Remote Work Is Quietly Making Us Lonelier — Here's What the Research Says About Why Community Matters

Most people will tell you they love working from home. No commute, no small talk with a coworker they cannot stand, no one looking over their shoulder. Surveys consistently find that the large majority of remote-capable workers say they would be happiest working from home, and many say they would take a real pay cut to keep it that way.

And yet a major new study, published this month in Science, found something that complicates that preference considerably: remote work has significantly deepened isolation and psychological distress in this country, and it accounts for roughly a third of the overall decline in American mental health between 2011 and 2024.

This is worth sitting with, because it runs counter to what most people believe about their own choices. The thing that feels most personally liberating may also be one of the most significant drivers of a worsening mental health landscape. That contradiction is not really about remote work specifically. It is about something more fundamental: how much human beings depend on incidental, unplanned, in-person contact with other people, and how easily that dependency goes unnoticed until it is gone.

What the Research Found

The study compared workers in jobs that could plausibly be done remotely, such as finance and software engineering, with workers in jobs that require in-person presence. People in remote-capable roles worked from home roughly three times as often in 2024 as they did in 2019, and as they did, something measurable happened to the texture of their days.

The majority of remote workers spend their entire workday completely alone. Over half report feeling less connected to their colleagues. Even in digital communication, remote workers receive less feedback from coworkers and have meaningfully less contact with people outside their immediate team.

What is particularly striking is that people did not compensate for this lost workplace contact by socializing more elsewhere. More days passed with no social contact of any kind — no greeting from an office mate, no small exchange with a barista, no nod to a fellow commuter. These are the kinds of interactions that are easy to dismiss as trivial. The research suggests they are not.

Workers in remote-capable jobs saw steeper increases in psychological distress, mental health visits, and antidepressant prescriptions than workers whose jobs required them to be physically present. And the pattern began in 2020 and has not let up since — pointing toward remote work itself, rather than more recent anxieties like AI displacement, as the driving factor.

The effect was not distributed evenly. People who lived with a spouse and children saw their mental health hold relatively steady. People who lived alone experienced a roughly 20 percent decline in psychological wellbeing. Isolation, in other words, compounds. The less embedded a person already is in other forms of daily human contact, the more remote work appears to cost them.

Why the Cost Is So Easy to Miss

If remote work is doing this much damage, why does it not feel that way to most people experiencing it?

Part of the answer is the pace at which the cost accumulates. Loneliness that builds gradually does not announce itself as loneliness. It gets attributed to other things — a hard year, a breakup, a friendship that drifted, the ordinary tiredness of getting older. The texture of an isolating life is rarely dramatic. It is just quieter than it used to be, in ways that are easy to rationalize as unrelated to where you happen to be sitting during the workday.

This is consistent with something I see often in clinical work. People rarely arrive in therapy saying "I think my life lacks adequate community." They arrive describing low mood, flatness, a vague sense that something is missing, irritability, or difficulty finding motivation. The absence of community does not present as a clearly labeled deficiency. It presents as depression, anxiety, or a diffuse dissatisfaction that does not trace easily to any single cause — which is exactly what makes it so important to ask about directly.

There is also a structural reason the cost is hard to see: a half-empty office is not an appealing alternative to working from home. When most of your colleagues are also remote, going into an office does not restore the social environment that used to exist there. The choice many people are actually weighing is not "office community versus home isolation." It is "isolation at home versus isolation in a quiet office." Neither option, as currently structured, delivers what used to happen by default.

The Office Was Doing More Than We Realized

One of the more striking findings referenced in this research is that the workplace has historically been the single most common place where American adults form friendships — ahead of religious communities, neighborhoods, children's schools, and sports teams.

This is worth pausing on, because it reframes what was lost when offices emptied out. It was not just a commute and a desk. For a very large number of adults, it was the primary infrastructure through which adult friendship actually happened. Adult friendship, unlike childhood and adolescent friendship, rarely has a built-in structure that produces it automatically. Work was that structure for millions of people, largely without anyone noticing it was serving that function until it stopped.

This matters clinically because friendship and social connection are not peripheral to mental health. They are among the most well-established protective factors we have. Strong social ties are associated with lower rates of depression and anxiety, better physical health outcomes, longer life expectancy, and greater resilience in the face of life stressors. Loneliness, conversely, has been associated with health risks comparable to those of smoking and obesity. This is not a soft or sentimental claim. It is one of the more robust findings in health psychology.

When the primary structure that produced incidental adult connection disappears, and nothing replaces it, the consequences are not abstract. They show up, as this research demonstrates, in mental health visit rates and prescription data.

This Is Not an Argument for Returning to 2019

It would be easy to read this research as an argument for mandatory full-time office return, and that is not the right conclusion to draw from it.

The prepandemic norm, in which work occupied every hour of the workday and frequently crowded out time with friends and family, was its own kind of problem. Many people who value remote work do so for genuinely good reasons: more time with their children, more flexibility during illness, freedom from long commutes, escape from difficult office dynamics. None of that should be dismissed.

The point is not that offices are good and remote work is bad. The point is that human connection requires structure, and that structure does not happen automatically. Whatever the working arrangement, something has to actually produce the in-person contact that our nervous systems and our psychological wellbeing depend on. For decades, the office provided that structure as an incidental byproduct of simply showing up. Remote work removed the structure without anyone deciding to remove the connection it produced, and most people have not yet found something to replace it.

What This Means in Practice

The research points toward a conclusion that is genuinely useful, even if it requires intention that used to be unnecessary: connection has to be built deliberately now, because it is no longer happening by accident.

This looks different depending on your circumstances, but a few things are worth naming directly.

If you work remotely, audit your week for incidental human contact. Not scheduled, purposeful socializing — actual incidental contact. A coffee shop where someone knows your order. A walk where you might run into a neighbor. A coworking space, even occasionally. These small, low-stakes interactions are not filler. The research suggests they matter more than most people assume.

If you live alone, take the finding about compounding isolation seriously. The mental health cost of remote work fell hardest on people without a spouse or family at home to provide a baseline of daily contact. If that describes you, building deliberate structures for connection is not optional self-care. It is a meaningful protective factor for your mental health.

Consider what structures actually produce connection, rather than just opportunities for it. A standing weekly lunch with a friend produces connection more reliably than a general intention to "see people more." Structure that requires no ongoing willpower to maintain tends to outperform good intentions.

If you manage other people, recognize that this is a workplace mental health issue, not just an individual one. Organizations that have taken this seriously have restructured physical spaces to centralize rather than isolate, rethought how they recognize the often-invisible work of connecting teams, and built deliberate touchpoints like regular one-on-ones into how teams function. These are not perks. They are interventions with measurable mental health value.

A Closing Thought

Robert Putnam wrote, more than two decades ago, that Americans were increasingly "bowling alone" — disengaging from the associational life that had once structured American communities. What this new research suggests is a continuation of that trajectory into the texture of an ordinary workday: many of us are now, in a real sense, typing alone.

The remedy is not nostalgia for a five-day office week that had its own real costs. It is a recognition that community does not assemble itself. It has to be built, and in the absence of the structures that used to build it without anyone trying, building it now requires intention that can feel unfamiliar, even effortful.

That effort is worth making. Community is not a nice-to-have layered on top of mental health. For many people, it is one of the load-bearing structures of it.

APA CITATIONS

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352

Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. Simon & Schuster.

Yang, E., & Pallais, A. (2026). The mental health costs of remote work. Science. [As referenced in The New York Times, June 2026]

The New York Times. (2026). Why remote work has made America lonelier — and what to do about it. The New York Times.

What the New Alcohol Research Means for Your Mental Health

A major study on alcohol and health made headlines this week — not only for what it found, but for how it got published.

The Alcohol Intake and Health Study was commissioned by the federal government but unreleased under President Trump, who decided not to feature its findings in new dietary guidelines after pushback from the alcohol industry and a congressional committee. The study, published June 9 in the Journal of Studies on Alcohol and Drugs, found that health risks increase with even low levels of drinking, and that no level of alcohol offers a protective effect on mortality. Grow Therapy

The scientific content is worth examining on its own terms, separate from the politics. And from a psychological standpoint, there is a dimension of this conversation that rarely gets the attention it deserves: not just what alcohol does to the body, but what it does to the mind.

What the Study Actually Found

Researchers reported there was no protective net effect of any level of alcohol consumption on health. Low levels of alcohol use may be associated with elevated health risks, with higher consumption associated with progressively increased risks of cancer, cardiovascular disease, and death and disability.

"We did not observe a significant protective effect of alcohol on health at any level of consumption," said Dr. Shield. "At low levels, alcohol may be associated with a reduced risk of ischemic heart disease and stroke. But when you look across the full range of health outcomes, including cancer and other chronic diseases, those potential benefits are outweighed by the risks, even at seven drinks per week."

The study concludes that even "moderate" drinking raises the risk of early death and more than 200 diseases, including cancer and heart disease, and that no amount of alcohol can protect against premature death. The researchers noted that individual risk varies based on genetics, lifestyle, and other factors — population-level statistics do not translate directly to any one person. But the headline finding is clear: the belief that moderate alcohol consumption is harmless or beneficial is not supported by the best available evidence.

The Politics Are Worth Noting — and Then Setting Aside

The study was commissioned by the Biden administration as one of two government reviews meant to inform new dietary guidelines. One official involved accused the Trump administration of "sidelining" the research — an allegation the administration denies. The guidelines that were released advised consuming "less alcohol for better overall health" without providing the detailed risk thresholds the study authors had developed.

Whatever the policy outcome, the science is published, peer-reviewed, and consistent with years of accumulating evidence. It is available.

The Mental Health Dimension

This is where I want to spend most of this post, because it is the part of the alcohol conversation that tends to get least attention.

Alcohol is not primarily a physical health issue for the people I work with. It is primarily a psychological one.

Most people who come to therapy with complicated relationships to alcohol are not people whose drinking looks like textbook addiction. They are people who have a glass or two of wine most evenings to decompress. People who drink more during difficult periods and less during easier ones. People who tried to cut back and found it harder than expected. People who use alcohol the way they use other things — scrolling, overworking, overeating — to manage feelings that have nowhere else to go.

Alcohol and the Anxiety-Depression Loop

Alcohol is a central nervous system depressant. In the short term, it reduces anxiety by dampening the brain's stress-response systems. This is why it feels like it works. The problem is what happens next.

As alcohol is metabolized, the nervous system rebounds — producing heightened anxiety, disrupted sleep, and emotional dysregulation that can last well into the following day. A 2026 systematic review found a significant association between hangovers and increased negative affect, including anxiety, stress, and depression, with people who have higher baseline anxiety experiencing the most severe effects.

This creates a cycle that is clinically recognizable and extremely common: anxiety leads to drinking, drinking temporarily reduces anxiety, the rebound effect increases anxiety, increased anxiety motivates more drinking.

Research found that drinking to cope was significantly associated with greater stress, anxiety, depression, and loneliness — and was a meaningful predictor of increases in depression over time. The motivation to manage distress appears to be driving the negative effects of alcohol use on mental health. Drinking while stressed is not the same, clinically, as drinking because the alternative is feeling something you do not have the tools to tolerate.

What Alcohol Use Often Communicates

In a clinical context, alcohol use rarely presents in isolation. It almost always appears alongside something else: unprocessed grief, chronic anxiety, a relationship that is not working, loneliness, trauma that has not found another way to surface.

This is not a moral judgment. It is a clinical observation. The nervous system learns, through experience, that alcohol reliably alters its state. When the state it most wants to alter is distress, alcohol becomes a solution — one with real short-term efficacy and significant long-term costs.

One of the most important things therapy can offer is not a focus on the drinking itself, but on the function it serves. What is the drinking solving? What emotional experiences is it managing that have no other outlet? These questions often open into territory that is far richer than a conversation about units per week.

A Note on the Sober-Curious Conversation

The sober-curious movement has normalized a kind of low-pressure re-evaluation of drinking that was largely absent from public discourse a decade ago. This is clinically useful. It has made it easier for people to examine their relationship with alcohol without the threshold of "do I have a problem?" — which carries significant stigma and tends to prevent honest reflection.

