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Image Source: Nadezhda Moryak on Pexels When I turned to my GP regarding the issues with my menstrual cycle, I expected more clarity. When I was diagnosed with Polycystic Ovary Syndrome (PCOS), I felt more confused than ever, as no one clearly explained what the diagnosis meant, but I was advised to consider going on the oral contraceptive pill or changing my lifestyle to lose weight. At the time, that suggestion only fuelled my insecurities and anxiety. I felt as if it was my fault that I was in that situation in the first place. I wish someone could have told me that it is not necessarily the case.     Being a postgraduate student in the unique Mind-Body Interface program me , I constantly learn that our minds and our bodies share a symbiotic relationship. My experience with PCOS is a first-hand testimony to this, and I am here today to share how it affects me every day.    PCOS is a multi-faceted condition that affects 6-10% of women of reproductive age , and it is mainly characterised by hormone imbalance, ovarian cysts, and irregular periods .  In my experience, the rise of PCOS has been described as a consequence of personal lifestyle choices related to factors like nutrition and physical activity. However, research suggests that, whilst lifestyle choices can account for how PCOS may manifest in those affected by it, the cause of PCOS is unknown. Experts call attention to the role of genetic vulnerability and early exposure to environmental toxins found in food containers, cosmetics, and other everyday products .  The ‘good’   Before my PCOS diagnosis, I had little to no knowledge about the menstrual cycle. With the limited amount of reassurance and information that I was provided by health professionals, I had to learn most things myself. I became more knowledgeable around themes of reproductive and endocrinological disorders that affect women every day, such as endometriosis, Premenstrual Dysphoric Disorder (PMDD), and mainly PCOS. I must admit that I do not think I would know as much as I do now if it weren't for my diagnosis.  Image Source: Windows on Unsplash With all the information and research, I have encountered on my journey so far, I have perfected my ability to recognise sources relaying unwarranted knowledge and advice. For one, I stay clear of wellness influencers on social media. Whilst there are well-informed professionals on social media that can provide accessible and user-friendly information, the media often provides unfounded, mixed evidence relating to under-researched topics like PCOS. For example, there have been instances where individuals have been caught selling fake remedies and cures to vulnerable people dealing with PCOS .  Web pages from sources that have no medical background are also a red flag, which is why I recommend reliable sources such as the NHS and other respected medical sources.     It may sound strange, but I am grateful for how infrequent my menstrual phase is. I tend to get my period every few months, which means I don't always deal with the pain that comes with it. I experience a significant amount of pain during my periods, alongside a vast list of other symptoms. My experience is similar to that of many other women, as studies point to an increased risk of dysmenorrhea and other pain conditions among those with PCOS . The sharp, back-stabbing pains can also be caused by the rupture of an ovarian cyst . However, in some cases, it may require medical attention because of potential infection or other serious complications.    I could not imagine going through that pain on a regular monthly basis.     The ‘bad’  Whilst I don’t experience menses every month, there are a multitude of symptoms unaccounted for by the diagnostic criteria that affect me every day. For one, chronic fatigue affects every aspect of my life: from my social interactions to my ability to get through a day at work or university. There is no amount of sleep that will prevent me from feeling like my body is giving up on itself. In fact, I have uninterrupted sleep every night, but somehow I struggle to get through the day without feeling like an absolute wreck. Unfortunately, despite its prevalence amongst women with PCOS , chronic fatigue is an underrecognised symptom.  Image Source: Mushaboom Studio on Unsplash With the constant state of fatigue comes the brain fog. For me, the cold season worsens the situation, as my persistently low vitamin D is accompanied by increasing forgetfulness and mental fatigue. Unfortunately, vitamin D deficiency is extremely common in women like me. Like clockwork, every year I’m prescribed 50000 units (IUD) of vitamin D, which is only prescribed to people with a severe deficiency. On this regime, I sense an improvement in mood as I stop completely avoiding social interaction and have more positive thoughts throughout the day. I wish I could say that the fatigue and brain fog also improve, but it would be too good to be true. To this day, I haven’t found a definitive solution to this problem, but my hope is not completely lost.    