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I have alopecia, and I wear my bald head proudly now. Alopecia is hair loss  that can be the result of medical conditions, hormonal changes, or genetics. While it is treatable, sometimes its effects can be permanent. When I am out in public, I catch people staring. Online, where I share my story, I receive backhanded compliments — comments that circle how lucky I am to be attractive, or how I could always wear a wig, or how I should “dress up my face” more to distract from the baldness. I could hide away . These things used to matter to me so much – what others said and thought of me. It was as if they were the air that I breathed. How It Began Approximately ten years ago, I had one hair appointment after another, a new woman’s fingers grazing my scalp every other month —  a braiding style here, an expensive lace wig there. In 2015, long before TikTok existed and before Snapchat became as popular as it is today, Instagram built the world of desirable women. Writer's own image On Instagram, I studied women who were deemed beautiful, sexy, and the ultimate prize by men. I secretly prayed that I would gather the same number of likes, comments, and attention. A man liking my photo somehow validated my worth and existence. My focus became achieving the most beautiful hair. Even if it wasn’t my own. I didn’t notice the first warning signs: the thinning of my edges, the brittleness of my hair at the crown of my head. No hairstylist raised red flags about what was going on with my scalp, and I don’t fault them for it. They ran a business, and their job was to provide what their customer needed, but their speciality was not natural hair care. Through this journey, I’ve learned the importance of seeking out stylists who specialise in and care about a woman’s natural hair.  How It Got Out of Control In my mid-twenties, after another disappointing rejection from a man, I became obsessed with the notion that I simply needed to fix my body. I became their fantasy, and I was deeply attached to the validation and attention they gave me. I would do anything to maintain the illusion —  even sacrifice my natural hair for expensive weaves that flowed down my back. Writer's own image But soon, my hair stopped growing, and I couldn’t hide from it anymore. I panicked. If I weren’t a man’s fantasy, if I weren’t the bombshell, they wouldn’t want me anymore. The attention would be lost, the adoration gone, and I would once again be an afterthought. Forgotten. Truth be told, I could’ve sought help for my insecurities then, but I needed to play the game of fantasy a little bit longer. How I Lost It All During the pandemic, at thirty-two, I cut what little hair I had left and became a new woman: carefree, bold, and still beautiful. The attention had waned slightly, but I still gathered eyes and adoration from men online and in public, feeding my deep-seated wounds.   Writer's own image I tried to keep living the fantasy by dyeing my hair every month – one month, blonde, the next, jet-black, and one day, even purple. I empowered other women to embrace their flaws while I hid behind a mask of complete acceptance. I became a self-love coach, spoke at wellness events, and hosted retreats for women seeking guidance on how to love the skin that they were in. While it felt reaffirming to help others, I couldn’t shake the feeling that something wasn’t right. How could I help anyone if I weren’t being honest with myself first? Two years ago, I woke up and discovered that the crown of my head was completely bare. I stood in front of my bathroom mirror, and I could see straight through. I had a small afro at this point. I should not have been able to see my scalp. But there it was. There was no amount of brushing, twisting, moulding that could hide this truth that lay bare before me. The dam had broken. The illusion was gone. I panicked, tears welled up in my eyes, my stomach churned, and I felt a deep sense of dread looming over me. What was I to do? I had played the game for so long that I had nothing left to give. What do you do when you lose a piece of your identity that has kept you desirable, wanted, and valued in the eyes of others? How I Regained Myself  I could hide away . I tried to. I wore wigs. I kept up the fantasy. But something kept gnawing at my subconscious: “You don’t need this anymore,” I heard a voice – my own voice - say, “you’re enough. You’ve always been enough.” What was I afraid of? That I wouldn’t be loved? That I wouldn’t be chosen? One morning, I stood in my bathroom and stared at my reflection in the mirror as I shaved my head completely. Surprisingly, I didn’t cry, I didn’t scream, I didn’t shout -  I laughed. A deep, full belly laugh escaped from the depths of me as I realised that I had been fooled. I thought something would change by accepting my alopecia, that somehow, I would be a different woman, undeserving or unworthy. But how naive I had been! I was still the same person with the same face, the same smile, and the same open heart. Fear had tried to cripple me, but it was all a facade. My life did not end, nor did it blow up in my face. As I stared at myself, I held myself in my arms, rocking back and forth. My chest heaved. The cries began then. Through therapy, I came to understand: by honouring myself, I was ultimately healing my inner child  because, for so long, I had been trying to console her by being the fantasy, by being the perfect woman, by seeking validation from others when my younger self had always been looking for me to give her that love and affection. Where I Am Writer's own image Through therapy, self-work, and prioritising my self-care, I now know the only validation I need is my own. I work through my insecurities by affirming myself daily in the mirror – I tell myself I am worthy, I am beautiful, I am enough – and I extend gratitude to my body and my bald head for being healthy. I wear clothes that make me feel confident, and I always add an extra accessory or two that gives me an extra oomph.   There are days when the old negative voice wants to creep back in, but I don’t retreat when I hear it. I let myself be seen. I let myself feel the discomfort of it all. Because I now know that shadows cannot thrive in the light, I let the pain wash over me, seep into my pores until it falls to the floor. Then, I breathe in deep and let the love I feel for myself take hold of me. And all at once, I am whole again. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Severe acne may seem only skin deep, but its effects on mental health can be devastating. I’m Anna, a primary school teacher and writer who has struggled with acne since my late teens. I have been through almost every treatment imaginable, and have suffered the consequences of this visual, mental, and medical condition for over six years. Image Source: Ron Lach on Pexels Acne is a term most people are familiar with, whether from their own hidden school photos or the plague of teen movies that overuse it as a plotline. However, for the group of us who are unlucky enough to suffer it into adulthood, what was once a harmless phase can have a big effect on both physical and mental health. I began to develop acne at fifteen, and although the itchy red bumps, protruding whiteheads, and blossoming scars were uncomfortable, I didn’t feel like I particularly stood out. At university, however, this barrage of spots so visible on me no longer showed on the faces of my peers. When others began taking endless selfies and posting their faces for the whole world to see, I hid mine away, only posting group photos, or ones taken in lighting moody enough to blur my skin into looking normal. My confidence was shattered, and I found myself drowning in social anxieties about people seeing me, judging me. The constant comparison to my clear-skinned peers was exhausting. Severe acne, though it may seem superficial, can have huge effects on a person’s self-esteem, and carries with it a long line of medications and frustrating doctor’s appointments. However, after many struggling years, I have finally been able to feel comfortable in my own skin. Image Source: Vitaly Gariev on Pexels Anxiety It’s my third year of university and I am attempting to apply make-up whilst not looking in the mirror. Unsurprisingly, it’s not going well. The best concealers can’t disguise dark pink scars under my cheekbones, and even if they did, the dimpled texture is uncoverable. I look up methods of blending away acne on TikTok and am hit with reams of porcelain-skinned models telling me to ‘ just drink more water. ’ Suddenly, the dress I’m wearing begins to itch, the shoes become too tight, and the inevitable excuse text is sent to the group chat. It complains of period pains, or something more understandable than the fact that I don’t want to see my own face, or for anyone else to see it either. When discussing acne with a friend who also suffered, I remember her telling me that ‘It’s all you can see, so you forget that other people don’t notice it. ’ But that’s easier said than done. Acne became the only thing I would see if I looked in the mirror, the photo, the Instagram post. At points, it would stop me from leaving the house, and low self-esteem began to dictate the life I was living. Image Source: MART PRODUCTION on Pexels The Pill Going to the doctors wasn’t straightforward for me, as I struggled to see acne as something that warranted medical attention. It felt selfish, taking up the doctor’s time for a condition that was only on the surface. But it was affecting my mental health, and my sense of self. Supported by friends, I finally booked an appointment. I would’ve liked that to be the end of it, to have been handed a cream and to have clear skin forevermore. Unfortunately, that wasn’t the case. Firstly, I was told it was hormonal, and that the only answer was to go on the contraceptive pill. I could fill a page with the different pills I was put on, all with beautiful names like Dianette and Yasmin. They sounded like fairies from a children’s book but impacted my body in ways I was unaware of. Having recently read ‘ How the Pill Changes Everything’ by Dr. Sarah E. Hill , I realised why each of these pills made me feel so different. Fluid retention made my face rounded and moon-like, hormones dulled my emotions, and I felt a disconnect with my own body that I only recognised once I’d stopped the daily dosage. The continuously fluctuating hormones had effects on my body that I’m still living with today. Alongside this, I was also prescribed two rounds of antibiotics and copious amounts of retinol creams, all to no avail.  