You do not need to identify as an alcoholic, or be in crisis, to ask whether your drinking is serving you well. The new research supports that curiosity. It does not demand abstinence. What it does suggest is that the cultural default — that moderate drinking is benign, and that examining your relationship to it is only necessary if things have clearly gotten out of control — is not well-supported by the evidence.

If you are noticing something — recognition in the anxiety-depression loop, a discomfort with how much you are drinking, an awareness that it has become harder to stop than it used to be — that is worth paying attention to. Not as evidence of a disorder, but as information about what else is going on.

What AI Is Doing to How We Feel About Work — and Ourselves

The conversation about AI and work tends to organize itself around a single, concrete question: will my job still exist?

It is a reasonable question. But in the therapy room, that question is rarely the whole story. What I hear more often is something less concrete and harder to name: a background unease that has been building for months, a sense that the ground beneath a professional identity has quietly shifted, a worry not just about whether a job will disappear but about what it would mean if the work that defines you became something a machine could do.

That is a different kind of question. And it is the one I want to address here.

The Numbers Tell Part of the Story

The economic data on AI and work is genuinely uncertain. A comprehensive analysis of three independent labor datasets found no detectable rise in aggregate unemployment for workers in AI-exposed occupations since late 2022. What the same data did show, however, was a closing door for younger workers — a nearly 20% drop in young developer employment from 2024 peaks, and roughly one in three organizations expecting AI-driven workforce reductions in the near term. Notably, the disruption is beginning at the top of the skill ladder, not the bottom — the workers most exposed to AI today are the highest-paid and most-educated. ScienceDirectScienceDirect

This is clinically significant. The people most likely to have organized their identity, self-worth, and life structure around professional achievement are now among those most directly in AI's first wave.

What the Research Says About AI and Meaning at Work

Beyond job displacement, there is a subtler but equally important story about what AI is doing to the experience of work itself.

A 2026 study in Scientific Reports found that passively relying on AI — copying AI-generated content rather than engaging with the task directly — reduced self-efficacy, sense of ownership, and the meaning workers perceived in their work. Workers who collaborated actively with AI, drafting first and then refining with AI assistance, showed less erosion of these psychological dimensions. KOSU

The distinction matters. What damages the psychological experience of work is not AI use per se, but AI use that removes the worker from genuine engagement with the task. Classic perspectives emphasize that work is not merely a means of production but a central source of human identity and meaning — and that meaningful work emerges when individuals experience a sense of agency and purpose. Strip those out — not by taking the job but by making the job no longer require what is distinctively human — and you have a mental health problem even in the absence of unemployment. KOSU

Work, Identity, and What Happens When the Ground Shifts

For most working adults, work is not simply a source of income. It is a primary source of identity. It structures time, provides social belonging, confers status, and supplies the daily evidence that one is competent, valued, and needed.

The APA's 2025 Work in America Survey found that 54% of U.S. workers reported that job insecurity had a significant impact on their stress levels. Research published in JAMA Network Open found that greater job security was associated with meaningfully better mental health outcomes. Connecticut Public

AI-related insecurity introduces something distinct from ordinary job insecurity. Ordinary insecurity says: I might lose this position. AI-related insecurity says something more fundamental: the things I am good at might not matter in the way I thought they did. The expertise I spent years developing might be replicable by a tool that costs a few dollars a month.

That is an identity challenge, not merely an economic one. And identity challenges tend to produce anxiety, depression, and an existential disorientation that does not respond well to reassurance about aggregate job numbers.

The Particular Burden on High Achievers

High-achieving professionals — people who have organized significant portions of their identity and self-worth around competence and accomplishment — are often among those hit hardest by this shift, not because their jobs are most threatened, but because their relationship to their work is most psychologically loaded.

When your sense of self is built substantially on being very good at something, and the thing you are very good at becomes something a machine can replicate, the threat is not just professional. It raises questions that go far beneath the employment contract: What am I for? What makes me valuable — not as a worker, but as a person? What remains that is distinctively mine?

These are reasonable responses to a genuinely disorienting shift. But they are also, without support and reflection, the questions most likely to produce sustained anxiety and loss of meaning that erode wellbeing over time.

What Uncertainty Does to the Mind and Body

Even for people whose jobs are not immediately at risk, the ambient uncertainty of this period carries its own weight. Decades of research have shown that job insecurity negatively impacts workers' mental and physical health as well as job satisfaction, commitment, and trust. The mind's threat-detection system is designed to respond to identifiable dangers. It is less well-equipped to handle prolonged, ambiguous threat — a landscape shifting in ways that are difficult to predict or prepare for. The result is a persistent background activation of the stress response: disrupted sleep, reduced cognitive flexibility, and the kind of sustained low-level hypervigilance that depletes the emotional resources needed to engage creatively with change. Connecticut Public

This is not catastrophizing. It is a nervous system responding, with the architecture it has, to a situation that is genuinely uncertain and genuinely consequential.

What Actually Helps

I want to be careful not to offer easy reassurance, because the situation does not warrant it. AI is changing work, the pace is accelerating, and the disruption is real. What I can offer is an honest account of what tends to support people through genuine identity disruption.

Separating who you are from what you do. The capacity to hold a stable sense of self that is not entirely contingent on professional achievement is one of the most robust protections against the psychological damage of career disruption. This is a capacity that can be developed — and one therapy is well-positioned to support.

Engaging actively rather than passively. The research suggests the psychological risk is not in using AI but in ceding agency to it. Workers who use AI as a collaborator — thinking first, then augmenting — preserve more of the psychological dimensions of meaningful work.

Naming the identity questions directly. The anxiety that surfaces around AI and work is often not primarily about the job. It is about the self. Bringing those questions into explicit awareness is more useful than managing them through distraction or reassurance-seeking.

Attending to what remains distinctively human. Judgment. Relationship. Context. Ethical reasoning. Creative synthesis. Embodied experience. These are not consolation prizes. They are the things that have always mattered most in the work that matters most to people.

A Note on When to Seek Support

If anxiety about AI and work is disrupting your sleep, your concentration, your relationships, or your sense of purpose — if the uncertainty is settling into something that feels less like concern and more like despair — that is worth taking seriously.

Navigating major identity disruption is a legitimate clinical concern. It does not require a formal diagnosis. It requires a space to think carefully about who you are, what you value, and what a meaningful life looks like when the structures that once organized it are shifting.

I work with adults in New York City navigating anxiety, career disruption, identity questions, and the intersection of professional life and psychological wellbeing. [Reach out here] if you would like to explore what support might look like.

APA Citations:

Brand, J. E. (2015). The far-reaching impact of job loss and unemployment. Annual Review of Sociology, 41, 359–375. https://doi.org/10.1146/annurev-soc-071913-043237

Nguyen, T., Weinhardt, J. M., & Campbell, E. (2026). Relying on AI at work reduces self-efficacy, ownership, and meaning while active collaboration mitigates the effects. Scientific Reports, 16, 13583. https://doi.org/10.1038/s41598-026-42312-6

The New York Times Magazine. (2026, June 9). Who will actually thrive in the hybrid A.I.-human work force. The New York Times Magazine. https://www.nytimes.com/2026/06/09/magazine/ai-jobs-workforce-labor.html

Weir, K. (2026). Workers are facing an age of uncertainty. Monitor on Psychology, 57(1), 76. https://www.apa.org/monitor/2026/01-02/trends-work-uncertainty

Why "Good Enough" Is Better for Your Mental Health Than "The Best"

Here is something that shows up in therapy more often than you might expect: a person who is objectively doing well — good job, good relationship, good life — who cannot stop wondering if something better is out there.

They are not ungrateful, exactly. They are haunted. By the apartment they did not rent, the job offer they turned down, the partner they might have met if they had stayed on the app a little longer. Every decision, once made, immediately generates a parallel universe in which a different choice led somewhere better.

This is not a character flaw. It is a well-documented cognitive style that psychologists call maximizing — and the research on it has a lot to say about anxiety, decision fatigue, and the specific kind of unhappiness that feels inexplicable precisely because everything is, by most measures, fine.

The Psychology of Maximizing

The concept comes from Nobel laureate Herbert Simon, who spent decades studying how humans actually make decisions. Simon observed that humans cannot truly evaluate all available options for most decisions — there are too many, our information is incomplete, and our minds are not built for it. Instead, we consider a manageable set of options, find one that meets our standard, and move on. He called this satisficing — a blend of "satisfy" and "suffice." The satisficer's standard is not "the best available" but "good enough for what I need."

Simon was a committed satisficer in his own life. He wore one brand of socks, ate the same breakfast every morning, lived in the same house for 46 years. These were deliberate choices to remove low-stakes decisions from his attention so that his cognitive resources remained available for the things that actually mattered.

The maximizer operates differently. The standard is not "good enough" but "the best." And because that standard is difficult to confirm — you can only know you found the best if you have exhausted all the others — the search tends to continue long past the point of diminishing returns.

What the Research Shows

Researchers developed a scale to measure where individuals fall on the spectrum between maximizer and satisficer. What they found was consistent: maximizing is associated with worse outcomes, not better ones.

Maximizers tend to be less satisfied with their decisions even when those decisions are objectively good.

They are more prone to regret, more likely to engage in social comparison, and less happy overall. They second-guess more. They ruminate more. The very process of trying to ensure the best outcome produces the psychological conditions that undermine satisfaction with whatever outcome they reach.

Satisficers do not have lower standards. They simply have standards that are achievable and confirmable. "Good enough for me" can be met. "The best" rarely is.

Why It Has Gotten So Much Worse

The sheer proliferation of options is part of it — one economist calculated that consumer options in modern economies exceed those of preindustrial societies by a factor of roughly 100 million. That extends into the most fundamental questions of identity: who to be, how to live, where to work, whom to love.

Social media added a specific and damaging layer: the infinite comparison engine. When you can see curated versions of other people's careers, relationships, and lives at all times, "good enough" begins to feel like settling. Research has found that simply having many options to compare makes people less satisfied with whatever they choose. The mere awareness that something else might be out there degrades the present moment.

Dating apps are the purest expression of this — a system architecturally designed to keep users wondering whether a better match exists beyond the next swipe. And AI now promises to optimize everything, which carries the hidden risk of expanding the menu of comparisons indefinitely, producing not better outcomes but more haunted ones.

What This Looks Like in the Therapy Room

The clinical presentation of maximizing rarely announces itself by name. It tends to look like this: a patient who made a good decision but cannot stop wondering if it was the right one. Someone in a solid relationship with a persistent background awareness that other options exist. A person who accepted a good job and immediately began scanning for signs they should have waited.

What is tricky is that maximizing feels like conscientiousness. It presents as due diligence. The person doing it is not sure they have permission to stop — because stopping before finding the best option feels like settling.

But the research is clear: the search itself is a cost. And most maximizers are not accounting for it.

Satisficing Is Not Lowering Your Standards

This is the point most people resist. Choosing "good enough" is not resignation or a failure of ambition. It is the recognition that there is a standard — your standard, based on what actually matters to you — and that when that standard is met, continued searching produces diminishing returns on outcomes and significant costs to wellbeing.

The question worth asking is not "is this the best?" but "is this good enough for what I actually need?" Those questions produce different psychological experiences. The first cannot, in most cases, be answered with confidence. The second can be.

A Practical Reframe

In clinical work, one of the most useful reframes for people caught in maximizing patterns is this: the goal is not to find the best option. The goal is to find a good option and then fully invest in it.

Research on relationship satisfaction bears this out. Couples who psychologically close the door on alternatives — rather than keeping it open — report higher satisfaction and stronger attachment. The act of committing, not the quality of the match itself, is a significant predictor of relationship wellbeing. Investment produces satisfaction. Continued search undermines it.

A few things that help in practice:

• Clarify your actual criteria before you start searching. "The best" is not a criterion — it is an instruction to keep looking. Specific, confirmable criteria allow the search to stop.

• Name the cost of continued searching. Time, attention, cognitive load, and eroding satisfaction with what you already have are real costs. Making them explicit counteracts the bias toward treating more searching as always worthwhile.

• Practice committing. For chronic maximizers, closing options feels like loss. That discomfort is worth sitting with rather than immediately acting on — it is usually the sensation of commitment, not the sensation of a mistake.

