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.

I've been curious all my life—from collecting samples for my microscope as a kid, to investigating psychiatric biomarkers as a PhD student now—but for me, this curiosity didn't belong in the same box as dresses and pink. I was never girly . I put up a fight against my mother whenever she tried to put me in dresses when I was a toddler. Throughout my childhood, my wardrobe mostly consisted of my brother’s hand-me-downs, and even now in my late twenties, it’s a sea of black, blues, and greens with the occasional piece in white or cream. Throughout my teens, pink felt frivolous, girly , and childish—something I would roll my eyes at. The first time I bought a dress was in my early twenties, and I barely ever wore it, because, again, it felt too girly . But what does that even mean? And why did I reject it for so long? Image Source: Becca Tapert on Unsplash The Great Pink Rejection I’m not alone in rejecting pink and all things girly . For most of modern history, anything coded as “feminine”—softness, playfulness, pastels, flowery or pink aesthetics—was systematically devalued as frivolous and weak. Women dressed as men to be taken seriously and to have better opportunities and pay. Even today, many girls learn that sparkly things and bright colours are unprofessional, something to “grow out of” for career success. As young women, we discover that success in a male-dominated world requires rejecting stereotypical markers of femininity and girlhood and embracing more neutral or masculine-coded traits. Want to be seen as intelligent? Skip the pink. Want a career advancement? Ditch the glitter. We are told that femininity is an obstacle rather than something to celebrate. And of course, this affects boys too: Any “feminine” traits are frequently snuffed out and replaced with masculinity. But this is a whole other issue worth its own discussion. Yet, femininity is still expected of us in every other aspect of life. This creates the unachievable expectation women are held to, and many women hold themselves to: Be girly and feminine, but only when it suits society, and never too much or too little. As described in a previous ITM article , America Ferrera as Gloria captured this perfectly in her famous monologue in the Barbie movie, describing the impossible contradictions women face daily:  “ It is literally impossible to be a woman. […] It’s too hard! It’s too contradictory and nobody gives you a medal or says thank you! […] I’m just so tired of watching myself and every single other woman tie herself into knots so that people will like us. ” The Power of Claiming it Back In recent years, something has changed. By embracing pink and girly things, women challenge the idea that femininity means less power, less seriousness, or less maturity. There is nothing less about us. This follows a broader feminist tradition of reclamation; activists have similarly reclaimed words like “slut” and “queer”, turning insults into sources of power and identity. When I see a businesswoman presenting herself with a feminine aesthetic, I see someone refusing to play by patriarchal rules, someone rising above masculine standards with strength and attitude. We can be soft and strong, pink yet powerful, girly yet serious. Before Greta Gerwig’s Barbie, Elle Woods in Legally Blonde delivered this same message. Outside of fiction, we have Taylor Swift, who is making music history again and again while presenting herself in soft and pastel or colourful, sparkly looks. These cultural representations make pink both commercially visible and politically resonant. Image Source: Joel Frank on Unsplash Girlhood as Healing For many women, reclaiming girlhood connects to what we call “inner child work” in psychology – healing parts of ourselves hurt or suppressed in childhood. Many of us experienced being forced to grow up too quickly, told our interests were "silly", or being pressured to act maturely, prematurely. At the same time, boys’ behaviour around us was often excused with “boys will be boys”. Reclaiming pink, flowers, sparkles, and playfulness becomes self-soothing and healing. For me, this didn’t mean pink lipstick or glittery sequins. Instead, I started buying more dresses, floral blouses, and a cute blush. It might not be the epitome of girly , but 14-year-old me wouldn’t have been caught dead in them. It feels like giving my younger self permission to enjoy something I had learned to reject—things reserved for girly girls. And research shows an actual psychological benefit to this: engaging with creativity and playfulness significantly buffers stress, anxiety, and depression . This movement also counteracts internalised misogyny. Messages about femininity being weak often become internalised shame. Towards oneself and others. I never minded being a girl, I simply didn’t want to appear weak and immature. By actively embracing what we once rejected, we are rewriting those shame responses and practising self-acceptance that improves self-esteem, body image, and relationships. I don’t need a pink blazer, but I can appreciate a colleague who is rocking hers at a conference. Encouraging girlhood in others creates communities—online and offline—where women affirm each other’s experiences and validate what once was (and sadly still is) stigmatised. There’s something deeply healing about finding people who celebrate parts of yourself that society taught you to hide. Image Source: ksama on Unsplash It’s Not all Sunshine and Rainbows However, this movement still faces problems. First comes commercialisation. Brands jumped on trends like Barbiecore, turning feminist resistance and mental health into a quirky marketing opportunity. When “empowerment” becomes merely a slogan on pink products, the movement risks returning to what it opposes: playfulness and femininity dismissed as unserious. Marketing also creates exclusivity. Dominant imagery of girlhood often features white, thin, middle-class aesthetics of a narrow beauty standard and financial resources. Women of colour, trans women, plus-sized women, and working-class women get pushed aside, again, by companies and peers alike. Then there’s romanticisation. For many, especially marginalised women, girlhood wasn’t soft or playful. It meant trauma, early sexualisation, and exclusion. A nostalgic emphasis can gloss over these harsher realities, promoting a girlhood that never existed universally. Last comes concerns about depoliticisation. Focusing on pink aesthetics reduces feminism to 'vibes' rather than addressing systemic issues like wage gaps and reproductive rights. There’s also worry about reinforcing gender binaries—setting “pink” equal to “girlhood” sometimes strengthens the categories it aims to challenge. Image Source: Celina Yoo on Unsplash Making Your Own Way down the Pink Brick Road I don’t think we need to choose between feminine aesthetics and political awareness, or between healing our inner child and acknowledging that pink lip gloss is not on everyone’s path of recovery. We can enjoy pink and girly moments while fighting for systemic change. We can celebrate personal healing while recognising that empowerment looks different for everyone. Awareness of the movement’s limitations may be the key to its success. After all, the most radical aspect about reclaiming girlhood isn’t the pink and the glitter, it’s permission for women to be complex beings and revoking fake binaries of strength and softness, seriousness and play, political awareness and personal healing. Mental health doesn’t depend on embracing or rejecting pink. What matters is genuine, authentic choice, rooted in self-knowledge and acceptance and not dictated by shame or trends. Create your own path, and if healing comes through pink lip gloss? Perfect. Consider this your permission to be whoever you are—pink, political, or somewhere beautifully in between. Image Source: Hoite Prins on Unsplash