After nearly two years of trying to clear away this onslaught of spots, I was prescribed the giant of all acne treatments: Accutane. Accutane Accutane, or Isotretinoin Roaccutane  as mine was called in the UK, clears acne by reducing the production of sebum: an oily substance produced by the skin. In short, it prevents your body from producing spots by drying out your skin (and lips, and hair…) so that there’s no oil to make them. And just like that sounds, it’s horrible. When I first went on this medication, my cousin told me that you can tell who’s been on Accutane, because they have unusually strong opinions about lip balm and body lotion. In the future, anyone who asks me about it will immediately receive the response ‘CARMEX AND AVEENO’. Added to my trial of desert-ified dermatology, I also found that doctors were unsympathetic, to the point that no one actually explained to me what Accutane was. One appointment where I asked for a different contraceptive pill was especially memorable: Because Accutane can cause severe birth defects and miscarriages, it's important to avoid pregnancy whilst on it. However, at this time, I had been on a contraceptive pill for over a year that I was originally told would cause blood clots if I took it for more than six months. I voiced my concern to the doctor, asking to switch to a different pill. The doctor ignored my request, instead shouting ‘ You will kill the baby!’ .   All further questions suffered the same infanticidal response, along with a jabbing finger at a diagram of a pregnant woman with a stop symbol cutting through her belly. This diagram was plastered at least thirty times across every inch of Accutane’s packaging. Embracing the scars Image Source: cottonbro studio on Pexels I would like to say that the six months I spent on Accutane cleared my skin forever, but unfortunately, that’s not the truth. My skin is not perfect now, and I doubt that it ever will be, but it’s certainly better. Even seeing it a little bit clearer allowed me to look further than just my acne. The only good thing about being so fixated on the spots on your face is that it leaves you little time to develop other insecurities. Now when I look in the mirror, I make a conscious effort to see past the scars that still linger on my cheekbones. Instead of focusing on minor imperfections, I have learnt to see the parts of my face that look beautiful. Instead of covering any acne I choose to distract with a glittery eyeshadow, or a different shade of lipstick. I doubt that I will ever have the perfect skin that Instagram and TikTok models have from "just drinking water" (and using tricks of light and camera filters) but I have learnt that I can be beautiful even with acne. I have learnt how to feel comfortable in my own skin. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Image Source: Ellie Burgin on Pexels After struggling with mental health challenges since my teenage years, I was diagnosed with cyclothymia at the beginning of 2025. But what is cyclothymia? Looking back, I realise that this lesser-known mood disorder has impacted my relationships, work, and social life, even if I did not know that at the time.   Getting this diagnosis at 43 was not something I had foreseen.   On my laptop screen, in a minimalist white office I had booked for privacy, the serious but kind face of the psychiatrist stared back at me, enlarged via Zoom. We had spent the last hour going over my whole life history. She furrowed her dark brows. “Anneliese, have you heard of cyclothymia?”   No, I had not.   What had brought me to this moment?   The peaks and troughs had become increasingly dramatic. For weeks, a veil of gloom fell and lingered. Inevitably followed by periods of sudden positivity and productivity. I would have enthusiasm for work again, organise the whole house, and my partner would catch me singing in the kitchen. And I had started to notice that this was a cycle on repeat.   The doctor asked, “Has anything helped?” It was difficult to say. Over the years, several rounds of CBT reduced my anxiety levels. But the effects did not tend to stick long-term. I was also taking antidepressants and, with my GP's guidance, had changed the dose, but to no avail. I felt stuck. Image Source: Pixabay on Pexels Finding out more about cyclothymia A few hours after meeting the psychiatrist, I was googling ‘cyclothymia’ and reading the Mind website : ‘You may get a diagnosis of cyclothymia if: ●      You've experienced both hypomanic and depressive mood episodes over the course of two years or more. ●      Your symptoms aren't severe enough to meet the diagnostic criteria of bipolar 1 or bipolar 2.’ Looking at my life in overview, this began to add up. As a child I often felt down and enormously worried. My chest hurt and head spun with images of disasters and accidents. At the same time, I pushed myself hard in school and was always on-the-go with extracurricular activities.   As I matured, I had lots of highs and lows. Binge drinking, often being impulsive and intense, taking risks. Normal for your teens and early twenties? Maybe. But in between these whirlwind episodes were times of despondency and isolation, hours spent lying in the dark. This period is best exemplified by a text message I received by accident from a friend, “Anneliese is being weird again.”   As an older adult, I had hugely industrious and optimistic phases: studying, working, having my children, developing a freelance career, achieving. More positive, chatty, and outgoing than before. And then, out of nowhere, I would be down for the count, overwhelmed by all the work I had to now deliver. My sensitivity heightened, tearful, snappy, paranoid, convinced I was unlikable: avoiding anyone other than my immediate family. It ached to form my mouth into a smile. My voice was flat and monotone when I spoke. Getting treatment and support Back to the present day: the psychiatrist prescribed me mood stabilisers . Over the course of the last year, they have been increasingly effective. I am now on more of an even keel.   Researching cyclothymia was useful but occasionally frightening. Reading that it could lead to ‘ severe, complex, borderline-like bipolarity ’ felt overwhelming. Equally, much of what I read enabled me to make sense of my experiences. For example, people with cyclothymia, like me, often access health services because of distressing feelings of depression and anxiety , and are less likely to recognise their more elevated states.   I had depressive episodes that felt very debilitating, but on reflection, I also recognised that the peaks on my emotional rollercoaster did influence my daily life. This was hypomania, characterised by ‘ abnormally elevated ’ mood, energy, or activity, but not as extreme as mania. For instance, in the months before my psychiatry appointment, my mind filled with ideas for writing, topics for a PhD, businesses, hobbies, projects, in a way that felt uncomfortable. Sometimes these ideas were fruitful, but often I abandoned them. My partner would tell me not to overdo it, but it was hard to stop being busy, and my sleep was disrupted: my brain buzzed with thoughts. One issue is that kind of apparent productivity is valued and even rewarded in our society: think of ‘hustle culture’. So maybe it’s harder to spot, even when it has negative consequences? Image Source: Meg Boulden on Unsplash Telling other people The question of labels and diagnoses is tricky. At times, cyclothymia felt too vague and soft in its definition. Everyone has moods, but I suppose the difference is that for me, there was a clear pattern. And this relentless cycle had been dominating me.   I struggled to tell people. I imagined they would not believe me. Talking to close colleagues, family, and friends did not bring the push-back I expected. In fact, there was not much reaction at all. It also made sense that not everyone understands the terminology, as cyclothymia is relatively rare, with a lifetime prevalence between 0.04% to 1% . The term was first used to refer to a mood disorder in 1877, but even today public awareness seems minimal. Still, I felt relief in having a framework to comprehend the fluctuations in my mindset and behaviour. Image Source: Dan Meyers on Unsplash Attitudes towards mental health problems The ongoing public debate around an ‘overdiagnosis’ of mental health conditions has intensified my nervousness about disclosing my experiences. Despite this, I am sharing it now with the hope of encouraging an environment where people, young and old, are safe to talk about their wellbeing. It is so important that others can access support without fear of their experiences being trivialised.   Psychological wellness is nuanced and changing. A cyclothymia diagnosis has given me a new perspective on past behaviours and actions that previously filled me with shame and distress. Moving forward, I am not ‘fixed,’ but I do not feel broken anymore.   It is getting easier to be gentler with myself and accept that my motivation, feelings, and self-confidence will still fluctuate. Spotting the signs of when an extreme change in mood is on the way and giving myself some grace. For me, warning signs included increased self-isolation, as well as stronger emotional reactions to everyday happenings (crying because an email I received felt a bit too blunt!), and a rise in negative self-talk: “What is the point in applying for this job, I am rubbish at everything anyway?”   