The Deeper Stakes

There is a Haruki Murakami story in which a boy and girl meet on a street corner and immediately recognize they are perfect for each other. They talk for hours. Then doubt creeps in: if they are truly meant for each other, they reason, they can part and will inevitably find each other again. The boy walks west. The girl walks east. They were perfect for each other. Years later they pass on a street, memories faded. They never reconnect.

The tragedy is not that the right person was lost. It is that the search for certainty destroyed something that was already, right there, enough.

Many of the patients I work with who are caught in maximizing patterns are not missing something. They are standing inside a life that contains real good things, unable to settle into it because some part of their mind is still searching for confirmation that this is the right life.

That particular kind of suffering responds well to therapy. Not because therapy provides the certainty the maximizing mind is looking for, but because it helps people examine the standard they are holding themselves to, where it came from, and whether it is actually serving them.

Good enough, chosen consciously and invested in fully, is often where a life of real satisfaction begins.

Citations:

Iyengar, S. S., Wells, R. E., & Schwartz, B. (2006). Doing better but feeling worse: Looking for the "best" job undermines satisfaction. Psychological Science, 17(2), 143–150. https://doi.org/10.1111/j.1467-9280.2006.01677.x

Schwartz, B., Ward, A., Monterosso, J., Lyubomirsky, S., White, K., & Lehman, D. R. (2002). Maximizing versus satisficing: Happiness is a matter of choice. Journal of Personality and Social Psychology, 83(5), 1178–1197. https://doi.org/10.1037/0022-3514.83.5.1178

Simon, H. A. (1956). Rational choice and the structure of the environment. Psychological Review, 63(2), 129–138. https://doi.org/10.1037/h0042769

Sparks, E. A., Ehrlinger, J., & Eibach, R. P. (2012). Failing to commit: Maximizers avoid commitment in a way that contributes to reduced satisfaction. Personality and Individual Differences, 52(1), 72–77. https://doi.org/10.1016/j.paid.2011.09.002

Neuroplasticity Is Real — And You Don't Have to Be an Olympian to Use It

Eileen Gu is 22 years old, the most decorated freestyle skier in Winter Olympics history, a Stanford student, and worth north of $20 million. When Fortune recently asked her to take readers inside her mind, she did not talk about talent or discipline in the way athletes usually do. She talked about something more specific: the daily practice of examining and deliberately modifying her own thinking.

"I apply a very analytical lens to my own thinking, and I modify it," she said. "You can control what you think. You can control how you think. And therefore, you can control who you are."

She credits neuroplasticity — the brain's capacity to change its own structure and function based on experience — as the mechanism behind this. And she is right that the science supports her. What is worth unpacking, from a psychological standpoint, is what neuroplasticity actually means, what it requires, and why it matters far beyond elite athletic performance.

What Neuroplasticity Actually Is

Neuroplasticity is not a metaphor or a motivational concept. It is a well-documented property of the brain — the capacity to reorganize its neural connections in response to experience, learning, and behavior.

For most of human history, the brain was thought to be largely fixed after childhood. What neuroscience established over the latter half of the twentieth century is that this is wrong. The brain retains the ability to form new neural pathways, strengthen existing ones through repeated use, and weaken or prune connections that go unused throughout the entire lifespan. Learning a new skill, developing a habit, practicing a way of thinking — all of these activities physically change the brain's structure over time.

The oft-cited phrase in neuroscience is "neurons that fire together, wire together," attributed to the work of Donald Hebb. When we repeatedly activate the same neural circuits — through thought patterns, behaviors, emotional responses — those circuits become more efficient, more automatic, more deeply embedded. This is why habits are hard to break: the neural pathways supporting them have been reinforced through repetition until they require very little deliberate effort to activate.

It is also why change is possible. New patterns, practiced consistently, can become as automatic as the old ones.

What Gu Is Actually Doing, Psychologically

What Eileen Gu describes — journaling, breaking down her thought processes, applying an analytical lens to her own thinking and then deliberately modifying it — maps closely onto something clinical psychologists have been doing with patients for decades.

It is metacognition: thinking about thinking. The capacity to step outside your own cognitive processes, observe them as processes rather than facts, and evaluate whether they are serving you.

This is one of the core mechanisms of Cognitive Behavioral Therapy. In CBT, a significant portion of the work involves helping people notice the automatic thoughts that arise in response to situations — the interpretations, predictions, and self-assessments that happen below the level of deliberate awareness — and examine them. Are they accurate? Are they the only way to interpret the situation? Are they producing responses that are useful or responses that are making things harder?

What Gu is doing informally through journaling is a version of the same process. She is interrupting the automatic nature of her own thinking, holding it up to examination, and asking whether it is aligned with who she wants to become. The fact that she is doing this as a 22-year-old with a brain still rich in the particularly high plasticity of early adulthood gives her a real advantage. But the mechanism is available at every age.

The Therapy Connection: Neuroplasticity Is Why Treatment Works

One of the most important clinical implications of neuroplasticity is that it provides a neurobiological basis for why psychotherapy produces lasting change.

For a long time, a common skepticism about therapy was that it could change how someone felt or thought temporarily, but could not change anything fundamental. The neuroscience suggests otherwise. Effective psychological treatment — CBT, EMDR, exposure-based therapies, and others — does not just shift mood or thinking in the moment. It changes the brain.

Studies using neuroimaging have found that successful CBT treatment for conditions like OCD, depression, PTSD, and anxiety produces measurable changes in brain activity and structure — in some cases comparable to the changes produced by medication. The prefrontal cortex, which is involved in regulation, evaluation, and executive control, shows increased activation after treatment. The amygdala, the brain's threat-detection hub, shows reduced reactivity. The neural pathways supporting rumination, avoidance, and threat amplification become less dominant. New pathways supporting more flexible, regulated responding become more established.

This is neuroplasticity in action. Therapy is, among other things, a structured way of using the brain's capacity to change itself.

The Part the Success Narrative Leaves Out

The Fortune article, and the broader cultural conversation around neuroplasticity, tends to frame it as a tool for optimization — a lever high performers can pull to become better, faster, more successful.

That framing is not wrong, but it is incomplete in ways that are clinically important.

The same mechanism that allows Eileen Gu to deliberately shape her thinking toward her goals is also the mechanism by which anxiety, depression, trauma, and dysfunctional patterns become entrenched. Neural pathways supporting worry, self-criticism, avoidance, and threat perception are reinforced by the same process as neural pathways supporting confidence and clarity. The brain does not distinguish between patterns that serve us and patterns that do not. It strengthens what it uses.

This means that for people who have lived with chronic anxiety, early trauma, or years of negative self-talk, the task is not simply to "think positively" or "rewire the brain" through journaling and good intentions. Those pathways have been reinforced over years, sometimes decades, and they run deep. The work of changing them is real work — it requires sustained effort, often professional support, and a tolerance for the discomfort of doing things differently before the new way feels natural.

This is not pessimism. It is accuracy. And it is actually more hopeful than the optimization narrative, because it takes seriously what change requires and points toward approaches that are evidence-based rather than simply aspirational.

What This Looks Like in Practice

For the people I work with in therapy, neuroplasticity is not a concept I invoke by name very often. But it is the implicit foundation of almost everything we do together.

When someone with anxiety practices responding to a feared situation without avoidance, they are weakening the neural pathway that links that situation to danger and building a new one that links it to manageability. When someone with depression practices behavioral activation — engaging in activities even before motivation returns — they are using behavior to shift neural states rather than waiting for the neural state to shift first. When someone examines and challenges a long-held belief about themselves and practices holding a different one, they are doing exactly what Gu describes: modifying their own thinking through deliberate, repeated effort.

The key word is repeated. Neuroplasticity does not work through insight alone. The moment of recognizing a pattern is important, but it is not the same as changing it. Change requires practice — not perfect practice, but consistent, sustained engagement with the new way of responding, thinking, or behaving, often while the old way is pulling hard in the other direction.

This is why therapy is not just a conversation. It is a structured opportunity to practice new ways of processing experience, with support, feedback, and the gradual accumulation of a different neural history.

You Do Not Have to Be 22

One of Gu's more notable comments was that she has neuroplasticity "on her side" as a young person. She is right that the brain's plasticity is particularly high in early adulthood, when the prefrontal cortex is still developing and neural networks are especially open to reorganization.

But neuroplasticity does not end at 22, or 35, or 60. The research on adult neuroplasticity is clear: the brain retains meaningful capacity for structural change throughout the lifespan. The rate may be somewhat lower and the effort required somewhat greater than in early development. The capacity itself does not disappear.

What this means practically is that it is never too late to change a pattern, learn a new way of responding, or build a different relationship with your own thinking. The evidence base for psychological treatment shows this consistently: people in midlife and later adulthood make significant, lasting changes through therapy, and the neurobiological substrate for those changes is the same one that allows a 22-year-old Olympic champion to deliberately shape who she is becoming.

The brain you have now is not the brain you are stuck with.

What is genuinely interesting about Eileen Gu's approach is not the success it has produced, though that is impressive. It is the orientation it reflects: treating the mind as something to engage with deliberately rather than something that happens to you.

That orientation is at the heart of good psychological work. The thoughts that arise automatically, the emotional patterns that feel like personality, the self-assessments that feel like facts — none of these are fixed. They are the current output of a brain that learned, through experience, to run those processes. And a brain that learned something can learn something different.

That is not a promise that change is easy. It is a statement that change is possible — which, for many people carrying long-standing patterns they did not choose and did not deserve, is exactly what they most need to hear.

APA CITATIONS

Hebb, D. O. (1949). The organization of behavior: A neuropsychological theory. Wiley.

Linden, D. E. J. (2006). How psychotherapy changes the brain: The contribution of functional neuroimaging. Molecular Psychiatry, 11(6), 528–538. https://doi.org/10.1038/sj.mp.4001816

Pittenger, C., & Duman, R. S. (2008). Stress, depression, and neuroplasticity: A convergence of mechanisms. Neuropsychopharmacology, 33(1), 88–109. https://doi.org/10.1038/sj.npp.1301574

Takeuchi, H., Taki, Y., Hashizume, H., Sassa, Y., Nagase, T., Nouchi, R., & Kawashima, R. (2011). Effects of training of processing speed on neural systems. Journal of Neuroscience, 31(34), 12139–12148. https://doi.org/10.1523/JNEUROSCI.2948-11.2011

What "The Pitt" Gets Right About Trauma — and What It Means for the Rest of Us

If you have been watching "The Pitt" on HBO Max, you already know it is not a typical medical drama. There are no romantic subplots softening the edges, no convenient resolutions at the end of an episode. Each season takes place across a single continuous shift in a Pittsburgh emergency department, and the result is something that feels less like television and more like an endurance experience — which, for a lot of viewers, is exactly the point.

What has drawn particular attention from clinicians, healthcare workers, and the New York Times is not the medical realism, though that is also notable. It is the psychological realism. Specifically, the show's unflinching portrayal of PTSD in Dr. Michael Robinavitch, the ER chief played by Noah Wyle, has resonated with viewers in a way that most depictions of trauma on screen do not.

It is worth examining why. Because what the show captures about how trauma actually works — and how people avoid dealing with it — has implications that extend well beyond emergency medicine.

What the Show Gets Right About Trauma

Dr. Robby does not have PTSD the way it tends to be depicted in film and television: sudden flashbacks, dramatic breakdowns, clear cause and effect. His trauma presents the way it usually does in real life: quietly, sideways, embedded in behavior rather than announced in symptoms.

He cannot stop moving. Between patients, between crises, he fills every available moment with the next task. His colleagues notice before he does, and they name it clearly: the constant motion is not dedication, it is avoidance. He is keeping himself busy precisely so he does not have to stop and feel what is underneath.

This is one of the most accurate things the show depicts. Avoidance is the central maintenance mechanism of PTSD. The symptoms — intrusive memories, hypervigilance, emotional numbing, disturbed sleep — are painful enough that the natural human response is to move away from anything that might trigger them. Keep busy. Stay distracted. Stay in motion. This works, in the short term, in that it reduces acute distress. What it also does is prevent the processing that would allow the trauma to lose its charge over time.