Many women report other problems that are underrecognised as symptoms of PCOS. In a previous article , a fellow ITM contributor, Sophia, explained how cystic acne, abdominal fat, and mood swings made her feel self-conscious.    The ‘ugly’  Learning what I know about PCOS was not an easy ride. Whilst I now feel more confident about the knowledge I gained, the limited amount of reliable information made my experience more discouraging. With research being underfunded and the inability of health professionals to provide satisfying information , where is one meant to get their knowledge from?     As an impressionable 16-year-old, I resorted to the self-proclaimed experts on social media, where the common themes ranged from weight loss, forbidden foods, and promising cures . In my desperate search for answers and solutions, I came across a multitude of false claims, such as the existence of different types of PCOS. I distinctly remember being made to feel guilty about doing high-intensity workouts, which left me feeling very conflicted. Up until my diagnosis, I used to run track, swim, or play tennis. Those were the times I felt the healthiest I had ever been, so how did social media convince me that it was not good for me?   Image Source: Elisa Ventures on Unsplash Well, considering how common it is for women with PCOS to come across misinformation, being influenced by such media content should not come as a surprise, but it is cause for concern. Influencers have been known to sell promises to ‘cure the root cause of PCOS’ with their unfounded diet plans, supplement regimes, and laboratory tests , causing women thousands of pounds worth of costs and a great deal of mental distress. The fast-spreading misinformation on social media contributes to the encouragement of dangerous and extreme behaviours, including unsupervised use of inappropriate medication for weight loss , and takes away the spotlight from safer management options like healthy, well-balanced nutrition. The use of platforms that facilitate access to evidence-based information , tips and advice , discussion forums, and symptom tracking is essential for avoiding the detrimental influence of misinformation and confusion.    Light at the end of the tunnel  I cannot begin to explain how the growing accounts of women with PCOS help me feel more validated and part of a community. Articles that allow voices like Sophia’s to be heard introduce me to new perspectives and advice that allow me to grow more confident and learn new ways of managing my own experience with PCOS. Whilst limited, there are online communities that allow others affected by PCOS to share this sentiment. And with this article, I hope to contribute to the growing voices of women with reproductive and endocrinological disorders, and help those who may feel out of depth or misunderstood to feel connected and seen.

As one of the thousands of Levantine migrants (originating from the Levant region, including the countries of Syria, Palestine, Lebanon, Jordan etc.) whose families are now in the Gulf in pursuit of a better life, my world shattered the morning of the 28 th of February. I had returned home from my studies in the UK for a quick visit with my family and to attend a family event. That morning, my mother woke me up claiming the war had started. “What war?” I asked, certain that my home country, Lebanon, was once again under attack. Photo by Lara Jameson on Pexels  I suddenly hear an explosion.   My mind begins to race, and the realisation that the Gulf is involved hits me. I open my phone and skim my notifications: “US base hit in Bahrain”, in the United Arab Emirates (UAE), Qatar, Kuwait… I cannot process the words displayed on my screen, and my inability to wrap my head around the facts emphasises how unthinkable the situation felt just a few days ago. Manama, Bahrain, February 28. REUTERS/Hamad I Mohammed Growing up the way I did meant I was privileged; I was fortunate enough to think “No, not me, not here”. My parents made sure that I would not have to experience any of this, not the way they did.   As a child of the Levantine diaspora, you often hear bits and pieces of your parents’ childhoods, as they rarely give you full stories. The environment my parents grew up in was not ideal, as the 70s and 80s were a time of civil and regional war in Lebanon. I’ve heard storie s — my father hearing that his parents’ home had blown up while at the market, my mother and her family being in their apartment when their building’s roof was bombed. There was little to no acknowledgement that it was difficult for them to survive, that it affected them heavily, or that they did their best to shelter my siblings and me from similar experiences. However, these sentiments became apparent as I grew to find meaning in the actions they took and decisions they made.   See, when I was five years old, a bomb detonated next to my school in Beirut, and while I cannot recall the event, my parents have rarely spoken of that day.   