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Artwork by Olivia Marsh As my friends and I approach our 25th birthdays, we have been apprehensively awaiting the arrival of our text messages from the NHS inviting us to our first cervical screenings. These screenings, previously referred to as smear tests, are offered every 5 years to women and people with a cervix aged 25 to 64 to check cervical health and help prevent cervical cancer. During the appointment, a tube-shaped tool called a speculum is inserted into the vagina to push open the vaginal walls, and a sample of cells is taken from the cervix for testing. The sample is checked for specific types of the Human Papillomavirus (HPV), a sexually transmitted virus that can cause abnormal cell changes and significantly increase the risk of cervical cancer. A speculum can be quite an invasive instrument for a tender muscle; while some feel only pressure, many describe insertion as uncomfortable, and for a few, it can be painful. Since the 19th century, there has been little change to the cold, metal design of the device. Only recently has innovation begun to consider comfort during appointments. Students in the Netherlands designed the ‘Lilium’ in 2024, a speculum made from rubber that allows for gentle opening, which received worldwide celebration. While alterations can be made to the device, the nature of gynaecological appointments shapes a power dynamic that reflects the vulnerability women continuously encounter. A way around this can be the option of self-insertion, which, when offered, is thought to reduce anxiety and encourage attendance. Cervical cancer is one of the most prevalent forms of cancer amongst women, and of the estimated 880 deaths each year in the UK, 99.8% are thought to be preventable. Numerous challenges can explain avoidance of these appointments, shaped by an individual’s intersecting identities and experiences. Common examples include medical mistrust, history of sexual trauma, disability, fear, misconceptions about the HPV vaccination and the sexual transmission of HPV. Since graduating from KCL, studying MSc Psychiatric Research, I’ve been researching the lived experiences of inequalities in women’s health with the aim of spreading awareness. Lying in the Shadow of Exploitation Artwork by Olivia Marsh Medical mistrust is steeped in a history of exploiting the female body; some of the most grotesque examples of gynaecological research were the experiments of J. Marion Sims. The lack of care and protection the ill-fittingly titled “Father of Gynaecology” showed for the enslaved Black women he relentlessly operated on without anaesthesia has left its scar. Institutionalised racism and medical stereotypes have resulted in people from Black, Asian and other minority ethnic (BAME) backgrounds suffering poorer health outcomes and turning away from routine exams. The UK government has found that people from BAME backgrounds are less likely to attend their cervical screenings than White British people. It is believed that different cultural attitudes surrounding sex and a lack of knowledge about the necessity of these screenings could be in part responsible for this difference, evident from interviews with women from ethnic minority backgrounds, revealing that several women did not recognise the term ‘cervical screening’. For some, the language barrier poses as the greatest obstacle to access. A recent case study of a clinic in England providing care for many patients whose first language was not English found that educating staff on how to most effectively discuss cervical screenings, offering flexible appointments, and placing cervical screening leaflets in different languages in the waiting room, helped increase screening attendance rates. Implementing inclusive communication strategies across the NHS and updating cultural competence training could dramatically aid attendance, especially in the most densely populated, diverse communities. The ‘M’ and ‘F’ Label Artwork by Olivia Marsh NHS communication systems can also affect trans patients’ screening invitations. I recently spoke to my friend about an aspect of his transition, which he is happy for me to discuss. As a trans man, he changed his NHS profile to ‘Male’ and, despite having a cervix, stopped receiving invitations for appointments. The distinction between sex and gender remains inconsistent across NHS services, and while not always the case, responsibility is often placed on trans patients to be aware of what sex-specific anatomical exams they need. My friend explained to me that trying to access gender affirming care is fatiguing enough without the added burden of requesting routine tests. Also, the nature of the appointment can cause severe dysphoria for trans patients. Ensuring staff partake in sensitive communication training is therefore essential to minimising non-attendance. Going forward, research is needed to understand the barriers present for trans patients and how clinicians can prevent dysphoria, as well as a consistent system to ensure all patients are correctly identified for their routine tests. An Epicentre of Anxiety Artwork by Olivia Marsh One of my closest friends faces her cervical screening with an overactive pelvic floor; she agreed to discuss her experience for this article. An overactive floor can cause numerous issues in the pelvic region, including painful sex – often associated with vaginismus, the involuntary spasm of vaginal wall muscles, and vulvodynia, pain in the vulva caused by an unidentifiable source. While often portrayed in the media as associated with sexual trauma, there can be no obvious explanation. Typically described as feeling the vagina is blocked by a wall, my friend has made the distinction that her general anxiety holds itself in her body, and upon instances of possible vaginal penetration, her anxieties are directed there. She’s been attending physiotherapy to ease her pelvic floor and recommends belly breathing for anyone during their next cervical screening to relax pelvic muscles and increase comfort. While my friend still wants to attend her cervical screening, the looming prospect of the appointment has created greater anxiety for her to urgently progress in therapy. The Future of Cervical Screenings The Renewed Women’s Health Strategy for England was just published - echoing concerns of pain and discomfort during gynaecological procedures - acknowledgement of which should hopefully propel progress. Furthermore, the news recently highlighted research advances being made into testing for HPV at home using samples of period blood. Collecting menstrual blood at home using pads or tampons would overcome many obstacles to cervical screenings, and for those who do not menstruate, such as post-menopausal women, other options would still be available. While this method is in early stages of testing, the NHS has been developing a self-test kit, which began rollout in early 2026 for anyone overdue for an appointment by over 6 months. A vaginal swab is taken at home, then posted to a lab for analysis of signs of HPV. However, this cannot detect cell changes that may lead to cervical cancer; therefore, an in-person appointment would be required if signs of HPV were found. These alternatives would mitigate the fear, embarrassment, and logistical challenges of attending an in-person appointment for many. Unsurprisingly, from the women who have completed both the self-test and clinical cervical screening, 85% agreed that they would like the option to choose between the two. During the writing of this article, I had my first cervical screening, and although I was slightly apprehensive, I was pleasantly surprised by how little discomfort I felt, helped by the nurse’s friendliness. However, women lie on a vast spectrum of differences and do not conform to a one-size-fits-all model. We need greater choice in the healthcare we receive to accommodate the various challenges that are associated with accessing reproductive care; crucially, to ensure that as many people as possible attend life-saving screening appointments.