The show also captures something clinicians see frequently: the person most surrounded by acute suffering can be the least likely to identify themselves as someone who needs help. Robby has spent years working in emergency medicine. He has seen more death and human crisis than most people will encounter in a lifetime. That exposure does not make a person invulnerable to trauma. In many cases it creates the conditions for it — particularly the cumulative, repeated kind that does not trace back to a single incident but accumulates across years of high-stakes, high-loss work.

The Difference Between Burnout and Trauma

One of the more clinically useful things "The Pitt" does is make visible the distinction between burnout and PTSD, two conditions that are frequently conflated and that require meaningfully different responses.

Burnout is the result of chronic workplace stress that has depleted emotional, cognitive, and physical resources over time. It presents as exhaustion, cynicism, reduced sense of efficacy, and emotional distance from work. It is serious, it is treatable, and it is extremely common in high-demand professions. But it is not the same as trauma.

PTSD involves the nervous system's response to events that overwhelmed its capacity to process. Where burnout depletes, trauma dysregulates. A person with PTSD is not simply tired. Their threat-detection system has been recalibrated by experience in ways that make the present feel perpetually dangerous, even in the absence of actual threat. Intrusive memories surface without warning. Hypervigilance keeps the body in a state of readiness that is metabolically and psychologically expensive. Sleep is disturbed not just by fatigue but by the nervous system's resistance to the vulnerability that sleep requires.

Both conditions are present in "The Pitt," and the show is careful not to treat them as identical. Robby's colleagues who are burned out are exhausted and demoralized. Robby himself is something more destabilized — still functional, still brilliant at his job, but running on a foundation that is starting to crack.

This distinction matters clinically because the interventions are different. Burnout responds to rest, boundary-setting, workload reduction, and rebuilding a sense of meaning and control. PTSD requires targeted, trauma-focused treatment — and often, continuing to push through without that treatment makes things worse rather than better.

Why High-Functioning People Are Often the Last to Get Help

One of the things "The Pitt" captures with particular accuracy is the way competence can mask psychological distress for a very long time.

Robby is exceptional at his job. He makes the right calls under pressure. He maintains the trust of his colleagues and residents. From the outside — and often from the inside — he looks like someone who is handling it. The very skills that make him effective in the trauma bay (compartmentalization, rapid decision-making, the ability to suppress emotional reaction in a crisis) are also the skills that allow him to function for extended periods while something is quietly not working underneath.

This is a pattern I see regularly in clinical practice, not only with healthcare workers but with anyone whose professional identity is built around competence and performance. The higher the stakes and the more someone's self-concept is tied to being able to handle things, the longer they tend to wait before seeking support. The capacity to keep functioning reads, to them and often to others, as evidence that things are okay. It rarely is.

Research consistently shows that PTSD symptoms in healthcare workers are significantly underidentified and undertreated. A systematic review examining PTSD in hospital-based healthcare workers found that PTSD symptoms are associated with burnout, compassion fatigue, increased medical errors, and reduced quality of care — consequences that affect not only the individual but also their patients. The reasons people do not seek help are familiar: stigma, the belief that others have it worse, the cultural norm in high-demand professions that struggle is something to be managed internally, and the genuine difficulty of finding time for care when the job is all-consuming.

What Trauma Treatment Actually Looks Like

The show raises, more implicitly than explicitly, a question that is worth addressing directly: what does it look like to treat PTSD in someone like Robby?

The evidence base for trauma treatment has advanced significantly in recent decades. The gold-standard approaches, according to current VA/DoD guidelines and a substantial body of peer-reviewed research, are trauma-focused therapies that engage directly with the traumatic material rather than around it.

Cognitive Processing Therapy (CPT) helps people identify and examine the beliefs that trauma has produced — about safety, trust, control, self-worth, and relationships — and evaluate them against evidence rather than treating them as established facts. For someone like Robby, whose trauma has likely shaped how he understands his own responsibility for outcomes he could not control, this kind of cognitive work is often where the most meaningful shifts happen.

Prolonged Exposure (PE) works through graduated, structured engagement with avoided memories and triggers, allowing the nervous system to learn that the memory, while painful, is not the same as the original danger. It is the clinical formalization of what happens naturally when trauma resolves on its own: the events are told, retold, and gradually lose their ability to hijack the present.

EMDR, Eye Movement Desensitization and Reprocessing, uses bilateral stimulation while a person holds a traumatic memory in mind, in a way that appears to reduce the emotional charge of the memory and facilitate its integration. Research on EMDR in healthcare workers, including studies conducted during COVID-19, has shown meaningful reductions in PTSD symptom severity.

All of these approaches share a common feature that is also the thing most people with PTSD most want to avoid: they require turning toward the difficult material rather than away from it. This is uncomfortable by design. It is also why having a trained therapist guide the process matters. The goal is not to relive the trauma. It is to process it in a context that is safe enough that the nervous system can update its threat assessment and allow the memory to become part of the past rather than a recurring presence in the present.

A Note for Healthcare Workers and First Responders

If you are in a profession that regularly exposes you to acute human suffering — medicine, emergency response, social work, law enforcement — I want to name directly that what you carry from that work is real and that it warrants the same care that you extend to the people in your charge.

The cultural norm in these fields, the one "The Pitt" depicts with some precision, is that you manage it. You debrief, if there is time. You go home. You come back and do it again. This works until it does not, and often people do not notice it has stopped working until the accumulation is significant.

You do not have to be in crisis to benefit from support. You do not have to be unable to function. The fact that you are still showing up, still performing, still caring for other people is not evidence that you do not need care yourself. It is often, in fact, evidence of how much you do.

References

Carmassi, C., Foghi, C., Dell'Oste, V., Cordone, A., Bertelloni, C. A., Bui, E., & Dell'Osso, L. (2020). PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Research, 292, 113312. https://doi.org/10.1016/j.psychres.2020.113312

Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128–141. https://doi.org/10.1016/j.cpr.2015.10.003

Di Nardo, M., Terzoni, S., Cammarata, S., Baccelli, F., Bistoletti, B., Cologni, G., & Ferrara, P. (2022). Post-traumatic stress disorder among healthcare workers during the COVID-19 pandemic in Italy: Effectiveness of an eye movement desensitization and reprocessing intervention protocol. Frontiers in Psychology, 13, 942188. https://doi.org/10.3389/fpsyg.2022.942188

Orrù, G., Marzetti, F., Conversano, C., Vagheggini, G., Miccoli, M., Ciacchini, R., Panait, E., & Gemignani, A. (2021). Secondary traumatic stress and burnout in healthcare workers during COVID-19 outbreak. International Journal of Environmental Research and Public Health, 18(1), 337. https://doi.org/10.3390/ijerph18010337

Ramachandran, S., Bhatt, M., Bhattacharya, S., & Grover, S. (2021). A review of PTSD and current treatment strategies. Missouri Medicine, 118(6), 546–551.

The Questions Men Have About Therapy But Don't Ask Out Loud

Something has been shifting. More men are searching for therapists, walking into offices, and having conversations they would not have had five years ago. The cultural permission to take mental health seriously is wider than it has ever been, at least on the surface.

And yet in my clinical work, I notice that men often arrive carrying questions they have not asked anyone — about what therapy actually is, what it asks of them, whether it will help, and what it means about them that they are there. These questions often go unspoken not because the answers are not wanted, but because asking them feels like another form of exposure in an experience that already feels unfamiliar.

So here, directly, are the questions I hear most often from men — and honest answers to each.

"Do I have to talk about my childhood?"

Not necessarily, and not right away.

The cultural caricature of therapy as an endless excavation of childhood wounds puts a lot of men off before they have even started. And while understanding the past is genuinely useful in certain kinds of work, therapy is not a single thing. Cognitive Behavioral Therapy, for instance, is largely focused on the present: the patterns of thinking and behavior that are creating difficulty right now, and what to do differently. It is concrete, structured, and goal-oriented in ways that many men find more intuitive than the open-ended exploration they feared.

A good therapist will work with what matters to you and what you actually want to change. If childhood is relevant, it will emerge when it is useful. If what you need is practical tools for managing anxiety, improving sleep, or handling pressure at work or at home, that is where the work will go. The first session is largely about figuring out together what the work should be.

"Is something actually wrong with me, or am I just stressed?"

This is one of the most common questions men arrive with, and it is almost always asked with some underlying hope that the answer is "just stressed" and therefore no significant help is needed.

The honest answer is: that distinction matters less than how you are functioning and how you are feeling.

Stress, anxiety, depression, and burnout exist on a continuum and they do not always announce themselves with clear labels. What tends to matter more clinically is whether something is persistently interfering with your sleep, your relationships, your work, your ability to enjoy things, or your sense of yourself. Irritability that your partner keeps bringing up. Drinking more than you used to. A low motivation that has lasted longer than a rough week. Feeling like you are going through the motions.

These are not character flaws and they are not signs of weakness. They are signals that something in the system is under more load than it can handle without support. You do not need a formal diagnosis to benefit from therapy, and waiting until things are worse is not a prerequisite for getting help.

"Will I actually have to talk about my feelings? Because I'm not sure I know how."

Yes, to some degree. But less than you probably think, and it can be learned.

Many men arrive in therapy with a genuine unfamiliarity with emotional language, not because something is wrong with them, but because emotional vocabulary is rarely taught and often actively discouraged. Boys learn early that feelings are to be managed privately, pushed through, or converted into action. The language of inner experience can feel genuinely foreign.

Good therapy does not require you to arrive fluent in your own emotional life. Part of what the work does is build that capacity over time. It often starts more concretely: what is happening in your body when things feel off, what situations consistently make things worse, what you notice yourself doing or avoiding. From that concrete starting point, the emotional layer becomes more accessible gradually. You do not have to know how you feel before you start. You start, and it becomes clearer.

"I've been dealing with this for years. Is it too late?"

No. And this question is worth taking seriously because of what it reveals: the belief that having struggled silently for a long time is itself evidence that the struggle is permanent, or that help could have worked once but no longer can.

Neither is true. The duration of a problem does not determine whether it is treatable. Many of the most meaningful changes I have seen in clinical work have come from people who had been managing something alone for a decade or more before seeking support. What the duration does tell us is how entrenched certain patterns may be, and that the work may take longer. But longer is not the same as impossible.

There is also something worth naming about the years of managing alone: that took real effort. The capacity that allowed someone to keep functioning, keep working, keep showing up for the people who depend on them while carrying something heavy, is a real capacity. Therapy does not ignore that. It works with it.

"What if I start and it doesn't work?"

This is a reasonable concern, and it deserves a straight answer rather than reassurance.

Therapy does not work for everyone in every form. The evidence for certain approaches, particularly CBT and its variants, is strong across a wide range of conditions. But the fit between a person and a therapist matters enormously, and the first therapist you try may not be the right one. This is not a reason to avoid trying. It is a reason to treat the first attempt as information rather than a verdict.

What also tends to make therapy not work is starting before you are ready to be honest, or going through the motions without real engagement. If you try and it does not feel useful, that is worth saying out loud to the therapist. A good one will want to know. And if it is clearly the wrong fit, it is worth trying again with someone different rather than concluding that therapy itself is the problem.

"Isn't therapy just talking? Why can't I just talk to a friend?"

Friends are genuinely valuable, and strong social connection is itself protective for mental health. This is not an either-or.

But therapy offers something different from friendship. A therapist is trained to hear what is being said and what is not being said, to recognize patterns across sessions, to offer frameworks that help make sense of what you are experiencing, and to do all of this without their own needs, history, or reactions entering the room. The relationship has a specific structure and purpose that conversation with a friend, however meaningful, does not replicate.

There is also something about the asymmetry of a therapeutic relationship that many men find freeing: you do not have to manage the other person's feelings about what you share. You are not taking care of anyone in that room. You can say things you could not say to someone whose opinion of you matters to your daily life, and that freedom is often where the most useful work happens.

"What will people think?"

In my experience, this question has two layers. The outer layer is about what colleagues, friends, or family members might think if they knew. The inner layer, which is usually the more operative one, is about what it means about you.

On the outer layer: the cultural moment around men's mental health is genuinely different than it was a decade ago. More public figures, athletes, and men in visible roles have spoken about therapy and psychological struggle. Attitudes are shifting. And the practical reality is that most people in therapy are not telling their coworkers, and confidentiality is foundational to the work.

