with these thoughts?
  • Are there alternate ways of viewing yourself? What are they?
  • What would these more helpful views and thoughts look like? 

Tune into your tension. “Our experiences of anxiety and self-criticism almost always involve a somatic component,” Hoffman said. For instance, you might feel tightness in your chest or a pit in your stomach.

She suggested closing your eyes; identifying the location of your tension; visualizing “softening the sharp edges around the physical pain or discomfort”; and giving yourself a gentle caress at that spot, while saying the phrase you picked (from above).

Struggling with anxiety is hard enough. Then when we add our feelings of inadequacy, deficiency and shame, getting through the day may feel downright impossible. Again, know that you’re not alone in these feelings. You’re one of millions. Many millions.

And remember that anxiety is treatable. Every day doesn’t have to feel like a mountain you must scale. Every day doesn’t have to feel like a hurdle. So if you’re not working with a therapist who specializes in anxiety, consider it.

Maybe you think this only confirms how weak you really are; it only confirms how much of a mess you really are. But it’s actually one of the bravest things you can do.


How to Be a SuperDad

Fathering a child is easy. A night of passion and you’re done. But being a real dad, a hero to your kids and a “manly man” to yourself, requires stepping up. Being around isn’t enough. Showing up for an occasional event isn’t enough. Weekend visitations can be enough, but only if you are interested and hands-on. Even love is not enough, if it isn’t expressed and shown regularly.

To be a dad, a real dad, not just a sire, requires effort — day-in and day-out effort. It requires doing the ordinary requirements of childcare consistently, predictably, and with a positive attitude.

Parenting well is certainly rewarding, but it isn’t always easy. Sometimes it seems to require “super” human effort. Any parent (mom or dad) who does it deserves to be seen as “Super” but not everyone knows how.

Since Father’s Day is coming up, this article focuses on what it takes to be a “Super” dad.  I hope it is validating for those who are already flying high on being a dad and helpful, even inspiring, to those who are trying to figure it out.

Why be a Superdad? Because being a Superdad is great for the dad as well as the children. Active fathering builds a man’s self-esteem. It often gives life new meaning and motivates men to be the best they can be. It can even balance out dissatisfaction on the job. One Gallup poll showed that 59% of the men interviewed found more satisfaction in caring for their family than from success at work.

Further, fathers who partner with their kids’ mother in the regular care of their children have more successful marriages. If divorced or never married, they have a more cooperative and friendly relationship with their ex — which makes parenting when separated less stressful. Most importantly, Superdads have a lifetime positive relationship with their children.

How to Earn That Superdad Cape:

Every father can be a Superdad for his kids but you have to earn the cape. It doesn’t show up on the front porch when a child is born. It doesn’t come with a big income. It doesn’t come with good intentions. If you want a cape, you need to be an active, involved father throughout a kid’s lifetime. Earning it is not impossible. The skills of Superdaddying take commitment and practice.

Be hands-on for the great parts of daddying:  That means rocking an infant, playing on the floor with young kids, and doing daily (yes, daily) fun stuff. Research has shown repeatedly that rough-housing with dad teaches kids to deal with challenges, to take reasonable risks, to have confidence in their bodies and to be more socially capable. Why? Because while moms tend to focus on safety first, dads tend to be more willing to tumble and generally be more physical in their interactions. Kids need both kinds of parenting.

Be hands-on for the not-so-pleasant parts:  That means changing poopy diapers, wiping noses, staying up with kids who are sick, and cleaning up their messes. Kids whose dads are unfazed by the basic but not entirely pleasant activities of nurturing are perceived by their kids as more caring and more connected with them. So — Hum a tune while you change their diapers. Comfort them when they are sick. Make picking up their toys as much fun as playing with them.

Be reliable:   Superdads can be counted on to do what they say they will do when they say they will do it. They only make promises they can keep. If circumstances make it impossible to follow through on a commitment, they let the kids know as soon as they can. Reliability helps a child feel safe and secure.

Show up:  Superdads don’t just drop in from the sky now and then. They get home for dinner. They supervise homework, play with their kids evenings and weekends, and go regularly to practice, games, and performances. They go to teacher conferences and doctor appointment. Superdads know that showing up shows kids their love.