It is a regular Tuesday when they hear an explosion. Within minutes, they are notified through word of mouth that it comes from a building near my school. At the time, both my parents work at opposite ends of the city, and before mobile services are restored, they rush to my school from their respective offices. My mother picks me up and takes us home. My father arrives a few minutes later and requests to pick me up. As minutes go by, the expressions of panic from the school staff grow, and my father quickly understands that I cannot be located. His mind immediately takes him to the worst scenario it can conjure. He believes I am taken or hurt and is immediately terrified. Eventually, the mobile networks come back up, and my father gets in contact with my mother, learning that I am safe at home with her.   That day, my parents decided that they would not watch my siblings and I endure what they did. Shortly after, my parents found a way to relocate to the UAE. It was an emerging haven for skilled Arabs offering safety, stability and a better life. I began my studies there and received a gold-standard education, which helped me to later pursue my bachelor’s and now my master’s degree in the UK. All the while, I was, to a certain extent, sheltered from the chaos of Lebanon, the civil unrest, corrupt politics and financial instability. Not to say that my home country isn’t a beautiful place where I wish I could have grown up, but simply to highlight that the move brought opportunity, a tolerant, friendly environment, and an international upbringing exposing me to a variety of cultures and ways of thinking, where many felt they belonged.   I have always been grateful for the decision my parents made. The larger part of my family later also relocated, and we built a community here with a strong support system. Thus, I feel connected to Dubai, the city I grew up in, which is why I am shocked as the events of the 28 th of February and subsequent days are unravelling.   Videos of fires — in familiar neighbourhoods and places I frequent — have spread across social media, instilling fear and anxiety amongst residents and myself. I soon understood that interceptions of incoming attacks are causing debris to fall, leading to fires. And, as the numbers are published later that day, highlighting the number of missiles intercepted and drones stopped, I realise how, despite the reality of the current situation, I am still privileged. My version of war includes Wi-Fi, family and friends gathering, and access to everything I need in a country that is going far to keep all those within it safe. Thankfully, the government is well-equipped, and all fires are extinguished in a timely and safe manner. The injuries are minimal, and the deaths are extremely limited. The days following the 28 th  of February have felt calmer; however, regional tensions are increasing. The short-term resolution for these ongoing events in the region feels less and less likely. Oscar Chan on Pexels The airspace is mostly closed to protect civilian safety, which has left a number of tourists stranded here and some residents unable to return home. I am amongst those affected by these closures, as I was meant to be back in the UK by now to resume classes and complete my degree. I am worried about when I will be able to return, the impact this delay will have on my studies, and the broader impacts these events will have on others. However, the government has made efforts to ensure everyone’s needs are met, including extending stays free of charge and providing free accommodation and food. Repatriation flights have also now commenced, as the airports open for a couple of hours a day.   Companies are asked to take care of their employees, businesses are giving back to the community, and schools have gone online, adopting systems aimed at catering to all circumstances. The headlines do feel heavy and some are finding it difficult to cope at the moment, but as I’ve read in local newspapers, mental health helplines and consultations are open to those struggling, and support groups have been organised to help us carry each other through.   I would be lying if I said I’m not on edge, that I don’t worry when I hear a jet circle around my area or the loud sounds from interceptions. But the opportunities the Gulf has offered my family and the degree to which it is equipped to uphold order, extend generosity and ensure the safety of citizens, residents, and visitors keep me grateful for the roots I have built and the life I have the privilege of pursuing here.   With every day escalating, my home country of Lebanon is becoming increasingly impacted by this war. While my family back home is currently safe, the number of civilians harmed and infrastructure damaged is devasting. These conflicts in the Middle East are affecting many across the region, and my thoughts and prayers are with all those who are affected by these events.