On the inner layer, which matters more: seeking support for something that is not working is not weakness. It is, in the most straightforward sense, competence. You identified a problem. You found a resource. You did something about it. That sequence describes someone who manages their life effectively, not someone who cannot handle it.

The men I have worked with who have been most helped by therapy are not the ones who arrived with the least resistance. They are the ones who came in skeptical, stayed because something started to shift, and eventually looked back and wished they had not waited as long as they did.

A Note for Men Considering Starting

You do not need to have a crisis to justify therapy. You do not need to be certain it will help. You do not need to know exactly what you want to work on.

What you need is enough curiosity, or enough discomfort, to walk in and see what happens. The first session is a conversation. You are not committing to anything beyond showing up for it.

Spring Anxiety Is Real: Why You Might Feel Worse When Everything Looks Better

April arrives. The light is back. The city is louder, more alive. Everyone around you seems to be shaking off winter and stepping into something more expansive — outdoor dinners, weekend plans, a general sense of momentum and renewal.

And somehow, you feel worse.

More restless. More irritable. Sleeping fitfully despite the exhaustion. Anxious about things that didn't seem to bother you in February. Maybe even a low, vague dread that you cannot quite locate or name — which is its own particular kind of unsettling, because nothing is obviously wrong.

If this sounds familiar, you are not alone, and you are not irrational. Spring anxiety is real, it is documented, and it has several intersecting causes that are worth understanding — especially because the cultural narrative around this season makes it so much harder to take seriously.

The Counterintuitive Truth About Spring and Mental Health

Most people associate seasonal mental health challenges with winter: shorter days, less light, reduced activity, the classic picture of seasonal affective disorder. And winter is genuinely hard for many people.

But research consistently shows that depression and anxiety rates — and notably, suicide rates — actually peak in late spring and early summer, not in the depths of winter. This finding has been replicated across multiple countries and decades, and it consistently surprises people who expect the data to tell a different story.

The reasons are multiple and they interact. Understanding them does not make the experience disappear, but it can make it considerably less bewildering — and bewilderment, in the presence of anxiety, tends to make anxiety worse.

The Biology: Your Nervous System Is Playing Catch-Up

Spring involves a rapid and significant shift in the biological conditions your nervous system operates within, and that transition is not seamless for everyone.

Light and circadian disruption. As days lengthen, light exposure increases dramatically and earlier-morning sunrises begin penetrating bedrooms that were dark through winter. This disrupts melatonin production — the hormone that regulates sleep timing — which can fragment sleep even for people who do not feel tired in a traditional sense. And disrupted sleep has downstream effects on emotional regulation, irritability, and anxiety that are well established in the literature. You can be losing meaningful sleep before you notice you are doing it.

Serotonin fluctuations. Increased light exposure triggers increased serotonin production. This sounds straightforwardly positive — and often is. But serotonin is not simply a "feel good" chemical. It is a regulator. For people with sensitivities to serotonin fluctuations — including some individuals with anxiety disorders — rapid increases can produce restlessness, agitation, and heightened reactivity rather than simply elevated mood.

Allergies and inflammation. This is one of the least-discussed but most clinically interesting mechanisms behind spring anxiety. When the immune system responds to environmental allergens — pollen, mold, increased particulates — it releases cytokines, inflammatory chemicals that can cross the blood-brain barrier and directly affect mood regulation, cognitive clarity, and emotional tone. Research has found meaningful associations between seasonal allergic rhinitis and elevated rates of depression and anxiety during pollen season. If your spring anxiety always arrives roughly when your allergies do, this is not a coincidence. Your immune system and your nervous system are in conversation, and allergy season is a stressful time for both.

Daylight Saving Time. The spring clock change — seemingly minor — reliably fragments sleep in the weeks following the switch. Studies have linked it to increased cardiovascular events, traffic accidents, and mood dysregulation in the days and weeks that follow. For people already managing anxiety, this compressed disruption to circadian timing can act as a meaningful trigger.

The Psychology: The Weight of Renewal

Beyond biology, spring carries a specific psychological burden that winter — with its cultural permission to hibernate — does not.

Spring is the season of supposed to. You are supposed to feel energized. You are supposed to be making plans, getting outside, being social, starting fresh. The cultural messaging around this time of year is relentless: renewal, new beginnings, productivity, emergence. It is the season most saturated with the expectation of positive feeling.

For someone who is actually feeling anxious, flat, restless, or depleted, this creates a painful gap between inner experience and outer expectation. In cognitive terms, it is a recipe for self-directed criticism: What is wrong with me? Everyone else seems to be flourishing. I should be happy — the weather is finally nice. That secondary layer of shame and self-judgment sits on top of the original distress and amplifies it.

There is also the social activation that spring demands. For people with social anxiety or strong introversion, winter offers a natural, socially acceptable reduction in obligation. The cold weather and shorter days provide cover for staying in, declining invitations, keeping a quieter life. When spring arrives, the implicit social contract changes. The expectation of activity, participation, and visibility returns. For some, this shift from low-demand to high-demand social seasons is genuinely destabilizing — not because they dislike other people, but because the pace of re-engagement outstrips what they are ready for.

Spring also tends to cluster with high-stakes external events: the end of the academic year, tax season, performance reviews, relationship transitions, major life decisions that were deferred through winter. The season of renewal often arrives carrying a pile of things that have been waiting.

What Spring Anxiety Can Look Like

Because spring anxiety does not fit the cultural template of what anxiety "should" look like in this season, it often gets misread or minimized — including by the people experiencing it.

It can look like irritability that seems disproportionate to circumstances — snapping at people you care about, feeling a low tolerance for minor frustrations.

It can look like sleep difficulties that are distinct from winter patterns: trouble falling asleep despite fatigue, early-morning waking, a mind that will not quiet down at night even when the day was physically tiring.

It can look like a restless, keyed-up sensation — not quite panic, but a background hum of unease that makes it hard to settle, concentrate, or feel present.

It can look like a strange resistance to things that are supposed to be enjoyable — plans you made, gatherings you were looking forward to, the arrival of good weather itself. Anhedonia in spring is confusing precisely because the season is so full of ostensibly pleasant things.

It can also look like a resurgence of symptoms that were quieter over winter. For people with pre-existing anxiety, the biological and psychosocial shifts of spring can lower the threshold for symptoms that were better managed in a more contained season.

What Actually Helps

Understanding the source of spring anxiety does not eliminate it, but it does change what you reach for. A few things that are genuinely useful:

• Protect sleep aggressively. The circadian disruption of spring is real and its effects compound quickly. Blackout curtains to block early sunrise, a consistent wake time, and a wind-down routine become more important in this season, not less. If your anxiety is spiking and your sleep has shifted, start there.

• Name the pressure, not just the feeling. If part of what you are experiencing is the gap between how you think you should feel and how you actually feel, naming that explicitly to yourself — and perhaps to someone else — can reduce its weight. You do not have to perform springtime. The season does not obligate you to feel renewed.

• Pace your social re-entry. You do not have to accept every invitation or match your output to the season's energy. Deliberate, manageable social engagement is more sustainable than a sudden leap into a full social calendar, especially if winter was quieter. Give yourself permission to transition gradually.

• Consider the allergy-anxiety connection. If your symptoms correlate with elevated pollen counts or allergy season, treating the allergies may have more mental health benefit than you expect. Reducing systemic inflammation reduces its downstream effects on mood and cognition. This is an underutilized lever.

Don't wait for the season to pass. One of the more counterproductive responses to spring anxiety is the assumption that it should resolve on its own because the season is supposed to be good for mental health. Waiting for the calendar to fix it can allow a manageable spike to become a more entrenched pattern.

Are You Using AI for Emotional Support? Here's What a Psychologist Wants You to Know

Something has quietly shifted in how people are managing their mental health between therapy sessions — and increasingly, before they ever make an appointment at all.

Many people are now turning to AI chatbots to process stress, rehearse difficult conversations, vent about relationships, and search for coping strategies. It is immediate, available at any hour, and carries none of the vulnerability that comes with disclosing something to a real person. For someone sitting with anxiety at 11pm who isn't sure it rises to the level of a therapy appointment, an AI chatbot feels like a reasonable first stop.

A new paper published in JAMA Psychiatry is drawing attention to this shift — and making a pointed argument to the mental health field: it is time for therapists to routinely ask patients about their AI use. Not as a judgment, but as clinical information as relevant as sleep, exercise, or alcohol consumption.

I think this is exactly right. And I want to explain why, from where I sit as a clinician.

What People Are Actually Using AI For

The research, led by Shaddy Saba at NYU's Silver School of Social Work and colleagues, reflects a behavioral reality that is already in the room with many of my patients — whether it gets named or not.

People are using AI chatbots to think through interpersonal conflicts before they happen. How to approach a hard conversation with a partner. How to respond to a difficult message from a family member. What to say when a colleague does something that feels unfair. This kind of social rehearsal is something humans have always done — with friends, in journals, in therapy — but AI offers it without friction or social cost.

People are also using chatbots to process emotional experiences in real time: venting about a bad day, describing what anxiety feels like, asking whether what they are going through sounds like depression. Some are using AI as a supplement to therapy. Others are using it as a substitute, either because they cannot yet afford care, are on a waitlist, or haven't yet decided that what they are experiencing warrants professional support.

All of this matters clinically. Because the content of those conversations — the things people type into a chatbot at midnight that they haven't said aloud to anyone — can tell a therapist a great deal about what is actually at the center of someone's distress.

What AI Gets Right, and Where It Falls Short

There is a reason AI chatbots feel supportive in the moment: they are designed to be affirming and responsive. They do not get tired. They do not become uncomfortable with difficult material. They do not carry their own emotional reactions into the conversation. For someone who has experienced judgment, dismissal, or rupture in human relationships, that kind of consistent, non-reactive presence can feel genuinely relieving.

This is not nothing. Feeling heard, even by a machine, can reduce acute distress.

But there is a meaningful difference between feeling heard and being changed — and that difference is where the limitations of AI become clinically significant.

Therapy is not primarily a listening service. It is a process of change. It works by helping people recognize patterns they cannot see from inside them, challenge beliefs that feel like facts, build tolerance for the emotions they have been avoiding, and practice different ways of relating — including in the therapeutic relationship itself. Good therapy is often uncomfortable. It asks you to look at things you came in hoping to avoid. It challenges you. It does not simply affirm what you already think and feel.

An AI chatbot, by design, does the opposite. It tends to validate, agree, and reflect back what the user presents. Former National Institute of Mental Health director Tom Insel has noted this directly — that AI chatbots can be affirming to the point of sycophancy, simply reinforcing a user's existing thoughts and feelings rather than creating the conditions for genuine change. For someone with depression who believes they are a burden, or someone in an unhealthy relationship who is looking for confirmation that their partner is the problem, that uncritical validation can quietly deepen the very patterns that brought them to seek support in the first place.

There is also the question of what AI misses. People often use chatbots to process things they feel too ashamed or frightened to bring to another person — including, as psychiatrist Roy Perlis notes in his JAMA Psychiatry paper, thoughts of suicide. The anonymity of an AI conversation can lower the threshold for disclosing distress that would never come up in a clinical intake. That content is clinically meaningful. Without the conversation happening between patient and provider, it remains invisible to the people best positioned to help.

AI Use as Clinical Information: What It Can Reveal

What the researchers argue — and what I find compelling — is that asking patients about their AI use is not just about monitoring a habit. It is a clinical window.

What someone brings to an AI chatbot can reveal what they are most preoccupied with, what they feel they cannot say to the people in their lives, and what coping strategies they are already trying. It can also reveal avoidance: if someone is consistently using AI to manage conflict with a partner rather than having the actual conversation, that pattern is clinically significant. It may be maintaining the very relational difficulty they say they want to address.

Bringing AI conversations into the therapy room — even in general terms — can enrich the clinical picture in ways that a structured intake never would. It surfaces the content of someone's private inner life in a way that is less guarded than direct disclosure, because it has already been said to something that felt safe.

It can also open up a valuable psychoeducational conversation about what therapy is and how it works, and why the frictionless support of an AI chatbot, however comforting, is doing something fundamentally different from what happens in a well-functioning therapeutic relationship.