Photo by Erin Doherty on Mamamia Heartbreak is a common experience, often understood as a time of emotional crisis which can be resolved with feeling-based healing. Some typical advice you may have heard (or given) is: “the feeling will pass, you’ll get over it”, or “sit with your emotions”. But this advice feeds into the stigma that heartbreak is solely an emotional experience and pays no mind to all the physiological impacts. I am a student on the MSc Psychology and Neuroscience of Mind-Body Interface. In this article, I will explain how the body is impacted during experiences of heartbreak, specifically regarding neurotransmitters (the chemical messengers in your brain). This may help explain some of your post-breakup behaviours and remind you that healing from heartbreak is more complex than just your emotions. Seeking support, whether that be formal, informal or clinical, is okay. But Heartbreak is an Emotional Crisis? If we reflect on the stereotypical heartbreak scene, we see the heartbroken individual in bed with tissues, crying into ice cream whilst watching the Notebook. But in the real world, not all people deal with heartbreak this way. Some people have no tears or outward sense of sadness. No one should feel abnormal or guilty for not following the “heartbreak script”. Your emotions may not align with the movies, but just know your physiology is ‘heartbroken’. Heartbreak symptoms occur along a spectrum; it is an individualistic experience comprised of both emotional and physiological components. In extreme cases, heartbreak can even cause physical conditions such as stress-induced cardiomyopathy, also known as broken heart syndrome. This is a condition where the heart muscle becomes weakened and can be fatal. However, broken heart syndrome seems to be the only well-known physical association with heartbreak. To cope with and heal from heartbreak, it is important to understand how the body reacts physiologically. But before we continue, let’s emphasise that heartbreak isn’t just romantic. Romance isn’t the pinnacle of everyone’s life; heartbreak can also result from grief, family issues, or strained friendships. The dopamine binding trap in heartbreak The neurotransmitter system, which involves the happy feel-good hormone (dopamine), is (understandably) disrupted during heartbreak. Disruption in dopamine levels can impact mood and cause a reduction in motivation, sometimes triggering depression. So, what is actually happening during heartbreak? When we are in love, our brain associates the other person with feelings of comfort and reward, which triggers the release of dopamine. When relationships end, and the feeling of being heartbroken creeps in, the sudden loss of reward causes dopamine levels to be unstable. In the immediate stages of heartbreak, the instability of dopamine causes its levels to dramatically increase and decrease. Interestingly, this change in your dopamine system may help explain why you feel the urge to text your ex or check their social media after a break-up. When memories of the person trigger dopamine release, your brain starts linking that dopamine ‘hit’ with them. Over time, this can create a pattern of reinforcement which maintains your sense of attachment to them. The dopamine release keeps you feeling attached to the person and that motivates the desire to check in on them or gain access to them. So, to heal from heartbreak, it could be useful to remove anything that might trigger memories of the other person, to avoid this dopamine release cycle. This could be getting rid of (or even hiding) anything that triggers memories: text chains, photos, jewellery, clothes, anything! Maybe going into no contact might be the best thing for your physiology and emotional well-being. Regulation of the dopamine system is crucial for healing; if you feel ready to move on and form new romantic attachments, regulation of dopamine function is a necessity. Cortisol’s helpful (and unhelpful) contributions during heartbreak The hypothalamic-pituitary-adrenal (HPA) axis is a system which releases cortisol. Cortisol is known as the ‘stress hormone’, so we can think of the HPA axis as a stress alarm, and when heartbreak hits, the alarm sounds and cortisol flows! When heartbreak, or any psychological stressor, activates this axis, the first part to respond is the hypothalamus. The hypothalamus is a region in the brain which is responsible for hormonal control. It releases Corticotropin Releasing Hormone (CRH), the first stress signal, which then triggers the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH is the second stress signal, which travels through the bloodstream to tell the adrenal cortex to cope with heartbreak. Photo by Daniel Leal, Internal Medicine Functional Medicine The release of cortisol allows the body to mobilise energy to respond to stress. This increase in cortisol is essential and works to provide us with resources to cope with heartbreak. Despite the HPA axis working to support us in the initial phases of heartbreak, it is well known that heartbreak does not typically resolve itself overnight. The HPA axis tends to be chronically active for a prolonged period, which can cause mental and physical health complications to occur, such as appetite changes, cognitive difficulties, sleep disturbances and even reduce the immune system’s ability to fight off infections and diseases. Overall, prolonged production of cortisol “holds us” in the depths of heartbreak, contributing to many symptoms which affect daily functioning. Why is mood regulation so much harder during heartbreak Another key system affected by heartbreak is the serotonin system, which plays a key role in mood regulation and contributes to emotional wellbeing. During heartbreak, dramatic adjustments to the serotonin system make feeling calm, balanced and in control much harder. Serotonin levels drop during heartbreak, causing mood swings and a lack of impulse control. Dysfunction in the production of serotonin is associated with a variety of mental and physical symptoms including sleep disturbances, cognitive difficulties, depression and anxiety. This can make the process deeply confusing; though heartbreak is the time you wish to regulate and understand your mood, it’s also the time where your own neurobiology is working against you! Good news is, this disruption is not permanent. When your serotonin levels return to normal, mood regulation becomes easier, and many people notice improvements: mornings where you feel like yourself again, can think more clearly, and experience moments of peace within your emotions. Final reminder to all The reason I wrote this article is to bring attention to the physiological impacts of heartbreak, but also to remind you all that getting help is okay. Please reach out to friends, family members, loved ones, and if necessary, your GP. The neurotransmitter systems discussed in this article provide some insight into the physiological impacts of heartbreak. If you have had appetite changes, sleep disturbances, anxiety, cognitive difficulties, sickness or feelings of depression, it may be due to contributions of the body in reaction to this emotional shift. The biggest take-home message of this article is do not underestimate how your body reacts to what your mind is having to process and to reach out for help if you need it. The mind and body are connected in many ways and heartbreak is not exempt from this. Photo from Marah Bashir on Unsplash

