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What Do You Do With Too Much Time on Your Hands?

What Do You Do With Too Much Time on Your Hands?

Everybody’s always complaining about how busy they are. Stressed out, running around, too much to do, no time to relax.

Yet, the opposite problem exists for many people. They have too much time on their hands. Nothing to do and all day to do it. And, that’s not just retired or unemployed folks. It’s also working people who don’t know how to spend their time off.  So what do they do? They keep working.  Surprisingly, more than half of Americans don’t take all their paid vacation days.

Clearly, no one likes being stressed out, with no time to relax or do what they want to do.  That’s why we crave leisure time. A break from work — yay! A break from household tasks — whoopee! A break from childcare — wow, time for myself!

What makes leisurely pursuits so enjoyable is their break from regular responsibilities. But when we have nothing to look forward to for the day, for the week, for the month, leisure time is anything but enjoyable. It’s unnerving. It makes us uneasy. It makes us feel unnecessary. And it is oh, so boring.

With too much time on your hands, not only do you feel bored but you probably also feel lonely, anxious, angry and depressed. And, if you are living with others, it’s so easy to point fingers of blame (“we never do anything”). Let’s face it, most people simply don’t know what to do with themselves when they are alone (or with a partner), when they have no structured activity or scheduled socializing.

Recognizing what you’d like to do, initiating the event, and then following through with making it happen is hard to do on your own. Hence, people have a tendency to while away their leisure time with passive activities — such as watching TV, playing video games, drinking or sleeping the day away.


All leisure time activities are not the same in value either. Those that have the highest potential for making us feel joyful and jubilant are those that are active, such as participating in games, sports, hobbies, travel and socializing. This is true whether you have a weekend off, a summer off, are independently wealthy or are fully retired.

Mihaly Csikszentmihalyi, author of the best-selling book Finding Flow, says that most people feel happiest when they are “fully involved in meeting a challenge, solving a problem or discovering something new. Most activities that produce flow — a peak feeling of happiness — come from being fully involved in something, focusing our attention and making demands on our skills.”

Though many people would agree that such activities improve their mood, they still frequently fall into passive pursuits. Why should this be so? The answer is clear. It takes more time, energy and thought to schedule a tennis game with friends than to flip on the TV. Even if you’re planning a solitary activity, like taking a stroll on the boardwalk, you have to organize yourself to dress right, drive there, park and get motivated to walk. It’s not a major production to do, yet it’s still much easier to not bother and let the time go by passively.

If, when you have leisure time, you feel more listless and lethargic than rested and relaxed, it’s time to get going. Stop taking the easy road. Instead, push yourself or gently pull yourself forward. Get involved in activities that require movement, learning and/or socializing.

As your mood improves, your outlook on life will blossom. Then you’ll realize you no longer have too much time on your hands. Nor, will you be “crazy busy.” Happily, you and your free time will be dancing in tandem.


The power of love: how relationships benefit body and mind

The power of love: how relationships benefit body and mind

“All you need is love,” sang the Beatles. When one considers the widely documented health benefits of being in a happy relationship, they might have been on to something. In this spotlight, we take a look at the health reasons for celebrating being with someone.

Couple kissing.

Research has demonstrated a myriad of health benefits – physical, mental and emotional – associated with being in an affectionate relationship.

With Valentine’s Day approaching, many people fortunate enough to find themselves in relationships will be preparing for a day of celebration. The health conscious may look at boxes of chocolates and meals in restaurants warily, but it is worth remembering that outside of these indulgences, a wealth of health benefits have been identified for people in relationships.

Many will be aware that sex is a form of exercise, increasing the heart rate and reaching an average peak at orgasm comparable to forms of light exercise, such as walking upstairs. It is also fine for people with heart disease to have sex, so long as they can still do equivalent activities (such as walking up two flights of stairs) without experiencing chest pain.

Outside of this, though, several other health benefits arise from being in a relationship. And being in a loving relationship is not simply a bed of roses; different types of relationship have their own effects. We investigate.

Put a little love in your heart

The heart is one of the most conspicuous symbols of love, and perhaps it is unsurprising that love is associated both literally and figuratively with one the most important organs in the human body. With February being American Heart Month, it seems prudent to examine the less obvious benefits to the heart first.

Research has indicated that being in a satisfying relationship can lead to improved survival rates after coronary bypass surgery – an aggressive treatment for heart disease. The effects of satisfaction were reported to be just as important to survival as traditional risk factors, such as obesity and tobacco use.

This finding may have been due to happy relationships encouraging healthful behavior, such as quitting smoking and keeping fit.

Less active displays of intimacy than sex can also be beneficial to cardiovascular health. One study found that couples holding hands for 10 minutes followed by a 20-second hug had healthier reactions to a public speaking task than participants who merely rested quietly.

The couples that had brief warm social and physical contact exhibited lower heart rates, lower blood pressure and smaller increases in heart rate, with results comparable for men and women.

“These findings suggest that affectionate relationships with a supportive partner may contribute to lower reactivity to stressful life events,” write the authors. The implication from the study is that affectionate relationships could be related to better cardiovascular health.

Hypertension can be dangerous, leading to serious conditions including heart failurestroke and heart attack. Research has also found that it can increase the risk of cognitive decline later in life. However, lowering blood pressure is not the only aspect of being in a relationship that benefits cognitive functioning.

Always on your mind

Sex has also been found by researchers to improve mental health. A small study of 46 men and women suggested that like other forms of physical activity, sex reduces levels of stress.

Researchers conducted stress tests involving acts such as doing mental arithmetic out loud, finding that people who had sex coped better with stress than participants that had no sex at all.

A person’s sense of well-being can also be improved by sex. A much larger study of 3,000 people aged 57-85 demonstrated that those who were having sex rated their health much more favorablythan those who were not.

In this study, it was not just sex that led to improved well-being, but being in a satisfying relationship overall. The researchers found that participants in close relationships were more likely to report they were in “excellent” or “very good” health, rather than merely “good” or “poor.”

According to the Mayo Clinic, thinking positively in this manner could lead to further health benefits, including reductions in the risk of the following:

  • Common cold
  • Depression
  • Distress
  • Overall mortality.

Dr. Larry J. Young, of Emory University in Atlanta, GA, told Medical News Today that the benefits to health and well-being that come from being in a relationship are best understood from seeing what happens when a relationship is lost, either by death or splitting up:

“Loss of a loved one (e.g. spouse or romantic partner) leads to an increase in mortality, immune suppression, cardiovascular disease and depression.”

Love is not the same for everyone

It should be pointed out that no one seems to experience love in precisely the same way as everyone else. We are all drawn to different kinds of people and expect many different things from a relationship. It should not be surprising, for this reason, that the health implications of love also vary.

Happy affectionate couple hugging.

Could levels of affection and attachment style determine the health benefits couples receive from their relationship?

Recently, MNT reported on a study investigating the effects of attachment style on pain relief. Adult attachment style refers to patterns exhibited by individuals in relationships related to how they seek or avoid closeness.

Typically, the presence of a partner in a painful situation would be considered comforting and a relief, yet this was not the case for every participant in the research.

In a small study of 39 women, “moderately painful” laser pulses were administered to the participants’ fingers while their romantic partner was present and then absent. The authors found that the more women were avoidant of closeness in their relationships, the more pain they experienced when their partner was present.

The authors concluded that “partner presence may not have beneficial effects on the experience of pain when the individual in pain is characterized by higher attachment avoidance.” The presence of others may disrupt the preferred method of coping with “the threat value of pain” for such individuals.

For the women reporting high closeness with their partner, it may be oxytocin – a hormone sometimes referred to as “the love hormone” – that could be responsible for their experiencing reduced levels of pain.

Lead author Dr. Charlotte Krahé told MNT they believed that oxytocin might be part of a neurobiological mechanism involved in shaping the effects of interacting with close others on the pain experience.