I am writing this piece as I believe that navigating addiction within a family is a unique experience that only those who have lived through it can truly understand. I hope these reflections offer some hope to others walking the same path. If anyone came across my family now, you would never be able to tell what we have been through. And although our bond is so unique and tight, our past cannot go unnoticed. In my case, things were different from the beginning. Even though, as a kid, I was completely unaware of the underlying issues, I always knew something was "unique". When I was born, my mom was 29, working as a music producer, and my dad was 35, working at his father's company. Of course, when you are at this age, freshly married with a newborn child, you have a lot to celebrate. In Greece, it is a typical part of our culture to drink when you're celebrating, so no one in our circle really thought much of it. But that is how my peculiar but amazing childhood started. It wasn't until I was around 12 that my father took over the company, and that's when the drinking became a stress reliever rather than a celebratory potion. Adrian Vieriu on Pexels. What followed was years of unpredictability. My dad would go through episodes that none of us could anticipate or fully understand at the time. It would be excessive fun, that would turn into deep anger, and sometimes he would even disappear for a few days. As a teenager, I did not have the emotional tools to process any of this. I was reactive, and so was my sister, though we each found our way of coping with what was happening around us. She always had a softer relationship with my dad, whereas I was usually the one to fight with him. I think part of me was fighting for answers I didn't know how to ask for, and a father I wasn’t sure I still had. At one stage, clinicians believed he was experiencing bipolar episodes. Years later, after he had stopped drinking, we were told that many of the behaviours we had witnessed may have been linked to trauma and alcohol use. In other words, the drinking was not just a symptom — it was feeding something far bigger, and none of us had the language for it back then. It was difficult for all of us to understand and admit what was going on right under our noses. I think this was one of the hardest processes along the way. Especially for my mother, who was essentially responsible for holding the entire family together. The quiet hero My mother is, without question, the quiet hero of this story. While my sister and I were reactive teenagers trying to make sense of our world, and my father was lost inside his own, she was doing something almost impossible: giving up her ego to stand by her husband. At times, my sister and I felt like she couldn't understand that our dad had an addiction, that she was too patient, too forgiving. But the truth is that she was simply trying to protect us. She was absorbing far more pain than we ever knew and doing it in silence so that we could still have a childhood. To put yourself aside completely, for years, for your family, and to do it not from weakness but from an enormous quiet strength. Without her, we would not be where we are today. But admitting what was really happening was a process that took time for all of us. There is something particularly cruel about addiction within a family; it grows in the spaces between people, quietly, until one day you realise it has been shaping everything. The atmosphere at home, the conversations you avoided, the things left unsaid. You don't see it clearly when you are inside it. You just feel that something is a little off, and you learn to live around it. My Path of Discovery When I moved to the UK for my undergraduate studies, I was alone for the first time in my life. I was responsible for my own wellbeing and, to be honest, I messed it up. Having lived in this environment for my whole life, I immediately turned to what I knew, and I started drinking. Other than that, I was doing well: I was going to my classes, I had made a lot of friends, I was eating well, but I was drinking every day. Sometimes from early in the afternoon. It took me a while and a lot of therapy to understand what I was doing. But the moment I did, my life changed completely. I had inherited a coping mechanism without ever choosing it. I had watched someone I loved use alcohol as a way to manage the weight of the world, and somewhere along the way, without realising it, I had started doing the same thing. That realisation was one of the most uncomfortable and important moments of my life. Alexis Ricardo Alaurin on Pexels It was around that same time that my father started going to rehabilitation programmes and, for the first time, made a real change in his life as well. That process was harder than I had ever expected. All the anger I had carried towards him for years, for the unpredictability, for the pain, for the childhood moments that could have been different, slowly began to shift. It did not happen overnight. It took a lot of work from both sides. But I was eventually able to realise that all those years, my dad was just in so much pain and pressure himself, and he simply did not have the strength to see it clearly. Of course, that is never an excuse. But at the end of the day, we are all human. And I chose my father above my own ego. Behind the mask The best way I can describe addiction is that it is like a mask. Not just for the person wearing it, but for the entire family around them. It covers the real person underneath, and it distorts how everyone else sees themselves, too. Recovery, then, is not just the removal of a substance; it is the slow, painstaking process of learning who everyone really is without it. Who your parent is. Who you are. Sergio Souza on Pexels Almost four years now, my dad has been sober. And every year, I get to know more of who he actually is, and was, behind that mask. Watching him re-emerge has been one of the most profound experiences of my life. He is funny, warm, and present in a way I had not always known him to be. And I think about how much strength it must have taken to walk away from something that had been suppressing him for over twenty years. That is its own kind of bravery. If anyone came across my family now, they would see a tight, loving, slightly chaotic Greek family. They would not see the years it took to get here. They would not see my mother's quiet sacrifices, or my father's long road back to himself, or the girl who moved to another country and unknowingly started repeating a pattern she had grown up watching. But we see it. And we carry it with us, not as a wound, but as proof of what love, honesty, and relentless effort can actually do. Addiction is powerful. But so, it turns out, is the choice to face it.

Understanding Dissociative States and Disorders Have you ever found yourself staring out of the window on a train and suddenly realised you had no idea how many stops had passed? Maybe you’ve caught yourself daydreaming in class, rereading the same sentence five times, or performing familiar tasks on autopilot. Most of us know what it’s like to experience these mild and temporary mental “check-outs” from time to time. Many of us might not realise that these sorts of feelings or experiences exist on the spectrum of dissociation, a term used to describe a range of experiences involving a disrupted or altered sense of connection to thoughts, memories, emotions, the body, or reality. While often brief and harmless, these experiences sit on a continuum that, at its more extreme end, can become clinically significant and deeply distressing. Image by Fidan Nazim Qizi on Pexels The term dissociation is often thrown around in all sorts of contexts, to describe many different things, from ordinary distraction to severe psychological distress. In reality, dissociation is not one single experience, but a range of experiences that can look very different from person to person. My own interest in dissociation comes from both personal curiosity and academic work. With a background spanning science and art, including embodied practices like dance, where connection to and with the body is central, I became fascinated by what happens when this connection feels disrupted, distant, or absent altogether. This paved the way for my PhD research exploring bodily awareness in depersonalisation-derealisation disorder (DDD), and continues into work in the Neurological, Affective and Dissociative Symptoms (NEUROADS) Lab led by Dr Susannah Pick at King’s College London, where I am currently based as a postdoctoral researcher. Here, we will unpack what dissociation is, look at why the mind sometimes disconnects in the first place, and examine the relationship between dissociation and the body. So, What Actually is Dissociation? At its core, dissociation involves a disruption in the normal integration of experience. This might mean feeling detached from thoughts, emotions, memories, surroundings, identity, or even from the sense of being fully present in your own body. Put simply, the mind’s usual sense of unity or continuity becomes altered. Dissociation can be difficult to define because it does not look the same for everyone. Two people might both describe feeling “disconnected” while referring to experiences that feel completely different internally. In many ways, dissociation is less a single symptom and more a broad collection of ways the mind can distance itself under certain circumstances. Image by Nishant Das on Pexels Because dissociation can take many forms, people often use different words to describe it: detachment, disruption, separation, fragmentation, depersonalisation, derealisation, and compartmentalisation. These terms overlap, but each captures slightly different aspects of dissociative experience. For some people, dissociation can feel like emotional numbness. For others, it may feel dreamlike, foggy, distant, or unreal, as though the world around them has lost its familiarity. Some people describe watching themselves from the outside or feeling strangely absent from their own body, almost like observing their own life rather than fully participating in it. Others experience gaps in memory, visual distortions, or a blurry and uncertain sense of self or identity. Importantly, dissociation exists on a spectrum. The mild and temporary mental “check outs” mentioned earlier are relatively common, especially during periods of stress, anxiety, exhaustion, overwhelm, or emotional strain. For some people, however, these experiences can become more persistent and disruptive to daily life. They may interfere with memory, emotional regulation, relationships, work, identity, or the ability to feel connected to reality and to oneself. This is where dissociation may move beyond an occasional experience and into the territory of dissociative disorders. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), dissociative disorders include: Dissociative identity disorder (DID) – involves disruptions in identity and significant gaps in memory. Dissociative amnesia, including dissociative fugue – involves periods where someone is unable to remember information about themselves or life events. Depersonalisation/derealisation disorder (DDD) – involves persistent, recurring feelings of detachment from the self (depersonalisation), surroundings (derealisation), or both. Even within psychiatry and psychology, however, the boundaries within dissociation are not always clear. For example, functional neurological disorder (FND), which can include a range of symptoms from non-epileptic seizures, to tremors, to sensory changes, that are not explained by an identifiable neurological cause, is classified differently across diagnostic systems. In the DSM-5 it falls under Conversion Disorders, while the International Classification of Diseases-11 (ICD-11), groups it under dissociative disorders, reflective of the elevated dissociative symptoms often reported in FND. This reflects a broader challenge within the field: dissociation is complex, multi-layered, and often difficult to neatly categorise. Why Might Someone Dissociate? One of the most important things to understand about dissociation is that the brain is usually trying to do something when it happens. Although dissociation can feel strange or unsettling, we might generally understand it as serving some kind of psychological or protective function, rather than occurring for no reason. Current theories suggest dissociation is often linked to the brain’s attempts to cope with experiences that feel overwhelming, threatening, emotionally intense, or impossible to escape. Image by Kagan Karatay on Pexels Importantly, dissociation is not always linked to trauma, although trauma is an often cited contributor. Dissociative experiences can also occur during periods of high stress or anxiety, alongside other mental health difficulties, due to exhaustion or burnout, emotional conflict, or in response to alcohol and drugs. Dissociation might be understood as a survival response, something the mind may do when experiences become too overwhelming, stressful, or emotionally intense to fully process in the moment. In traumatic situations, this response can genuinely help someone survive, reducing pain, fear, or emotional overload in the moment. You have probably heard of the “fight or flight” response, but the nervous system can also react to threat by freezing or shutting down. Dissociation is often thought to be closely linked to these states. Rather than confronting danger directly, the mind may create distance from it through numbness, detachment, memory gaps, or feelings of unreality. Dissociation tends to happen automatically, almost like the brain pulling an emergency brake behind the scenes. For some people, particularly those exposed to repeated or early-life trauma, dissociation can become a learned coping strategy. If mentally “checking out” once helped somebody get through overwhelming situations, the brain may continue to use the same strategy long after the original danger has passed, in situations that are quite ordinary. Understanding dissociation as a protective response can help make these types of experience feel a little less mysterious. Dissociation and the Body When it comes to treatment, there is no universal one-size-fits-all approach. However, because dissociation often involves feeling disconnected from the self or body, there has been increasing interest in the development of interventions that aim to rebuild a sense of bodily safety and connection. In the case of depersonalisation/derealisation disorder (DDD) specifically, experiences of disembodiment and detachment from one's body could be reflective of alterations in the processing, sensing, or awareness of bodily signals and sensations (otherwise known as interoception). Some studies have indeed found differences in interoception/bodily self-perception and mindfulness in people experiencing DDD. Building on this, in my PhD research, I examined the relationship between dissociation and the body itself, exploring interventions that aim to strengthen one’s bodily connection. In both online and in-person studies examining the use of dance/movement tasks to reduce dissociative symptoms in DDD, participants reported less bodily detachment after task completion, with greater body awareness during the tasks also linked to lower levels of symptoms. Image by Bianca Salgado on Pexels Direct work with the body allows for the generation of bodily experiences, rather than thinking about their absence. This research highlights the possible therapeutic value of dance/movement practices as a complementary approach for symptom reduction, and the development of greater body awareness, in dissociative and related disorders. While there is still much left to be understood, these findings point toward a more integrated way of thinking about dissociation, one that includes both psychological and bodily experience. Ultimately, feeling ‘present’ or ‘in the here and now’ is something that is continuously constructed, shaped through the interaction of mind, body, and surroundings. In this sense, presence is not a fixed state, but something we continually return to.