A Note About the Broader Picture

The JAMA Psychiatry paper by Perlis makes a point worth sitting with: the mental health field is at an inflection point with AI, and the risks have received considerably less attention than the promise.

The potential benefits are real. AI tools may eventually expand access to mental health support for people who face significant barriers to care — cost, geography, waitlists, stigma. The global treatment gap in mental health is enormous, and AI is not going to close it alone, but it is a conversation that the field has to take seriously.

At the same time, the availability of AI chatbots as pseudo-therapeutic tools carries risks that are genuinely difficult to evaluate. The probabilistic nature of large language models means their capacity to produce harmful responses — or simply unhelpful, validating ones — is hard to predict and harder to regulate. An AI chatbot does not have a license to revoke. It does not have a governing ethics board. It cannot be held accountable in the way a clinician can, and the people most likely to rely on it as a primary mental health resource may be the least equipped to evaluate its limitations.

The paper calls for thoughtful regulation, clinician training, and ongoing evaluation of how AI is actually affecting mental health outcomes in practice. These are not hypothetical concerns. They are the preconditions for this technology being used in ways that genuinely help people rather than giving them a convincing substitute for the help they actually need.

What This Means in Practice

If you are currently using an AI chatbot for emotional support, I want to be clear: I am not suggesting that is something to be ashamed of or to hide. It is an understandable response to real emotional needs, and for many people it is filling a gap that matters.

What I am suggesting is that it is worth being thoughtful about what the gap is and whether AI is genuinely addressing it — or providing enough relief to reduce the urgency of addressing it differently.

There are questions worth sitting with:

Are you using AI to process difficult feelings and gain perspective, or are you using it to avoid conversations, decisions, or confrontations that need to happen with actual people in your life? Are the responses you are receiving pushing you toward growth and change, or primarily confirming what you already believe? Are you turning to AI instead of therapy because the barrier to care feels too high, and is that barrier worth examining?

These questions do not have a single right answer. But they are the kind of questions that belong in a therapy room — and increasingly, they are questions about AI use itself.

References

Perlis, R. H. (2026). Artificial intelligence and the potential transformation of mental health. JAMA Psychiatry, 83(4), 409–413. https://doi.org/10.1001/jamapsychiatry.2025.4116

Saba, S., & colleagues. (2026). [AI use and mental health care: Implications for clinical practice]. JAMA Psychiatry. [As reported in NPR, April 6, 2026: https://www.npr.org/2026/04/06/nx-s1-5766349]

The "Core Sleep" Myth: What Sleep Medicine Actually Says

If you have spent any time on wellness corners of the internet recently, you may have come across the concept of "core sleep" — the idea that there is a minimum essential portion of your night that delivers the most important sleep benefits, and that the rest is optional. The implication is appealing: sleep smarter, not longer. Get the good stuff, skip the padding, and reclaim your hours.

It sounds like optimization. As a sleep psychologist, I want to gently redirect it.

"Core sleep" is not a clinical term. It does not appear in sleep medicine literature, and it is not a concept used in Cognitive Behavioral Therapy for Insomnia (CBT-I), which is the gold-standard, evidence-based treatment for sleep difficulties. What it appears to be is a simplified — and somewhat distorted — interpretation of something real about how sleep is structured, applied to a conclusion that the research does not support.

Here is what the science actually says, and why it matters for how you think about your own sleep.

There Is Something Real in the Idea — But the Conclusion Is Wrong

Sleep is not uniform across the night. Deep sleep — specifically slow-wave sleep, or NREM stage 3 — does concentrate more heavily in the first portion of the night. REM sleep, the dreaming stage most associated with emotional processing and memory consolidation, accumulates more in the second half. This architecture is real and well-documented.

The mistake the "core sleep" concept makes is treating the first part of the night as sufficient because it contains more deep sleep, and treating the second half as less essential. This misunderstands what the different stages are doing.

Deep sleep and REM sleep serve different and complementary functions. Deep sleep is particularly important for physical restoration, immune function, and certain forms of memory consolidation. REM sleep plays a central role in emotional regulation, creative thinking, and the processing of complex or emotionally charged experiences. Both matter. They are not interchangeable, and neither is optional.

A useful way to think about it: sleeping only through the first half of the night is like leaving a film at the halfway point. The setup is complete. But the second half is where the meaning gets made, where the threads come together, where the experience becomes whole. You have not gotten the film — you have gotten part of it.

Why "Core Sleep" Is So Appealing

It is worth taking seriously why this concept resonates. It taps into something deeply familiar in how many of us relate to productivity and time: the belief that everything, including the body, can be optimized. If sleep has a most-efficient portion, maybe we do not need to give it the full eight hours. Maybe we can compress it, extract the essentials, and get back to everything else.

There is also something specific about sleep recommendations that breeds fatigue. Consistent sleep schedule. Limit screens before bed. Keep the bed for sleep only. These are the recommendations that have been repeated for years — because they are the recommendations that actually work. But familiarity can make them feel less exciting, and people are naturally drawn to approaches that feel newer or more sophisticated.

In clinical work, a significant portion of what we do together is not explaining the recommendations — most patients already know them. It is the harder work of examining what gets in the way of actually carrying them out, and troubleshooting the real obstacles. That is usually where the change happens.

The appeal of "core sleep" is understandable. But the underlying promise — that you can function well on meaningfully less sleep if you just structure it correctly — is not one the evidence supports.

What Happens When You Consistently Underslept

One of the more striking findings in sleep research is the gap between how people feel when they are chronically sleep-restricted and how they are actually performing. Studies consistently show that people adapt to reduced sleep in the sense that they stop noticing the deficits. They feel as though they are functioning fine. Objective measures of focus, memory, reaction time, and decision-making tell a different story.

This matters for how we evaluate sleep strategies. If you try limiting yourself to what you believe is your "core sleep" and you feel okay the next day, that feeling is not strong evidence that the strategy is working. It may simply reflect the brain's diminished capacity to accurately assess its own impairment.

Over time, consistently shortchanging sleep — even by amounts that feel manageable — accumulates. The effects appear in cognitive performance, emotional regulation, immune function, and longer-term health outcomes. Sleep debt is real, and the body keeps its own accounting.

What Actually Makes Sleep Restorative

In clinical practice, the question that matters most is not whether someone is hitting a specific number of hours, but how their sleep is functioning and how they are functioning because of it.

The qualities that tend to make sleep most restorative are continuity and consistency. Consolidated sleep — sleep that flows relatively uninterrupted through its cycles across the whole night — is more restorative than the same total hours fragmented by repeated awakenings. Consistent timing, going to bed and waking at roughly similar times, supports the circadian regulation that allows all the stages to occur in their proper sequence and proportion.

Daytime functioning is the other essential signal. Energy, focus, mood, and the ability to engage with your life are what we are ultimately trying to support. If sleep is doing its job, those things should be reasonably stable. When they are not — when fatigue is persistent, concentration is scattered, mood is fraying — that is information that the sleep, regardless of its duration, may not be providing what the body and brain need.

It is also worth naming something that often gets lost in optimization-oriented sleep conversations: good sleep does not have to be perfect. Even people with genuinely healthy sleep have off nights. Variability is normal. The goal is not flawless sleep architecture measured to the hour — it is sleep that is, over time, sufficient and restorative. Releasing the pressure to achieve perfect sleep is, somewhat paradoxically, one of the things that tends to make sleep better.

The Deeper Issue With Sleep Shortcuts

The "core sleep" concept is one example of a broader pattern in how sleep information circulates online: a real scientific observation gets extracted from its context, simplified, and repurposed into a recommendation that the original science does not actually support.

This matters because beliefs about sleep shape behavior around sleep, and some of those beliefs can quietly make sleep worse. The belief that you can function on very little sleep if you just optimize correctly can lead people to undersleep and then rationalize their impairment. The belief that there is a specific, narrow window of essential sleep can generate anxiety about whether you are hitting it — and anxiety about sleep is itself one of the most common drivers of insomnia.

CBT-I spends a significant amount of time working directly with beliefs about sleep: examining where they came from, testing them against evidence, and replacing unhelpful ones with more accurate and flexible thinking. What someone believes about sleep is often as clinically relevant as what they are doing behaviorally.

What to Focus on Instead

If the goal is genuinely restorative sleep, the evidence points clearly toward a few things:

Prioritize the full night. Both the deep-sleep-rich early portion and the REM-rich later hours serve your brain and body. Protecting the whole sleep period — not just the first part — is what allows all the stages to complete their work.

Consistency over perfection. A regular wake time is the most powerful regulator of your sleep architecture. It does not have to be rigid to the minute, but the more consistent it is, the better your circadian system can anticipate and prepare for sleep.

Pay attention to how you feel. Daytime energy, mood, and cognitive clarity are your best personal metrics for whether sleep is doing its job. These are more meaningful than a sleep tracker score or a fixed hour target.

Approach sleep without excessive pressure. Sleep is a biological process, not a performance. The more urgently we pursue it, the more elusive it can become. Good enough, most nights, is genuinely good enough.

Citations

Diekelmann, S., & Born, J. (2010). The memory function of sleep. Nature Reviews Neuroscience, 11(2), 114–126. https://doi.org/10.1038/nrn2762

Killgore, W. D. S. (2010). Effects of sleep deprivation on cognition. Progress in Brain Research, 185, 105–129. https://doi.org/10.1016/B978-0-444-53702-7.00007-5

Morin, C. M., & Espie, C. A. (2003). Insomnia: A clinical guide to assessment and treatment. Springer.

Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003). The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117–126. https://doi.org/10.1093/sleep/26.2.117

Walker, M. P., & Stickgold, R. (2006). Sleep, memory, and plasticity. Annual Review of Psychology, 57, 139–166. https://doi.org/10.1146/annurev.psych.56.091103.070307

When Fear of Aging Actually Makes You Age Faster

Most of us have had the thought at some point — catching our reflection in an unexpected mirror, forgetting a word that should come easily, noticing a shift in our body that wasn't there a year ago. I'm getting older.

For some women, that thought passes. For others, it lingers, loops, and grows into something that shapes how they move through their days: a persistent, underlying dread about what aging means for their health, their body, their independence.

New research from NYU School of Global Public Health suggests that this fear — specifically, anxiety about aging — may do more than weigh on the mind. It may be accelerating the very process it fears.

What the Research Found

Published in February 2026 in the journal Psychoneuroendocrinology, the study examined data from 726 women participating in the Midlife in the United States (MIDUS) study. Participants reported how much they worried about different dimensions of aging: declining health, becoming less attractive, and being too old to have children.

Researchers then analyzed blood samples using two established "epigenetic clocks" — molecular tools that measure biological aging independently of a person's chronological age. One clock, called DunedinPACE, measures the speed of biological aging in real time. The other, GrimAge2, estimates accumulated biological damage over a lifetime.

The findings were striking: women who reported higher levels of aging anxiety showed signs of faster biological aging on the DunedinPACE clock. In other words, the more anxious a woman was about growing older, the faster her cells appeared to be aging.

"Our research suggests that subjective experiences may be driving objective measures of aging," said Mariana Rodrigues, the study's first author and a PhD student at NYU School of Global Public Health. "Aging-related anxiety is not merely a psychological concern, but may leave a mark on the body with real health consequences."

Not all aging worries carried the same weight. Concerns about health decline were most strongly tied to faster epigenetic aging. Worries about appearance and fertility, by contrast, did not show the same biological association. The researchers suggest this may be because health fears are more persistent — they don't naturally diminish with age the way reproductive concerns do.

Why This Matters: The Mind-Body Loop

The idea that psychological distress accelerates biological aging is not new. A substantial body of research has established links between chronic stress, anxiety, and depression and a range of physical health outcomes — including cellular aging. What makes this study notable is its specificity: it's not just general anxiety driving these effects, but anxiety about aging itself.

This creates a particularly insidious loop. You fear what aging will do to your health. That fear generates chronic psychological stress. Chronic stress — through cortisol dysregulation, inflammation, and epigenetic changes in gene expression — may accelerate the very biological processes you were afraid of. The anxiety about aging becomes a driver of the aging process.