Talk to your kids:   Talk to them, not at them. Some studies show that kids learn different words and different styles of communication from dads than from moms. When they are talked to by both parents, the kids expand their vocabulary and develop their verbal skills. Yes, you can talk to an infant. They babble, you tell them your news. As they get older, you can talk about their day, discuss the story you read at bedtime, and explain the steps of whatever you are doing.

Earn their respect, not their fear: Superdads know that discipline is about teaching, not about punishment. Studies confirm that spanking, yelling, and threatening only teach a child to fear adults and to go underground when they make mistakes. Instead, Superdads set up clear expectations — and clear consequences — for behavior. When your child does something wrong, talk about what they should have done differently, and try to involve them in what should happen next. Yes, a consequence may be necessary, but consequences that are fair and understood are more likely to teach the lesson.

Be a dad, not a babysitter: One of the most destructive ideas in American culture is that an involved dad is doing their kids’ mom a favor or is “baby sitting”. You’re not. You are doing one of the most important jobs a person can do. You are raising a child to be a competent, educated, moral, socially adept adult. To be a Superdad is to embrace your parenting role.

Model compassion and competence: Children really do learn most from what they live. Children whose fathers couple competence with kindness grow up to be competent, compassionate men. They are more likely to be successful in their careers and in their relationships. Best of all, they are more likely to become Superdads themselves.

Soon it will be another Father’s Day. What better day to make or renew your commitment to be a Superdad? Earn that cape and tie it on. Others may not be able to see it but you and your kids will certainly know it is there!

June 16 2018


Trigger-Induced Depression

7 Ways to Manage Clinical DepressionThe last three to four weeks for me have been extremely hard. I found myself in the grips of a deep depression. I am fortunate enough to no longer suffer from the deep devastating suicidal depression that once came with my bipolar depression, I am blessed in that way. However, nonetheless it is still a devastatingly life-halting depression that really makes life difficult to tolerate for a few weeks and difficult to carry on with my daily activities.

My normal, everyday personality is more along the lines of a bubbly, happy person, and I tend to have a larger than life, over-the-top personality. These last few weeks though I couldn’t find a way to enjoy even going out with my friends let alone smiling when we were out. It got to the point while we were out where they would ask many times over, “Tosha are you having a good time?” I would assure them I was, and honestly, I was trying to have a good time, however it was difficult to enjoy myself because the depression was so thick.

Think of depression as a black thick tar, that is what it feels like you are trying to live your life going through. Each day you are struggling to survive by crawling along barely making it, because this thick black tar is holding you back as you are trying to move forward. Every time you move it almost feels as if it is drying up around you and it is getting harder to move all the time. People who have never experienced a true bipolar depression think that it is just feeling sad when we say we have depression but it is so much more than just feeling sad. It is a complete total fatigue of energy because it takes completely every ounce of what we have to just get out of bed some days. Which is why many days we just won’t even do that.

I have anemia from having weight loss surgery, when my iron is low is when I will feel the most depressed. I figured this time my iron was low, but I had a doctor appointment this past Friday, and when I went in and saw the doctor my levels were perfect, better than perfect. This time my depression was all mood related and nothing is physically wrong with me. Which meant that I needed to make sure I was following my care plan to a T to make sure I was not letting any outside triggers influence my mood at all. The very next day I began.

As I started to dissect my care plan to figure out what I was doing wrong. I thought what had I changed recently that could be making me depressed and triggering a depression? It all started 4 weeks ago when I started to cook full size meals for my family most nights, meaning that I would eat at 5 or 5:30 at night instead of 6:30 or 7 when I would take my meds for bed. When I did that I wouldn’t get to bed on time, and I would end up staying up way past my bedtime then and be up half the night. Being up half the night ended up triggering my depression. I was doomed. My depression creeped in quickly and it held on for dear life.

By this past Monday I didn’t want to get out of bed. I went to see my favorite band this past weekend and I was there and trying to enjoy myself and I smiled and I danced, but I wasn’t truly enjoying myself. That was when I knew I had to do something and fast. This week I made some changes to my care plan that got me back on track. I am eating correctly again. Getting my meds on time. I got back to the gym, too. I had been slacking there as well, but if I take my meds on time and go to bed at the right time I have energy the next day.