My name is Liam Virgo, and I am an advocate for functional neurological disorder (FND), pushing to raise awareness for this life-changing condition. For the past ten years, I have been fighting a quiet, gruelling war to reclaim my body and my identity after a sudden illness turned my teenage world upside down. While the physical realities of severe FND are devastating, the profound mental health struggles, emotional scars, and psychological isolation that accompany it remain deeply hidden in the shadows. We often talk about what the body loses during a neurological crisis, but we rarely address what happens to the mind trapped inside it. Photo by Author What is Functional Neurological Disorder? FND is a disorder in which the brain and nervous system do not communicate or function properly, causing neurological symptoms with no physical injury or structural abnormalities in the brain. From this condition, I experienced the transition from being a carefree child to a prisoner in my own body. It all happened with terrifying speed, leaving no time for my mind to process the magnitude of what was disappearing. Doctors often use a brilliant computer metaphor to explain FND to the public. They tell you that if the human brain is a computer, my hardware—the physical nerves, the spinal cord, the bones, and the muscles—was entirely undamaged. The issue was a massive, systemic software crash. The signals sent by my brain were getting scrambled, misdirected, or lost entirely before they could ever reach my limbs or vocal cords. But while the computer metaphor makes perfect sense to clinicians in a hospital corridor, it fails to capture the immense, overwhelming mental health struggles that come with watching your own physical form glitch out. The Day My Body Logged Out My life changed forever in 2016 when I was 13 years old. One moment I was a healthy teenager, and the next, my brain and body began slowly shutting down. Within an incredibly short period, I lost my ability to walk, use of my hands, or even my ability to communicate, leaving me completely non-verbal. I had all my abilities taken away from me and had to leave school because of my sudden deteriorating condition. I was rushed to the hospital and came out four months later with a diagnosis of severe FND. I don’t really recall the early days of my illness, or even life before FND. Imagine waking up in a house with all the lights on, but every single door and window is completely welded shut. You can see the outside world moving forward through the windows, you can hear family and friends calling your name from the hallway, but no matter how hard your consciousness throws itself against the glass, you cannot make a single sound or movement to reach them. That is the terrifying psychological reality of severe FND. It is the feeling of being awake and conscious but locked inside a physical form that has stopped taking orders from your brain. I became bedridden as a result of my condition. FND caused me to lose my ability to sit up. It got to the stage where my body couldn’t tolerate sitting on any form of equipment apart from a hospital bed. I was bedridden for years and felt trapped inside my mind and body. The trauma of losing my mobility and my voice at 13 completely shattered my sense of identity. Adolescence is supposed to be a time of growing independence and finding your voice in the world. Instead, I was suddenly thrust into a state of total, agonising vulnerability and absolute dependence on others for my most basic needs. I required 24-hour care and couldn’t do anything for myself. The psychological impact of this shift was immediate, heavy, and utterly devastating. I wasn’t just fighting physical symptoms; I was fighting an internal wave of severe anxiety and a profound sense of isolation that felt impossible to communicate to those sitting right next to my bed. I spent years navigating intense mental and physical health struggles; I felt trapped inside my own body. The sheer exhaustion of trying to force a non-compliant limb to move or trying to drag a single word past your lips when the software code is broken takes a massive cognitive toll. The Hidden Stigma in the Medical System FND is one of the most common reasons for a neurological outpatient visit, yet it remains one of the most misunderstood conditions. A survey conducted by the charity FND Hope found that 81.6% of 503 participants with FND felt that they had been treated poorly due to stigma. Stigmatisation and the lack of understanding of FND can shape clinical interactions in ways that leave patients feeling dismissed, disbelieved, or blamed for symptoms they cannot control. When you are already experiencing a mental health crisis, being made to feel like you are somehow imagining your physical symptoms is completely damaging. As someone with FND, but also an advocate for spreading awareness about the condition, I’ve heard many stories about dismissive loved ones, but also neglectful clinicians. Personally, for me, the lack of validation for the symptoms I was facing created a secondary layer of trauma that was difficult to shake. Breaking through this medical scepticism and finding clinicians who treat FND with the physical and psychological gravity it deserves was a crucial, yet painfully slow turning point in my recovery. Image Source: Funkcines Terapijos Centras on Pexels Reintegration and Rewriting the Code Reclaiming my life did not happen overnight; it has taken a decade of intense, gruelling physical, emotional, and neurological rehabilitation to finally learn to walk and speak again. After five years of being paralysed, I learned how to stand. I’m now re-learning how to walk. This all required a complete, intentional overhaul of my mental health support system. I had to learn the delicate, frustrating art of "pacing"—discovering how to rigidly manage my limited cognitive and physical energy budgets so that I didn't trigger a massive, system-wide symptom flare-up by pushing my boundaries too hard. I had to learn to sit with my feelings rather than run from them. I had to accept the trauma of my past and slowly, piece by piece, rebuild an identity that was no longer dependent on whether my body performed perfectly on any given day. Neurological rehabilitation is just as much about retraining the mind to find peace in uncertainty as it is about retraining the legs to take a physical step forward. I had to forgive my body for crashing, and I had to train my mind to be patient while the software slowly rewrites its code. Never Give Up Hope The emotional scars that severe FND has left me with are still felt to this day. My experiences drove me to share my journey publicly and push to raise awareness about FND and what it’s like to become disabled as a teenager. I realised that the crushing isolation I felt as a paralysed, non-verbal 13-year-old boy is still being felt by thousands of FND warriors across the UK and the globe right now. The physical symptoms—the tremors, the pain, the weakness, the paralysis—are incredibly difficult to manage, but the accompanying mental health struggles—the loneliness, the anxiety, the feeling of being completely forgotten—are often what pull patients into the deepest darkness. At 13, I lost all my abilities, freedom and independence to FND, but 10 years on, I’m now more determined than ever to never give up hope and not let my disability hold me back from doing anything. Photo by Author 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: Jimmy Chan on Pexels I’ve noticed something weird, the last few years: people think I’m friendly. I’m referred to as outgoing, and even, occasionally, extroverted. It feels like I’ve pulled off some magnificent con–because for much of my childhood, I was deeply lonely, and through my adolescence, that loneliness gave me terrible anxiety. This is a story of growth before it is anything else–mostly because I started, socially, around rock bottom. My earliest memory in a classroom is of being laughed at by two girls. Though I can’t recall for the life of me what set it off, I remember their words, between shared glances and giggles: “We hate you! We really, really hate you!” I went to multiple preschools, repeatedly transferring because teachers weren’t sure how to handle me. I was autistic, but at the time, autism was terribly underdiagnosed in those assigned female at birth. One study from 2022 says that about 80% of us are undiagnosed by the time we reach adulthood. I’m immensely proud of how far I’ve come: at 25, I work in writing, make music on the side, and have people in my life I adore—my partner of two and a half years, and, yes, quite a few friends, with whom I enjoy life’s little joys, like thrifting or the theatre. But looking at childhood photos, I’m reminded of where I started: my awkwardness, my loneliness, the way I drew back from a world that didn’t accommodate my needs. The friendliness people take for granted in me took years to build up–or, more accurately, it took years to break down the barriers around that friendliness. A lot of it started with one word: sonder. On Sonder in All its Forms The word sonder was invented by the author John Koenig. In his own words, it’s “the realisation that each random passerby is living a life as vivid and complex as your own.” I blamed the lack of sonder in others for my loneliness–even though I didn’t have much for my peers, either. I caught the “not like other girls” bug early on. “Other girls” wanted nothing to do with me, so I figured the isolation would sting less if I leaned into it and saw myself as quirky and alternative. For years, I lost out on potential friendships because I figured that nobody in the world could possibly understand me. Two things finally broke this spell. First of all, I joined my high school’s concert band in eighth grade and discovered that nerdy, artsy kids were a dime a dozen–I was absolutely not alone or unique. We’d just been too shy to talk to each other, or in my case, maybe too stuck-up. A girl recognised the old anime on my t-shirt, a boy heard me playing the Pokémon theme song as I warmed up my flute, and before I knew it, I had a whole circle of wonderful weirdos in my life, with whom I fit right in. Secondly, I learned how to meet people halfway. In tenth grade, I was invited to my first house party–the exact kind of thing I’d spent most of high school rolling my