Oxytocin has been associated by researchers with parts of the brain that are involved in emotional, cognitive and social behaviors. Acts of intimacy, such as sexual intercourse, holding hands and looking into another person’s eyes, stimulate the release of oxytocin in men and women. The hormone is produced in larger amounts in mothers when they are giving birth or nursing.

In an article published in Nature, Dr. Young suggests that long-term bonding between mates may be regulated by the same mechanisms as those involved in maternal bonding.

Oxytocin “interacts with the reward and reinforcement system driven by the neurotransmitter dopamine – the same circuitry that drugs such as nicotine, cocaine and heroin act on in humans to produce euphoria and addiction,” he writes.

“I think this is the only reason that we do hug and touch each other all the time. I think this is the mechanism that keeps oxytocin levels high in relationships,” says Dr. Rene Hurlemann, a professor of psychiatry at the University of Bonn in Germany.

Addicted to love, and then withdrawal

“We have evidence that it is the withdrawal from oxytocin after social loss that leads to the depressive side effects, at least based on our studies in monogamous prairie voles,” Dr. Young told MNT.

A giggling nun.

A study of nuns has demonstrated that romantic relationships and sex are not required for good health and long life.

In a paper published in Psychopharmacology in 2012, Dr. Young and James P. Burkett reviewed research on drug addiction alongside research on social attachments. “The psychology of human love and drug addiction share powerful overlaps at virtually every level of the addictive process, from initial encounters to withdrawal,” the authors conclude.

Oxytocin was found to play a modulatory role in many aspects of drug addiction, along with additional roles in the processing of memories and information involved in social attachment.

The association between oxytocin and addiction was explored further last year in research conducted by the University of Adelaide in Australia. The study suggested that poor development of oxytocin during early childhood could explain why some individuals succumb to addictive behavior.

Dr. Young and Burkett state that the overlaps in the psychology of human love and drug addiction suggest that forms of treatment for one domain may be effective in another. “[For] instance, treatments used to reduce drug cravings may be effective in treating grief from the loss of a loved one or a bad breakup,” they write.

These findings suggest that further research into the neurobiological mechanisms of love could reveal ways in which its positive healthful effects could be brought to people that find themselves without it.

Not all doom and gloom for single people

Single people can feel quite downhearted around Valentine’s Day, being surrounded by people experiencing a joy that, at that moment in time, eludes them. Reading about these examples of health benefits for happy and affectionate couples may well contribute toward to this.

It is not all doom and gloom for single people, however. Research has found that having a good network of friends can have many of the same positive effects as being in a relationship.

One study of 1,500 people aged over 70 found that participants who reported having strong friendship groups tended to live longer than people with fewer friends. The authors suggested that this finding could be due to friends having a positive influence on lifestyle choices.

Despite all the health benefits that sex provides, research has also demonstrated that a life of celibacy can also be one that is long and healthy. A longitudinal study of 678 nuns aged 75-107 found many participants maintaining an active lifestyle and demonstrating strong cognitive function well into old age.

So, while there is much to celebrate about being in a relationship around Valentine’s Day, it is by no means the be-all-end-all, especially when looking from a health perspective. Good health and long life can be enjoyed by anyone, no matter what their relationship status is.


20% of Anorexics Are Men

20% of Anorexics Are Men

Twenty percent. And rising. More and more men are starving themselves to death in a pathological pursuit of perfection. Male anorexics have much in common with women who suffer from the same debilitating illness, but there’s a striking difference: For the vast majority of men, help is not on the way.

Editor’s Note: Will Brooksbank, one of the young men profiled in this story, died on June 13, 2014 at the age of 22. He had spent exactly half his life battling his anorexia. At his funeral, his family displayed a photograph of him on which they’d printed his final quotation in his section of this article.

A devout Christian, Will was a crusader for his God and his disease. His friends were the anorexics he met during his many hospitalizations, and his family has received many notes from them saying that Will inspired them—that he saved their lives. “He wanted to help everybody else in the world, but he couldn’t help himself,” says his father, Kenn Brooksbank, of San Antonio. Will’s family has established a fund in his name. Contributions can be mailed to the Eating Disorder Center at San Antonio, 515 Busby Drive, San Antonio, Texas, 78209. Checks should be made out to EDCASA, with “Will Brooksbank Fund” indicated in the memo line.

Anorexia has the highest mortality rate of any mental illness.

No one could possibly watch the hunger artist continuously, day and night, and so no one could produce first-hand evidence that the fast had really been rigorous and continuous; only the artist himself could know that, he was therefore bound to be the sole completely satisfied spectator of his own fast. Yet for other reasons he was never satisfied…. For he alone knew, what no other initiate knew, how easy it was to fast. It was the easiest thing in the world.

— “A Hunger Artist,” by Franz Kafka

I. Steven

280 lbs.

By the time Steven’s girlfriend broke up with him for good, over Christmas of 2009, her bulimia had gotten so severe that her menstrual cycle had stopped. Her doctors in Saskatchewan, Canada, said she might be infertile. To Steven, who had been looking for a piece of land where they could build a house and start a family, the news was devastating. He had gone to family-support days at her residential treatment center, but he says her disease gradually shut him out—that’s what eating disorders do to loved ones. Danielle* had broken up with him over and over again, and each time the pain was unbearable for him. Twice he had tried to kill himself. To drown out the anguish, he had ramped up his partying. Bulimia was her thing, alcohol and cocaine were his.

One night during that long, cold winter, after gorging on two plates of his mother’s lasagna, he went into the bathroom, turned on the shower to cover the sound, and stuck his fingers down his throat. Steven is five feet nine, and he weighed nearly 300 pounds at the time. In the past he had occasionally preempted a hangover by forcing himself to throw up. “It was like a high,” he says. “I felt like I’d gotten away with something. And then I knew that I could do it again, and pretty soon I was throwing up everything I was taking in.” His doctors would later call it trauma bonding—a way of keeping Danielle with him.

Steven has another way of describing it: Getting dumped was like being bitten by a vampire. It turned him into her.

212 lbs.

Steven comes from a family of “patch monkeys”—oil-field workers—and for two years he worked in electrical construction in the oil sands of Alberta, ten days on, four days off. His job was laying down power cable for the well pads. It was exhausting, dangerous work, but if you could hack it, you could make close to six figures straight out of high school.

During winter, the temperature in the oil fields can fall below minus-forty degrees, cold enough for exposed skin to freeze instantly. Steven was risking frostbite when he would slip away into the bush after breakfast and lunch, pull aside his balaclava, and force himself to vomit. He’d kick snow over the steaming pile and hurry back to work. After dinner he’d return to his trailer, turn up his stereo, and puke into his garbage basket. Then he’d toss the bag in a Dumpster.

This became his routine, but the secrecy wore him down. You had to hide the smell. The sound. Soon he found a neater, cleaner way: Instead of purging, he’d just eat less. By the early spring, he was consuming fewer than 400 calories a day—barely 15 percent of the recommended amount for a man of his size and occupation. He was drinking more than ever. In April 2010, after a bender nearly caused him to miss a flight back to the oil field, he checked himself into drug rehab.

His diet by then was two rice cakes, two tablespoons of peanut butter, and one small banana. Per day.

As recently as a decade ago, clinicians believed that only 5 percent of anorexics were male. Current estimates suggest it’s closer to 20 percent and rising fast: More men are getting ill, and more are being diagnosed. (One well-regarded Canadian study puts the number at 30 percent.) It’s unclear why, but certainly twenty years of lean, muscular male physiques in advertising, movies, sports, and of course, magazines like GQ—from Marky Mark to Brad Pitt to David Beckham—have changed the way both men and women regard the male body. And thanks to the web, those images are easy to seek out and collect. For American men, the chiseled six-pack has become the fetishized equivalent of bigger breasts. Like all fetish objects, it stands for something deeply desired: social acceptance, the love of a parent or partner, happiness.

But many afflicted men feel too stigmatized to go to a doctor—and many doctors don’t recognize the early, ambiguous symptoms. “It is not what a primary-care physician will consider at first glance,” says Mark Warren, founder of the Cleveland Center for Eating Disorders. “Often it won’t be what they consider at fourth or fifth glance.”