On the hypomanic end of the spectrum, I know that it’s time to slow down when my sleep is disrupted by a racing mind, or I am constantly on the move and unable to relax. I might feel tired, but I still find myself unable to stop pottering around where my family are all chilling out on the sofa. It helps to notice these changes, to pause, and to reflect if these thoughts and behaviours are beginning to escalate. I also take more rest breaks, rather than pushing myself to always be productive, always be achieving. Not exactly rocket science, right? But even these small changes have had a cumulative effect for the better.   Recently, I have started in-depth counselling, untangling various aspects of my life. Exploring my childhood, identity and place within my family has also been a useful way to better comprehend the emotional cycles. Talking with my counsellor can be hard sometimes, but it has also boosted my confidence and given me the space to recognise the positive qualities I possess, like resilience and openness to asking for support.   The journey to understand the light and the dark is ongoing, but I know that I am not defined by cyclothymia. And I now realise that I am more than just my moods. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Image Source: Andrej Lišakov on Pexels Three and a half years ago, I went through a traumatic event, the repercussions of which rippled out into what I hope to call the worst year of my life. And while that time is now behind me, and life has once again gone back to normal, there is one side effect that still casts a shadow over my life. It feels like I hear people talking about triggers all the time, about being aware and sensitive. But I rarely see anything that resembles an understanding of what I experience when I say I am triggered. Triggered, in a clinical sense, is understood as an emotional or psychological reaction to a stimulus , which can prompt a re-experience of trauma and produce an overwhelming response. For me, it’s a whole-body reaction that can take days to subside. Once upon a time, it was weeks. While I consider my reduced recovery time a win, I’m starting to accept that, to some degree, this may be something I have to deal with for the rest of my life.  The hardest thing to explain is that triggers aren’t necessarily rational. I’ve watched TV shows that graphically depict events similar to my experience and had no reaction. In contrast, something seemingly innocent and irrelevant can send me into a tailspin, like a badly worded text message. It’s very hard to give a blanket set of instructions about what sets me off. There are obvious things, which are directly threatening or aggressive, but then there have been more subtle cues which have caught me completely off guard. They make no logical sense, which makes it even harder to come to terms with the extreme reaction that I then have to contend with. I am a writer and educator, and after 15 years of working in education in Southwest England, I thought I had a solid understanding of the effects of trauma. But w hen my event happened, I had no concept of the longevity of its effects. Physically, I was fine. I remember a counsellor telling me that I was standing at the base of a mountain and internally shrugging it off. I had moved from the city to the countryside a year earlier for a slower pace of life and felt certain that recovery would be a matter of weeks. Had you told me that 3 years later, I’d still have days where I felt out of control, it would have terrified me. I thought these reactions were part of the event. For me, accepting them as part of the recovery has been an incredibly important part of moving on.   Image Source: Thomas Park on Pexels What Being Triggered Feels like in my Body and Brain For me, being triggered starts in my gut. It’s cliché, but it’s like a punch that knocks the air out of my lungs. Then it spreads. My knees get light, like there is an air bubble pushing them up, ready to spring. I struggle to regulate my breathing, and I stress sweat profusely. My back and shoulders tense. My skin itches. I can’t sit still. I can’t focus on anything but the stimulus. Whatever it was, no matter how big or small, it’s all I can think about. Imaginary rows with invisible people lasting days. Worse, I struggle to stay present and function. Holding a conversation is challenging because the trigger is still playing out in my brain. If I’m not engaged, I disassociate: more absorbed with the imagined threat than the real world. I struggle to eat. I’ve fallen into bed exhausted, only to be unable to sleep, on a couple of occasions, for several days. I develop tics. Rocking myself, rubbing my hands together unconsciously — all attempts to self-soothe. I literally can’t sit still. But what I have to be particularly careful of is what's going on in my brain. While I have often been told by my therapist that I get full marks for self-awareness, that in itself can be a curse. Knowing the absurdity of what I’m going through can make it worse, as I start telling myself off for not being able to calm down. I have to walk a fine line between forgiving myself for my reactions and giving myself space to process the trauma, while acknowledging when my thoughts are trapping me in my panic state. Far from controlling the sensation in my body, my brain tries to rationalise it. Justify it. Turn whatever prompted this reaction into a monster that makes my response appropriate and necessary. I have to be careful about who and how I talk about what I’m going through. The wrong type of validation can prolong the experience. The Only Way Out is Through While the urge is to regurgitate the event over and over again, what I’ve realised is that, in my case, this hamster wheel doesn’t help me. It simply prolongs the agony by getting validation for the fear from external sources, something that I crave. This started at the time of the event; while some people can hide their experiences for years, I found that I had to tell everyone: friends, family, strangers. Any within earshot could detonate the trauma bomb. Now I am careful of how I talk about what I am experiencing. I know that the trigger itself (however big or small) is not the issue. It’s about convincing both mind and body that I am safe in my space. Replaying the danger doesn’t help. Staying in myself, noting the physical sensations without judgement, and talking to ‘safe’ people, like trusted friends and professionals (Somerset’s Mindline service  has been invaluable to me, they offer a 30-minute call-a-day, alongside other mental health support services). Trying to ignore what is happening only makes it worse. The only way out is through it. I’ve also realised how important it is to maintain my self-care routines. Making sure I eat and exercise to try and get some endorphins flowing. But it has to be the right kind of exercise. Walking gives me too much time to stew and ruminate. Swimming, on the other hand, seems to naturally mellow me out a little. Image Source: Daiga Ellaby on Pexels How I Live with my Triggers I’m learning to accept my triggers and forgive myself for them. Because however uncomfortable it feels now, once upon a time they were sane reactions to a crazy situation. There was a time when I was in danger and failed to keep myself safe. My reactions are my body’s way of trying to make sure that isn’t going to happen again. My triggers are terrifying and paralysing and mind numbing, but they keep me safe. As I’ve had to rebuild my life in the last few years, they have forced me to pay close attention to my own wants and needs. Something that has done me good in helping me form better habits, hobbies, and stronger relationships. I’ve learnt how to step away from unnecessary conflicts and give myself space to have reactions. It’s made me aware of some of my own self-destructive patterns and helped me take steps to make healthier choices. I can’t say I’ll ever be ‘grateful’ to have triggers, but I’m not scared of them anymore. They have helped me rebuild myself out of a crisis, and I’m content knowing that even if I have to deal with them until my dying day, it means that I’ll have to take better care of myself. I pay more attention to my needs, even on good days, and prioritising self-care makes the good days better.   I may not always be in control, but I’m working with myself now, not against. And that feels better. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

I’m Emma Marns - freelance journalist and mother of one, on a seemingly neverending journey through the Wild West of mental health. I’ve experienced the good, the bad and the frankly unheard of - as I discovered after the birth of my child in the heatwave of 2022. Breastfeeding wasn’t widely discussed in my family and not many of my friends had children when I fell pregnant with my child in 2021. I’m not sure exactly where the passion for breastfeeding came from, but it was certainly there long before I got the obligatory ‘breast is best’ leaflet from the NHS midwife. I was blessed with a healthy, textbook pregnancy at the tail end of the Covid-19 restrictions in the UK. I spent much of my time researching hypnotherapy, water birth, and how all these lovely things would springboard joyously into successful breastfeeding. I have a long history of mental health problems and was assigned a Mental Health Midwife for the duration of my pregnancy. Photo by freestocks on Unsplash Armed with knowledge about how to tackle and counteract the most common problems – low milk supply, exhaustion and experimenting with different feeding positions or ‘holds’ being the main ones – I went into a 36-week scan having been reassured multiple times that my baby was, as much as the term exists, staggeringly normal. An hour later, my husband and I sat with a consultant hearing things like ‘gestational diabetes’, ‘repeat blood tests’, ‘98th centile’ and ‘intervention needed.’ My hitherto perfect pregnancy was thrown into disarray – I had no trace of gestational diabetes, as it turned out, and no palpating midwife could find evidence of an alleged mini-giant in my uterus. Nevertheless, it was decided I was much too high risk now to give birth in my lavender-mist bath, as planned, and after three days of standstill misery on an induction ward, I stubbornly walked myself into an operating theatre on a stifling Monday morning in August. Our, as it turned out, perfectly average-sized daughter was delivered by a completely unnecessary c-section so physically flawless I didn’t even lose that much blood. In recovery, the midwives marvelled at my hungry little jellybean. “Would you like to try giving her her first feed?” they asked politely. Would I ever, and I wriggled out of my hospital gown with the speed of someone who’d been out of surgery ten minutes. It was a standardly chaotic first-time feed, with lots of falling on and off and not much actual digestion taking place, but I was sure it would all be fine once we were settled. Those first few moments gave me an odd prickling sensation, but as I was half-numb from the spinal and out of my mind with joy, I didn’t have much time to notice. We had to stay on the postnatal ward for 48 hours monitoring and then, I had nothing but time to notice. I received little to no breastfeeding support even though I practically begged on my numb knees for it – the staff were too busy in the next bay, trying to bully the young new mum recovering from infection into breastfeeding when she had no intention of doing so. I had a spiteful Healthcare Assistant come and glance at me, tell me my ‘nipples were insufficient’ and shove a bottle of formula into Melody’s mouth before I could say no. I tried to persevere with harvesting colostrum for a syringe feed – even being milked like a cow by a nurse whilst I sobbed at one point – and trying to latch Melody on. Every time I did, I’d start to cry, feeling like a thousand bugs were crawling up my legs and feeling like all the lights had been turned off in the world. By the time we got home, Melody was almost completely formula-fed and I was already devastated. Formula is perfectly safe, perfectly healthy and a very valid feeding choice for any parent - but it just wasn’t what I wanted. My friend, who had successfully breastfed her son for a year after a c-section and sepsis, rushed round with an electric breast pump and showed me how to use it. It was incredibly powerful, and so were the feelings – I felt dark, swallowed up by a depression so sudden and so wrathful that I couldn’t even speak. While she was busy marvelling at how much milk I’d produced so quickly, I was mentally plotting out a route to the level crossing around the corner from our flat, and how I might get there without being missed until it was too late. Once the pump was off, the feelings almost completely subsided, like it had never happened. “Did you, um...” I asked, “ever feel... sad, when you were breastfeeding?” She can’t have heard me correctly because her answer didn’t quite tally. “Oh, I cry over all sorts of things now, ever since I had him!” she chuckled. “Lots of people do.” We continued like this until Melody’s five-day check. The midwife asked if I was breastfeeding. “It... makes me feel strange,” I managed to say, barely articulate through exhaustion and sadness. I couldn’t explain how the moment anything – pump, or baby - attached, even so much as running water hitting my breasts in the shower, made me pray for swift and merciful death almost instantaneously. “Not breastfeeding,” she scribbled down on my notes, “doesn’t like the feeling.” Not totally inaccurate, I thought, but a staggering understatement, to say the very least. I tried to reach out for help, but I just couldn’t articulate properly how I felt, what it was like to be in my body at those moments. My mental health midwife signed me off after two weeks of sobbing at home. The Health Visitor was appalled and had me re-evaluated. I was discharged again, as they said the feelings I was describing weren’t pregnancy or post-partum related, and must be “to do with things from the past” - although no one could specify what they might be. One night when snatching an hour or two of sleep, I had a dream. A man in a white coat was embracing me – wait, no, not embracing suddenly. Holding me down. “Where am I going?” I asked him. He looked at me, pitifully. “You know where you’re going,” he said. I had to stop. My husband’s family generously bought us a Prep Machine because their daughter had found it somewhat lifesaving in her own new motherhood. I cried as we unboxed it. I gave back the borrowed breast pump, remembering all the hopeful hours I’d spent in pregnancy researching everything to do with breastfeeding. I’d looked into everything – everything, except this. In the end, it was my husband who found it. An article had been published online in the US about a condition called ‘D-MER’: Dysphoric Milk Ejection Reflex . In a nutshell, a condition in which at the point of milk letdown, negative emotions such as shame, depression and anxiety surge the mother instead of the euphoric and bonding oxytocin. Once it had a name, it was easy to Google and see that, whilst rare, other women had reported feeling the same. There are some academic papers available , showing it was serious enough to warrant proper medical research. The cause? No one knows. Critically under-researched and still very much not understood, like many women’s health issues, even my midwife friend had never heard of it. If I thought I’d been crying before, the wave of emotion hit me like a tonne of bricks when I realised: I wasn’t insane. I wasn’t a terrible mother or a bad person. It was real, but why it chose me, I’ll never really understand. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Image Source: Sunshine Design on Pexels With every burst of laughter I drew from the crowd, the loneliness behind my makeup grew a little deeper. My name is Shopia Green. I am a circus clown, and the image of my red nose, abandoned on the dressing room table, is the most honest photograph of my life. It is not just a prop; it is a portal. On one side, the vibrant world of the spectacle, where I am the embodiment of joy. On the other, the silence that consumes me when the last spotlight on the ring fades. This is the story of my most intimate contradiction: how the very heart trained to make hundreds of people laugh is the same one that battles a depression that refuses to leave the stage. I am writing this now because I have finally learned to dance with that shadow. The Mask of the Spectacle Under the big top, the large tent that takes centre stage at any circus, the rule is clear: the show must never stop. Rain, cold, good days or bad—it doesn't matter. When the music starts and the lights come on, I become "Pippa," the bumbling clown who makes children and adults roar with laughter at her antics. It is a magical, yet merciless, universe. The pressure to be always funny, always resilient, is constant and can be fertile ground for mental health struggles among performers. Backstage, between acts, other artists smoke, stretch, and joke. I would often curl up in a corner, trying to summon the energy for my next entrance. The persona of Pippa was so demanding that, at times, there was nothing left for Shopia. The Loneliness Under the Spotlights The loneliest place in the world is standing alone in the ring, under blinding spotlights, surrounded by the echo of laughter you created yourself. While the audience laughed, I felt like a stranger at my own party. I was the centre of attention, yet completely invisible. People loved Pippa, but no one knew Shopia. This disconnect between the public persona and the private person began to create a chasm inside me. In the dressing rooms, the contrast was physical. The smell of candy floss and sawdust gave way to the damp of old changing rooms. The glare of the spotlights was replaced by gloom. And the deafening noise of the crowd transformed into a silence so profound I could hear my own heart begging for peace. Image Source: Ahmed on Unsplash The Day the Paint Ran The turning point wasn't dramatic. It was subtle, but for me, it was an earthquake. It was during a classic routine, the "infinite water glass." I was supposed to pour the water over myself. It was a routine I had performed hundreds of times. That day, as the cold water trickled down my face, something inside me snapped. Instead of a funny grimace, my expression simply... vanished. I stood there, staring into nothing, with the water mixed with makeup running down my neck. The audience, confused, laughed nervously, thinking it was part of the act. But it wasn't. It was Shopia overflowing, unable to sustain Pippa for one more second. In that moment of un-rehearsed vulnerability, I was no longer a clown. I was just a tired, wet, and sad person. And the emptiness I tried so hard to hide with jokes and pirouettes was now running down my face in streaks of black makeup for everyone to see. The Discovery in the Wreckage It was in that spilled, smeared overflow—where Pippa’s paint and Shopia’s tears finally mixed—that I found a path to healing. The essence of clowning is not in perfection, but in the courage to fail gloriously. What makes a clown beloved is their shared humanity—their ability to trip and yet get up with a smile (or even without one). I began to apply this wisdom to my depression. If Pippa could honour her failure, why couldn't Shopia honour her sadness? I stopped treating my pain as a flaw that ruined my art and began to see it as one of many colours on my emotional palette. This journey of self-compassion was fundamental. The vulnerability I had tried so hard to hide became my greatest tool. This freedom to be imperfect is a transformative power. An Art Reborn from the Ashes This radical acceptance did not weaken my art; it made it more truthful. My performances evolved. I was no longer acting out joy; I was acting out life. Sometimes, Pippa would be quiet, just observing the audience with a serene expression. Other times, her sadness was incorporated into the act, creating a deeper, more melancholic comedy. To my surprise, the audience connected even more. They felt the authenticity. People weren't laughing at the clown; they were laughing with the clown—and, somehow, with the woman behind her. Image Source: Getty Images on Unsplash My Life Now: An Imperfect Balance My story is not about defeating depression, but about learning to coexist with it. It's about discovering that the clown's light doesn't shine in spite of the darkness, but in contrast to it. The courage to wear the red nose is the same courage I need to look in the mirror and accept the woman behind the smeared makeup. Laughter and tears are not enemies; they are companions in the same existence. Honouring this duality is what makes us whole. Today, I carry my red nose not as a mask, but as an invitation. An invitation to celebrate the messy, imperfect, and profoundly human beauty of simply being. And in the end, that is what art, healing, and life truly are: the courage to show your true colours, whatever they may be. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Image Source: Tricia Patras Everyone has had one of those nights where they feel overwhelmingly Lonely . Lonely within your body, heart, and mind all at once. It’s a feeling similar to living unexplainably separate from yourself. You hope it won’t revisit as often as it does.   The Loneliness lingers, almost long enough to graduate into its mentor: Depression. Loneliness tries to impress its more overpowering sibling until, finally, Depression allows Loneliness to take shelter under its wing. When that happens, it all becomes one—one big Depression. I’ve experienced various forms of this sadness, but the Great Depression has happened twice in my life: 2013 and 2020.   As a person who always feels everything at a deeper pace, mental illness has always followed me. Not only have I battled Anxiety and Control, but I’ve let Fear drive me in my romantic relationships. I have always found a way to invert this into my creativity and luckily found my outlet with writing. Readers who have struggled with love, rejection, or the codependent weight of family history will hopefully see themselves reflected in my work. By laying bare the messy, complicated process of healing, I hope to reframe ordinary struggles as extraordinary acts of survival. Image Source: Tricia Patras The First Great Depression: A tale of unrequited love The first depression overcame me when I was utterly enamoured with a love unrequited. Eventually, I started having a hard time understanding that I had to deal with my thoughts independently. I found it easier to push them aside and deal with his thoughts, instead. I willingly chose to put myself last, a choice I would take back instantly. I desperately wanted him to love me, and I agonised over him.   My relationships had previously consisted of co-dependency that I learned from my parents and their tumultuous marriage. So, when I met someone who shared a traumatic bond with me, I latched on fast and hard. As a young and confused twenty-year-old, I couldn’t get a grasp on myself or anything around me. My family was falling apart, even more than before. We were losing our childhood home to bankruptcy, my mom’s drinking problem was at an all-time high, and I was the constant cheerleader for my sister’s life. I was trying to hide that my foundation was crumbling down, just as much as our home was.   My deep-rooted Anxiety then turned into migraines that would cause unexplainable blackouts, which led to hospital visits. I was not only mentally disintegrating, but now also physically.   My emotions consumed my body, and I had little control over stopping them. I would frequent the bathroom stalls between my college classes to indulge in my daily panic attacks.   I frequently recall myself holding my breath, crying silently, so no one would hear my pain. I kept relying on my situationship to resolve my Anxiety attacks instead of doing the work myself. As long as I was damaged, he would feel needed, and I would get his attention. Win, win. This Depression taught me what a toxic relationship was. I later learned that love didn’t have to be this hard. Love could even be happy, if I let it. I just had to find a way to reroute my connection with love, especially since I correlated it so much with the word damaged . This type of Depression helped me understand that the two words didn’t have to go together. Depression led me to rock bottom, which gave me no choice but to reevaluate my escape route to the top. It brought me to Italy, where I did my best soul searching and discovered my value to the world and vice versa. I learned to love myself more than anyone else. Image Source: Tricia Patras The Second Great Depression: Navigating a Pandemic and New City The second Great Depression was a bit different. The pandemic hit, and the streets became bare. A two-week stay at home in Chicago turned into two months. My mum was hospitalised, lost her job, and couldn’t pay rent. She was dying from a virus without a cure, and I couldn’t see her. The ups and downs were uncontrollable, so I spent most of my time just numb to avoid feeling and facing my emotions. It was a sadness that lingered. Unlike the first Great Depression, I wasn’t able to function. I had nothing to wake me up in the morning—no priorities, no job, no money, and no dream to achieve. I watched my beautiful, safe place, Chicago, start to become a shell of what it once was. The same walks that inspired me now brought a great eeriness. Every day felt like I was losing small bits of myself, hoping that I wouldn’t wake up with nothing left. I was addicted to the co-dependency of being with my family. As unhealthy as it was, I simply felt like a child who couldn’t eat or sleep without knowing my family was okay. I became so consumed with my family’s health and well-being that I neglected my own. I gained ten pounds, stopped going to therapy, my face broke out, and I refused to write. I felt I had nothing left in me. When I reached this point, I had a faint memory of the life I started in San Francisco. I owed it to myself to explore the idea of going back, since I had the privilege to do so. This decision saved me. If I had moved back home permanently, I would have become entrapped by my Depression with the fear that I’d never be able to get out. I did not crawl out of this hole overnight. My first month back in San Francisco was challenging. My mum’s best friend passed away from COVID, and I understood that most of the friendships I had made were gone. I was back to square one. Except this time, I was more bruised and had the Depression pulling me down every time I would try to stand. Then, my good friend, Fate, made an appearance. The day I thought of moving home to be close to my family, I was sent a sign. My friend Rachael had asked me to move in with her, to my dream apartment in the very location that made me fall in love with San Francisco in the first place. I got another chance to keep trying. Once I moved in, each day started slowly getting better. I started writing again. I started eating better. I regained a small chunk of my confidence that I thought was gone forever. The situational factors of the First and Second Depression were different; however, I learned over time that the Loneliness was the common factor. Once I started understanding how to own my Loneliness and turn it into something outward, or even celebrate it, that’s when I started healing. Most importantly, I started seeking the beauty in my surroundings again. Instead of looking at the big picture, I appreciated the small ones that I captured daily. I accepted that life would still be challenging, but I was willing to fight it. I was excited to fight it. And that is why you should never be ashamed of your Depression. Use it to change you. Use it to love you. This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

Community building has become something of a trend, especially over the past year. The more I scroll through social media, the more events I see. While I enjoy seeing people come together, it can also feel overwhelming to be flooded with Instagram posts and WhatsApp groups promoting countless events and gatherings.  Traditionally, communities are formed by groups of people connected through shared spaces or common interests, religion, culture, ethnicity, or values. It is in our human nature to feel a sense of belonging and companionship. When we belong to a community, we experience a connection that extends beyond ourselves, built on shared values and mutual understanding. This sense of social cohesion offers emotional support during difficult times and reassures us that our struggles are shared. It also provides a feeling of safety while helping us embrace and value our differences. I often struggled to find a true sense of belonging, which is what led me to write about this topic. At some point, the endless gatherings, events, and social activities became draining, and finding a community that truly felt like mine became challenging. Over time, I’ve realised that there is nothing wrong with that. As an international student who moved to London four years ago, I set out to rediscover the sense of community I once had and to understand what felt missing in my life here. Like many international students, I found myself searching for “my people,” though what that means looks different for everyone. For some, it’s about shared values; for others, it’s about rediscovering fragments of what community once felt like back home. The film Frankenstein  (2025) captures elements of this experience, which I will reflect on later in this article. Image Source: Christopher Paul on Unsplash In Madagascar, being part of a community was rooted in a shared identity, cultural background, and religious beliefs. I experienced both the positive and the negative sides of this. While I was surrounded by a large group of people with whom I shared many similarities, I often struggled to form meaningful connections. Much of the support I received wasn’t the kind I needed, and it didn’t encourage personal growth or help me become a better version of myself. Contribution often felt transactional rather than genuine. I want to be clear that this reflects my personal experience, not a collective one. So, when I moved to London a few years ago for university, I naturally hoped to find what I felt was missing. Instead, I realised that I had to start from scratch. The positive aspects of the community I experienced back home, such as the celebration of my culture and religion, a strong sense of togetherness, close bonds, and shared experiences, looked very different here. In the beginning, it felt as though I was scavenging for something entirely unfamiliar. Later, as I began to recognise the beauty in what I had once experienced, I found myself searching for something similar in a new context. London is home to a vast range of communities. While I can’t claim to have explored all of them-that would be impossible- I have found fragments of what I’ve been looking for in different places. Yet, despite these moments of connection, there remains a lingering sense of loneliness. Recently, I watched a film that reflected many of these experiences, capturing both the comfort and the complexity of wanting to belong to a community, and the emotional aspect of it.  