Image Source: nikko macaspac on Unsplash Nightmares are a common part of our childhoods that usually subside as we reach adulthood. But if you’re like me, those nightmares may have taken ahold of you, well into your adult life.   I have always been pulled towards anything spooky. As a young girl, I had my head stuck in books about ghosts. Now, as an adult and creative writer, I choose to write about distressing subjects like true crime and the paranormal. I am currently writing a crime thriller, and living in a small, sleepy village in the Northwest of England makes the perfect background. Because I always surround myself with the macabre, it might seem obvious why I would frequently have nightmares - but there were also some overlooked issues, too.   A few years ago, I detailed my experiences living with a nightmare disorder, including sleep paralysis, in an ITM piece called “ Am I Haunted ” - at the time, I was still searching for explanations as to why or what was happening to me. This piece is a reflection on what has changed, what therapy has helped me uncover, and what I now understand about the relationship between stress, anxiety, grief, and the mind’s darkest corners. Image Source: Nik Shuliahin on Unsplash Life Itself is a Nightmare I have suffered from anxiety for as long as I can remember, and my avoidance in dealing with these issues (due to being an adult and expecting people to judge me for not “getting better”) made my disorder even worse.   Through therapy, I have learned that my nightmares are my brain’s way of saying, “hey, we aren’t done with this yet.” I live with anxiety that can be deeply intrusive; a missed phone call meant something terrible had happened, silence from someone meant I’d upset them - the present and future felt saturated with dread.   Recent incidents, such as losing my job, combined with struggling to find a new one, and a series of unstable roles beforehand, intensified this cycle; my day became filled with stress, and my nights crowded with nightmares. Therapy is what helped me recognise how tightly these two worlds were linked. Image Source: Marek Studzinski on Unsplash Never-Ending Nightmare Fuel After my Grandad passed away in 2019, my sleep cycle became so disturbing that I developed a fear of falling asleep. It didn’t matter what I had watched or read beforehand; I was a huge fan of the US show Supernatural and was banned from watching it during this period. But it wasn’t as simple as just ‘not watching scary shows’ (one of my worst nightmares came after watching an episode of the Gilmore Girls, which if you know, isn't considered scary).   Grief is a universal human burden, and it became one of my greatest stressors after my Grandad's death. The unspoken pain of losing my best friend surfaced as relentless nightmares, leaving me exhausted and anxious. Even when my grief became easier to handle, I would still have nightmares about ghosts, death, being attacked or chased by sharks and other weird creatures. And whilst everyone will have these types of dreams every so often, for me, it was almost every single night.   It became apparent that the one thing that linked all my parasomnias was stress, but also my inability to ask for help.   What Has Worked For Me   One way to take back control is to write down your nightmare once you wake up, but as a new, positive version, and you rehearse this version during the day. This is a type of cognitive behavioural therapy called Nightmare Rescripting or Imagery Rehearsal Therapy . It is a way to help the brain learn a new way to deal with nightmares and help reduce their intensity and frequency. Although I have never tried this therapy in a professional setting, I would do it at home, either as soon as I woke up from the nightmare or before I went to sleep at night, and eventually, it started to help.   Lucid Dreaming Therapy is a type of therapy centred on the practice of lucid dreaming, which is when someone becomes aware that they are dreaming and can take control of their dream . Taking control allows you to change the trajectory of the dream. There are various techniques used to do this, like repeating the words “when I begin dreaming, I will remember that I’m dreaming” before you go to sleep, or writing down your dreams after you wake up, as it can help you notice ‘dream signs’.   Dream signs can be a specific person, a certain object, or walking into a familiar room - for me, it was the appearance of my Grandad. Each night before I went to sleep, I would remind myself of this, and eventually I began to pick up on this during my dream; I would point out my Grandad, and I would shout "leave me alone" at the entity I could feel him morphing into, and the nightmare would eventually cease, or I would wake up.   While there are many techniques to try and subdue nightmares, a common underlying cause is stress, so starting a journey with a counsellor or therapist can be very beneficial - and this is what has helped me the most. Talking openly has been the best way for me to deal with debilitating emotions, and if you’re struggling, you should try it too; talking to your friends and family about your feelings or what is on your mind can help alleviate pent-up emotions.   Part of the reason our minds can feel like breeding grounds for worry comes down to how the brain is wired - psychologists call this negativity bias . It is an evolutionary survival mechanism that once helped our ancestors stay alive by prioritising potential threats. Today, the same wiring still reacts to emotional pain, and this "emotional alarm system” triggers the stress hormone cortisol, which makes the brain more sensitive to negativity.   This understanding, which I learned through therapy, highlights why talking about our emotions can be so powerful. By expressing ourselves out loud, we can break the loop by giving shape to overwhelming thoughts, and we can help our brains learn that emotional experiences aren’t threats to our survival but experiences we can process and move through. My Nightmares Today Image Source: Rachael Elizabeth (author) Night after night, my subconscious would drag up everything I had been pushing down whilst awake - even now, my nightmares span everything from loss to violence. But therapy has shown me that my nightmares aren’t the enemy; avoidance is.   Seven years after the passing of my Grandad, I can think and talk about him without being plagued by nightmares. Today, I am still navigating stress due to job loss, and trying to secure a new one, and whilst therapy hasn’t cured my nightmares overnight, it has given me the knowledge that I don’t need to be fearless, just honest.   Stress is unavoidable, and nightmares are not punishment; they are messages. And while they may still visit me, I no longer meet them with the same fear - now, I listen, and more often than not, that makes all the difference.