Diagnosis is hard. Finding treatment is even harder. Many residential centers don’t admit men, out of a belief that treatment should be sex-specific. There is no data to support this belief, though clinicians think that certain gender-specific issues are best addressed in therapy or in single-sex groups within a larger coed facility. Some centers prefer not to treat men, because they may inadvertently remind female clients of the trauma they have endured at the hands of abusive fathers, husbands, or lovers. Of the fifty-eight residential treatment centers listed in the Alliance for Eating Disorder Awareness’s 2011-12 guide, only twenty-five admit men. “Most men with eating disorders are living with them quietly and painfully,” says Warren. “I would guess at least three-quarters of them don’t get any treatment. They’re suffering without help.”

129 lbs.

Steven got lucky in drug rehab: One of his counselors was a recovering bulimic. The first thing she told him was that he would die if he continued eating only 400 calories a day. Together they created an 800-calorie menu: two hard-boiled eggs and two pieces of toast for breakfast, a banana and a cheese stick for a snack, and portion-controlled versions of the day’s cafeteria meal for lunch and dinner. During his thirty-four days in rehab, Steven nonetheless lost almost a pound a day. Within two months of being discharged, he was consuming 1,200 calories daily, still a dangerously low amount. But he believed he was getting better. He was eating every two and a half hours.

Steven had been overweight as a kid and often depressed. He remembered thinking that his life would be so much better if only he were thin. Even now he believed his weight was the only thing holding him back. He told himself that all his troubles were going to be over soon. In the first sixteen months of his disease, he lost more than 150 pounds. He was constantly sore, constantly tired; he remembers going for a massage and hearing the masseuse gasp when she saw his naked back. A summer breeze would make him shiver uncontrollably. His friends fell away as he descended into “deep, deep isolation.”

He began calling residential eating-disorder facilities, but he couldn’t find one that would admit men. “It was incredibly frustrating,” he says with a pained smile. “It takes an incredible amount of balls to ask for help, because it’s thought of as a girl’s disease, and you finally work up the courage and there’s nothing there.” Drug rehab, he points out, isn’t gender-exclusive. Neither is rehab for sex addiction.

Blake likes being around people but avoids them: “People are the ones who force you to eat.”

For fear of encountering food, he rarely left his apartment. Instead he sat in front of his computer and made lists of dream meals he would never eat—a stuffed-crust pizza from Pizza Hut, a cheeseburger he read about online that used the halves of a Krispy Kreme doughnut for a bun. One doctor told him to try a nutrition shake called Ensure. “You just can’t,” Steven says. “Like, if I did, I might have a heart attack and die. They don’t understand the kind of anxiety you feel.”

Being obese for so many years had permanently stretched the skin of his torso. To him, the folds that pooled around his navel and hung from his pecs looked like fat. His mother had been trying desperately to make Steven see how emaciated he’d become. What if I showed you a photo? she asked. As Steven stripped down to his bors, she snapped four pictures. Above his jutting hipbones, his waist is so deeply indented that it looks Photoshopped. His features are masklike and vacant, but from behind the mask his eyes look bewildered and frightened. His physical wastedness is like a plea.

Anorexics may not look the way they want to look, but they always look the way they feel.

158 lbs.

“When I saw the pictures,” Steven, 25, says now, “I knew I was mentally fuckin’ crazy to think I was fat.” He began forcing himself to eat, progressively increasing his intake to 2,200 calories a day (the same willpower that has carried him into his third year of sobriety). But even now he weighs almost everything he eats. Breakfast, for example, is thirty grams of oatmeal with one chopped apple and one cup—”118 to 125 grams”—of blueberries.

We are sitting in a hotel restaurant in Saskatoon. When the waiter appears, Steven interrupts his story to ask if the steak is prepared using oil and, if so, what kind and how much. The waiter is stumped. He leaves to confer with the chef. “A little bit of oil increases the calories,” Steven explains. “You never know by how many.” He tells me that he always orders steak or fish in restaurants, because the calories tend to be consistent. He glances around the room eagerly but furtively, as if he’s not sure he’s supposed to be here. Eating in restaurants makes him giddy, he says. It makes him feel as if he’s getting better.

Steven now works for a company doing electrical-equipment estimates for major commercial construction projects. He’s good at his job. He’s obsessive about details, and he has an earnest manner that makes you trust him. His tattoos and long hair make him look like a heavy-metal drummer, and in fact he used to dream of being one. But it wasn’t just about the music. He was—still is—fascinated by gaunt musicians like Slash and Shannon Larkin. He collects photographs of them on his hard drive.

He sees a therapist, and lately he’s been preoccupied with the same questions: Am I ready to start dating again? Why am I so emotionally detached? Why don’t I feel close to anything? She tells him that all the drugs and the malnourishment depleted his body of endorphins and that his body needs time to resume producing them.

He has a new routine. Every Wednesday night, he stops eating and drinking at 7 p.m. He wakes up at six the next morning and turns on Howard Stern (another gaunt hero of his). He empties his bowels and his bladder. Then he steps onto a scale.

Anorexia is diagnosed on the basis of three criteria: self-induced starvation, a morbid fear of fatness, and the suppression of sex-hormone production. Along with those symptoms, an anorexic either has a body-mass index below 18.5 (the statistic is a measurement of body fat; for a six-foot-tall man, a BMI of 18.5 would mean weighing less than 137 pounds) or has lost more than 30 percent of his ideal body weight.

A male anorexic tends to conform to a particular personality type: “anxious, obsessive, persevering, and perfectionistic,” according to Arnold Andersen of the University of Iowa. He is desperate to please and hypersensitive to rejection and humiliation. The illness typically takes root during adolescence, and it is almost never the first, or only, way he tries to deal with social, sexual, or academic anxiety: He may also use drugs, or cut himself, or have OCD. A young man faces a heightened risk if he was overweight in grade school and teased for it, or if obesity or eating disorders run in his family, or if he participates in a sport that emphasizes speed or weight control (such as wrestling, distance running, or cycling), or if he’s gay, as are an estimated 18 percent of male anorexics.

The neurological roots of anorexia remain elusive, but one promising avenue pinpoints a region of the brain’s gray matter called the insula. Among its functions are satiety and bodily awareness. When there’s too much norepinephrine (a stress hormone) in the insula, as there is in the brains of anorexics, these senses are distorted: Anorexics feel full when their stomachs are empty and see a fat person when they look in the mirror. Their pain threshold is elevated. Their fight-or-flight response is permanently switched on. Anorexics exist in a state of near-constant panic, and for reasons no one understands, that panic attaches itself to food.

In the early stages of the disease, an anorexic experiences a sense of accomplishment and an exhilarating clarity of mind. His body is still making endorphins, and he throws himself into ercise with the single-mindedness of an Olympic athlete, even if his own goal is always receding. As the disease burrows in and the malnourished body begins to conserve its resources by shutting down hormone production, he goes numb. His libido vanishes. Other people cease to exist for him. The anorexic starts out trying to control food and ends up being controlled by it. Virtually every decision he makes is dictated by his horror of it.

**Tuesday, December 13, 2011 **

I’m going to be donating bone marrow in two days. I look forward to it not because I’m going to be giving some 12-year-old in desperate need a piece of me…but because I’ll be losing a whole liter of weight.

— A post on Blake’s blog. In fact, fluid is replaced when you donate your marrow, so there is typically no weight loss.

II. Blake*

In the living room of his parents’ house, there is a framed montage of school photos of Blake from kindergarten through twelfth grade. A laughing blond little boy slowly dissolves into a dark-haired high school senior with pinched features. Beneath his wide shoulders and loose shirt, his bare arms look far too long and thin for his body, like the arms of an El Greco saint.