Frankenstein (2025) is a gothic science-fiction drama inspired by Mary Shelley’s 1818 novel Frankenstein . The film stars Oscar Isaac as Victor Frankenstein and Jacob Elordi as the Creature. It opens with Victor being tormented by his own creation, before unfolding through a series of flashbacks that reveal both his inner conflict and the Creature’s struggle to find identity and belonging. The film explores a cascade of powerful themes, including alienation, vengeance, love, generational trauma and emotional confrontation. However, the theme I want to highlight most is community and society’s response to someone who is simply trying to find a place where they can exist as themselves. Image Source: Frankenstein on Netflix In the movie, wanting to belong to a community is shown as a basic human need, but also something that can be hurtful if not found or denied. The Creature does not initially seek power or revenge; it longs to be accepted, spoken to, and connected with others. When it believes it might belong somewhere, it becomes gentler, more hopeful, and more thoughtful, learning how to adapt and care. This reflects the positive impact of community: belonging allows individuals to grow, understand right from wrong, and feel anchored in the world. However, the movie also shows what happens when someone is constantly pushed away. The Creature is judged only by how it looks, and no community ever gives it a real chance to show its inner beauty. Being rejected over and over, turns loneliness into anger and sadness, hence his hunt for Victor to create a being just like him. Victor himself plays a crucial role in this outcome; by abandoning the Creature and refusing to offer any sense of family or belonging, he reinforces its isolation. The film makes it clear that exclusion can be just as damaging as cruelty. Ultimately, Frankenstein suggests that the need to belong is not a weakness but a universal need. The real danger arises when communities decide who “deserves” to belong and who does not. When connection and understanding are denied, the harm extends beyond the individual, turning isolation into tragedy for everyone involved. While my own experiences do not compare to the depth of what the Creature endures, its longing for belonging resonated with me deeply. In a society that increasingly promotes hyper-individualism, the film serves as a reminder of the importance of community. By embracing one another as we are and recognising the positive qualities that encourage growth, we move closer to creating environments where people can truly belong. Although finding community, especially across cultures and borders, can be difficult, remaining open to new faces and traditions brings us one step closer to building spaces that feel right for us.

Image Source: Amina Falkins on Pexels As a researcher working at the intersection of digital technologies and women’s health, it is always so empowering to see the latest advancements in FemTech ( tech-driven products like apps and wearable devices to address female health, like pregnancy and menopause) such as menstrual blood being discovered as a valuable biomarker , and wearable products for menopause detection. It empowers me, as a South Asian woman in science, to do the work I do. Today, I’m pleased to share that we, as part of the HappyMums project, are contributing to this field. We have recently published the protocol of a clinical study being led by King’s College London, in collaboration with partners across Europe. In our study, we are investigating the use of a smartphone application to gather data to help us predict the development of antenatal depression (during pregnancy). Image Source: Screenshot from PubMed Why are we doing this? Antenatal depression affects close to 30% of pregnant women globally, and common risk factors include previous mental health history, lack of social support, and a history of trauma. If left untreated, antenatal depression can have a significant impact on both the mother and baby. It is therefore vital to develop our understanding of the risk factors so that we can identify mothers who may need support to ensure both their well-being, and the well-being of their babies .   What are we going to do? We are recruiting 1,000 pregnant people between 13 and 28 weeks’ gestation across 7 international centres (approximately 150 per centre), who are either currently suffering with symptoms of antenatal depression, or meet the criteria for at least one risk factor for symptoms . Our screening questionnaire covers aspects such as fertility issues, history of mental health conditions, current consumption of alcohol, and current life stress. Once recruited, consented, and enrolled in the study, they will be given access to the app, for use up to two months after they give birth. Image Source: dumitru B on Pexels What sets this app apart from the rest? Brilliant work is being done by others in the field, focused mainly on postpartum depression . Specifically, they are using screening tools to screen for postpartum depression. We contribute to this literature by starting screening for at-risk populations for depression in pregnancy. We wanted to integrate different types of data, not only for screening, but to build machine learning models that will aid clinicians in decision-making in the future. Our app uses several key features to create a full profile for each participant that gives us information about their ongoing mental health, cognition emotion recognition, and physical activity. These features include: Mental health questionnaires : Participants will complete validated mental health measures at different timepoints in their pregnancy. This will help us track their mood and mental health across their entire pregnancy. Games and tasks : different activities, such as a mood and events diary, games to test thinking and memory, and emotion recognition tasks will help us to better understand how each woman is thinking and feeling across their pregnancy. Smartphone sensors : with the women’s permission we will record their physical activity, such as their step count to understand how and when they move across their pregnancy.   This data will be used to build machine learning models capable of predicting antenatal mental health trajectories. This means that we will harness the benefits of machine learning (a type of artificial intelligence that assists data analysis) to investigate whether it can be useful in seeing which women actually develop depression in pregnancy, from a range of risk factors. These models will combine multiple data types like the mental health measures and digital data, and the resulting models will be tested for their capabilities of predicting and identifying antenatal depression, as well as response to treatment. The overall aim is to develop a data collection device which could in future be paired with a dashboard for the patient’s clinician to view their data for use in clinical and treatment decisions. In addition to this, our participants are given access to a wellbeing course, curated by perinatal experts from the consortium. It contains chapters specific to pregnancy trimesters, covering important topics such as motherhood and biology, birth plans, and breastfeeding, to name a few. We felt it was important to include this, to not only increase the motivation to use the app but also provide relevant, verified information about pregnancy and mental health. Image Source: Getty Images on Unsplash Where are we going to do this? The HappyMums mobile application study is being conducted at seven recruitment sites across Europe and coordinated by King’s College London. The other six sites are: University of Milan (Italy), Ospedale San Raffaele (Italy), Charité (Germany), University of Helsinki (Finland), SWPS University (Poland) and Catholic University of Croatia (Croatia). As I wrote in a previous article for Inspire the Mind, we have the technological expertise of Abacus (the app developers), and collaborators from the Artificial Intelligence in Medicine Lab at the University of Barcelona. With their help, we will use a federated learning (FL) platform to integrate clinical and digital data from other sites, for analysis. This will allow us to collaborate and share data without relying on legal delays and data transfer agreements.  You can read more about this approach here . I am truly grateful for the opportunity to work on this project. I was once wary of using digital technology in the mental health space, fearing, like many , that artificial intelligence could take away our jobs. Working on this project, however, has made me appreciate the potential artificial intelligence has to aid clinical decision-making. When wielded a s a tool, not to replace, but aid clinical decision making, AI has the potential to reduce the burden on healthcare systems, and reduce wait list times. Above all, the work we do is to make sure people get appropriate and timely intervention. With this app, by screening women early on, using a wide range of parameters (digital and clinical), I am excited for the opportunities we have ahead of us.