A biological overview of the seasonal changes across mood disorders “The changes of the seasons are especially liable to beget diseases” — Hippocrates (5th century BC). Here we are, April has come and is already about to end. We are now in the middle of the spring and approaching summertime, to the delight of many. However, even if most of us are happy for the arrival of spring, this may be a very trying time for both our body and mind. Spring is a period of great changes, not only in the landscape surrounding us. The progressive and massive environmental development of the contemporary world have certainly detached us from changes in the natural world. We do not live in the wild, and we can vastly adjust the environment to our wishes. Still, we are significantly affected by seasonal changes . We just need to look outside. The days are getting warmer and the sun is staying out longer, increasing the daylight time. This has been further amplified early this month by the “summer time”, that forced us to reset our clocks to one hour ahead. All these modifications could seem trivial, but they affect our wellbeing. Of course, under physiological conditions, our body is able to face them and react in a positive way. However, people suffering from mental illnesses may be hyper-sensitive to these changes. These changes could actually be a trigger for the development or exacerbation of the disease. The way our body reacts to this combination of external stimuli is multifaceted, and involves several biological factors in an intricate interaction orchestrated by our brain. The light-dark cycle has a deep impact on the biology of the brain . In particular, there is a specific cerebral area, located in the very middle of the brain, which has been proved to be crucial in mediating these changes: the hypothalamus . It is strictly connected to the other brain areas and regulates several essential biological functions, for example hormone secretion and response to stress . Image from topsimages.com The hypothalamus contains a specific group of cells that regulate the so-called circadian rhythm , from the Latin circa : approximately, and diem : day. We can think of it as an internal clock regulating a wide variety of biological functions within a 24-hour time frame. And health problems can be linked to a disruption of this rhythm. Many of us have experienced the well-known “jet-lag”, often related to long-distance trans-meridian (east–west or west–east) travels, and mostly characterized by sleep disturbances and fatigue. However, this 24-hour daily rhythm is also strictly related to a longer rhythm which covers the four seasons all over the year, known as circannual rhythm . So, during seasonal changes our body must face a plethora of signals. This can destabilise our homeostasis, that is, our steady internal functioning, affecting also our mood. Someone could feel happier and more energic, while others tired, fatigued, and listless. Well, this may not be just the weather. Indeed, specific psychiatric disturbances, such as mood disorders (depression, bipolar), are frequently sensitive to seasonal changes. The arrival of spring, as well as autumn, could be associated with a failure in the biological adaptation of the body to the seasonal changes , leading to disrupted communication between the circadian (day) and circannual (seasonal) rhythms, and resulting in the onset of an episode of a mood disorder . Seasonality and mood disorders Mood disorders are disturbances of the basic individual’s affective status. These may occur as a lower —  depression  — or an elevated —  mania  — mood compared to the subject’s normality. Both these conditions are pathological and related to severe and life-threatening consequences. Depressive disorders are characterized by the presence of depressive episodes only, while bipolar disorders by the presence of manic (or hypomanic, when less severe) episodes, besides depressive ones. Seasonality is important in both depressive and bipolar disorders. A cyclical course, with recurrent episodes, is typical of mood disorders. Exacerbations and remissions may repeatedly occur at specific times of the year. According to the diagnostic criteria of the last version of the most commonly used classification of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the presence of a “ seasonal pattern ” can be applied to both. This means that patients with mood disorders could experience relapses and remissions of their illnesses recurrently at specific times of the year , usually in association with specific seasons. Photo by Omar Lopez on Unsplash Seasons and mental health have mostly been studied in relationship with the old concept of “ seasonal affective disorder ”. This is a peculiar subtype of depressive disorder, with recurrent depressive episodes in autumn-winter and remissions in spring-summer. It is still the most common type of depression with seasonal features, also called “ winter-depression ”, and it is observed particularly in higher-latitude countries (for example, Scandinavia or Alaska) where variations in daylight across seasons are most marked. It is also clear that mood alterations could involve not only depressive episodes, but importantly also manic (and hypomanic) ones . Moreover, episodes of a mood disorder could be worsened not only in autumn-winter, but also during the spring-summer shift . Mood disorders with seasonal features are quite common. Around 10% of depressed patients have a seasonal course. Even higher rates have been reported for bipolar disorders. Seasonal depression is more frequent in younger persons and is often associated with a specific symptomatologic pattern, characteristic of the “atypical” subtype of depression , which includes increased appetite and need for sleep, and loss of energy. These symptoms are also frequent in the bipolar form of depression (or bipolar depression), that is, depressive episodes occurring in people suffering from bipolar disorders. Of note, patients with manic episodes have higher rates of admission into hospitals during spring and summer, when sunlight exposure is longer. A seasonality