When he was 12, Blake was a state-ranked chess player, a clarinetist, and a good soccer player and swimmer. In high school, though, he started becoming forgetful and unable to concentrate. He was tested and eventually diagnosed, dubiously, with a “processing-speed deficit.”


teven plummeted from 280 pounds to 129.

Blake began dieting at 17. Then he discovered eating-disorder blogs, and his life changed. On a website called PrettyThin, he began communicating, and competing, with people who he says were “trying to get their numbers down.” He was six feet one, 145 pounds: thin, but not impressive in this world. People in the forums wrote scornfully about “wannarexics”—wannabe anorexics, and Blake was terrified that he might be one. Nothing could be worse than that—to be told he didn’t belong, not even here.

To avoid eating, he’d apologetically point to the chewing gum in his mouth. (He carried gum everywhere.) He’d wear a medical-ID diabetes bracelet so that he could turn down sweets. He’d cut food into pieces too tiny to pick up with his fork. Sometimes he’d deliberately spill milk onto his plate. And if none of that worked, he’d make himself throw up.

Today Blake weighs just enough to hold at bay the suspicions of his mother, who’s a PE teacher. He is what’s known as a subclinical anorexic. His weight is low but not life-endangering, and he eats only as much as he needs to maintain it. He still overercises, but not to the same degree as before. He runs ten miles round-trip to go to his part-time job and shop for food. (He’s a vegetarian, and he eats mostly raw foods.) If he has to travel longer distances, he drives his father’s car but parks it in the most remote space in the lot. His attitude toward food is part of a consistent ascetic philosophy: He doesn’t listen to the radio, use air-conditioning or heat, watch TV, go to the movies, drink, or do drugs. He says that he’d prefer to be homeless, as long as he could take a shower before going to work.

At a Whole Foods near his parents’ house, Blake surveys the salad bar. Salmon is off-limits, as are chicken, eggs, blue cheese… He says he wouldn’t even be eating this meal if I weren’t with him. I ask how he’d handle being here with a family member. He wouldn’t make a fuss, he says. “I have extreme paranoia about people finding out and trying to institutionalize me.”

Blake is extremely gaunt, with startling green eyes, a prominent jaw, and a small, reddish goatee. Around his neck he wears a silver peace-symbol pendant the size of a drink coaster. He almost always has on a black cloth cap, and he uses its visor to avoid making eye contact. He frequently volunteers in his community, and today he’s wearing a T-shirt from a recent blood drive that reads ARE YOU MY TYPE?


Blake is 21 now and says he can’t wait to move out of his parents’ house so he can eat less. Sometimes the portion sizes are just too big. Sometimes he’d prefer to skip a meal entirely. Although he loves being around people, he says, he also feels compelled to avoid them. “Because people are the ones who force you to eat.

His low GPA, the product of his illness, haunts him. He says he’s disappointed his parents. But this past semester he did well enough to transfer from community college to a good state university. He lights up when he talks about it. He just visited the campus, and what excited him most, he says, were all the hills and stairs.

Steven is healthier today.

Anorexia has the highest mortality rate, between 5 and 10 percent, of any mental illness. Half of the deaths are by suicide, the other half from medical complications. The illness lasts an average of eight years in men, a third longer than in females, probably because men wait longer to seek treatment. Twenty percent of recovered anorexics die before reaching their life expectancy. Like a layer of soil that reveals a long-ago period of drought, the organs of an anorexic’s body seem to retain the scars of being starved.

Without potassium, the muscles of the heart weaken and develop rhythmic abnormalities that can be fatal, particularly if the patient is a relentless overerciser. Bones deprived of calcium lose their density, causing osteoporosis. The condition is insidious and hard to treat. You may think you’ve fully recovered from a five-year bout with anorexia, but without your realizing it, your bones have begun to rot. At 40, stepping off a curb, you might suffer a spinal-compression fracture, losing inches of height. The disease can also cause irreversible cognitive damage: The brains of severe anorexics are often indistinguishable on MRIs from those of Alzheimer’s patients.

In preadolescents, anorexia halts puberty. A boy’s voice doesn’t change, he doesn’t grow facial or pubic hair, the growth plates of his bones don’t fuse. If he can return to a healthy weight, all these mechanisms will probably start up again, even after a decade.

You can die from not eating, and you can also die from eating again. As an anorexic begins to ingest food, the rate of his blood circulation increases. Sometimes his atrophied heart can’t handle it. This condition is called refeeding syndrome, and it can be fatal.


— A laminated pink sign on a door at the Acute Center for Eating Disorders at Denver Health hospital

III. Will

55 lbs.

The Acute Center treats the nation’s most desperately ill anorexics—men and women whose BMIs are in the single and low double digits and who weigh 70 percent or less of their ideal weight. Often patients arrive here on the verge of death. Sometimes they are brought by air ambulance. Sometimes, as if to make a statement about their self-sufficiency even amid the ravages of the disease, they gather bags that weigh more than they do and fly to Denver all alone.

That’s what Will has done. A week ago, on the day of his arrival, he could barely lift his head from his pillow. Today, as his doctor and I enter his room, he stands up from his bed, his knees buckling. He is wearing shorts and a short-sleeve shirt. He looks like he’s 10 years old and 80 years old at the same time. His forearms are as wide as my two fingers, and his knees are wider than his thighs. His teeth protrude because the skin is stretched so tightly across his face. His thick blond hair sticks out in all directions; it looks as dry and brittle as dead grass. Will has been struggling with anorexia for a decade, since he was 11; the last year of school he attended from start to finish was sixth grade. He is a devout Christian, and this is his fourth hospitalization in the Acute Center in three years. “He’s been within days of death many times in his life,” says Jennifer Gaudiani, his doctor. “Will is one of a number of patients we’ve seen who get better but not well.”

Will’s neatly folded clothes cover the room’s wide window ledge. He sits down at a small table nearby. He speaks with the voice of a child—the voice of an 11-year-old preserved in amber, the voice of a 21-year-old who has never gone through puberty. He is alternately proud, raging, despondent, helpless, anguished, and charming. During our conversation, he frequently weeps.

_It began when I was in middle school. I had grown up swimming competitively, and I was a pretty elite swimmer—went to state, placed in state. I was having panic attacks, so I quit. Both my parents were collegiate swimmers. They never said, “You gotta achieve, you gotta succeed.” They encouraged me and complimented me. But I took that as “You gotta go even above that.” When I was looking good, I may have only been four foot nothin’, but I had the six-pack and I was cut. I got the attention. But it was never enough. _

_ It wasn’t necessarily about my body at the beginning. It was more of, like, my size. The guys around me were starting to grow, and I wasn’t. In middle school I was insecure and wanting to make up for it. The new thing was about controlling my food and my body so that I could look and feel good, fit in. The eating disorder came because I needed something else to excel at._

Up close, lanugo is visible on Will’s cheeks—the soft yellow hair that grows on an anorexic’s body, most likely to conserve heat. It gradually falls away as an anorexic returns to health.

_I was everybody’s friend in middle school, but I was always, like, the little buddy. Not having a sex drive because of the eating disorder was just a smack in the face. Like, that’s something else to make you different. I compared my insides with people’s outsides, you know? And the eating disorder became a numbing-out mechanism, a way to distract myself from how lonely and empty I felt. _

_ Getting help at that young of an age and being a male was like shooting in the dark and expecting to get a bull’s-eye. When I did find places, I was the only male, and a lot of the material that they were doing in the groups was all about females. On some issues, like the body-image stuff, their concern was completely different than mine. A lot of the females are dealing with abuse, so they’re not going to trust men. And I would take that personally at times, because I do just love people and want to help. Then it’s awkward because they don’t want to say certain things because I’m there, and I see that in them, and then you just don’t feel like you can open up to really anybody. _

_ Eventually it reinforced the insecurities and the feeling worthless. That even in getting help, I was still the odd man out. It made for almost a bitterness or an anger toward the eating-disorder community.