This is not a reason to feel worse, or to add fear-of-fear-of-aging to the list. It's a reason to take aging anxiety seriously as a target for psychological intervention — not just for quality of life, but potentially for long-term physical health.

Why Women Are Particularly Vulnerable to Aging Anxiety

The study's focus on women is deliberate and clinically meaningful. Women in midlife often face a specific convergence of pressures that can amplify anxiety about aging.

There are the cultural messages — still pervasive, still damaging — that tie a woman's value to her youth, her appearance, and her fertility. There is the reality of perimenopause and menopause, which brings physiological changes that can feel sudden and disorienting. And there is what Rodrigues describes as the particular weight of being the person who witnesses aging most closely: women in midlife are often simultaneously raising children and caring for aging parents. They are watching what decline looks like from the front row.

"Women in midlife may also be multiple in roles, including caring for their aging parents," Rodrigues noted. "As they see older family members grow older and become sick, they may worry about whether the same thing will happen to them."

In clinical work with women, I see this often. The worry isn't abstract. It's anchored to a specific face — a mother after a stroke, a father with dementia — and it carries the implicit question: Is that what I'm heading toward?

An Important Caveat: What the Study Doesn't Prove

The researchers are careful — and we should be too — about the limits of what this study shows.

Because it is cross-sectional (capturing one point in time rather than following women over years), it cannot establish causation. We don't know for certain that aging anxiety causes faster biological aging. It's possible that women who are already experiencing early signs of health decline are, reasonably, more anxious about aging. The relationship may run in both directions.

The study also found that when researchers adjusted for certain health behaviors associated with anxiety — smoking, alcohol use — the statistical association weakened and was no longer significant. This suggests that some of the biological impact of aging anxiety may be mediated through behavior: people who are chronically anxious may cope in ways that have their own health costs.

This doesn't diminish the finding. It actually adds clinical texture to it. If the pathway runs through behavior, that's potentially good news — behavior is something we can work with in therapy.

What This Means in Practice

For clinicians and for patients, this research opens up a conversation that mental health treatment has been slow to have: aging anxiety as a discrete, treatable psychological concern with potential downstream effects on physical health.

We have frameworks for health anxiety. We have frameworks for body image distress. We have rich clinical literature on grief, loss, and existential concerns. Aging anxiety sits at the intersection of all of these — and yet it often goes unnamed in therapy rooms, treated as a natural background hum rather than a clinical target.

What might it look like to treat it directly?

Cognitive approaches can help examine the specific beliefs driving aging anxiety: the catastrophic predictions about health decline, the rigid equations between aging and loss of worth, the all-or-nothing thinking about what "getting old" means. Many of these beliefs are amenable to careful, compassionate examination.

Acceptance-based work, such as Acceptance and Commitment Therapy (ACT), offers a different route: rather than disputing the fear, it helps people hold aging concerns with more flexibility — acknowledging uncertainty about the future without being consumed by it, and investing in values-based living in the present.

Meaning-making and narrative work can help reshape how a person understands their own aging story. Aging is not only loss. For many women, midlife brings clarity, confidence, and freedom that earlier decades didn't. The dominant cultural narrative about aging is not the only available narrative.

Addressing the social and structural dimensions also matters. Rodrigues closes her research with a call for broader cultural conversation: "We need to start a discourse about how we as a society — through our norms, structural factors, and interpersonal relationships — address the challenges of aging." Therapy can be part of that shift, but it cannot carry it alone.

Reference

Rodrigues, M., Bather, J. R., & Cuevas, A. G. (2026). Psychoneuroendocrinology, 184, 107704.

Winter Fatigue vs Depression vs Insomnia: How to Tell the Difference

Feeling exhausted in the winter is common. Shorter days, colder weather, and disrupted routines can leave many people feeling sluggish, unmotivated, or “off.” But not all winter exhaustion is the same. Fatigue, depression, and insomnia can look similar on the surface, yet they have different causes and require different approaches.

Understanding the difference can help you choose the right next step and avoid unnecessary frustration.

Winter Fatigue: When Your Body Is Slowing Down

Winter fatigue is often a physiological response to seasonal changes. Reduced daylight affects circadian rhythm and melatonin production, which can leave you feeling groggy, low-energy, or mentally foggy.

Common signs of winter fatigue include:

• Low energy during the day

• Heavier sleep or difficulty waking up

• Increased appetite or cravings

• Reduced motivation without persistent sadness

Importantly, people with winter fatigue can usually sleep when given the opportunity. The issue is not insomnia, but rather a mismatch between light exposure, activity levels, and internal clocks.

Helpful strategies often include:

• Morning light exposure

• Gentle increases in movement

• Consistent wake times

• Reduced daytime napping

Depression: When Fatigue Is Emotional as Well as Physical

Depression can intensify in the winter months, especially for those sensitive to seasonal changes. While fatigue is a common symptom, depression goes beyond tiredness.

Signs that fatigue may be part of depression include:

• Persistent low mood or emotional numbness

• Loss of interest or pleasure in activities

• Feelings of hopelessness, guilt, or worthlessness

• Changes in sleep and appetite that do not improve with rest

Sleep in depression can be irregular. Some people sleep excessively and still feel unrefreshed. Others experience fragmented or early-morning awakenings. The defining feature is not just poor sleep, but a shift in mood, motivation, and self-perception.

Treatment often focuses on:

• Psychotherapy

• Behavioral activation

• Addressing negative thought patterns

• Supporting sleep and circadian rhythm

Insomnia: When Sleep Itself Becomes the Struggle

Insomnia is not simply about being tired. It is a condition defined by difficulty falling asleep, staying asleep, or returning to sleep, despite adequate opportunity to rest.

Key signs of insomnia include:

• Long periods awake in bed

• Frequent nighttime awakenings

• Racing thoughts at night

• Anxiety about sleep itself

In winter, insomnia often worsens due to disrupted schedules, reduced light exposure, increased stress, and longer time spent in bed. Over time, sleep can become effortful and associated with frustration or fear.

Unlike fatigue or depression, insomnia is often maintained by:

• Increased sleep effort

• Over-monitoring sleep

• Spending excessive time in bed

• Trying to “force” rest

Evidence-based treatments like Cognitive Behavioral Therapy for Insomnia (CBT-I) target these patterns directly.

Why These Conditions Overlap and Get Confused

Winter fatigue, depression, and insomnia frequently coexist. Poor sleep can worsen mood. Low mood can disrupt sleep. Fatigue can increase time in bed, which can worsen insomnia.

This overlap makes self-diagnosis difficult and often leads people to try solutions that inadvertently increase symptoms. For example:

Sleeping in may worsen circadian disruption

Trying harder to sleep may increase insomnia

Pushing through exhaustion may deepen burnout

Understanding what is driving your symptoms helps clarify what will actually help.

When to Seek Support

If fatigue, low mood, or sleep difficulties persist for several weeks, interfere with daily functioning, or feel increasingly distressing, professional support can be helpful. The right intervention depends on the underlying pattern, not just the symptom.

Winter can be a challenging season, but struggling during this time does not mean something is wrong with you. Often, it means your system needs a different kind of support.

Feeling tired in winter is common. Feeling stuck, hopeless, or unable to sleep is not something you have to push through alone. Differentiating between winter fatigue, depression, and insomnia allows for more compassionate and effective care.

Sometimes the most important step is not doing more, but understanding what your body and mind are actually asking for.

Mental Wellness Month: Why You Don’t Need Extreme Resolutions to Improve Your Well-Being

January marks Mental Wellness Month—a time meant to help us reset, restore, and reconnect with ourselves after the intensity of the holiday season. But in reality, the New Year often brings a different atmosphere: pressure, urgency, and a sense that we should be doing more, achieving more, or transforming ourselves completely.

Instead of feeling refreshed, many people feel behind before the year even starts.

This is the paradox of January: the month designed for mental wellness can easily become one of the most emotionally demanding.

Why the New Year Feels So Emotionally Heavy

The New Year taps into the psychology of the “fresh start effect,” which can be motivating—but also destabilizing. The moment the calendar resets, many of us feel compelled to reinvent our health, productivity, relationships, and routines all at once.

The problem is that this mindset encourages all-or-nothing thinking, which is closely tied to anxiety, self-criticism, and burnout.

Layer onto this the winter season—shorter days, disrupted sleep schedules, social withdrawal, and reduced natural light—and it’s easy to see how January can become a perfect storm for emotional overwhelm.

Mental Wellness Month helps reframe the conversation: well-being doesn’t come from pursuing an ideal version of ourselves. It comes from cultivating sustainable habits that support the nervous system and allow our minds to reset.

Why True Mental Wellness Comes From Sustainable Habits

The research is clear: long-term change is driven by consistency, not intensity.

The more pressure we place on ourselves to “fix everything,” the more likely we are to freeze, avoid, or abandon the plan entirely.

That’s why the most effective mental wellness practices are simple, gentle, and realistic—especially at the start of a new year.

Here are a few habits that truly make a difference:

1. Protecting 10–15 Minutes of Intentional Rest

One of the easiest ways to support mental health is to introduce brief periods of intentional rest into your schedule.

This isn’t zoning out on your phone or half-watching TV—it’s a deliberate pause that signals your nervous system to downshift.

Examples:

• Folding laundry slowly and mindfully

• Sitting with a warm beverage

• A few minutes of quiet stretching

• Simply breathing without multitasking

Even small doses of restorative rest can reduce irritability, improve emotional resilience, and calm racing thoughts.

2. Getting Daily Natural Light (Even Briefly)

Light exposure is one of the strongest regulators of mood and circadian rhythm.

In the winter, reduced daylight can worsen sleep disturbances, fatigue, and symptoms of depression.

You don’t need a long outdoor routine—just:

• 2–5 minutes by a window

• A quick walk around the block

• Standing outside while you drink your coffee

These tiny exposures help reset your internal clock and can improve both mood and sleep.

3. Choosing “Minimum Goals” Instead of Extreme Resolutions

Most resolutions fail not due to lack of willpower, but because they’re too big, too fast.

Instead of:

• “I’ll meditate every day” → Try “I’ll take 3 slow breaths before bed.”

• “I’ll work out daily” → Try “I’ll move my body 2–3 times a week.”

• “I’ll sleep perfectly” → Try “I’ll dim my lights 15 minutes earlier.”

Minimum goals build momentum. Extreme goals build guilt.

4. Prioritizing Real Human Connection

Emotional well-being is strongly tied to our sense of belonging.

But January often brings isolation—cold weather, social fatigue, and a return to packed schedules.

Intentionally scheduling two small moments of connection—a walk with a friend, calling a family member, or simply chatting with someone you trust—can significantly reduce feelings of loneliness and stress.

5. Treating Sleep as a Foundation, Not an Afterthought

Sleep underpins mental health in almost every measurable way.

Better sleep improves:

• Emotional regulation

• Cognitive function

• Stress tolerance

• Overall resilience

You don’t need a complicated routine. Try:

• A stable wake time

• A short wind-down without screens

• A darker, cooler sleeping environment

These simple shifts often have a larger impact than people expect.

Mental Wellness Month: A Gentle Invitation, Not a Mandate

Mental Wellness Month is about stepping back from the pressure to “be better” and instead focusing on being steadier. Wellness doesn’t require a reinvention. It requires compassion, pacing, and habits that work with your life—not against it.

As we move deeper into the new year, remember that mental wellness is built in the small margins of the day—in the pauses, the connections, the breaths, and the choices that support your nervous system.

If you begin the year gently, you give yourself the space to grow sustainably through the months ahead.

The New Year Isn’t Always a Fresh Start — Anxiety & Depression in January

Every December, the world seems to hit “reset.” We’re encouraged to reflect on the past year, write fresh goals, rethink our habits, and step into January as a new version of ourselves.

For some, that feels exciting.

For others—especially those dealing with anxiety or depression—the New Year can feel heavy, stressful, or confusing.

If the transition into January brings more pressure than motivation, you’re not alone.

Why the New Year Can Trigger Anxiety

1. Pressure to “fix” everything at once

New Year’s culture often leans into perfectionism: new habits, new routines, new productivity systems. For people who already struggle with anxiety, that pressure can amplify worries about not doing enough.