When treating patients, we often focus primarily on improving their clinical outcomes, and as such inadvertently overlook their broader care needs. These include their perceived problems across health, social, service, and daily functioning areas. Individuals with psychosis, a mental condition characterized by a distortion of reality, often experience poor overall functioning, meaning a difficulty in managing everyday activities, including self-care , social relationships , and work or study , which tends to be even worse when childhood adversities occur. This low functioning appears to be linked to a higher level of unmet needs for care. Importantly, care needs are strong predictors of quality of life, and patients tend to prioritize improvements in daily functioning over purely health-related outcomes. I am a PhD Student in Neuroscience at the Section of Psychiatry of the University of Verona, and I work on the interplay between psychiatry, biology, and genetics. In this piece, I am going to talk about the needs for care in individuals affected by psychosis. In my research, I work closely with Sarah Tosato, Associate Professor at the Section of Psychiatry, who has co-written this piece with me. The impact of childhood adversity, such as sexual and physical abuse, on needs for care remains poorly studied in people experiencing their first episode of psychosis (FEP), who are individuals in whom psychotic symptoms have only recently emerged. Addressing the effects of childhood abuse is crucial for developing more precise and effective treatments tailored to the individual’s specific care needs. Image Source: Author used OpenAI's Sora to generate the illustration In our study , we examined the longitudinal association between physical and sexual abuse and needs for care in a sample of FEP patients. More specifically, we assessed the extent to which physical or sexual abuse and specific care needs occur across various domains, as well as the extent to which these needs remain unmet. We hypothesized that abused patients would have a worse outcome than non-abused patients in terms of a greater number of unmet needs. This study is in the framework of the wider GET-UP project. In our study, we involved 276 individuals experiencing their first episode of psychosis. Of these, almost 30% reported childhood physical abuse and 16.5% reported childhood sexual abuse. Needs for care were evaluated using the Camberwell Assessment of Need (CAN), an instrument that gathers information about basic, social, health, functioning, and service-related needs, assessing both the total number of needs and whether these needs are met or unmet. For example, it asks questions such as “Do you have problems keeping clean and tidy?” and “How do you find budgeting your money?”. Each item is scored 0 (no problem), 1 (there is a problem that is met given an ongoing intervention), or 2 (actual serious problem and no interventions received, unmet need). The GET UP project: Patients were recruited from the Genetics Endophenotypes and Treatment: Understanding Early Psychosis (GET-UP): Early Intervention and Assessment of Needs and Outcome (PIANO)Trial , a multicenter longitudinal study conducted in 117 Community Mental Health Centers located in the Veneto region, Italy. The GET-UP PIANO aimed to study the feasibility and effectiveness of an integrated psychosocial intervention (cognitive behavioral therapy for psychosis (CBTp), psychosis-focused Family Intervention (FIp), and multiprofessional case management (CM) of early-stage patients and their families) compared to usual care. In Italy, usual care for FEP patients typically consists of personalized outpatient psychopharmacological treatment, combined with psychosocial management by a multi-professional mental health team. Instead, CBTp focused on the formulation and modification of psychotic experiences, emotional distress, and maladaptive beliefs, using standard CBT techniques adapted for psychosis. An optimal number of 20-30 CBT sessions per patient was expected to be delivered over a time frame of 9 months. FIp aimed to improve family communication, problem-solving skills, and coping strategies, as well as to reduce expressed emotion. It included an optimal number of 10-15 sessions over 9 months, with each individual family. Every patient/family had a dedicated CM, who coordinated all planned interventions. Key findings Image Source: Author used OpenAI's Sora to generate the illustration The main result of our study shows that individuals experiencing their first episode of psychosis, who were physically or sexually abused as children, tend to have more needs for care than those who were not abused, especially those who experienced physical abuse. Physical abuse was more strongly linked to unmet needs, particularly in social (sexualexpression, social networks, and intimate relationships) and services areas (like having a phone and access to the internet, or having information about personal condition and treatment, and being independent with transportation). It can be hypothesized that prior exposure to physical abuse increases relational vulnerability, making it more difficult for individuals to recognize, express, and address their own needs within care settings. Interestingly, sexual abuse did not appear to be associated with unmet needs in our sample. This was surprising as other studies have shown that individuals with a history of sexual abuse often report unmet needs, particularly in areas related to intimacy and relationships. One possible explanation is that participants in previous studies were older and had been living with psychosis for longer, meaning their needs may have become more complex over time. Another possibility is that in our sample, patients with a history of sexual abuse may have had better access to healthcare, which effectively addressed their needs for care. The study also found that greater severity of psychotic symptoms and lower functioning were both associated with a higher number of needs, especially unmet needs, suggesting that difficulties in daily life may make it harder to engage with appropriate services. This is crucial because it highlights the importance of targeted intervention following discharge to prevent a cycle of rehospitalization. Implications for treatments Image Source: Author used OpenAI's Sora to generate the illustration Overall, these findings suggest that early traumatic experiences, particularly physical abuse, may have long-lasting effects that extend beyond symptom severity and influence how well individuals are able to access and benefit from care. Identifying each person’s specific needs for care is essential to providing effective, individualized treatment. Even in well-functioning mental health systems, some needs often remain unmet, especially among those with a history of childhood trauma. These individuals may feel more isolated and less able to seek help, which can make recovery more challenging. This underlines the importance of considering trauma history in both clinical practice and research, as overlooking it may mean missing critical opportunities to provide appropriate support.

In an era where we are often bombarded with seemingly glamorous and smooth transitions into parenthood, the movie Die, my love shows viewers the other end of the spectrum.   Based on the novel of the same name by Ariana Harwicz , Die, my love follows aspiring novelist Grace, played by Jennifer Lawrence, and her boyfriend Jackson, played by Robert Pattinson, as they leave their life in New York City for a small farmhouse in rural Montana. We first meet the couple while they are touring the house prior to the move. Grace is pregnant, and the pair appear carefree, excited by the prospect of starting over and discussing plans for Grace to write the next “great American novel.”   After the baby is born, Grace begins to rapidly unravel, losing her grip on reality and descending into what the viewer assumes to be ‘madness’, but what those of us in psychiatry would recognize likely as a portrayal of postpartum psychosis. Through a series of dark and unsettling scenes, the audience is positioned inside Grace’s experience as she throws herself through a window, attempts to jump from a moving car, and tears paper from the walls until her nails bleed. Image Source: Screenshot from Die, My Love As a researcher focused on mental health during and after pregnancy, I was immediately drawn to Die, My Love . Maternal mental health is rarely portrayed on screen, and when it is, motherhood is often filtered through an idealised lens that leaves little room for struggle or complexity.   There is much to unpack about the film’s psychological meaning and whether it accurately represents postpartum psychosis. But what stayed with me most was its broader cultural role: how media portrayals of maternal mental health can validate women’s experiences and reduce stigma when handled with care, yet risk reinforcing fear, shame, or misunderstanding when done poorly.   Importance of representation Society expects mothers to be perfect. As a result, many women conceal how they are truly feeling, through fear of being deemed an unfit mother. This is a serious issue, because untreated perinatal mental health disorders can have long term impacts on both the mother and the infant . As the film illustrates, mental health difficulties do not occur in isolation; they place strain on relationships, disrupt daily functioning, and can gradually erode the stability of the home.   Analyses of television and drama narratives about mental illness suggest that accurate, empathetic portrayals can increase public understanding and encourage help-seeking, while reducing stigma. Additionally, emerging research on social media content related to postpartum depression indicates that mothers engage strongly with shared personal experiences.  As I have written previously in my discussion of Inside Out 2 and its portrayal of puberty, when media representations take emotional experiences seriously rather than simplifying them, they can help audiences feel understood and less alone in navigating psychological change.   