effect is also present for the most tragic consequence of mood disorders, suicide, with rates that also increasein spring or early summer. Clinical implications From a psychiatric point of view, these observations are particularly important. It is important that a correct diagnosis considers the life-time history of the patient , and specifically investigates seasonal patterns of relapse. It is important also for patients and their relatives not to underestimate fluctuations in mood related to seasonal changes, promptly asking for help if needed. Seasonality can also offer an opportunity to prevent (or at least be prepared for) an episode of a mood disorder. Of note, a treatment specifically acting on circadian rhythms and counteracting the effects of light variations exists: light-therapy . This treatment is effective in addition to antidepressant drugs for depressive episodes, mostly for those with a seasonal pattern. “ April showers bring May flowers ” Spring is certainly a particularly delicate time of the year for people with mental health problems, and changes in mood, appetite, energy or sleep during this period should be considered a wake-up call for clinicians and patients. But it is not all just bad. The knowledge of the potential effects of seasonal changes in some people with mental disorders can allow us toprevent or better treat recurrences, thus limiting their impact . “Is my mental health problem seasonal?” This is a question that all people suffering from a mood disorder should consider, and should try to answer together with their clinicians, in order to improve their mental health. Photo by Jeremy Bishop on Unsplash

As time progresses since the pandemic struck, we have found ourselves plunged into a new world that has forced us to change how we live, work and look after ourselves. Having an avid interest in the arts, I’m always in vigorous pursuit to get my diary booked with music, poetry, arts exhibitions, and events on offer. No longer able to absorb the creative and cultural tapestry which brought pleasure, autonomy and fulfilment, due to COVID-19 government regulations , my quest for meaningful activities was thrown into disarray. I am currently in my final few months of qualifying as an Occupational Therapist at St George’s University of London. I recently completed a research placement with the incredible King’s College London research team and was thrilled to be offered the opportunity to share my reflection of using photography to enhance health and well-being. ‘Timeless Love’ - Author’s own work Using photography to stay engaged with the world and to help combat this solitude, brought salubrious benefits beyond expectations and felt like having the power of a therapeutic tool in the palm of my hands. Balancing my final year of occupational therapy practice placements, academic commitments as well as a health condition which required trips to hospital for treatment and surgeries without the support of close friends and family, due to government regulations , proved challenging. ‘Tranquillity’ - Author’s own work On my hospital trips, or blithely wandering to get a daily dose of fresh air and exercise when the need to decompress bellowed, I found myself taking photographs. Despite having convinced myself of being scarce on the creative front, I was captivated by filtering nature’s beauty and the turmoil around me. Author’s own work One paramount tip I have learnt from a dear friend, who is a talented portrait artist, is to pay attention to what I feel, see, hear and think, before taking a shot. Ruminating in my own thoughts, aspirations and desires, my photographs subconsciously capture the essence of my surroundings. Almost like a heightened state of inner self, there is a psychological link in my creativity, emotions, identity and communication, which is captured in my photographs. This coupling of photography and psychology is not new, as described in another Inspire the Mind blog . Taking photographs has been shown to promote mindfulness, whilst stimulating making meaning of what is around us. It gives a sense of purpose, and for some, creates a community. We share experiences and achievements which have been shown to tackle loneliness, stress, anxiety and grief during times of adversity, evidenced in this research by Lancaster University . From my standpoint, this has illuminated the therapeutic power of photography and the camera as a creative instrument, described by Dr Bursztajn . Portrait Painter Clae Eastgate in her studio, Shopshire Hills, UK - Author’s own work A few photography tutorials and YouTube videos later, recognising the need for allocating time to self-care, I began exploring what being a shutterbug (a photography enthusiast), had to offer. There is no master plan for what I photograph. Anything that evokes an emotive, energised, creative feeling which allows me to decelerate and breathe, is captured in my photographs. ‘Reverie’ - Author’s own work Admittedly, it feels as though I am in a state of ‘flow’. Are you familiar with this term? It is a psychological concept named in 1975 by Hungarian-American psychologist Mihaly Csikszentmihalyi and is especially well recognised in occupational therapy practice . The state of flow is a subjective experience; precisely how I feel when taking photographs. I am immersed in an activity which is enjoyable and nothing else seems to matter. Experiencing a shift of consciousness from one’s worries, a forfeit of self-consciousness almost, and a distortion of time in pursuit of pleasure, which this study describes. I capture the feeling, or moment in my photographs and what that evokes, rather than what I see. ‘Solitude of the sea’ - Author’s own work So, why has photography been so paramount in enhancing my health and well-being, as I try to adapt to a second year of life with Coronavirus? For some of you reading this, you may think this trivial and unimportant. However, research from the National Institute of Clinical Excellence (NICE) shows, when we need a break from work or other responsibilities, partaking in meaningful and enjoyable activities, be it photography, sports, arts or time in nature, manifests a feeling of calm, vitality and restoration, whilst improving our self-care. ‘Joie de Vivre’ (Joy of Living) - Author’s own work Globally, the pandemic is having a detrimental effect on the mental health of people whilst placing increasing demand on services. There is no silver bullet, or panacea , for how we adapt to a different way of living since the emergence of Covid-19. Nonetheless, by using an approach where we prioritise, look after and take time out for ourselves, be it photography, arts, sports or whatever else colours your world, undoubtedly, you’ll begin to recognise how vastly this can enhance your emotional, physical and mental health and well-being, as I have discovered with photography. ‘London Sunrise’ - Author’s own work I’ll leave you with one of my favourite quotes by photographer, Henri Cartier-Bresson, which I think applies to any activity we partake in to promote well-being: “It is an illusion that photos are made with the camera… they are made with the eye, heart and head.”