Image Source: Photographer Mike Carroll In 1989, the reign of Romania’s Communist leader came to a sudden, brutal end when Nicolae Ceauşescu was executed by firing squad on live television. In the revolution that followed, international observers rushed into a nation long sealed off from view – only to discover nearly 170,000 abandoned children being raised in warehouse-like orphanages.   In response, at the request of the Secretary of State for Child Protection in Romania and in collaboration with the Romanian Ministry of Health, a group of US researchers launched the Bucharest Early Intervention Project ( BEIP ). For those unfamiliar, the BEIP is the only long-term randomized study that placed children being raised in state-run institutions either into high-quality foster care or to care-as-usual, to determine whether family-based care could repair the socioemotional harm caused when children’s earliest years were spent in institutions rather than families. It is a landmark study that has fundamentally shaped what we know about the impacts of early adversity.   As a researcher interested in the ways in which early adversity (e.g., abuse and neglect) “gets under the skin”, I had a clear goal for my postdoctoral training: to work on the Bucharest Early Intervention Project ( BEIP ).   The research I have completed over the course of my postdoctoral fellowship has focused on how early institutional care (and subsequent placement into high-quality foster care) impacts wellbeing during adolescence and early adulthood in the context of the BEIP.   The BEIP Study The BEIP began during a time when Romania had essentially no foster care system and relied on large, state-run institutions (warehouse-like orphanages) to raise children. Under dictator Nicolae Ceauşescu, harsh pronatalist policies (i.e., encouraging an increased birthrate) coupled with widespread poverty resulted in many families abandoning children they could not afford to raise to these institutions. This practice was supported by the regime’s widespread belief that the state could raise children more effectively than their families. Even after Ceauşescu’s deposition in 1989, widespread poverty and institutionalization continued, and Romania was struggling to restructure child protection while managing enormous numbers of institutionalized and newly abandoned children. The aim of the BEIP was to improve the welfare of Romanian children by establishing foster care that was affordable, culturally sensitive, and replicable in other settings. In tandem, this project offered an unprecedented opportunity to examine the effects of institutionalisation on the brain and behavioural development of young children and to determine whether these effects could be remediated through intervention - both of which would have enormous implications for children worldwide. It is not an exaggeration that the BEIP offers the strongest existing evidence that the early social environment strongly impacts development and can be substantially improved through high-quality foster care early in life.   Image Source: Photographer Mike Carroll The BEIP has followed 136 abandoned infants and toddlers. Half of the children were randomly assigned to foster care while the other half were assigned to care as usual. A matched comparison sample of children raised in their birth families were also followed, to contextualise developmental outcomes.   Over more than two decades of follow-up, the BEIP has provided the strongest causal evidence to date that severe early psychosocial deprivation profoundly shapes development, and that early, stable, family-based care can substantially alter those trajectories. Children who remained in institutions showed lower IQ, more emotional and behavioural difficulties, and atypical attachment patterns. However, children placed into high-quality foster care - especially before the age of two - demonstrated striking improvements across cognitive, emotional, and social domains.  My research on the BEIP has been both hard and hopeful. The hard The arms of early adversity reach deep within one’s biology and across the lifespan.   