Importantly, Die, My Love resists a narrative that questions Grace’s fitness as a mother. Grace’s distress is never framed as a rejection of her child; she is shown loving her baby, holding him, responding to him, and remaining emotionally connected even as she unravels. This distinction matters. While maternal mental health difficulties can affect the mother–infant bond, they do not automatically erase love or attachment. Too often, cultural narratives collapse these complexities into a single, damaging stereotype of the “bad mother.” By separating Grace’s love for her child from her psychological deterioration, the film offers a more nuanced portrayal; one that is especially important within a wider media landscape that frequently equates maternal struggle with maternal failure. Image Source: Screenshot from Die, My Love In this way, Die, My Love contributes to a growing body of media representation that allows mothers to feel seen in their struggle, and may help give them the courage to seek support rather than suffer in silence.   The risk of conflating maternal mental health with madness For the majority of Die, My Love , viewers are confronted with unanswered questions. The film never explicitly states that Grace is experiencing postpartum psychosis; instead, we are asked to follow her fragmented and often disorienting perspective. Personally, I see this as a deliberate and effective artistic choice by the director: Grace and Jackson live in near-total isolation, cut off from both community and support. As Grace begins to navigate motherhood, the challenges she faces, and the extreme toll they take on both her mental health and the couple’s relationship, are as confusing to them as they are to the audience. The couple attempt to ignore what is happening, largely due to a lack of awareness that such experiences are possible. By placing us inside that same uncertainty, the film not only mirrors their isolation but also highlights how easily maternal mental illness can go unrecognised when there is no support or understanding to name it.   However, this absence of diagnostic clarity is not without risk. While ambiguity can foster immersion, it can also invite moral judgment rather than empathy, potentially replacing uncertainty with spectacle. Representation matters, but without sufficient context, even radical portrayals of mental illness can unintentionally reinforce stigma. Image Source: Screenshot from Die, My Love An ending portraying no way out At the film’s conclusion, we watch carefully as Grace returns home after time in a psychiatric facility. In her absence, the once chaotic farmhouse, previously a reflection of her unravelling, has been completely transformed by Jackson. The walls are painted, the bathrooms she destroyed are repaired, flowers are placed neatly on every surface, and even the cracks in the foundations have been filled. On the surface, it is an act of care. Jackson is trying to build a peaceful, welcoming home for her return. Yet the transformation also feels unsettling, as though every trace of Grace’s distress, every visible sign of what she went through, has been wiped away. Grace tries to step into this new version of her life. She bakes a cake for her own homecoming, with “welcome home” piped carefully across the top, performing the role expected of her.   However, soon after the party begins, Grace quickly begins to spiral and leaves for the woods. Jackson finds her and turns to her once again and promises he will “try harder,” a refrain he has repeated throughout the film. This time, Grace simply responds, “enough.”, before disappearing into the forest and starting a dramatic forest fire, in which she disappears before the film cuts to black.   While the ending of Grace walking into the flames is metaphorical and open to interpretation, it does suggest a bleak kind of inevitability; Grace receives treatment, yet nothing seems to shift. While real-world treatment for maternal mental illness is far from perfect, there is meaningful and effective support available. By presenting recovery as impossible, the film risks reinforcing a sense of hopelessness. For mothers who may already feel afraid to speak up, the message could be damaging. For those in at risk of perinatal mental illness or in recovery, it could be troubling.   In sum, Die, My Love occupies a complicated but important space in the representation of maternal mental health. While its ambiguity and dramatic intensity risk reinforcing fear or hopelessness, its refusal to idealise motherhood and its insistence on showing maternal struggle offer a rare and validating portrayal. Ultimately, the conversation it sparks may be its greatest strength; reminding us that support exists, and that seeking help is not a failure of motherhood, but an act of care for both mother and child.

When I was studying in high school, I came across a quote by Karl Popper, a philosopher and academic, that really caught my attention. He once said: "Avoiding mistakes is a narrow-minded ideal. If we don’t dare face those challenges that are so difficult as to make the error almost inevitable, knowledge will not be developed. It is from our more daring theories, including those that are wrong, that we learn the most. No one can avoid making mistakes, but the important thing is to learn from them". Image by Kenny Eliason on Unsplash Popper’s words sound reasonable, yet fully embracing the idea of learning from errors and living with that mindset is far from easy. I am in that period of life, the 30s, where I find myself questioning my life and the choices I make. I am a PhD student in Neuroscience at the University of Verona, Italy, and I often end up asking: "Am I on the right career path? Was this lab experience good enough for my growth? Should I study more to acquire that skill?" Social media does not help me in this thinking loop. When I scroll through my feed, I am constantly exposed to the apparent successes of others, which makes me focus even more on what I feel I am lacking. I start comparing my path to theirs, replaying my decisions in my head, and questioning whether I am doing enough or moving fast enough. Over time, this comparison turns into rumination and leaves me feeling frustrated, inadequate, and increasingly afraid of making the “wrong” choice. Sharing these thoughts with my friends, I realised something else: many people in my generation struggle deeply with making choices in many aspects of life. We are haunted by questions like, what if I’m wrong? What if I have bad consequences from this decision? What if this is not the best possible option? It seems like we are unable to trust the process. We found ourselves with too many options to choose from, yet we are expected to make the “right” one straight away, and a backup plan, in case of failure. Understandably, this state generates anxiety, and I see it everywhere around me: a shared fear of making mistakes, of choosing “wrong”, and failing. But what if we are looking at mistakes in the wrong way? Errors are a part of knowledge As a researcher working in a lab, I can say that error is not an exception. It is the rule. A scientific theory is, by definition, an idea that can be proven wrong. Science progresses not by avoiding mistakes, but by actively putting ideas in conditions where they might fail. In this sense, error is not the opposite of knowledge; it is how knowledge grows. The same is true for the human brain. Our brains learn through trial and error. It constantly builds internal models of the world, tests them against reality, and updates them when they do not work. Our brain processes errors in different ways : Errors catch our attention. When we are confident that we know something but later discover we are wrong, this is called a "high-confidence error". In these moments, areas of the brain involved in decision-making, like the medial frontal cortex and anterior cingulate cortex , act like an alarm, telling our brain there is a mismatch between what we believe in and what we discover. Interestingly, this response does not happen only when we are wrong, but also when we are unexpectedly right. In these moments of contradiction, the brain is surprised and marks the feedback as important, prompting us to pay closer attention. Errors challenge our brains to make an effort. When we make a mistake and then get the right answer, our brain has to work harder to "delete" the wrong information and "save" the new one. This extra effort, managed by the dorsolateral prefrontal cortex , which is involved in conflict resolution, monitoring, and control, makes the memory stronger and long-lasting than if we had just passively read the right answer. The fear of making mistakes Modern life puts enormous emphasis on performance, speed, and efficiency. We are constantly stimulated, constantly responding, and constantly judged. Consequently, intelligence is often measured as doing the right thing at the right time, as fast as possible. Image by Timon Studler on Unsplash But learning takes time and requires both attention and reflection. Indeed, the brain does something more special than merely responding to stimuli: it shapes who we are and the capacities that make us human, such as contemplation, imagination, and dreaming. When we are forced to operate on a fast-paced timeline like instant clicks, notifications, and rewards, we sacrifice depth for speed. Our attention span erodes, and we become trapped in stimulus–response loops. And this conflict between how our brain actually works and how we are asked to function generates anxiety of failing. This is where rumination appears. In my clinical practice during my doctorate in psychology, I routinely saw people stuck in their recurring thoughts. Rumination gives us the illusion of solving problems, but in reality, it is just repetitive, anxiety-driven thinking that intensifies our fear of making mistakes. For many, especially young adults like me, making a mistake feels like a judgment: What happens if I fail? What kind of person am I? We do not realise that making errors means being alive and the only way to face it is to do it and learn to fall. Short-term mistakes are frequent and necessary to avoid long-term errors. Not moving, not choosing, not taking a risk: this is where real failure lies. Freedom begins when we accept being fallible We often have a double standard when it comes to mistakes: we hide our own and judge others’. At the same time, we live in a culture that celebrates success stories without revealing the numerous wrong turns that led to them. But how much freedom would we gain if we accepted our own mistakes? Image by Melanie Stander on Unsplash We need to accept that mistakes are a fundamental part of life, a natural aspect of being human. Accepting error means accepting pain, uncertainty, and vulnerability. It means trusting that growth also comes from unpredictable mistakes and that controlling everything cannot be the solution for our need to perform well. Ultimately, the most precious experience in life comes from something we did not plan and from our ability to start again after making a mistake, as Popper once said.