He pauses repeatedly to open and close his jaw. Later his doctor explains to me that Will has lost fat even on the tiny pad near his middle ear that seals his Eustachian tube. With the tube open continuously, Will hears a constant rushing of air, as if he’s in a wind tunnel. Shifting his jaw closes the tube temporarily.

Food became my identity: I’m good if I eat this, this, this, this; I’m bad if I don’t follow my meal plan. There was a lot of: “My parents are telling me to do this, and I can’t do it, and they’re disappointed in me.” It made me think that all their emotions depend on what I’m able to eat that day.

You know that eating will make you healthy. What is it that prevents you from eating?

_Like, right now? Because then I don’t have an excuse anymore, I guess? _

For what?

_For not being perfect. Or I have to face that emptiness inside of me. Or at this point in my life, I have to face my past, you know? I have to face the bad choices of staying in the eating disorder and the loss that I have from that. _

Your doctors obviously care for you as a person, not simply because you’re their patient. There’s a tenderness in the way they talk about you.

I guess that’s why I have this issue, because I don’t feel that. Ever.

Do you understand that there are people who love you?

_That’s what I’m wrestling with right now. No matter what I do, I just don’t feel loved. _

But something keeps you coming back here to get help. What is it?

It’s my God. It’s God. Because I know, I know, I know deep at my core, and I may not be able to live it out right now, and I may not be able to grasp it, but I know that love is there. I know that. From just intellectually looking at my life and just seeing His hand and His guidance. I remember lying in my bed, and I was praying—I was like 8 years old—I said, “God, you know I give my life to you.” I was this super-fired-up little kid: “I don’t care if I have to go in the cafeteria tomorrow and dive in front of ninjas who are throwing ninja stars at Betty and Steve and take it for the team. Use me whatever way you want!” I look back and I see what I’ve lost. But that’s where my hope is that I can get back to that childlike zest for life: in my God. And there’s no reason I should be alive. There’s no scientific reason that my body should still be functioning. I have been at death’s door way too many times. Something’s there.

Although I have referred you to hospitals (primarily because they are readily available ways to keep you safe from imminent danger), I think you would most benefit from a residential setting…. Your state of mind, the hopelessness, the inability to feed yourself warrants a higher level of care…. If we took men I would 100 percent recommend our program.

— Excerpt of e-mail from therapist Keesha Broome to “John Doe,” September 19, 2008, submitted as evidence in John Doe v. Monte Nido Residential Center.


There are blank spots in John’s life that he can’t fill, periods of time he can’t remember: weeks, maybe months, living with his stepfather, who bullied him. Huge swaths of his adolescence, when he’d cut his arms with a razor blade to punish himself for overeating or to calm himself after some high school humiliation. The two days he went missing in July 2010, which ended with him waking up at the bottom of a ravine, bleeding and bruised, his car neatly parked on the mountain road above. Somewhere among these events may be a clue to the mystery of why he got sick. Or maybe the clue is at the very beginning of his story: When his brother was born, John was sent to preschool, where he refused to eat unless he was fed by hand. He was 3 years old.

John, now 35, has several “body-checking” routines. He notes how loose his watch is, and the waistband of his pants. Then he spreads his fingers as wide as they’ll go and searches for the indentation on the back of his hand where the thumb tendons meet the wrist. He remembers seeing a close-up of Brad Pitt’s hands in Mr. Mrs. Smith and thinking, “He’s got it!” He remembers Philip Seymour Hoffman’s hands in Mission: Impossible III:He didn’t have it.

Entering college, John weighed 140 pounds. By the time he graduated from law school and began working full-time, his weight had doubled, to 280 pounds. He had seen drastic gains and losses in the past, but this time he “freaked.” He cut his daily intake to 350 calories—a sixteen-ounce Gatorade, a Subway grilled-chicken salad, and a cup of coffee—and began cycling to work, thirty-four miles round-trip. He lost more than one hundred pounds in eight months. In May 2008, his mother, visiting Los Angeles from out of town, told him he looked great. She was a yo-yo dieter herself. When she came back in August, she said it again: You look great. But this time, she confided, she actually meant it.

He had just been let go from his job. John has degrees in law and engineering and a true photographic memory, but he’d become so malnourished that his mind couldn’t hold a thought. He’d also become so numb that he no longer cared.

His anorexia was full-blown. He couldn’t control the overercising, and he couldn’t stop overcontrolling the eating. In September his therapist at a Monte Nido outpatient program in Los Angeles recommended that he enter residential treatment. But Monte Nido’s residential centers didn’t admit men, nor did any other similar facility in Los Angeles County at the time. By December he weighed 160 pounds, and he was admitted to Castlewood in Missouri. There he finally began to improve. During Family Week, the clinical director gave a speech that resonated with him: If normal people are Ford Escorts, he said, then Castlewood’s clients are Ferraris—brilliant but high-maintenance and neurotic. John was discharged weighing 170 pounds.

But after he returned to Los Angeles, he quickly relapsed. He spent the next two years in and out of treatment, trying and failing to control his disease. In April 2010, he entered an inpatient program in New Orleans, but before he’d even completed the stipulated thirty days, his insurance company cut him off, having decided his health was not immediately in jeopardy. He came home to a condo that was about to go into foreclosure. He was unemployed and living on disability insurance. He began trying to give away his car and his dog. He didn’t expect to live much longer.

And yet, simultaneously, he began drafting a sex-discrimination lawsuit against Monte Nido’s residential centers in California. On August 30, he staged a call to the facility, knowing they’d tell him they admitted only women. “I think people have to see Monte Nido to understand, because it sounds just like full-on discrimination,” Carolyn Costin, the center’s founder and ecutive director, says today. “But I think if you’re there and you see the close quarters they’re in, in their jammies being weighed, you know, talking about their menstruation… Adolescent girls, they and their parents don’t want them to be next to adult men.” (Spurred by the rise in male anorexia, Costin says, she is thinking of adding a program for men.)

On September 2, John filed his lawsuit in Los Angeles Superior Court. He was convinced he had the law on his side. Indisputably he had the inhuman discipline that accompanies his disease: Never go to court against an anorexic lawyer. In the filings that followed, John went punch for punch with Monte Nido’s counsel, which included a large international law firm. A jury trial was scheduled for May 29, 2012.

John texts nonstop as he weaves through Santa Monica traffic in his red BMW convertible (“a piece-of-shit 3 Series,” he says later as he hands the keys to an admiring valet). He drives aggressively, gunning the engine to beat red lights, which causes me to repeatedly slam backward into my seat. On the stereo, he blasts Ke$ha, Mika, and Lisa Loeb. “All this music ended up on my iPod,” he says, “because I was spending three months with nothing but young women.” Taken together, his luxuries betray an affluence that ran out, somewhat suddenly, about four years ago. It’s slowly coming back; he has a new job that he loves, and it has allowed him to hold on to everything he was about to lose.

John and I are on our way to a barbecue at his friend Kate’s house. Kate* is the only person who stuck by him as anorexia drove him further into himself. Her son, Andy,* who was 6 when John met him and is now 13, adores John, but Kate has only recently allowed them to spend time together again. She was protecting Andy.

For much of the night, John and Andy quote dialogue at each other, from FuturamaSouth Park, and The Princess Bride. John has an Asperger’s-like fascination with the guts of machines—cameras, automobile engines, nuclear reactors—and he holds forth to Andy on the persistence-of-vision phenomenon and its implications for film and video (specifically in Peter Jackson’s The Hobbit). Andy is riveted.

When food is served, John eats as if it’s a relearned behavior, as if he’s a robot trying to pass as human. He tells me he eats only because not eating will trigger a sequence of events that begins with him losing his job: “And if I lose the job…” Mordantly he observes that he still reads articles about the Golden Gate Bridge to see “whether or not they’ve ever gotten around to installing that suicide barrier.” He calls it his Plan C.