eyes at. Truthfully, I was terrified: what if I was peer-pressured into doing drugs? What if people wanted to play spin the bottle? Would I have to kiss somebody? I’d never kissed anybody! And of course, worst of all: what if I was just being invited as a joke? Spoiler alert: I was not forced to do drugs or kiss anybody, and I had a really great time. Most of the house party was just hanging out with people, cracking jokes, and listening to music. I realised that these classmates who’d invited me weren’t just basic party girls: they had passions, dreams, and talents. And all this time, I’d never bothered to give them a chance. That’s sonder for you: everyone has an incredible story, one worth hearing. Image Source: Joaquin Carfagna on Pexels On Self-Sonder Letting people in is just half the battle: you also have to see yourself as worthy company. That’s hard–maybe even harder than reaching out in the first place. Under my pretentiousness, I was deeply insecure, and painfully aware of all the things that held me back–my awkwardness, my anxiety, my access needs as an autistic individual. For years, I let in people who said they cared about me, but treated me terribly. I became convinced that I had to compensate for all that I was, and that ended with me feeling even lonelier, and worse, believing it was what I deserved. But when you see everyone as having a rich inner world worth exploring, it’s easier to see that in yourself, too. You have stories to tell, a sense of humour, something you love to do. And even if it feels like you don’t, it’s never too late to change that. I’ve seen people my age beat themselves up for never daring to try something new or reach for an opportunity, and I wish I could just grab them all by the shoulders and tell them that there’s still time. The next love of your life–a person, a place, a passion–could be waiting right around the corner, and they’ll love you right back when you find them. For way too long, I kept myself in a box, one taped tightly shut, so people couldn’t even peek inside. That wasn’t fair to anyone–me, least of all. On Unfairness–and Not Settling Sometimes, though, it’s not you being unfair to yourself, or some person in your life being unfair to you. Sometimes the unfairness is bigger than that, and entirely out of your control. I try not to play the “what if” game–often because what’s done is done–but more than once, I’ve found myself wondering if, in a kinder world, I wouldn’t have been such a lonely kid. If autism acceptance had been further along, would I have gotten the support I needed? If homophobia hadn’t been so prevalent, would I have made it through elementary school without being called slurs? In a less misogynistic world, would I have avoided the “not like other girls” trap? There’s no way to know. That said, today, secure and confident in all that I am, I will not stand for mistreatment from anyone. Not friends, not family, not a partner. Image Sourcee: Bilakis on Pexels Reaching out is a balancing act: you have to see the good in others, and in yourself. The world isn’t making that any easier–social media, climate change, AI, pick your poison–but when you pull it off, whole new worlds open up. Even years down the line, as friendly as I seem, there’s still pain from what I let people do and say to me in the past. I’m still recovering from the harmful relationships my insecurities trapped me in, and I will be for a long time. Childhood photos are still bittersweet, portraits of a kid who was frustrated and misunderstood, often hiding their face in a book. I wish I could tell them all about the friends I have now, and how I never compromised who I was to make them. But now, I’ll know my worth for the both of us. 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.

Trigger Warning: Discussion around inpatient mental health units, discussion of eating disorders, discussion of loneliness. Image: Michael Driver on Behance No matter what, at least I have control. Or that’s what I used to think… When I was 14, I was admitted into hospital with an eating disorder; I left my home, my family, and my community all behind. Not knowing how long it would be until I was able to go home, I was scared and very alone. The very thought of the distance that I was away from my home made me feel ill. And yet, though every day I would sit with groups of young people who were struggling with similar things, I would still feel so alone. The only thing that I took with me into that hospital was my eating disorder. Had my eating disorder really become my closest friend in here? My name is Megan and I currently work for Toucan (the West Midlands CAMHS Provider Collaborative). I support with commissioning projects by using my experience with mental health to insight change within the services. I have decided to write this article to help people understand the complexities of eating disorders and how the treatments offered can often be counterproductive. I hope that this article can be a talking point for change in these (often dated) forms of treatment. When I first met my eating disorder My eating Disorder developed during the Covid Pandemic. I was always enthusiastic about education and was very sociable, so when the pandemic hit all of that was taken away from me. I was, like everyone my age, unable to socialise with my friends. I became very lonely and unfortunately, slipped into the hands of an eating disorder. It didn’t let me go and just pushed me further and further away from the people that I loved. Only worsening my loneliness. It wasn’t long before my illness just felt all consuming. Despite the clear effect the eating disorder had on me, leaving me lonelier than ever before, I wasn’t able to come to that realisation. The separation I sometimes think about the separation from my eating disorder like a breakup. I had to build up enough anger towards it so that I could recognise that it was causing me harm. Which is hard to do when you feel like your very existence relies on it. Image: Shubham Dhage on Pexels The eating disorder gave me comfort and reassurance when I needed it, but then tortured me when I went against it. The interesting thing is that when I was admitted into hospital, the eating disorder felt like it was the one person who I took inside with me. It was the closest thing I had to a family member living with me. I often look back on that time in my life and think about how it was a miracle that I ever recovered. My eating disorder would have kept me there if I hadn’t realised how much control it had over me. The eating disorder didn’t give me control; it had control over me. Once I finally confronted and understood that fact, I broke up with it. I got back to the people who actually loved me. Are inpatient stays counterproductive? Treatment for eating disorders vary, and while some people can receive treatment at home, many young people experience inpatient stays – whether that’s in a general hospital, eating disorder hospital, or Tier 4 hospitals (a specialised care setting for young people with severe mental health problems). I often feel very conflicted about my own experience being hospitalised, though I understand now that being hospitalised protected me and maybe it was what I needed.But there is also a part of me that thinks that it prolonged my recovery. Image: Beyzaa Yurtkuran on Pexels My eating disorder was predominantly a result of being lonely and feeling powerless during lockdown; the eating disorder offered me control over something finally, and I accepted it. I have always been someone who finds comfort in plans and structure, so it makes sense that I spun so quickly into the midst of an eating disorder. I understand the need for hospitalisation to keep people safe from harm – I guess that’s what hospitals are for! But when did mental health hospitals become so closed off and alienated? Why is there a time limit on how long family can visit for? Why can units be so scary to visit? Why did I always feel unable to talk to other patients and even staff? A call for change It frustrates me that inpatient mental health units are such isolating places. The nature of an eating disorder is to push loved ones away so that the illness can have complete control over you. So how can recovery take place when a young person is physically removed from their home where those people live, and instead isolate them with the illness alone? The eating disorder has ultimately got what it wants. It’s not long before you start to think and believe that the loneliness is too overwhelming and all consuming, but at least the eating disorder is always there. Image: Felicity Tai on Pexels Looking back on this time in my life it sometimes feels like a miracle that I was even able to recover. The life-changing experience of being admitted into hospital when you are a young person is one which I wouldn’t wish on anyone. I understand that this all seems scary. But once I was able to have home leave and have longer family visits alongside full holistic support from staff, I was able to recover. The less isolated I was and the more human interactions I had, the easier it became. You may have personally experienced an eating disorder, known someone with an eating disorder, or are just curious about what I meant in the title. Regardless of why you are reading, I want you all to know: it is possible to recover! I have hope. Hope that mental health services will notice this link and notice that long-term inpatient stays prolong recovery. I hope that this article helps recognise the direct link between loneliness and longer inpatient stay for people battling with an eating disorder. And finally, I hope that more options for treatment in the community are made available to reduce risk of isolation that can come with long term inpatient stays because ultimately, the journey can become far easier once you are not alone. If you or someone you know is struggling with an eating disorder, there are organisations that may be able to offer some support and guidance. Follow the links bellow to find out more: Beat - the UK’s eating disorder charity offers support for both people battling an eating disorder and those who care for them. The UK's Eating Disorder Charity - Beat NHS overview - information about eating disorders (NHS England) Overview – Eating disorders - NHS 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.