It doesn’t always have to be a huge trigger that messes up your care plan. It can be a subtle change that can throw you off. However, a simple change can make the difference in not having depression or having depression when you have bipolar disorder. Stability is a constant balancing act, but that is the ultimate goal. Stability! I know it is hard to find, but in mental health recovery the goal is to have more days stable, then depressed or manic. Everyone’s recovery looks different, but recovery in every form is wonderful.


How to Break the Stress Reaction Cycle

As hard as it may sound to pull out of this stress reaction cycle, it is possible. The first step in creating any positive change is always raising your awareness of what the cycle is, how you participate in it, and what pains the cycle creates.

Why? Because you can’t change a habit you don’t know you have. And if you don’t recognize the pain the habit is creating, you won’t have the motivation you need to make new choices and break out of the cycle that has become familiar despite the fact that it is destructive.

The practice of mindfulness is an incredibly powerful tool to help you find that awareness. Mindfulness teaches us to pay attention, non-judgmentally, to what is happening in the moment. Mindfulness not only counteracts stress, but also prevents it from happening in the first place, because when you practice mindfulness you can begin to observe your patterns and make new choices instead of compulsively acting them out over and over. Mindfulness helps you break the cycle. It also sets the stage for your parasympathetic nervous system to take over and to create the conditions your body needs in order to heal itself. Start to check in with yourself when you feel that old familiar feeling of stress creep in and try to observe the thoughts you have and actions you take in response to it.

A foundational piece of mindfulness is to be non-judgmental about the thoughts and feelings you pay attention to, so resist the urge to beat yourself up for wanting a piece of cake to help you feel better or feel guilty about how much time you spent scrolling through your social media feed instead of working on the project or having the conversation that’s causing you so much stress. At this point, you simply want to raise awareness of how you react to stress.

Another Thing to Become Aware of: Your Inherited Patterns

Whether you realize it or not, you were born into a family with its own unique patterns of maladaptive coping mechanisms. Just as you inherit eye color, height, and talent from your parents, grandparents, and great-grandparents, you can also inherit an addictive personality, or a tendency to reach for sweets, or a quick temper.

In your attempt to deal with the stresses that life has thrown your way, you have been repeating patterns that began even before you were born. Recognizing what those patterns are and how they have shown up in your own choices is such a relief. It’s empowering to know the truth so that you don’t have to blame yourself and feel shame for obstacles that you inherited.

Choosing Better Coping Mechanisms

Once you recognize your patterns, it is absolutely possible for you to break them and choose new coping mechanisms that actually support you instead of contributing to your breakdown. Just as your body has physiological mechanisms that help you respond to stressors, it has an equally powerful system that helps you relax. This is ruled by the parasympathetic nervous system.

Spending more time in parasympathetic realm also cues deeper emotions, such as compassion, in what’s known as the “tend and befriend” response. This drive to connect with others is really what motivates you to wander in to the office kitchen during a hectic day — you’re looking for someone to talk to, even though you may think you’re there to see if there are any leftover pastries from the morning breakfast meeting! When you spend more time in the parasympathetic realm, you not only benefit your physical health, you tend to your emotional health, because it sets the stage for you to deepen your relationships, develop a support network, and exercise your compassion. This helps you find the support you need to start making changes in how you deal with your stressors.

Heal the Body with Conscious Relaxation

Now it’s time for a deeper dive into the pool of relaxation. Conscious relaxation is exactly what it sounds like — using your mental awareness to produce a relaxed state that is profound. The practice builds body awareness, focus, and empowerment — because once you know how to do it, you never need to feel trapped in a stress reaction again.

I have included instructions below for a conscious relaxation practices called a body scan:

Body Scan

Time 20-40 minutes

If you can, practice this three to five days a week for six to eight weeks, as research suggests people reap more benefits from this practice when they keep at it.

How to practice:

  • A body scan can be performed lying down or sitting. You can close your eyes if that feels comfortable for you.
  • Once you are comfortable, begin by taking a few deep breath in through your nose and out through your mouth.
  • Start noticing your body, feeling the weight of your body on the chair or on the floor. Notice where your body is in contact with the floor or chair, and where it isn’t.
  • Now place your attention on your feet. Notice the sensations of your feet touching the floor—the weight, pressure, vibration, and temperature.
  • Next, notice your legs against the floor — is there pressure, pulsing, heaviness, lightness?
  • Move on to your back and see what sensations you can feel there.
  • Now bring your attention into your stomach area. If your stomach is tense or tight, let it go and relax. Take a breath.
  • Notice your hands. Are they tense or tight? See if you can allow them to let go and relax.
  • Now pay attention to your arms. Feel any sensations happening there. Let your shoulders drop and let go of tension and tightness.
  • Notice your neck and throat. Let go of tension and tightness. Relax.
  • Relax your jaw. Let your face and facial muscles soften. Let go of any tension and tightness that may be there.
  • Then expand your awareness to take in your whole body, feeling how it feels to be in your body in this moment.
  • Take a breath.
  • Be aware of your whole body as best you can. Take a breath.
  • Bring your hands together rubbing them together to generate heat in your hands and place your hands over your eyes. Slowly open your eyes and come back to the room.
  • Notice how you feel.
  • Thank yourself for providing the space to connect to your mind, body, and spirit.
  • Give yourself a gift of love and dedicate a space to practice this technique regularly.

The body scan I am leaving you with is the best place to start in learning how to break the stress reaction cycle in your life. Conscious relaxation practices such as the body scan help by systematically placing your attention on each and every part of your body and inviting them to relax, one by one. Over the years I have learned this is the best place to start with my patients before covering more ground work using yoga, breathing techniques, more conscious relaxation exercises, and the power of positive affirmations.

Starting with this basic body scan is the first step in uncovering how powerful it is to connect to your body, mind, and spirit. It’s such a beautiful mindfulness practice helping us accept and acknowledge our thoughts, feelings and bodily sensations without judgement, so we can start to listen more attentively to how our body feels and what it needs to HEAL!



Center for Disease Control and Prevention, “Defining Adult Overweight and Obesity,” accessed on 9/19/17 at



Psychology Around the Net: June 16, 2018

Happy Saturday, Psych Central readers!

If you’re having the kind of weekend we are here in my neck of the woods (i.e. 90+ degree weather — whew!), take a break inside and cool down while you catch up on some of the latest in mental health this week including the psychology behind being hangry, how you can use persistent regrets to change your present life, the connection between Bob Ross and relaxation (and we’re not talking painting, here), and more!

Feeling Hangry? New Study Explains The Psychology Why People Get Angry When Hungry: The Oxford English Dictionary recently accepted the word “hangry,” but new research gives us a deeper look into why people get so angry when they’re hungry.

6 Pearls to Consider When Treating Pediatric Bipolar Disorder: There’s data to support that lithium is the ideal treatment option for pediatric bipolar disorder — and there’s data to suggest lithium should be a second or even third treatment approach. So, what’s the deal? When should doctors use — or hold off on — treating pediatric bipolar disorder with lithium?

A New Study On the Psychology of Persistent Regrets Can Teach you How to Live Now: Instead of trying to repress your negative, sad thoughts or adopt a “no regrets” attitude, your best bet is to dig into the regret, become familiar with its nature, and the nature of how you respond to it.

Cannabis Does Not Increase Suicidal Behavior in Psychiatric Patients: New research finds there’s no significant link between using cannabis use and suicidal behavior in people with psychiatric disorders — findings that contrast with pre-existing data that does link cannibas use to increased suicidal behavior in the general population. However, the researchers do note that, based on a small subset of study participants, the heaviness of cannabis use did increase the risk of suicidal behavior in males which suggests a closer follow-up of those patients.

Why Mental Illness Is So Hard to Spot in Seniors: So many factors go into why detecting mental illness in seniors — ageism, stigma, not enough time spent with their primary care doctors — but once it is spotted, many of the same treatment options for non-seniors (medication, talk therapy, and family support) can be just as beneficial for older people.

Let Bob Ross Beat Away Your Stress Like a Wet Brush: Here’s something fun. The subscription meditation app Calm has added Bob Ross to its catalog of narrators of their “sleep stories” (the soothing stories meant to help calm your mind before bed). Get ready to float away to dreamland on some happy little clouds.

June 15 2018


How Misreading Your Body’s Signals Can Cause Anxiety

It’s 9 AM Monday morning. You’ve just pulled into work and are ready to pitch your presentation to the senior management team. Your PowerPoint slides are damn near perfect and you’ve gone over the script dozens of times. You’ve got this.