I have shown that growing up in an institution can have long-lasting effects on children’s development. It can alter functioning of the cardiac and metabolic systems; accelerate biological aging; and can influence how well someone copes and functions during early adulthood. Across this work, one thing has emerged as crystal clear: stability matters. Disruptions in care – being moved from one placement to another – can affect the timing of puberty and can further speed up the ‘ticking’ of the biological aging clock across childhood and adolescence.   However, the importance of stability cuts both ways, and herein lies the hope. The hope While both early institutionalisation and disruptions carry risks, stability of the caregiving environment is protective .   While young people with a history of institutional care showed poorer functioning during early adulthood (e.g., less engagement in education and skilled employment), those who experienced stable foster care placements during childhood showed greater educational engagement and higher-skilled employment than those with disrupted placements.   The lesson across two decades of data is remarkably consistent: stability matters. Early, nurturing, and consistent caregiving does not simply improve behaviour – it shapes physiology, developmental timing, and adult functioning.    The Implications BEIP’s findings make clear that early, stable, family-based care is not only preferable but is biologically and developmentally necessary for healthy maturation across childhood and into emerging adulthood.   Findings also highlight that child welfare systems must prioritize placement stability – not just removal from unsafe environments – if they truly wish to support children’s long-term physical health, mental health, and capacity to meaningfully participate in adult roles.   Even more broadly, the BEIP demonstrates that policies and interventions implemented during the earliest years of life can shape trajectories across the lifespan, altering both risk and resilience. Image Source: Photographer Mike Carroll The relevance of BEIP in 2026 Living in the United States during my postdoctoral training has further driven home the broader implications of BEIP findings, beyond the post-communist Romanian context.   In the US, 80% of all cases reported to child protection services involve neglect – and estimates suggest that 85 to 95% of children in foster care experience at least one placement disruption while in care. While the ‘zero tolerance’ policy (which aimed to prosecute all adults crossing the US-Mexico without inspection) was officially ended in 2021 , families continue to be separated at the border under other practices and policies.   Currently in 2026, parents are being detained and deported by the United States Immigration and Customs Enforcement (ICE) while children remain in the United States; many previously separated families have yet to be reunified ; and reports continue to emerge detailing where detention effectively separates families and exposes children to unacceptably adverse conditions .   The science is clear: separating children from primary caregivers and subjecting them to unstable care environments carries measurable biological and developmental consequences, which underscores the importance of evidence-informed policies aimed at minimizing child-caregiver separations. Looking Forward As I prepare to move beyond my postdoc to become an Assistant Professor at Dalhousie University in Canada, I am committed to continuing this work at the intersection of biology, development, and policy, with the aim of generating the kind of hard data that makes it impossible to ignore children’s need for stable, nurturing care.   Following the outstanding examples of my formidable mentors on the BEIP, Drs. Charles Nelson, Nathan Fox, Natalie Slopen, and Charles Zeanah, I am dedicated to spending my career ensuring that what we now know from the BEIP—that adverse early experiences literally get under the skin—translates into systems that protect, rather than undermine, children’s lifelong health and potential.