I never had to think when I switched between speaking Tamil and English, it was second nature to me. I spoke Tamil at home and English at school, sometimes mixing the two without realising it. I had never given much thought to the role of an interpreter. I had always translated for my parents during appointments and considered it normal. It wasn’t until I began observing GP appointments as a student that I realised how many details were overlooked. There is one appointment I remember clearly. A woman in her thirties walked in with her son, who volunteered to translate for her as the scheduled interpreter was not available. They both spoke Tamil, and without meaning to, I understood every word they said. At first, everything seemed to go well; the GP asked general details about the abdominal pain the woman was experiencing, and her son translated clearly everything she said. The GP continued, asking more personal questions about her menstrual cycle; I could sense a shift in both the mother and son. The mother took her time before speaking, giving very short and rushed answers. The son started to hesitate before translating, missing out details and mumbling his words. It felt very uneasy seeing the awkwardness and discomfort between the two. Image by National Cancer Institute on Unsplash I quietly caught the GP’s attention and told him I was fluent in Tamil. With the consent of the patient, her son waited outside while we finished the appointment. I spoke very gently in Tamil, trying to make her feel at ease. Her answers started to be longer, more specific, and the relief was evident on her face. The GP continued to ask direct questions, which helped him gain a clearer picture of what was going on. At the end of the appointment, the woman and her son thanked me. In that moment, I realised how differently the appointment could have ended and the value of a professional interpreter. I am writing this piece as a current medical student, whose understanding of language barriers has been shaped by both my personal and professional experiences. From translating for my parents as a child to observing GP consultations as a student, I have seen firsthand how communication gaps can affect patient care. This has motivated me to reflect on the impact of language barriers and the urgent need to address them. Language Barriers in UK Primary Care The UK is very linguistically diverse, with more than three-hundred different languages spoken. In fact , over 20% of primary school children speak English as an additional language . Nonetheless, patients with limited proficiency in English face significant language barriers in healthcare , resulting in a higher risk of adverse events, misdiagnosis and unplanned readmissions.   The UK’s Equality Act 2010 places a legal duty on the National Health Service (NHS) to reduce inequalities between patients with respect to their ability to access health services. The guidance for primary care states that ‘patients should be able to access primary care services in a way that ensures their language and communication requirements do not prevent them receiving the same quality of healthcare as others.’  However, there has been little progress in implementing this guideline, with large gaps between the policy and the reality that many patients experience.   Non-English-speaking patients face multiple barriers when accessing healthcare, including struggling to communicate their symptoms clearly, understanding medical information, booking an appointment, and even requesting the needed language support. For example, a pilot study exploring the experience in South Asian communities with limited English proficiency reported that lack of confidence in the system, difficulty in requesting language support, and fear of being a burden impacted the experience of care in this population.  Image by Hrant Khachatryan on Unsplash+ Communication barriers are also experienced by healthcare professionals. A nationwide study of 599 primary care physicians in Switzerland found that 90% experienced language barriers at least once a year, with 30% encountering them weekly. While no large-scale nationwide survey exists in the UK, qualitative research and numerous reports consistently highlight clinicians’ concerns regarding language barriers. Lack of Adequate Support for HealthCare Professionals What is even more striking is that healthcare professionals do not have access to adequate tools to overcome these barriers. Although professional interpreter services are considered the gold standard for addressing language barriers in primary care, they are often unavailable and, as such, replaced by ad hoc translation by patients’ family members or friends. In fact, the study cited above reported that while 88% of clinicians expressed a desire to access professional interpreting services, over 60% had never done so. This led over 60% of clinicians to rely on patients’ relatives and friends, including 23% who depended on minors. While translation by relatives and friends is often the most practical solution, it is not the most optimal. As illustrated by the earlier example of the woman presenting with abdominal pain, relying on her son to translate created discomfort and reduced the amount of information shared, which in turn limited the clinician’s understanding of her medical needs.  Indeed, research has shown that translation by relatives or friends is associated with higher rates of errors, ethical and confidentiality concerns, as well as lower satisfaction for both patients and clinicians. So, What is the Way Forward? To address this issue, alternatives to professional interpreting services have been explored. At present, the most promising solution involves using digital translation tools and remote interpreting devices. A systematic review assessi ng different research studies exploring the performance of ChatGPT-4 and Google Translate in translating text and instructions found that translation accuracy was above 90% in both tools . However, it is important to note that up to 6% of instruction sets were translated incorrectly, which was deemed clinically concerning . As such, the study concluded that currently these tools are suited for low-stakes situations, as they lack accou ntability and clinical validation. Despite these limitations, digital translation tools represent a key area for future research and hold potential to help mitigate language barriers for both patients and clinicians. Image by Andrey Matveev on Pexels Beyond professional interpreting services, education is another area for addressing language barriers in healthcare. There are many educational initiatives aimed at helping healthcare professionals develop the skills and awareness needed to recognise communication challenges and work with the services effectively. For example, the Interpret2Improve initiative was an educational programme designed for healthcare students to focus on collaborating with interpreters. Out of the 22 participants, 14 reported increased awareness in addressing language barriers after the programme. This suggests that education can improve clinicians’ confidence in interacting with interpreter services; however, it cannot alone resolve the wider systemic issue. Nonetheless, these programmes still remain valuable in teaching clinicians to advocate for their patients’ rights, particularly when access to professional interpreting services is required.   Educational programmes should also focus on improving awareness of non-verbal cues — such as tone, facial expressions, pauses, and body language — and on the ability to read between the words to recognise subtle signals from patients. This is especially important when language directly limits what can be verbally expressed. Everything discussed in this article highlights that no single solution is sufficient to address language barriers in healthcare; rather, a combination of strategies is required. The need to address these issues is undeniable, and we must continue to advocate for change. Equitable care means providing patients with a space where they feel comfortable enough to express themselves and have their voices heard. As a future doctor, this is the kind of care that I aspire to deliver.