Loneliness is sometimes sad and uncomfortable, and I think we like to pretend it isn’t happening when it is. We hide the feeling from people we know, like saying it out loud means something is wrong. I now reject this and would like to say: I need social connection, and I’m not afraid to say it anymore! Image source: Selçuk Çalışır on Pexels I’m working as a student research assistant in a psychology research lab that looks at adolescent mental health, more specifically, loneliness. I’m coming to the end of my placement (which I am very sad about by the way), and I’ve realised this hasn’t just been about getting experience or figuring out if I like research and academia. It has actually changed how I think. This sounds dramatic, but it’s true. By the end of this, I hope to offer some insight into how important social connection is and maybe get you to rethink the way you see loneliness, not just as a personal feeling, but as something shaped by the world around us. Before I continue, it is important to make a distinction between being alone and feeling lonely. These are not the same thing. Feeling lonely is a subjective, uncomfortable feeling of disconnect that comes from a gap between the relationships you want and the ones you actually have, while being alone is more of an objective and neutral physical state. We can choose to be alone, but we can’t really choose to be lonely. That means you can be surrounded by people and still feel completely alone, or be physically alone and feel completely fine. I’ve felt lonely living in a house with eight loud, social people, and I’ve also felt completely fine living alone. It’s not about how many people are around you. It’s deeper than that. Also, just to note, loneliness isn’t inherently bad. In small doses, it can actually be quite adaptive; it’s like your brain is telling you that you need social connection. It only really becomes a problem when that feeling sticks around for too long, or when the reasons behind it are out of your control. Loneliness is a social justice issue This was the first paper my supervisor sent me when I started my placement, and I remember thinking, ‘Oh, loneliness is quite political!’ The paper argues that the way society is set up now actually feeds into loneliness. It links this to neoliberalism, which is basically the system that pushes individualism and independence. In simple terms, it promotes the idea that you should be self‑sufficient and manage everything on your own, rather than relying on others or working collectively. You can even see this in workplaces. Research shows that modern industries can push people to think and act as individuals, for example, by weakening unions, or even through teamworking that still measures and separates people. So, even when you’re in a “team”, you’re not always made to feel like part of one. At the same time, neoliberal ideology tends to increase competition and reduce people’s sense of connection to others. This can make people feel more alone and harm their well-being. We’ve therefore normalised the pressure of figuring out life alone, instead of within communities. When put in a system like that, it becomes much easier for loneliness to persist. It’s not surprising anymore; it’s normal. Privilege Check And once you start thinking that loneliness is the norm, it becomes hard to ignore that access to social connection isn’t equal. Instead, like most good things, access to stable social connections is a privilege. It’s easy to say “just go out and connect” when you actually feel like you belong in the spaces around you. But in reality, not everyone does. Some people don’t feel like they belong; some face exclusion or discrimination; and some just don’t have the time, money, or access to places where connection can happen easily. To list a few, lack of green spaces, travel costs, and family, financial, and academic responsibilities all create real barriers. And those barriers are not evenly distributed. Some people have to work much harder just to access the same opportunities for connection. So “just go meet people” is terrible advice! It ignores the fact that for some people, that option isn’t as easy as it sounds. We need to start thinking about whether the opportunity for connection is actually available to everyone. Image source: Olgaç Lale on Pexels The self-shame is real, but it shouldn’t be Before, I saw loneliness as a personal thing. Something I was responsible for fixing. Like if I felt lonely, it meant I hadn’t tried hard enough to connect, or that I was somehow socially “failing.” But that whole way of thinking is wrong, and it actually makes things worse. It puts all the responsibility on the individual and ignores what’s happening around them. What ends up happening is a cycle. People feel lonely, feel embarrassed about it, don’t talk about it, and then feel even more isolated. So, it’s not just that people are lonely; it’s also that they feel like they’re not supposed to be lonely, like it means something is wrong with them. But the reality is, loneliness is actually really common. A lot of people experience it at different points in their lives, even if no one is talking about it out loud. The need for social and emotional companionship is universal. It doesn’t mean that something is wrong with you. It just means you’re human. Social connection is major Social connection matters in small, everyday ways. Not in a “have loads of friends” way, but in meaningful moments. I have always had a habit of going into spaces and rushing myself to get out. Walking into a shop, avoiding eye contact, paying, and leaving. But there is life in asking the shopkeeper how their day has been, saying hello, talking to people around you instead of pretending they don’t exist. I’ve realised most people are a bit shy too. There’s this unspoken rule where no one wants to be a bother, so we all avoid interaction, even when we might actually want it. But for me, that’s something I’m trying to unlearn. It’s always nice to chat, even briefly. Side note, but relevant: if you ever worked in retail, you may agree with me here. I have, and I promise you, if you want to ask if there is another size in stock, please do. I have gone through whole shifts without a single interaction, just hoping someone would ask me anything. People don’t want to be a bother, so they stay quiet, but honestly, ask. Those small moments are still moments of connection sometimes! And something I’ve really loved about this placement is getting coffee with my colleague after lunch. It’s not just about the coffee; it’s the walk there and back, the quick catch-up, the small break in the day where I get to be out of my own head and in a conversation. That changes everything. I think we underestimate how much these small moments add up. Image source: Author's own image I don’t think I’ve solved loneliness, but I definitely see it differently now. It’s not something to be embarrassed about, it’s just a signal that you need connection. I’ve started noticing it more in myself and in other people. And instead of ignoring it, I’m trying to do something about it. Loneliness isn’t something to hide from. It’s something to respond to, individually, but also as a society.