As everyone gathers in the room, you’re suddenly flooded with a hit of adrenaline. The bad kind. In a flash you become acutely aware of what your body is doing: beads of sweat forming on your brow, a dry mouth that no amount of water can fix, and a steadily increasing heart rate thumping inside your chest.

This ability to perceive the signals of your body is known as interoceptive accuracy (IAc). There are, as the example demonstrated, different psychosomatic cues that you pick up within yourself during states of anxiety. But above all, a beating heart is the hardest one to ignore.

It’s for this reason that heartbeat perception, as brain scientists call it, is a direct proxy for measuring people’s IAc and reported anxiety and stress levels.

IAc and a Beating Heart

Having the ability to accurately detect your own heartbeat is critical for reappraising your anxiety on a moment to moment basis. We know that anxiety is as much in the body as it is in the mind, and that a (mis)perception of a fast heart rate can easily contribute to the catastrophization of a panicked state.

It’s why some of the most effective anxiety-related therapies, like progressive muscle relaxation and deep breathing, tend to focus on muting a physiological response followed by a cognitive reappraisal technique.

Now in terms of IAc, the longstanding view was that it is an inherited trait, similar to eye color or height. Your IAc is immutable, unchanging. But now there’s new evidence suggesting that the situation matters just as much as the person: While some people may have inherently bad interoceptive ability, we can’t ignore the influence of the broader context. And this, if it turns out to be true, is a definite win for anyone looking to reverse a certain anxiety-based predisposition.

The Study and Findings

A team of researchers led by Martin F. Whittkamp out of the University of Luxembourg set out to investigate just how much of a role the environment plays in determining our ability to self-reflect on accurate biofeedback.

The researchers relied on two methods to measure IAc via heartbeat perception. The first, called the counting task is simply a comparison between actual measures of your heartbeat with your self-reported measures. Another method, called the heartbeat discrimination task, measures how accurately you can rate whether or not your heartbeat is in sync with an external stimulus such as a blinking light on a computer screen.

The team in this newest study compared the results of both a heartbeat counting task and discrimination task in two conditions: a resting state and a stress state. Mental stress was induced by having participants match the color of a flashing light bulb with a corresponding button as fast and accurately as possible. If this wasn’t stressful enough, the experimenter also chimed in with a few verbal cues urging the participant to perform better so as to not ruin the entire experiment.

In addition to comparing stress state IAc with resting state IAc, the researchers also designed a number of computational models. These models aimed to measure how much of one’s interoceptive accuracy is owed to individual ability versus the situation.

The results found that about 40% of a person’s IAc can be explained by his/her individual traits, while around 30% can be explained by the changing situation, leaving the remaining 30% to measurement error.

What this says is that your ability to detect and therefore modulate your bodily responses during an anxious state is not fixed. These signals are amenable to change. You can learn to more accurately perceive your beating heart in a high-stress environment. You can apply reappraisal techniques in mitigating your anxiety.

The findings of this study have the potential to inform research on stress and anxiety management. For example, having a general idea of how much your IAc is dependent on biological predisposition could provide leeway to pharmaceutical interventions to help combat debilitating responses to stressful situations.

For now there’s therapeutic power in knowing you can improve your IAc and work towards minimizing your anxiety.


Feldman, G., Greeson, J., & Senville, J. (2010). Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. Behaviour Research And Therapy, 48(10), 1002-1011. doi: 10.1016/j.brat.2010.06.006

Knoll, J., & Hodapp, V. (1992). A Comparison between Two Methods for Assessing Heartbeat Perception. Psychophysiology, 29(2), 218-222. doi: 10.1111/j.1469-8986.1992.tb01689.x

Richter, D., Manzke, T., Wilken, B., & Ponimaskin, E. (2003). Serotonin receptors: guardians of stable breathing. Trends In Molecular Medicine, 9(12), 542-548. doi: 10.1016/j.molmed.2003.10.010

Wittkamp, M., Bertsch, K., Vögele, C., & Schulz, A. (2018). A latent state-trait analysis of interoceptive accuracy. Psychophysiology, 55(6), e13055. doi: 10.1111/psyp.13055

This guest article originally appeared on the award-winning health and science blog and brain-themed community, BrainBlogger: How Misreading Bodily Signals Causes Anxiety.