Warning: This article contains spoilers for the Netflix series, 'Stranger Things' Mike, Lucas, Max, Will, and Dustin playing the last D&D campaign. Screenshot from Netflix, Stranger Things, Series 5, Episode 8 It’s time to accept it, Stranger Things  is finished. El is alive, trekking in a remote place with waterfalls. Mike is a successful writer. Will enjoys his life in New York. Max can walk again, and she and Lucas are still together. Dustin is an academic. I am planning my retirement. We have all become a little bit more adult since Episode 8, which aired on New Year’s Eve.   Why is it so difficult to accept that it is over?   This is not a rhetorical question. Thousands of fans online have, for weeks, argued that Episode 8 was not the end. According to the viral “Conformity Gate” theory , fans believed that there should have been a new episode coming out on January 7 th . Then on January 17 th . Netflix crashed because so many people visited the site looking for an episode that never existed. In the end, perhaps because of the strong rebuttal from Netflix, this hope has faded, too.   The Conformity Gate theory could be seen as a response to collective disappointment with the series’ ending, as many felt that the happy ending was too happy. All the protagonists return to a normal, conformity-based life, which is an impossible ending for them. Aren’t they a group of rebellious young heroes who have fought with interdimensional evil and saved our universe? How can they possibly settle into adulthood? It must be an illusion. A surprise will come. More adventure. More fights, with an even worse evil. There are so many clues left by the Duffer brothers that anticipate this. Haven’t you noticed that a doorknob shifts from left to right between episodes? It is certainly a signal for a mirror reality.   I am sorry, my friends. I am sad, too. I, like you, cannot imagine a life without El, Mike, Will, Dustin, Lukas… without Max, on whom I have written before . Because life without Stranger Things is simply sadder.   But no new episodes are coming. The story has finished. The supposed hidden clues are just technical mistakes. It’s time to understand the real motivation behind the Conformity Gate theory: we do not want to grow up.   At the end of episode 8, the Duffer brothers show, within the story itself, what many of us find difficult to accept. As Mike leaves his basement after what may be his last Dungeon & Dragons campaign with his friends, his 8-year-old sister, Holly, storms down the stairs with her friends of similar age. Having all just lived an incredible adventure, captured by Vecna, they start playing their own D&D campaign. Holly and her friends playing their first D&D campaign. Screenshot from Netflix, Stranger Things, Series 5, Episode 8   Mike looks at them, between a smile and a tear, as he realises that he is leaving this world behind as others step in to continue it. He turns and leaves the basement. He closes the door. The end.   And this was when I thought – yes, Mike, I am with you. I am you.     I am also grieving the child in me who remained in the basement, as I became (just a little bit more) an adult at the end of Stranger Things . The child in me who watched E.T.  and Ghostbusters and The Neverending Story  and Back to the Future ; who listened to Kate Bush and Diana Ross, played on local radio stations; who wanted to be James Bond or Indiana Jones or the Man with No Name cowboy. I left him playing in the basement when I closed the door with Mike, sharing his sadness. And as I am grieving Stranger Things,  I am also grieving that part of me, who could save the world by fighting evil because he could believe that the Upside Down world really exists.   I am not the only one with this view. My Italian friend and psychoanalyst, Laura Fonzi, whom I interviewed in preparation for this piece, is also a Stranger Things  fan. She confessed to having cried throughout the last episode, because of the nostalgia for her childhood that the series powerfully triggered through continuous references to her favourite movies. Moreover, she observes, “ E.T . and The Goonies  are movies where the children know more than the adults and save the world through their incessant ingenuity”. And then Stranger Things ends, and suddenly she is an adult again, with “the suffering that comes with growing up, when our child’s eyes, which could see (and believe in) the invisible, lose the spark, and we leave the epic adventures of our fantasy life for the ordinary of reality”.   As I remember my sadness, I can understand the people pursuing – hoping for, dreaming of – one more episode. Dreaming that the story is not finished, that the characters are still alive in the Duffer Brothers’ minds. Unfortunately, this is also not true. Yes, it is a disappointment, a painful emotion that is yet so important for growing up.    Indeed, I believe that this tension between fantasy and disappointment that I felt while watching Stranger Things  is what keeps us alive and creative. While I was watching, I could almost  believe it was real –fleetingly, ambivalently, romantically, knowingly and unknowingly, consciously and unconsciously, fluctuating between my inner world and the real world– I almost  could.  And then, at the end of every episode, every season, and now at the end of the story, I experienced the disappointment that comes when the bubble bursts. But isn’t this disappointment, as sad as it is, better than never experiencing these emotions? It is like when I wake up from a wonderful dream. This rude awakening is a price that I am happy to pay for the emotional aliveness that I feel when I completely yield to my imagination. Mike leaving the basement and closing the door. Screenshot from Netflix, Stranger Things, Series 5, Episode 8   By coincidence – or maybe not; as both the psychoanalyst Carl Jung  and Kung Fu Panda’s Grand Master Oogway  say, there are no coincidences – I am reading  The Book of Dust , the follow-up trilogy after His Dark Materials . The story, arguably so similar to Stranger Things , follows a young girl hero who saves the universe while travelling between worlds and meeting talking bear-kings and flying witches who can live for thousands of years. In this reality, humans have animal-shaped demons, a magic knife can cut between dimensions, gryphons dominate the sky, and a sentient dust permeates the universe.   And so, here is my advice for all of you, fellow Stranger Things  mourners. Stop wasting time and energy fantasising about impossible scenarios where a new mysterious episode is lingering in the darkness. Instead, embrace reality. Well, embrace a reality. Embrace a new  reality.   For me, at the moment, that reality is the Book of Dust .