I am a research worker on the BeFINE research study, and I feel very privileged to be part of a team that seeks to empower and hold space for underrepresented voices. Our study aims to understand and provide new ways regarding how best to support the well-being of Black families in the UK. The originality of this research excites us as it consists of active steps that seek to amplify opinions and experiences that are often overlooked. From reading this short piece, we hope readers will gauge how important this area of research is and share our excitement in supporting communities that have for so long struggled with access due to major barriers and social inequalities. The devastating impact of the COVID-19 pandemic on Black minority ethnic communities has been widely acknowledged and has led to a greater spotlight on groups exposed to pre-existing health and social inequalities. There is a growing literature documenting the adverse impact of COVID-19 on families, and the health and wellbeing of children and young people specifically from racial minority groups. Throughout the COVID-19 pandemic, Black minority communities have and are experiencing higher levels of mortality, hospitalisation, food insecurity, grief, and loss. Furthermore, declines in mental health have also been reported by Black ethnic minorities in a UK report as a consequence of financial fears and issues with housing and employment ignited by the pandemic. However, in the context of data indicating that non-White racial minority groups constitute 14% of the population across England and Wales, very little is known about the impact of the pandemic on families from racial minority backgrounds. As a means to improve health research, there has been an ongoing call for greater involvement of patients and the public within research from prioritising ideas for investigation to sharing and implementing findings. This form of involvement offers both a community perspective and lived experience that will allow health research to better meet the needs of diverse populations. However, despite an increase in patient and public involvement, participation from minority communities, including Black ethnic groups remains limited. The absent narratives from these communities and the lack of opportunities to offer input into health research has major consequences on healthcare and outcomes. Photo by RF._.studio from Pexels The Be FINE project Despite growing awareness and documentation of the health and social disparities faced by Black communities in the context of COVID-19, there is a lack of understanding of how families from Black racial communities have been specifically impacted and what could be done to best meet their mental health and wellbeing. Thus, to address some of these issues, the UK Research and Innovation (UKRI) COVID-19 rapid response has funded the Black Families Involvement in New E-learning (Be FINE) project. The study is led by Dr Valentina Cardi (Principal Investigator) and colleague, Dr Juliana Onwumere from King’s College London. The project has two main aims: firstly, to understand the experiences and impact of the COVID-19 pandemic on the parents and carers of children and young people (6–24 years) from UK Black minority ethnic communities; secondly, to explore with parents and carers the type of online information they would find helpful to develop skills to support the mental health and wellbeing of their children. Image by Rubbia Ali Advisory group involvement To meet the needs of this target group and ensure their lived experiences and perspectives remain at the centre of the project, we established and are working in partnership with a key stakeholder and lived experience advisory group, comprised of members from Black racial minority communities. Members within the group are from all walks of life and their knowledge, insights, and lived experiences are invaluable in informing and guiding decisions throughout the research process. The group has provided the space, structure, and safety for dialogues on relevant issues impacting the community and the research. The discussions and individual narratives are reflective of the wide range of perspectives within the same racial communities, which is too often overlooked within research. For all advisory group members, the experience of being involved in research decision-making was a new experience. To reflect on this, we have co-produced with the group a written piece of work (yet to be published) about their experiences and recommendations on how to support greater inclusion from other community members in health-related research. Over the next few months, we will be asking adult members of Black families to complete online surveys and participate in focus groups to get their unique perspectives of the challenges experienced and possible solutions. We hope the findings will advance our understanding of the unmet needs of a neglected and under-researched group. We also hope this project will develop into a wider programme aimed at developing online tools which are easy to access, acceptable, and feasible to use for Black families. These resources will be co-developed with members of Black ethnic groups and will overcome the limitations of treatments developed for, or adapted from, other ethnic groups rather than being specifically designed for the target population. Photo by Alex Green from Pexels We encourage readers from Black ethnic groups who care for children or young adults to participate in our study and complete the online survey to get their views represented in the next stages of research. The link to the survey is: https://bit.ly/3KIiO13

Photo by Melike B on Pexels My Chronic Illness Left Me Isolated, but Through Embroidery I Found Threads of Connection Overnight, at the age of nine, I went from an energetic, sociable child to housebound and isolated as Myalgic Encephalomyelitis (ME/CFS) and other comorbidities shrunk my world to my bedroom. ME is a chronic, fluctuating disease that causes symptoms such as severe fatigue, post-exertional malaise, pain, sleep problems, and brain fog. It can leave people bed or housebound, and there is currently no cure. As the years passed, I tried every form of low‐energy activity that I could do from bed. Seven years after first falling ill, my grandmother handed down to me pearlescent threads, sparkly fabrics, dazzling beads, fluffy clouds of silk fibre, and all manner of other interesting materials. Figuring I had nothing to lose, embroidery became my newest low‐energy activity and I was captivated. At first, embroidery was just a hobby to cut through some of the boredom that comes with the isolation of chronic illness. But in those pearlescent threads and sparkly fabrics, I found much more than just a hobby I could do from bed. I found a mindfulness practice to cope with the isolation of chronic illness, as well as a way to connect with my disabled and chronically ill identity, and an online community. Chronic illnesses, such as ME, often go hand in hand with isolation, causing feelings of loneliness and negatively impacting mental wellbeing. A 2023 study found that “social isolation is often an unavoidable consequence of living with ME” due to fluctuating and severe symptoms that often result in people with ME being “confined to the home and isolated.” This study tells a story that resonates deeply with my own experiences of ME and isolation. Before I became ill, I was happily in school and playing with friends on the weekends. After first falling ill, I spent an hour or two a day in school before crashing out with exhaustion on the weekends. My isolation became even more acute when mainstream education became impossible and, whilst best for my education, being at an online medical-inclusion school left me almost completely isolated. Embroidery became a way to cope with the feelings of loneliness and frustration that come with severe and fluctuating symptoms and the isolation of being often housebound. However, everyone experiences ME and other chronic illnesses differently. Embroidery is, for me, often an accessible art form I can do from bed as a person with moderate ME. However, there are periods where symptoms, such as hand pain and severe fatigue, prevent me from being able to access it. Furthermore, people with the severest forms of ME, who also suffer the severest manifestation of isolation, may be unable to access any craft as severe ME can leave people bed-bound, unable to sit upright or tolerate any light, touch, or sound. Chronic illness is complex, so what is accessible and helpful to some people may be inaccessible to others. Photo by Barbara Krysztofiak on Unsplash The Mindful Power of Embroidery Embroidery is probably not the first thing that comes to mind when you think of mindfulness. Meditation, yoga, and breathing exercises are perhaps more synonymous with the word. Mind states that mindfulness “works by taking your focus to the present moment and away from other thoughts.” The repetitive popping sound of a needle piercing through tightly pulled fabric. The long whoosh as thread zips its way through the newly created hole. The considered concentration of where to place each stitch, each colour, each thread. All of these culminate in a creative, mindful practice to enjoy from bed. The concentration, creativity, and repetitive actions help to distract my brain from my symptoms and the loneliness that comes with social isolation. Plus, simply stabbing tiny holes into a piece of fabric can be cathartic in and of itself when symptoms and isolation get tough. Many studies show that textile crafts, such as embroidery, have a positive effect on mental health and wellbeing. A recent 2026 narrative literature review emphasised the “therapeutic benefits of textile craft in improving participants’ mental health and wellbeing,” particularly helping people through depression and negative thoughts by providing repetition, structure, simplicity, and