We stand apart from the other guests for a moment, and John startles me by saying, abruptly, that he’s decided to settle his lawsuit. Monte Nido has hired new lawyers, and in his view they’re no longer arguing the case on its merits; instead, he says, they’re strategically outspending him. John can’t afford to depose their out-of-state witnesses or to hire his own experts. He knows that a judgment against him would have a chilling effect on future litigation of this kind, so he’s reached out to Monte Nido through a mediator. The terms of the settlement will be confidential. John likens himself to the John Travolta character in A Civil Action, who runs out of money fighting three giant corporations that have contaminated the water supply of a Massachusetts town. At the end of the movie, Travolta packs up his files and mails them to the EPA, hoping someone there will finish what he started.

John tells me he still feels fat all the time. The goal is to not think this way—he knows that. “But the people I know who have gone through treatment and say they’re at that point? This is going to sound awful, but they’re fat.” Is it possible, I ask him, that he might feel differently if he had a partner who loved him? He snorts. “It’s kind of like saying, ’Once you’re on the moon, what’s it going to be like to look at the earth?’ Ask me when I get there.”

*Names and some identifying details have been changed.

Resources for Eating Disorders:

Anorexia and Bulimia Care (ABC)

03000 11 12 13
parent helpline: Option 1
sufferer helpline: Option 2
self-harm helpline: Option 3

Provides advice and support to anyone affected by an eating problem.

Association for Family Therapy and Systemic Practice

Describes what family therapy is, and has a search facility to find a therapist in your area.


adult helpline: 0808 801 0677
youthline: 0808 801 0711

Offers information on eating disorders and runs a supportive online community. Also provides a directory of support services at

British Association for Behavioural and Cognitive Psychotherapies (BABCP)

01611 705 4304

Provides details of accredited therapists.

British Association for Counselling and Psychotherapy (BACP)

01455 883 300

Information about counselling and therapy. See sister website,, for details of local practitioners.


Elefriends is a supportive online community run by Mind.

Men Get Eating Disorders Too

Information and support for men with eating problems.

National Institute for Health and Care Excellence (NICE)

Produces clinical guidelines for the treatment and management of eating disorders.

Overeaters Anonymous Great Britain

Runs local groups throughout the country.


0800 068 41 41
Provides information and support for anyone under 35 who is struggling with suicidal feelings, or anyone concerned about a young person who might be struggling.


116 123 (freephone)
[email protected]
PO Box 90 90
Stirling FK8 2SA
24-hour emotional support for anyone struggling to cope.

Student Minds
Details of campus-based support groups for students experiencing difficulties around food or body image.

Midwife-led charity which provides information about eating problems in pregnancy.


parent helpline: 0808 802 5544

Information for both parents and young people.



Sam Smith and 9 other male celebs on body image

Sam Smith and 9 other male celebs on body image

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Singer Sam Smith has posted a shirtless photo of himself on Instagram, as a way to “reclaim” his body.

While these kinds of posts aren’t an unusual for celebrities on social media, Smith used this moment to open up about his battle with body image, admitting to starving himself for weeks ahead of upcoming photo shoots.

“Some may take this as narcissistic and showing off,” he wrote in his Instagram post, which features some bad language so obviously ask your mum before you click.

“But if you knew how much courage it took to do this and the body trauma I have experienced as a kid you wouldn’t think those things.”

With nearly a million likes, his fans have praised him for “inspiring” them with his “beautiful” message.

In a 2016 survey of more than 1,000 boys aged between eight and 18, 55% said they would consider changing their diet to look better and 23% said they believed there was “a perfect male body to strive for”.

The survey also found that the four biggest sources of pressure on secondary school boys to look good were:

  • Friends (68%)
  • Social media (57%)
  • Advertising (53%)
  • Celebrities (49%)

Despite the relentless pressure that young men can feel from the media, the survey found that more than half of the boys (56%) would find it difficult to talk to a teacher about their confidence and nearly one-third (29%) would find it difficult talking to their parents about it.

Here are eight other male celebrities who have spoken out about body image and are calling on the media to change their attitudes.

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1. Antony Costa

Antony CostaImage copyrightGETTY IMAGES

In 2017, Blue singer Antony Costa appeared on Lorraine and opened up about the “fat-shaming” he had experienced on social media.

Costa explained that when he first started out in show business before the dawn of social media, receiving criticisms “was water off a duck’s back” but now, the public are quick to point out flaws in selfies and paparazzi photos which he believes can be harmful.

“Me as a bloke in the business, it’s hard because you’ve got to keep up with the joneses, to be seen to have the six pack,” he said.

“But I’d rather be me and have a good personality then have a six pack”.

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2. Chris Pratt

Chris Pratt at the European Gala screening of Guardians of the Galaxy Vol. 2 in LondonImage copyrightGETTY IMAGES

Yes, you read that right! Actor Chris Pratt – who plays the gun-toting, butt-kicking, ripped Star-Lord in Guardians of the Galaxy – has struggled with body image, too.

In a press conference for the film in 2014, he said: “I’m sure I can’t relate to what females go through in Hollywood. I’m sure I can’t.

“But, I do know what it feels like to eat emotionally, and… to be sad and make yourself happy with food.

“And then to be almost immediately sad again and now ashamed and then to try to hide those feelings with more food. I know what that’s like. It’s a vicious cycle and it’s a very real thing.”

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3. James Corden

Host James Corden speaks onstage during the 20th Annual Hollywood Film Awards on November 2016Image copyrightGETTY IMAGES

In an interview with Rolling Stone in 2016, talk show host James Corden opened up about how he dealt with his confidence in school.

He explained: “If you’re big at school, you’ve really got two choices. You’re going to be a target. If you go to school and you’re me, you go, ‘Right, I’m just going to make myself a bigger target. My confidence, it will terrify them.’ That’s how I felt in school.”

Corden also touched on his frustrations on the way Hollywood represents larger people.

He said: “I could never understand when I watch romantic comedies. The notion that for some reason unattractive or heavy people don’t fall in love.

“If they do, it’s in some odd, kooky, roundabout way – and it’s not. It’s exactly the same.”

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4. Wentworth Miller

Wentworth MillerImage copyrightGETTY IMAGES

Prison Break actor Wentworth Miller opened up about his depression after being the subject of an internet meme joke by The Lad Bible in 2016.

Miller wrote in a Facebook post: “In 2010, at the lowest point in my adult life, I was looking everywhere for relief/comfort/distraction. And I turned to food.”

He continued: “It could have been anything. Drugs. Alcohol. Sex. But eating became the one thing I could look forward to. Count on to get me through”.

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5. Alex Sharp

Alexander Sharp attends the 2015 Tony Awards at Radio City Music Hall on June 7, 2015 in New York City.Image copyrightGETTY IMAGES

Alex Sharp starred alongside Lily Collins in Netflix drama To The Bone, which follows a girl’s treatment for anorexia.

When Collins’ character is admitted into a recovery home with six other patients, she meets Luke (played by Sharp), the only male patient in the house.

Talking to Broadway World about portraying a man struggling with an eating disorder, Sharp said: “It happens a lot and I think sometimes – because it is under-discussed and a taboo subject generally – when it is discussed it tends to be more about the female experience, because it is more prevalent, numerically.

“There had never been a representation of that in a feature-length movie. So that was something I was very interested in doing.”

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6. Ashley Hamilton

Actor Ashley Hamilton at the US premiere of Iron Man 3 in 2013Image copyrightGETTY IMAGES

Iron Man 3 star Ashley Hamilton told People in 2013 that he had suffered from bulimia and anorexia since he was a teenager and that he used drugs and alcohol to control his food addiction.

“I’ve been free from bulimia for years but I still struggle with food, restricting or overeating. That’s been the hardest for me in sobriety,” he admitted.

He continued: “It’s almost like drug addiction is totally acceptable to talk about in Hollywood. But food addiction? Nobody wants to talk about that. It’s really shameful as a man to have that.”

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7. Ed Sheeran

Ed SheeranImage copyrightGETTY IMAGES

The chart-topping singer told Planet Radio in a 2014 interview: “I was never really happy with my image and then I realised it was because I was eating fried food and drinking beer every day. You don’t have to kill yourself by getting into shape. Just eat right and don’t drink every day.”