2. Uncertainty about the year ahead

An anxious mind naturally scans for risk and unpredictability. A brand-new year—full of unknowns—can feel overwhelming rather than refreshing.

3. Increased social comparison

Year-in-review posts, success highlights, and big resolutions can create a sense that everyone else is moving forward faster. This can intensify anxiety and self-doubt.

How the New Year Affects Depression

1. Low energy meets high expectations

Depression often brings fatigue, low motivation, and difficulty initiating tasks. Pair that with the message that January requires a major life reset, and the emotional load can feel even heavier.

2. The post-holiday crash

The holidays disrupt routines, bring emotional highs and lows, and often involve intense social interactions. When January arrives, the sudden quiet can amplify feelings of loneliness or emptiness.

3. Self-reflection can turn self-critical

Reflecting on the past year is healthy, but depression often skews reflection toward perceived failures or shortcomings. This can deepen feelings of hopelessness.

What Helps: Supportive Ways to Enter the New Year

1. Set intentions instead of resolutions

• Intentions are flexible and values-based, like “Prioritize rest” or “Be gentle with myself.”

• Resolutions tend to be rigid and all-or-nothing.

• Intentions reduce pressure and support emotional steadiness.

2. Start small—really small

• Small, doable steps create momentum without overwhelming the brain.

Examples: A 10-minute walk, drinking one glass of water in the morning, two minutes of journaling at night, ease back into routine gradually.

• Routines help stabilize mood, but there’s no need to flip a switch on January 1st. Think of the month as a soft start.

4. Reduce comparison triggers

• A short break from social media can significantly reduce emotional overload during the first week of January.

5. Remember that nothing magical has to happen on January 1st

• The New Year is not a performance review. It’s simply another day on the calendar. You’re allowed to move into it slowly, quietly, and on your own terms.

The New Year Can Be Both Hopeful and Hard

If this season feels complicated for you, it doesn’t mean you’re doing anything wrong. Many people experience anxiety or depression this time of year—especially when the cultural pressure to “start over” is so high.

You don’t need a full reinvention.

You just need small, kind steps that help you feel grounded as you enter the year ahead.

The Holiday Season and Mental Health: Why It Can Feel Both Comforting and Overwhelming

The holiday season is often described as a time of joy, connection, and celebration. For many people, parts of that are true. The holidays can bring moments of warmth, nostalgia, and meaningful connection. They can also stir up stress, exhaustion, grief, and emotional overload — sometimes all at once.

Experiencing both is not a contradiction. It’s a very human response to a season that carries emotional weight, social expectations, and significant disruption to routine.

Why the Holidays Can Be Good for Mental Health

At their best, the holidays can support emotional wellbeing in subtle but important ways.

For some, the season brings:
• Time off from work or a slower pace
• Opportunities for connection with friends or family
• Traditions that create a sense of continuity and meaning
• Permission to rest or reflect at the end of the year

Moments of connection, shared meals, and familiar rituals can strengthen relationships and provide a sense of belonging. For people who feel isolated during much of the year, even brief social contact during the holidays can feel grounding.

There can also be psychological value in marking time. The end of the year invites reflection — what was hard, what changed, and what matters moving forward.

Why the Holidays Can Also Be Stressful

At the same time, the holiday season places unique demands on mental health.

Common stressors include:
• Financial pressure and gift-related expectations
• Disrupted routines, including sleep and eating
• Increased social obligations
• Family dynamics that bring up old patterns
• Grief or loneliness that feels sharper this time of year

For many people, there is also an unspoken expectation to feel grateful, joyful, or celebratory — even when they’re struggling. This pressure can lead to guilt or self-criticism when reality doesn’t match the idealized version of the season.

The Role of Sleep and Routine

Sleep disruption is one of the most common and overlooked contributors to holiday stress. Late nights, travel, alcohol, and irregular schedules can quickly affect emotional regulation.

When sleep suffers:
• Patience decreases
• Anxiety feels louder
• Emotional reactions intensify
• Coping skills feel harder to access

Maintaining even a loose sense of routine — especially around sleep and wake times — can provide stability in an otherwise unpredictable season.

Why Mixed Emotions Are Normal

It’s possible to enjoy parts of the holidays and still feel overwhelmed, sad, or disconnected. Many people experience joy and grief side by side — especially if the season brings reminders of loss, change, or unmet expectations.

Mixed emotions do not mean you’re doing the holidays “wrong.” They often reflect awareness and emotional depth.

Letting go of the idea that the season should feel one specific way can reduce unnecessary pressure and allow for a more honest experience.

Supporting Your Mental Health During the Holidays

Small, realistic steps often help more than grand plans for self-care.

Helpful approaches may include:
• Setting boundaries around time and energy
• Prioritizing sleep when possible
• Choosing which traditions feel meaningful — and which don’t
• Allowing yourself to opt out of certain expectations
• Creating moments of quiet or reflection amid activity

Mental health support during the holidays doesn’t require fixing everything. Often, it’s about reducing overload and making room for what feels manageable.

The holiday season can be both nourishing and draining. It can highlight connection while also amplifying stress, loneliness, or grief.

Acknowledging this complexity — rather than pushing for constant cheer — is often what allows people to move through the season with more steadiness and self-compassion.

If the holidays feel hard, you’re not alone. And if they feel meaningful in some moments and difficult in others, that’s not a failure — it’s a human response to a layered, emotionally charged time of year.

AI in Behavioral Health Is Evolving — And Sleep May Be the Missing Link

Digital mental health is entering a new era. Recaps from last month’s HLTH 2025 conference highlighted a clear shift across the industry: the focus is moving away from “AI hype” toward “AI impact.” Healthcare organizations, health tech companies, and clinical leaders are aligning around the same core message — outcomes, evidence, trust, and real-world engagement matter more than ever.

In behavioral health, this pivot feels especially relevant. AI-driven platforms are more advanced than ever, but the conversation is expanding beyond innovation for innovation’s sake. The questions shaping the future now sound different:

• Does the tool lead to measurable clinical improvement?

• Is it grounded in validated therapeutic models?

• Does it keep people engaged long enough to change behavior?

And nowhere is that shift more urgent than in the realm of sleep and behavioral sleep medicine.

Why Sleep Is the Next Frontier in Digital Behavioral Health

Technology can accelerate access to care, but sleep does not improve passively. It requires new habits, new routines, and new responses to stress, fatigue, and rumination. In other words — sleep is a behavioral system, not simply a biological one.

Decades of research on Cognitive Behavioral Therapy for Insomnia (CBT-I) have shown:

• Lasting sleep improvement depends on behavioral adherence

• Digital programs succeed when grounded in clinical fidelity

• People need support in the moment, not just information

It’s not enough to know what improves sleep. People need tools that help them follow through — especially when motivation is low, or when insomnia triggers anxiety, frustration, or avoidance.

The next generation of digital health solutions will succeed not because they track sleep more accurately, but because they help people change behavior more effectively.

From AI Hype to AI Impact in Sleep Medicine

As digital behavioral health matures, it’s becoming clear that the most effective use of AI isn’t replacing therapy — it’s enhancing the therapeutic process:

• Personalizing behavioral recommendations based on patterns

• Predicting relapse moments before they occur

• Delivering real-time coaching during high-risk periods (late nights, early mornings, high stress)

• Supporting accountability without increasing clinical workload

AI becomes most valuable when paired with evidence-based treatment frameworks and a clear path from knowledge → engagement → adherence → outcomes.

The market is beginning to reward solutions that demonstrate:

• Clinical validation

• Measurable symptom reduction

• Lower cost of care and improved access

• Lasting changes in daily functioning, not temporary engagement spikes

Sleep stands at the center of all four.

The New Mental Health Equation Includes Sleep

For years, clinicians have emphasized what the broader healthcare system is only now beginning to adopt:

• Sleep health is mental health

• Sleep health is physical health

• Sleep health is burnout prevention and workforce performance

Improving sleep has been linked to reduced anxiety and depression, improved immune function, decreased cardiometabolic risk, enhanced self-regulation, and improved cognitive performance. For employers, sleep improvement is increasingly tied to productivity, decision-making, emotional resilience, safety, and retention.

As the health tech sector looks toward scalable, cost-effective interventions, sleep emerges as one of the highest-leverage points of change across both clinical and organizational environments.

The Future of Digital Behavioral Sleep Medicine

The next wave of innovation in sleep and mental health will not be defined by:

✗ More tracking

✗ More data dashboards

✗ More generic “sleep hygiene” advice

It will be defined by:

✓ Clinical fidelity to gold-standard care like CBT-I

✓ Human-centered design that supports motivation and behavior

✓ Technology that enhances—not replaces—relational connection

✓ Demonstrated clinical outcomes, not just engagement analytics

The industry message is clear: real-world behavior change is the new benchmark of success. If the digital health space continues to invest in solutions that are clinically informed, evidence-based, and behaviorally smart, sleep has the potential to transform mental health at scale.

Trends in Digital Mental Health and Behavioral Health: What’s Changing and What It Means for Patients

The world of mental health care is undergoing a transformation. Virtual therapy, digital mental health apps, wearable technology, and skill-based online programs are reshaping the way people access care and understand their own emotional well-being. For those seeking support, these tools can create more flexibility, more personalization, and more insight than ever before.

But with rapid change also comes uncertainty. Many patients are unsure which tools are helpful, which are hype, and whether digital support can be as meaningful as in-person therapy. Understanding today’s digital mental health trends can help people make informed decisions and advocate for the type of care that feels right for them.

Why Digital Access Is Expanding — and Why It Matters

Virtual therapy has become a permanent and valuable model of care. Patients who previously struggled to make room for therapy in their lives — due to scheduling demands, commuting, childcare, health limitations, or anxiety around seeking support — now have access to treatment from wherever they are.

This shift is especially meaningful for:

• Young adults moving to new cities or managing work stress

• New parents balancing childcare responsibilities

• Individuals with chronic pain, mobility challenges, or insomnia

• People in rural or underserved areas with fewer available providers

Digital access does not dilute the therapeutic relationship. For many, it strengthens it by lowering barriers to connection and encouraging more consistent care.

Apps and Digital Programs: Reinforcing Skills, Not Replacing Therapy

There is no shortage of mental health apps, and not all are created equal — but when thoughtfully chosen, they can complement therapy in powerful ways. Behavioral health apps are especially supportive for:

• Tracking mood, sleep, habits, triggers, and progress

• Practicing coping strategies outside of sessions

• Learning evidence-based skills like CBT or mindfulness

• Increasing accountability during life transitions

Digital support works best not as a standalone solution, but as a tool that reinforces therapeutic goals.

Evidence-Based Approaches Are Becoming More Mainstream

The digital mental health movement has led to an increased focus on structured, data-driven interventions like:

• Cognitive Behavioral Therapy (CBT)

• Acceptance and Commitment Therapy (ACT)

• Dialectical Behavior Therapy (DBT)

• Cognitive Behavioral Therapy for Insomnia (CBT-I)

Patients are learning earlier, even before entering therapy, that talk therapy alone is not always enough — and that targeted, skills-based approaches can create lasting change for anxiety, depression, insomnia, emotional dysregulation, and behavioral challenges.

Wearable Tech and Self-Tracking: A New Window Into Mental Health

More individuals are using wearable devices to track sleep, HRV, movement, and stress signals. While wearables are not diagnostic tools, they can:

• Increase awareness of mind-body patterns

• Help identify stress cycles or disrupted sleep

• Reveal how lifestyle influences mood and energy

• Support engagement in treatment plans

When interpreted in collaboration with a mental health professional, this data can support behavioral change without becoming overwhelming or perfectionistic.

Human Connection Remains at the Heart of Healing

While digital trends are reshaping mental health care, the core of therapy has not changed: people heal in safe, trusting relationships. Technology should expand access — not replace connection. The future of mental health is most likely hybrid: digital tools to reinforce skills, and human-to-human care to support emotional growth.

Digital mental health is not about adding more technology to daily life — it’s about using technology intentionally to make care more reachable, responsive, and personalized. Whether someone is seeking support for stress, anxiety, insomnia, life transitions, or relationship challenges, there are more pathways to treatment than ever before.

If you’re considering therapy but don’t know where to begin, reaching out can help you determine what mix of digital tools and human support is right for you.