The Importance of Physical Activity on Your Mental Health: An interview with Michael Watson, MBE In my life, I have battled a gambling addiction and a brain tumour — and alongside these I experienced depression. Exercising through those tough times has helped me focus and keeps me moving forward. The British ex-boxer Michael Watson, who uses exercise as a tool to manage his mental health, was a hero of mine as a youngster. Seeing how he has dealt with adversity encouraged me to approach his agent, Brendan O'Connor, with a request for an interview. Recently, I was able to sit down for an intimate chat with Michael, where we discussed his brain injury, the positive impact of physical activity on his mental health and the MBE he was awarded. He also had plenty of advice for anyone struggling. Michael suffered a life-changing brain injury in a fight with fellow boxer Chris Eubank that left him unable to walk or speak for the following eight months. The biggest fight of Michael’s life was not in that one in a boxing ring, but the recovery that followed, described by his neurologist Peter Hamlyn as "extraordinary". In my previous blog, I presented my interview with Charlie Duffield who talked about his battle with a gambling addiction. Now I am focusing on telling the story of Michael Watson and his recovery from life-changing injuries. The night Michael's life changed Michael Watson had the W.B.O (World Boxing Organisation) Super-Middleweight world title in his grasp, ahead of Chris Eubank on points as the bell for the 12th and final round sounded at White Hart Lane in September 1991. In the 12thth round, Michael’s life changed in a second: Chris Eubank, from the brink of defeat, unleashed a devastating uppercut that made Michael collapse in the ring. Unbelievably, there were no ambulances or paramedics at the event, and as a result of the delay in his care, Michael's brain was deprived of oxygen for 8 minutes. Overall, there was a nearly 30-minute delay until Michael received care in a neurological unit. Subsequently, he spent 40 days and 40 nights in a coma and had six operations to remove a life-threatening blood clot from his brain. Now 56-years-old, despite receiving life-changing brain injuries, Michael has dedicated himself to helping other disabled people in sport and was awarded an MBE in 2012 in recognition for his excellent work for disabled sport. Michael's MBE was awarded due to his consistent campaigning for disability sport, calling for improved disabled access to gyms and fitness centres. Michael described the feeling of receiving an MBE as “the proudest moment of my life”. The positive effect of physical activity on mental health According to the Mental Health Foundation , participation in physical activity can help improve mental health. It provides countless benefits, both physical and mental. The benefits of physical activity on mental health is endorsed by the NHS , especially for people experiencing mild to moderate depression. "I spent a long time in a coma and then had a lot of frustration when I came out of the coma. I had to keep the faith and draw strength from somewhere”. Michael continued: " Muhammed Ali [the boxing legend] visited and told me that he knew I would recover. It resonated with me and gave me extra determination to prove the doctors wrong who said I would never walk again. Eventually, I learnt how to walk and talk again." Then Michael added: "I even managed to complete the London Marathon, which took me over six days. Completing the marathon made me so proud and helped me with my state of mind. I wanted to show people even when the worst thing happens, so much can still be achieved." Many sportspersons, including Tyson Fury , have proven how having an exercise schedule continues to help them overcome their mental health woes. Michael, like Tyson, sticks to a rigid exercise schedule every day, which has helped him avoid falling into further mental health problems. Michael has set himself goals to achieve such as lasting longer on the static bike and walk further daily to push himself. Michael’s experience of overcoming mental health issues through sport Michael Watson — The Sun (Getty images) — 23/2/17 "I think sport is great for adults and children and teaches discipline and teamwork", Michael continued. "Studies have proven that it releases endorphins, making it a great and productive outlet to improve mental health. The feeling I get when I work out every day is unrivaled. I am determined to push myself. I want to test myself when I walk and work out on the static bike every day. The feeling I get from working out is phenomenal. It works wonders for my mental health." Seeing Michael finishing the London Marathon, and noticing how exercise, in general, has helped him deal with his life-changing injuries, is truly awe-inspiring. Despite Michael’s struggles, hearing how he wants to inspire others despite his battles is a truly inspirational message. Mental health woes in boxing Boxers and other sportspeople seem to have an issue retiring when they are at the peak of their ability, and those that do retire are often tempted back. "A lot of sportspersons struggle to retire; many have to continue for financial reasons." Michael added: "Some make comebacks because they miss the adulation. Some will not know how to function without competitive sport." According to Dr Margaret Goodman (Neurologist and former ringside Physician), depression is a big problem for boxers . "Depression is quite prevalent among boxers," says Dr Goodman. "It is almost never diagnosed until it’s too late, and it manifests itself in so many negative ways." Retirement is a difficult option to take for any sportsperson. Michael, due to his injuries from that night in 1991, didn’t have a choice when retirement happened in his life. Michael Watson — Daily Mail — 23/07/21 Michael continues to show us every day that, even when the hard times come, we can all continue to lead productive and healthy lives. When asking Michael why he is passionate about helping others he said, brimming with pride: “It makes me feel alive when I help others”. Having survived a brain tumour I remember feeling a sense of loss during that time in my life. It often felt like the old me had died following the tumour and that was challenging to deal with. Michael has shown how powerful having a sense of purpose can be in combating mental health woes. He has a determination which is so apparent when talking to him. Whether he’s working out for longer than the day before, or he’s helping disabled people in sport through his campaigning for better access to sport for disabled people, there’s a clear fire burning bright in him - and that fire in him is infectious.