Commenting on body image pressures in the music industry, Sheeran said: “There’s enough fat people in the industry and there’s enough skinny people in the industry and there’s enough ginger people in the industry.

“There’s enough of everyone in the industry, and usually the ones that aren’t attractive are the ones that do the best.”

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8. Matt McGorry

Matt McGorryImage copyrightGETTY IMAGES

Before starring in Orange is the new Black and How to Get Away With Murder, Matt McGorry used to be a personal trainer and competitive bodybuilder, which actually made him more critical of his body.

When asked what we could do to change the conversation around male body issues he told US TV show Today: “When we lock our boys away from these feelings, not only are they more likely to hurt themselves but they’re also more likely to hurt others and to be the ones who are policing masculinity amongst other men.”

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9. Robert Pattinson

Robert Pattinson during a photocall at the Cannes Film FestivalImage copyrightGETTY IMAGES

Despite being nominated as one of the world’s “sexiest men alive” in 2009, Twilight star Robert Pattinson has still admitted to feeling insecure.

In an interview with Australia’s Sunday Style magazine in 2013, the Twilight actor revealed he suffers from body dysmorphia – an anxiety disorder that causes a person to have a distorted view of how they look.

“I don’t have a six-pack and I hate going to the gym. I’ve been like that my whole life. I never want to take my shirt off,” he said.

Follow us on Facebook, on Twitter @BBCNewsEnts, or on Instagram at bbcnewsents. If you have a story suggestion email [email protected].

Gaming Can Make A Better World

Gaming Can Make A Better World


Games like World of Warcraft give players the means to save worlds, and incentive to learn the habits of heroes. What if we could harness this gamer power to solve real-world problems? Jane McGonigal says we can, and explains how.

The Power Of Vulnerability

The Power Of Vulnerability

Brené Brown studies human connection — our ability to empathize, belong, love. In a poignant, funny talk, she shares a deep insight from her research, one that sent her on a personal quest to know herself as well as to understand humanity. A talk to share.

The 7 Signs of Narcissism & How to Spot Them

The 7 Signs of Narcissism & How to Spot Them


Narcissism has become a mainstream news topic – but reading about it online does little to educate you on how to spot the signs. In this episode, Dr. Ramani provides actionable insight on what narcissistic personality disorder looks like – the 7 signs of narcissism – and what to do when you recognize them. She answers… What are the 7 signs of narcissism? What are some real-life examples of each symptom of narcissistic personality disorder…

In my significant other?

In a co-worker or boss?

In my friend?

What does life look like for a narcissist?

What steps should I take if I think my friend or loved one is showing signs of narcissism?

If you haven’t watched the beginning of this series yet, watch episodes 1-3 HERE: “This is Why Narcissism is the “Secondhand Smoke” of Mental Health: “Narcissistic Personality Disorder vs. Self-Confidence: What You Need to Know”: Are Narcissists Born or Made? Causes of the Disorder & More:

10 Ways to Combat Seasonal Affective Disorder

10 Ways to Combat Seasonal Affective Disorder

By Genomind

As temperatures drop and the days become shorter, you may notice a dip in your mood. Seasonal affective disorder (SAD), or “winter depression,” is a common mental health problem. In fact, the American Academy of Family Physicians, reports that 4-6 percent of people may have SAD, and another 10-20 percent may have a mild case of SAD.

“SAD can be as debilitating as traditional yearlong anxiety and/or depression,” said clinical psychologist Amanda Rafkin.

SAD often occurs during the winter when lower levels of sunlight may affect the balance of hormones like serotonin and melatonin. Lower levels of these two hormones can negatively impact sleep, mood and overall well-being.

Want to boost your mood during dark winter months? You’re in luck! Here are 10 tips on ways to manage symptoms of SAD.

1. Know the Signs and Symptoms

In order to put a plan of action in place to manage SAD, you need to be able to recognize the signs and symptoms of the disorder. Feeling sad or less energized during the winter months are two signs of SAD. Once you realize you are experiencing SAD, you can seek professional help or take measures to help alleviate symptoms.

2. Exercise Regularly

Regular exercise can ease symptoms of depression, especially during the gloomy winter months.

You don’t have to be training for a marathon to enjoy the benefits of exercise, because any type of exercise activates dopamine and serotonin, the “feel good” chemicals in the brain. These chemicals can help fight symptoms of SAD.

Incorporate moderate physical activity, like walking or biking, for 30 minutes a day to get those neurotransmitters going!

3. Stay Connected

One way to fight SAD is by remaining connected to your loved ones and identifying your support network. Being able to communicate with those around you can help create a positive dialogue about ways to combat symptoms of SAD.

“Research shows that those with a larger support network can make behavioral changes easier,” psychotherapist Aimee Bernsteintells said. “Create an agreement with your support network to spend time together doing fun things, especially during the winter months, that will shift your mood and energize you.”

4. Get Enough Light

Try taking in as much sunlight as possible during the winter months. This can be as easy as opening your blinds during the day or getting outside in the morning. Getting a good amount of natural light during the day can help alleviate symptoms of SAD.

When the body absorbs sunlight, it also absorbs vitamin D, which has a number of health benefits. It may be hard to get enough vitamin D in the winter, so taking a supplement during dark winter months may help your overall mental health.

5. Try Light Therapy

The most effective way to combat SAD is with the help of a light therapy box. The box beams artificial light that mimics natural light. Before trying a light therapy box, make sure to speak with your clinician or therapist to see if this form of therapy is right for you.

“The SAD lamp helps regulate your circadian rhythms that get thrown off by days with shorter periods of light. Try using the box first thing in the morning,” said Rafkin.

Rafkin suggests choosing an early, consistent time to wake up every day to get more hours of daylight during winter.

6. Combat Unhealthy Habits

There are a number of ways to cope with symptoms of SAD, but it can be easy to rely on unhealthy coping mechanisms during winter. Activities like drinking or overeating may feel good in the moment, but can lead to feeling more anxious and depressed later on.

7. Write It Out

No matter the season, having a personal journal can be an effective tool to help combat depression. Depression can cause you to lose sight of the positive aspects of your life, but writing your thoughts and feelings down is a good way to keep those positive things in mind.

Rafkin suggests starting each journal entry with three things you’re grateful for, before writing down your emotions for the day.

8. Meditate

Mediation can have a positive impact on your mood because it boosts serotonin levels. Through meditation, you can calm your mind and move your attention away from anxious or negative thoughts.

9. Take a Vacation

If cold, gloomy winter days are getting you down, plan a vacation to a sunny location! Pack a swimsuit, grab a good read and head to a location where you can get all the natural sunlight you need.

Remember, winter won’t last forever and will eventually give way to sunny summer days where you live.

10. Get Professional Help

If you’re feeling especially blue during the winter, there’s absolutely nothing wrong with seeking professional help.

“A counselor can be a great source of emotional support and can help you identify healthy coping strategies to get you through the winter months,” Rafkin said.

Treatment for SAD

According to National Institute of Mental Health, there are four main treatments for SAD: medication, light therapy, psychotherapy and vitamin D. Depending on the person, these treatments can be used together or separately to manage symptoms of the disorder.

  • Medication: Selective Serotonin Reuptake Inhibitors (SSRIs) are often used to treat SAD. Bupropion, another type of antidepressant, has been approved by the FDA for treating SAD, too.
  • Light Therapy: Since the 1980s, light therapy has been the main treatment for SAD. Light therapy is supposed to replace diminished sunlight during winter with bright, artificial light. To help alleviate symptoms of SAD, it is recommended to sit in front of a light box first thing in the morning on a daily basis.
  • Psychotherapy: Cognitive behavioral therapy (CBT) can be effective for people experiencing SAD. CBT for SAD relies on identifying negative thoughts and replacing them with positive ones. Behavioral activation is another technique that may be used, which helps the person identify enjoyable activities to improve coping with winter gloom.
  • Vitamin D: By itself, vitamin D supplementation is not considered an effective SAD treatment. However, people with SAD have been found to have lower levels of vitamin D in their blood, which may be due to insufficient diet or insufficient exposure to sunshine.