a sense of purpose and achievement. Hand & Lock, one of the UK’s leading embroidery brands, claims that embroidery can alleviate stress by releasing neurotransmitters that promote wellbeing and reduce stress hormones, as well as reducing anxiety, lowering blood pressure, decreasing heart rate and keeping the brain healthy. Hand & Lock stresses the mindful qualities of embroidery, stating that it keeps “us in the present moment, silencing the parts of the brain implicated in generating negative emotions.” Connecting to my Disabled Identity Photo by Author I started my embroidery journey with simple designs promoting this feeling of mindfulness, but I soon realised that the art form offered a way to explore and express my disabled identity. Being socially isolated causes isolation from people with similar experiences, making disability and chronic illness lonely to navigate. Art can bridge this by giving disabled people a way to express their personal experiences, identity, and emotions. My first big embroidery project was based on the disability pride flag. On a background of black fabric to represent disabled people who have lost their lives, I stitched five nerve cells (representing the neurological aspect of ME) in the five colours of the disability pride flag (each of which represents a different type of disability). Researching the piece allowed me to learn more about disability pride and to express my experience through symbols that meant something to me, such as tiny forget-me-nots to represent the ME community and a nod to kintsugi to represent resilience. More recently, as I embarked on a journey of discovering the value of mobility aids, I sourced an old wheelchair wheel and stitched nine panels representing nine disabled artists. Developing this piece gave me a greater feeling of connection to the community I had become a part of. Photo by Author Connecting with Others I shared images of these embroideries online, which resulted in connections with people across the world, especially other people who were similarly isolated due to disability or chronic illness. Initiatives such as the Chronic Market (an online marketplace for artists and artisans with ME/CFS to sell their work and tell their stories), online crafting meetups, or simply people sharing images of art on their personal social media accounts all create an online art community. Online communities are incredibly important to chronically ill people, providing a way to connect with people even when housebound. Online communities based around art provide social connection and a space for a collective mindfulness practice or the creation of a platform for people to express their identity, tell their narratives, and engage with other people who have similar lived experiences. Threads of Connection When I first experimented with embroidery, I never expected that a combination of threads, fabrics, hoops, and needles would provide a tool to cut through the isolation of chronic illness. Embroidery has given me a medium through which to express my emotions and experiences, and to connect with others. In embroidery, I have found a sense of community, even when I’m unable to leave my bed. 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 generated with AI by Author Ever heard of picture perfect? Clicking posts, attracting attention, wanting to feel validated. Validated. Something so many teenage girls, like me, crave the feeling of. Ever looked at yourself in the mirror and not seen your true potential? All you see is what others want of you. All you see is a dysmorphic image of who you seem to be, a monster to you, and a so-called ‘perfect girl’ to others. My name is Joana. I am 14 years old, and I am living through the challenges that life throws my way. I have written this piece so you can truly grasp the importance of staying true to yourself without losing yourself in the process. This piece is about coming to terms with self-acceptance. Does Life Have a Meaning? “I will never be good enough… Why am I not as pretty as her?”, I say, watching my phone, admiring who he chose to spend the ‘rest of his life with’ instead of me because she was more ‘popular’. Gaining popularity. Popularity. But at what cost? Social media has killed pure intentions, leaving a mask of jealousy towards others and a deep insecurity towards your appearance. Trapped in a body where you must be how others portray you, never being yourself. Emotions get bottled up so deep, causing loneliness and thinking people will never understand you for being you. Stereotypes. Boys cannot cry because that makes them weak. Girls have to keep a full face of makeup, or else they look tired and sick. We are in constant connection. Our generation is constantly online, yet somehow, loneliness always creeps in. We feel connected to others, creating relationships, meeting people from social media. But are these connections ever really there? Constant rumours, people judging because they don’t really know the real you. The urge to show off, to feel like you are worth something. Did we ever have the freedom to be ourselves? Then the feeling of having no one emerges... Somebody just walks away because you dared to show your true self. Was it worth it? Was it ever love? All of a sudden, nothing is as bright as it used to be. Loneliness is a room of black and white. An unbearable escape. Feeling everything so deeply, yet nothing at the same time. You have no motivation. Why live? Once you reach that room, only changing your mindset can get you out. Living Loneliness Loneliness. It has driven me to do crazy things, leaving my mental health to deteriorate rapidly. There were times when I felt like the only way to distract myself from this constant aching was to take it out on myself. “You are stupid, you are ugly, you will never amount to anything”. I am the worst voice in my head, the darkest, the most dangerous of all. Connections. Connections. I have many connections now, but the idea of who I am supposed to be ruins the way I present a perspective of myself. Every relationship I ever had was never deep. I question every day if any of my friends ever enjoyed my presence. Hiding will forever be easier than putting myself out there just to get judged. Then I lost everyone and everything. All in a couple of hours, just because my so-called ‘friends’ made comments about me over a simple photo. Mockery, backstabbing, absolute betrayal. Oh, how shallow it was, everything I had. It could go away so rapidly. Loneliness. I feel worthless. Because no matter how many times I would put myself out there, no one seemed to care enough to give me a “like”. This is how social media works. It’s the Insta, Snapchat and TikTok game. Either you hide your true self forever and get considered popular, or you choose to be yourself and get constantly judged by people who do not know any better. It is hard to enjoy little things when you are stuck in something so big. And oh, is it scary... You are scared you will do something so bad that no one will be able to save you, just because you feel like you have no one. You have no one to call. You have no one to open up to. Feeling this is a deep melancholy of sadness. Thinking, feeling, watching. Watching. Watching everyone live their lives while you struggle to get out of bed. You are lonely. Fighting your inner demons, you may say. But you’ve grown so comfortable having them inside your head that fighting them feels like you will have no one in the end. Becoming too comfortable with these mind-eating demons that maybe, if you keep them a little longer, you will learn how to make friends with the darkness. Never has a day gone by when I didn’t feel like a walking ogre. Destroying everything I touched, leaving remains of happiness, until it turned to putrid ashes. I believe I am everyone I have ever loved, making me an incredibly difficult person to comprehend. Finding a life worth living. A term used by my therapist. I always felt like therapy never worked; however, if you do not want to change, then no one can save you from the hole you are digging. Deeper and deeper, entering a pit of loneliness and despair, until you look up and see how far from the sky you’ve dug. How do I get back up? Too much work, might as well continue digging, maybe there is a way out using less effort. After spending countless days drowning in sorrow, I got up. I started slowly shovelling dirt back into the hole I had created, not to bury myself alive, as I thought, but to reach the sky. I still constantly reminisce about the days when I was happy and such a sweet, innocent soul. But life goes on, and getting up is the hardest part of growth. Trust me, I would have buried myself there, letting the worms feel my empty heartbeat and taste everyone I have ever let in, in hopes of being finally understood. But I did not. Image provided by Author Life Worth Living I never thought I would make it past 12. Yet here I am, still pushing and trying my hardest to become the best possible version of myself. There is always a way out. Even if you lose yourself in the process. Finding myself again will forever be worth everything I have done to get to where I am today. Because what is a life worth living without the constant mistakes and lessons you learn along the way? Everyone has their struggles, making them the people they are. Minds are a complicated thing to depict. This is a good thing, otherwise, who are you without everything you’ve been through? We are playing the game; we experience loneliness like no generation before. And we get blamed for it by the same people who invented social media and put a mobile phone in our hands at 7 years of age. But we are stronger than that. I am Joana, a 14-year-old girl who has struggled to get where she is today. That is the joy of living. And there is so much more to life than staring at a phone the whole day. 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.