After and Beyond the Genome: Taking Postgenomics Seriously by Maurizio Meloni

7 Critical Coping Strategies to Teach Your School-Aged Kids

We aren’t born with the ability to cope with our emotions. We have to be taught. And many of us weren’t taught healthy strategies. Maybe we were yelled at or sent to our rooms. Maybe we were told to calm down and stop crying.

Either way, feelings weren’t discussed in a positive light—if ever. Maybe we watched our parents internalize their stress, shut down or lash out. And, as a result, we froze or freaked out when we started feeling stressed or anxious. We simply didn’t know what to do with these emotions.

Maybe we still don’t. Maybe we still struggle. Which is why it gets tricky when we need to help our own kids navigate their different emotions and various stressors.

Sometimes we forget that kids deal with real situations, just like us. They, too, deal with worries about failing and the health of their families. They, too, get frustrated with themselves. They, too, get anxious about different firsts—starting a new school year, meeting new people, working on new projects and assignments. They, too, go blank during important moments (like presentations or exams). They, too, have disagreements with friends. Sometimes they, too, worry about “adult” problems like money.

And it’s vital that we teach them the coping skills to navigate these situations and challenges well.

In the Coping Skills for Kids Workbook: Over 75 Coping Strategies to Help Kids Deal with Stress, Anxiety and Anger, Janine Halloran, a mental health counselor and mom to two elementary-school kids, features creative, practical suggestions. Halloran runs the valuable website Below are seven suggestions to try with your kids (and maybe even to adopt yourself!).

Practice deep breathing with a pinwheel. Deep breathing is important because it helps to relax our bodies. It boosts the oxygen supply to our brains and stimulates the parasympathetic nervous system, which promotes calmness. It basically communicates: There’s nothing to worry about here. We don’t need to fight or flee. We are safe.

For this activity, you can buy a pinwheel or have your child make their own. Halloran suggests teaching your child to breathe in through their nose and expand their belly, and breathe out to turn the pinwh.

Practice deep breathing with bubbles (or prompts). Do the same as above, except with bubbles, which is another great way to slow down (and soothe yourself). Halloran notes that for some kids prompts are especially helpful for teaching deep breathing. She suggests trying these ideas: “Breathe in like you’re smelling a flower; breathe out like you’re blowing birthday candles”; “Breathe in and out like Darth Vader”; “Pretend your belly is like a balloon. Breathe in and make the balloon bigger, then breathe out and make the balloon shrink.”

Engage in positive self-talk. How we talk to ourselves affects everything: It creates our lens for the world. So if we’re engaging in negative self-talk, we’re going to have a negative outlook on life, and on our abilities to cope with life.

Help your kids rethink their thinking. Help them understand that negative thoughts aren’t the truth, and they have the power to change them to something supportive. Halloran shares these examples: Change “This is awful” to “Let me focus on the things that I can control and the things that are going well.” Change “I’m not good at this” to “I’m just learning how to do this.”  You can talk to your child about the thoughts they have, and brainstorm together about revising these thoughts to more encouraging, compassionate messages.

List your favorite things. It’s helpful for your kids to turn to their favorite activities when they’re stressed out, and having a list means they have options at the ready. (It’s hard to think when we’re stressed.) Halloran suggests creating a list for things you love to do: at home, at school, outside, inside, by yourself and with others.

Use movement. Participating in physical activities is especially important when your child starts getting restless, antsy or irritable. Halloran shares these examples: jumping rope, doing jumping jacks, taking a walk, running in place, swimming, stretching, skipping, dancing, and taking a class (e.g., martial arts, gymnastics, rock climbing).

Create a feelings book. Healthy coping starts with being able to accurately identify our feelings. It starts with connecting and listening to ourselves. Halloran suggests kids jot down one feeling on a separate page of their book. She includes these feelings as examples: happy, frustrated, worried, sad, mad, scared. Ask your child to think of something that has made them feel that feeling—and write about or draw what happened.

Track your stress. This helps your child gain a deeper understanding of what stresses them out and pinpoint any patterns to their stress (e.g., gets stressed on Sundays). The key is to answer these questions on a piece of paper: “What stressed me out? What happened before? When did it happen? Where was I? What happened after?”

When we talk about feelings with our kids (in a compassionate, non-judgmental way), we empower them. When we teach them different skills and strategies to cope, we equip them with valuable tools to navigate real challenges—tools they’ll take into adolescence and adulthood.

We teach them to honor themselves. And that is a priceless lesson.

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