Learn more about ways to manage symptoms of SAD here.

Also published on Medium.

Categories: Mental Health News
5 Signs It’s Time to Seek Therapy

5 Signs It’s Time to Seek Therapy

Most people can benefit from therapy at least some point in their lives

David Sack M.D.

Contrary to popular misconception, you don’t have to be “crazy,” desperate or on the brink of a meltdown to go to therapy. At the same time, therapy isn’t usually necessary for every little struggle life throws your way, especially if you have a strong support system of friends and family. So how do you know when it’s time to see a therapist?

Most people can benefit from therapy at least some point in their lives. Sometimes the signs are obvious but at other times, something may feel slightly off and you can’t figure out what it is. So you trudge on, trying to sustain your busy life until it sets in that life has become unmanageable. Before it gets to this point, here are five signs you may need help from a pro:

#1 Feeling sad, angry or otherwise “not yourself.”

Uncontrollable sadness, anger or hopelessness may be signs of a mental health issue that can improve with treatment. If you’re eating or sleepingmore or less than usual, withdrawing from family and friends, or just feeling “off,” talk to someone before serious problems develop that impact your quality of life. If these feelings escalate to the point that you question whether life is worth living or you have thoughts of death or suicide, reach out for help right away.

#2 Abusing drugsalcohol, food or sex to cope.

When you turn outside yourself to a substance or behavior to help you feel better, your coping skills may need some fine-tuning. If you feel unable to control these behaviors or you can’t stop despite negative consequences in your life, you may be struggling with addictive or compulsive behavior that requires treatment.

#3 You’ve lost someone or something important to you.

Grief can be a long and difficult process to endure without the support of an expert. While not everyone needs counseling during these times, there is no shame in needing a little help to get through the loss of a loved one, a divorce or significant breakup, or the loss of a job, especially if you’ve experienced multiple losses in a short period of time.

#4 Something traumatic has happened.

If you have a history of abuse, neglect or other trauma that you haven’t fully dealt with, or if you find yourself the victim of a crime or accident, chronic illness or some other traumatic event, the earlier you talk to someone, the faster you can learn healthy ways to cope.

#5 You can’t do the things you like to do.

Have you stopped doing the activities you ordinarily enjoy? If so, why? Many people find that painful emotions and experiences keep them from getting out, having fun and meeting new people. This is a red flag that something is amiss in your life.

If you decide that therapy is worth a try, it doesn’t mean you’re in for a lifetime of “head shrinking.” In fact, a 2001 study in the Journal of Counseling Psychology found that most people feel better within seven to 10 visits. In another study, published in 2006 in the Journal of Consulting and Clinical Psychology, 88 percent of therapy-goers reported improvements after just one session.

Although severe mental illness may require more intensive intervention, most people benefit from short-term, goal-oriented therapy to address a specific issue or interpersonal conflict, get out of a rut or make a major life decision. The opportunity to talk uncensored to a nonbiased professional without fear of judgment or repercussions can be life-changing.

You may have great insight into your own patterns and problems. You may even have many of the skills to manage them on your own. Still, there may be times when you need help – and the sooner you get it, the faster you can get back to enjoying life.

Source:  David Sack, M.D., is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CEO of Elements Behavioral Health he oversees addiction treatment programs at Promises Treatment Centers in Malibu and West Los Angeles, The Ranch outside Nashville, a women’s psychiatric treatment program at Malibu Vista, The Recovery Place in Florida, and Texas drug rehab Right Step and Spirit Lodge. You can follow Dr. Sack on Twitter @drdavidsack.

The Science Of Getting Over Heartbreak

The Science Of Getting Over Heartbreak

By Danielle Braff
Chicago Tribune

Love is an addiction that was biologically designed so that we can mate successfully, said Helen Fisher, a senior research fellow at the Kinsey Institute, and New York-based author of “Anatomy of Love” who did a study last year linking love to substance abuse.

Unfortunately, like all addictions, a breakup can send you spiraling out of control.

You can’t eat, you can’t sleep, you have obsessive thoughts about your ex, and you’ll do anything to get him or her back, even if it means calling too many times or driving past your ex’s house at all hours of the day. And as soon as you get a response, you swing into euphoria — unless the response is negative, which can whip you back into despair.

“One main region of the brain (referred to as the brain’s reward system) is linked with all addictions — gambling, sex and all of the substance addictions: alcohol, nicotine, heroin and the others,” Fisher said. “That same region of the brain is activated when you’re rejected in love. That’s the biology of it.”

But unlike alcohol or gambling, which a fraction of people are addicted to, we’re all predisposed to love addiction, Fisher said.

“It’s a drive, a basic mating drive,” she said. “It evolved to help us rear our children as a team.”

Unfortunately, when this basic mating drive veers off track via an unwanted breakup for one person, it becomes a physical and emotional pain that you’ll have to deal with sans the help of an AA meeting or a rehab clinic.

But science has found ways to help with breakups. There are things you can do to make the pain go away faster, and there are things you might be doing that make your heartbreak worse.

You might find yourself journaling post-breakup, for instance, but while this seems like a therapeutic way to get all those thoughts out, it could make your heartbreak linger if you’re the type to brood or to ruminate.

Researchers at the University of Arizona found that those who looked for meaning in their relationships by writing in their journals made the least progress with their emotions — especially if they tend to seek a deeper meaning in their breakups. That’s because they continued the saga of their failed relationship through their journal, prolonging their suffering instead of moving on, said David Sbarra, psychology professor at the University of Arizona and author of the 2013 study.

If you do feel a need to journal, however, you should just write about your day. Those in the study who did not mention their breakup did well, Sbarra said. It helped them get back into their normal routine without focusing on their losses.

Talking about the breakup with someone other than your ex from a distanced, calm, rational perspective will also speed recovery, said Grace Larson, who authored a 2015 study on the topic.

“It helps you understand who you are outside of the ex-relationship,” Larson said. They end up using fewer “us” words when they spoke about the relationship, and used more “I” and “me” words.

But the talking shouldn’t go on for weeks, Fisher said.

After you’ve said everything you need to say, it’s time to stop mentioning your ex to anyone, she said.

Since love is an addiction, Fisher recommends using the AA method and treating an ex like something that is to be forbidden at all costs.

“Don’t write, don’t call, don’t show up at various places, don’t ask friends what he’s doing, don’t check him out on Facebook,” she said. “If you’re going to get rid of alcohol, don’t keep a bottle on your desk.”

It’ll be painful, but eventually, you’ll get over your ex. In her studies, Fisher said, they looked at the brain scans of people who were rejected mere weeks ago and those who were rejected months ago — and the brain activity declined as the separation increased, despite the memory of the event remaining strong. That means, she said, that the pain will decrease over time, though no one can definitively say how long it takes, as it varies from person to person depending on the length of the relationship and the flexibility of their emotions.

If all else fails, there’s an app to help.

Los Angeles-based Ellen Huerta founded Mend (starts at $4.99) when she was going through a bad breakup.

“I wanted a personal trainer to help me through a breakup,” Huerta said. Failing that, she wanted something or someone by her side every step of the way.

For the first 28 days of the breakup, Mend offers a heartbreak cleanse, which focuses on your body to help with the withdrawal symptoms, Huerta said.

Each day, it will advise you on how to self-soothe, to focus on your breath. In addition, you can check in and write in the app’s journal.

After you get through the first month, you graduate to the next step in Mend, which focuses less on the breakup and more on rebuilding your sense of self and your future.

“We do trainings about being single and dating and having a healthy relationship practice,” said Huerta, who said she managed to get over her heartache while she was developing her app.

And while she won’t reveal the number of subscribers, she said there are Mend users in more than 150 countries.

“Heartbreak is so universal,” Huerta said.

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