The Importance of Co-Production in Men’s Mental Health Research Editor’s note: This piece has been adapted from an article published on the UK Research and Innovation (UKRI) website and available here. My name is Nina, and I am a Senior Research Fellow at the Children and Young People’s Centre for Justice. This year, on the occasion of Men’s Health Week, I wanted to share how co-producing research and working alongside young men can help us understand and address the crisis in men’s mental health, drawing on my experience leading the Men Minds project as Principal Investigator. Image from the Men Minds Comic. When we think about men’s mental health, we often assume that men don’t want to talk about it. This is in part true; in fact, men are far less likely than women to seek help for their mental health, and are, in turn, less likely to be diagnosed with and receive support for common mental health conditions. However, we should not assume that these patterns mean that men experience fewer mental health challenges. We can’t ignore the fact that young men experience poorer outcomes in relation to some key health and social indicators strongly related to mental health – for example substance misuse, violence, and suicide. The stark reality is that 75% of the suicides among people aged 10 to 44 in the UK are by boys and young men. These gender-related differences in the mental health statistics are therefore likely to be reflective of reduced knowledge and understanding about men’s mental health, including clinical diagnostic practice, men’s reduced help-seeking behaviours, cultural norms and expectations around masculinities, and stigma associated with mental ill health. Similarly, support services and treatment options often fail to reflect men’s unique challenges and needs. This is not surprising given that men are underrepresented in mental health research, meaning that the evidence used to inform policy, services, and even public opinions might not reflect what men really think and need. Men Minds wanted to change that by involving young men in designing a research project to better understand men’s mental health. What is Men Minds? Men Minds was a research project funded by the UK Research and Innovation (UKRI) as part of the Adolescence, Mental Health and Developing Mind Programme, and it involved a collaboration between the University of Strathclyde, the Mental Health Foundation and Monash University. The aim of this research was to better understand young men’s mental health, and how young men’s masculine identities interfaced with their mental health, wellbeing, and marginalisation. Unlike many other studies, the difference of Men Minds was that it was coproduced with a group of young men. Co-producing the research meant that researchers and the young men worked together to design the study in a way that could meaningfully inform policies and services that reflect and respond to their realities. These young men demonstrated honesty, compassion, hard work and commitment, attending hundreds of hours of sessions over the life of the project and beyond. Many of them still remain engaged today, more than three years since we started, helping to disseminate findings and spread the word about young men’s mental health. What Did We Do? To deliver a co-produced approach, we initially set up a Young People’s Forum (YPF) of 10 young men aged 16 to 24 from marginalised backgrounds, including: refugees and asylum seekers, young men identifying as LGBTQ+, and young men who had been in conflict with the law. The YPF worked alongside the researchers for over two years to guide, design, deliver, and disseminate the project. Image from the Men Minds Comic. We focused on marginalised groups as we know they are more likely to experience additional challenges affecting their mental health and their ability to access support, as well as barriers to participating in mental health research. We felt that by focusing on young men who were more on the margins of society, if we could get things right for them, then we should be able to get it right for young men more generally.  The role of the YPF was to initially help us understand some of the key concepts in men’s mental health – masculinities, wellbeing,  help-seeking - from their own perspectives. The YPF then helped to shape and undertake the project; this included exploring and designing relevant and inclusive methods to engage other young men in the research as well as collecting the data. The young men in the YPF acted as co-researchers carrying out data collection with 60 of their peers across Scotland through interviews, focus groups, and surveys. By drawing on shared experiences and building trust, this peer research approach enabled the study to successfully engage young men from marginalised backgrounds. What Did We Find? Masculinities and Misconceptions We found that many young men no longer believed in the traditional stereotypes of what it means to be a man. They didn’t believe that men had to be strong and stoic, and they knew that men could experience stress, anxiety, depression, and other mental health concerns. However, although these young men had modern ideas about masculinity, they still felt restricted by traditional social norms and expectations from families, friends, schools, and other institutions. Sometimes these were real restrictions, where young men were told to behave in a certain way, and sometimes these were perceived restrictions in that young men believed they would be judged if they opened up. They also felt the weight of negative societal attitudes towards young men more generally. As a result, they shared common experiences of shame and stigma, which often left them feeling isolated and alone in their mental health challenges. Image from the Men Minds Comic. Peer Support, Reducing Stigma, and Normalising Conversations Men Minds highlighted the importance of providing young men with spaces where they are welcomed, and that facilitate a sense of community and connection. Spaces where there is ‘permission’ - but no pressure - to talk about mental health with no judgement. While Men Minds was not a form of therapy, the young men found therapeutic benefits in taking part, and realised they were not alone in their experiences. One young man said: “Even if we don't realise it, subconsciously we're learning from each other. So, while you're hopefully helping change the future of people’s thoughts and mental health and that you're also learning how to help yourself more.” Men Minds highlighted the value of peer support, which emerged in the wonderful, supportive community that the young men in the project created for each other. Who better to support and understand young men than young men themselves? What’s Next? Passing on the Men Minds Baton To reassure other young men, help spark conversations about mental health, and reduce stigma Men Minds produced a comic (featured throughout the piece!), based on real-life stories shared in the research. The young men also presented the findings at the Scottish Parliament, to ask MSPs to pay greater policy attention to young men’s mental health. Author's own image. Informed and inspired by the work of Men Minds, Glasgow City Council have rolled out a year-long programme across all secondary schools. As part of this programme, Young Men’s Minds groups will research the issues affecting boys’ mental health and wellbeing in each schools, and work with staff and other pupils to co-design relevant solutions. At the launch event, Men Minds participants shared their experiences and advice with the next generation of boys and young men, to encourage them to continue to challenge stereotypes and improve mental health for young men. We can’t wait to see what they achieve!

Ever wondered why you suddenly feel so calm whenever you are in nature? Be it at the park when you are having your Sunday picnic, by a waterfall, hiking or even after a camping trip? Well, that’s the healing power of nature. Whether you are consciously aware of it or not, nature has a way of relaxing and dare I say even healing you. Turns out there’s a name for this kind of healing and it’s called Nature therapy or Ecotherapy. The website WebMD describes nature therapy as “the practice of being in nature to boost growth and healing especially mental health”. As someone with a background in Psychology, and one who has been through therapy, I have always been keen to figure out other ways therapy can be conducted without necessarily sticking to a typical in-clinic session. Although I’m currently not a practicing therapist, my passion for mental health is what drives me to research various psychology-related topics. I consider myself a very outdoorsy person and spending time in nature has always been the quickest way for me to de-stress, long before I was even aware of the whole concept of nature therapy. Thus, you can imagine my excitement researching this topic to further understand if there is any connection between the outdoors and mental health. What comes into mind when you think of a therapy session? If you have never had the opportunity to see a therapist, I am guessing you now have the image of a clinic-like room with a cosy sofa and a therapist in glasses and a tablet asking you how you are feeling after every sentence. While this is not too far off from what to expect, I am here to let you know that this is not the only way to get things off your chest. Ecotherapy is just like having your regular therapy sessions but the key difference is that you are having your sessions outdoors. In a nutshell, nature therapy essentially involves: A therapist The outdoors: A park, farm, forest or even a garden Experiencing or working in nature, through activities such as stargazing, enjoying the views on a walk, cycling through a forest, gardening or farming Nature therapy programs can include different kinds of activities. Here are examples of the different types of Ecotherapy. 1. Forest Bathing Forest bathing is also known as shinrin-yoku which loosely translates to “taking in the forest”. This concept immerged in the 1980s in Japan as a mindfulness practice that involves consciously taking a walk in the woods and being totally immersed in the sights, sounds and smells of the forest. What initially started in Japan as an antidote to the tech-boom burnout has now turned into evidence-based wellness practice providing the science to support the fact that spending time in nature is healing. Some of the documented benefits of forest bathing according to the Association of Nature and Forest Therapy include a decrease in the levels of the stress hormone cortisol and in turn relaxing your mind while putting you in a positive mood, improving your mental performance, and creativity. Forest bathing has also been known to lower blood pressure, boost the immune system, and accelerate recovery from illness, as highlighted in an article published at the Yale School of the Environment. Photo by Lukasz Szmigiel on Unsplash This is a welcoming idea to someone with a busy mind and quite frankly, something I definitely need to try soon. If you are curious about how to get started, simply start by searching for a nature and forest therapist in your area. 2. Wilderness & Adventure Therapy While forest bathing can be done successfully either in a private or group setting, wilderness and adventure therapy works best in a group setting. This form of therapy involves spending time outdoors in activities such as rafting, rock climbing and hiking as a means of addressing behavioral and mental health issues as well as empowering the participants. Wilderness and adventure therapy utilises aspects of psychodynamic, cognitive-behavioral therapy (CBT) and occupational therapy. This approach is primarily geared towards teens and young adults. Photo by Hassan OUAJBIR from Pexels 3. Walk and Talk Therapy Typically conducted in parks, nature trails or urban green spaces by a professional therapist; “walk & talk” therapy is an approach that uses the therapeutic qualities of nature and movement, infusing the benefits of fresh air and exercise into a therapy session. Some professionals have found their clients to be more at ease in nature, “There’s something hugely freeing about being in open space and some people go deeper far sooner than they would do in a room,” says Psychotherapist and founder of the Nature Therapy School Beth Collier. Photo by Monstera from Pexels So, do you need a nature prescription? Although the three main forms of nature therapy highlighted above are usually conducted with the help of a professional therapist, this doesn’t mean that you cannot access the healing power of nature on your own. There are other forms of Ecotherapy such as outdoor yoga & meditation that you can easily do on your own and bring into your day to day life as a way to reduce stress. While direct contact with nature has many benefits, you don’t need to spend time in a green environment to experience the positive effects of nature. Several studies have found that a mere glimpse of nature from a window or even photographs of nature can improve people’s overall mood, mental health, and life satisfaction. Next time you are feeling a little overwhelmed and perhaps you don’t have much access to the green lush outdoors, now you have a few tips you can incorporate and if you are lucky enough to have access to a park or nature trail, try and make dates with nature a regular thing for your overall wellbeing. Header Image by Sharon Christina Rørvik on Unsplash