Exploring social determinants of health and bodily systems in Schizophrenia. The question surrounding the innate and cultural forces that can shape an individual goes as far as biology and social sciences go. Psychiatry can be understood as a hybrid medical speciality. While biological factors, such as genetics, hormones, and brain structure and function, play a crucial role in explaining the mechanisms of mental health disorders, the field is also deeply shaped by social influences. Our environment and life experiences profoundly affect how we feel and, by extension, our mental health.  Despite this, current approaches in psychiatry and neurosciences mostly focus on biological determinants. This has allowed for the development of medications that help improve mental health outcomes. However, focusing solely on biological systems does not encompass the breadth of the human experience, which is inherently social. Therefore, exploring the interactions between our social environment and biological systems would strengthen our understanding of the underlying mechanisms and offer new areas for treatment. As a psychologist and PhD student in biomedical sciences, I have always been fascinated by the interface between our social environment, our bodily systems’ response to it, and our mental health. In this article, I will present how I tackle this in my doctoral research, focused on social determinants and bodily systems in Schizophrenia. What are social determinants of health? The World Health Organisation defines social determinants of health as “the conditions in which people are born, grow, live, work, age, and people’s access to power, money and resources”. This is a broad definition, so here are some examples in relation to mental health. Economic hardship (at the individual and societal scale) is associated with lower reported well-being, higher rates of mental health disorders, substance use, and suicide rates. Education is a strong protective factor against mental health disorders. Social interactions and support are powerful protective factors against mental health disorders. Access to mental healthcare is essential as it allows for timely treatment. Universal health care access is also associated with better emotional well-being and allows the prevention and promotion of mental health. How do they influence mental health? These social determinants can be understood as long-term stress factors. Chronic exposure to stress can keep the body’s stress system constantly activated, eventually throwing it out of balance and degrading other bodily systems at the same time. Therefore, acting on social determinants of health, through policies reducing inequalities and promoting access to care, education, and healthy social interactions, is a powerful way to improve mental health. Why are social determinants left aside? As evoked earlier, many factors can influence mental health, but assessing all of them properly would require large samples. Biological research is particularly expensive when considering the cost of analysing blood samples, brain scanners, etc. These costs oftentimes limit participants' recruitment, restricting the number of variables researchers can realistically include. As such, a method that condenses various social determinants into a smaller set of variables would make it far easier to incorporate them. This is exactly what I am doing in my doctoral project. A proposition to include social determinants of health in biomedical research French sociologist Pierre Bourdieu offered an interesting theory to determine how individuals are disseminated across the social space. In this theoretical framework called “La théorie de l’espace social” or “the theory of social space”, he posits that one’s position in society can be defined through 4 different dimensions. These dimensions are understood as “capitals, ” referring to them as quantifiable in some way. Therefore, every individual in society possesses a quantity of social, economic, cultural, and symbolic capital. But what exactly do these terms mean? Social capital : Defined as the value of belonging to a group of people who share common traits and are connected through stable, meaningful relationships. In other words, it can be understood as the crossroads between the size of someone’s social network and the support they receive from it. Economic capital : Defined as the economic resources of an individual, which can be a factor of income through work (i.e., active income) or other sources (i.e., passive income), as well as movable and immovable property. Cultural capital : Defined as an individual’s cultural knowledge and resources. presented in three forms: (1) embodied form, referring to the culture an individual has internalised (e.g., vocabulary used); (2) objectivized form, referring to the possession of cultural goods; and (3) institutionalised form, which reflects how institutions recognise a person’s own cultural knowledge (e.g., university diploma). Symbolic capital : Defined as the prestige, honour, or recognition that an individual receives through the different “labels” they hold, often derived from other forms of capital. For example, the CEO of a large company or a university professor carries symbolic capital that reflects their status rooted in their economic, social, or cultural capital. Perception plays a key role here: symbolic capital depends on how others interpret and value these labels, which can vary across social groups and can be influenced not only by one’s other forms of capital but also by individual characteristics. Interestingly, the social determinants of mental health fit within these capitals. Going back to the examples provided earlier, social interactions and support fit within the social capital, while the economic inequalities can be mapped within the economic capital. This approach could therefore offer a way to explore the interaction between social determinants and biological indicators. My current project In my doctoral project, I am investigating the ties between status and position within the social space and the severity of schizophrenia through biological alterations. Essentially, I aim to understand how the social becomes biological and pathological. To do so, I measure the capitals among patients diagnosed with schizophrenia and healthy controls in a large dataset (Signature Biobank). This biobank is composed of data from over 2000 patients who visited the emergency room of the largest psychiatric hospital in the Canadian province of Québec. Photo by Author Enzo Cipriani To quantify Bourdieu’s capitals, I explored the different sociodemographic variables in the biobank and adapted them, creating four scores for each participant. I then investigated how these scores relate to various biological indicators and symptoms. I mainly focused on immune system activity, given the growing evidence that the immune system has an essential role, potentially explaining the emergence and severity of the disorder. The immune system is also tightly linked to the body’s stress system, which means prolonged stress can directly influence immune functioning. To do so, I measured concentrations of 9 cytokines, which are indicators of the immune system’s activity. These cytokines can be divided into three categories when considering their properties: pro-inflammatory (increases inflammation in the body), anti-inflammatory (reduces inflammation), and chemotactic (recruits immune cells to an infection site).  What have we learned so far in my project? So far, preliminary results identified that a better social capital (i.e., being in a relationship, having children, living with relatives, and having friends) is related to less severe anxious, cognitive, and depressive symptoms, while a better economic capital is related to less severe delusions. These dimensions are also related to participants’ immune profiles. People with higher social capital had higher concentrations of anti-inflammatory cytokines, showing a potential protective effect through attenuation of immune inflammation. So, the social seems to become biological and pathological through the immune system. In the next steps, I will investigate deeper how the social determinants and immune systems act individually or in synergy to explain schizophrenia’s severity. If you want to go deeper, you can go read a two-page document detailing a bit more of my methods or go read a book chapter I wrote that was recently published .