More than just “man’s best friend” When I was a child, I used to get ill quite often. On those days, while my friends were at school, I stayed at my grandparents’ house, wrapped in blankets, watching TV, feeling miserable in that specific way only children with a fever can. But I was never alone: My grandparents’ dog, Flora, would quietly sit beside me, her head resting on my lap as if she understood exactly what I needed. Somehow, I always felt better. My breathing softened, my body relaxed, and for reasons I couldn’t yet explain, her presence felt like care - someone watching over me. When Flora died, I was too young to fully grasp the permanence of loss, but old enough to know that I had lost one of my first best friends. And because my grandmother always said, “a home without a dog is just a house” , it didn’t take long until Cora arrived, who very quickly became another one of my closest companions. Image Source: Olivier Amyot via Unsplash Losing Flora was the first time I realised that loving an animal can shape you just as deeply as loving a person. As I grew older, my fascination shifted from simply feeling  how dogs changed me to trying to understand why . That curiosity of why we feel, behave, think, and connect the way we do became one of the reasons I chose to study psychology. Eventually, I wrote my undergraduate dissertation on dog-assisted therapy. Unsurprisingly, the findings only confirmed what many dog owners and lovers had felt intuitively: dogs influence human well-being far more deeply and more physiologically than most people realise. During my Master’s in Psychology and Neuroscience of Mind-Body-Interface , that fascination only grew stronger, especially how dogs shape our emotions, biology, and social environment. A 40,000-Year Partnership The relationship between humans and dogs is one of the oldest and most unique cross-species bonds we have. Archaeological and genetic findings suggest that humans and early dogs began sharing environments over 40,000 years ago . What began as coexistence gradually turned into cooperation: dogs benefitted from human protection and food, while humans relied on dogs for warmth, security, and early forms of companionship.  Over this long co-evolution, dogs became increasingly sensitive to human cues - our gestures, tone of voice, body posture, and patterns of behaviour. Research now shows that this responsiveness forms the basis for many of the psychological and physiological benefits  humans experience in the presence of dogs. At the same time, humans developed strong emotional bonds with dogs ,   experiencing comfort, safety, and reduced stress  during interactions. The human-dog partnership is therefore a long-standing form of cooperation, one that shaped not only behaviour but the physiology of both species. Image Source Robert Eklund via Unsplash How Dogs Calm the Body: The Nervous System Side Research on the autonomic nervous system provides some of the clearest evidence of dogs’ calming effects. Interactions with friendly, familiar dogs reduce physiological stress, lowering cortisol (a stress hormone), slowing heart rate, and promoting a calmer bodily state. Children exposed to a mild stressor, for example, show significantly lower glucocorticoid responses , meaning their bodies release fewer stress hormones when a dog is present compared to when they are alone. In a biopsychosocial framework , these responses make sense: Dogs provide predictable, non-judgmental social cues like steady breathing, a relaxed posture and a warm physical presence. These are signs that the human nervous system interprets as signs of safety . This process is often described as co-regulation : the phenomenon in which one organism helps another return to physiological equilibrium. Although usually discussed in human relationships, dogs can participate in this process too, simply by being near us. Oxytocin - the “Love Hormone” A major biological mechanism behind this calming effect is oxytocin . While often oversimplified as the “love hormone,” oxytocin plays a broader role in emotional regulation, stress reduction, and social connection. Human-animal interaction reliably increases oxytocin levels  in both humans and dogs. Moments of mutual gaze, gentle touch, or rhythmic interaction strengthen this hormonal loop, reinforcing trust and emotional safety. In this sense, the comfort a dog provides is not merely sentimental, but also deeply neurobiological. Image Source: Jamie Street via Unsplash Psychological and Social Mechanisms: Structure, Attachment, and Safety Beyond physiology, dogs support psychological well-being in powerful ways. Research shows that the human-animal bond often mirrors attachment processes  as dogs provide consistency and an emotional anchor during stress. I recognise that feeling from my own childhood. When I was sick at home, Flora didn’t “fix” anything, but her presence made difficult moments feel more manageable. And later, during adolescence, whenever I felt overwhelmed by exams, deadlines, or changing relationships, seeing Cora’s wagging tail could calm me almost instantly. Dogs also contribute to well-being by introducing routine, structure, responsibility, and physical activity like walking, feeding, or caring. These small, repeated behaviours create a sense of stability and purpose, factors known to protect mental health. On a social level , studies   show that dog ownership also increases social interaction and stronger feelings of community belonging. Attachment patterns can even influence how often and how confidently people walk their dogs, which in turn  affects physical health and social contact . In this way, dogs not only soothe individuals but subtly strengthen social ecosystems , especially for people who feel isolated or lonely, for whom a dog can bring daily purpose and a pathway back into human connection. Dog-Assisted Therapy and Interventions Clients often describe therapy dogs as making sessions feel safer and more accessible, particularly when discussing emotionally difficult topics. In this way, a therapy dog can act as a catalyst in the therapy process. Therapists also report that the dog changes the emotional tone of the room , softening defensiveness and supporting emotional regulation. Clinical research backs these observations. For example, individuals recovering from acquired brain injury demonstrate more social interaction and engagement  in sessions involving a therapy dog. Reviews on animal-assisted interventions  indicate that friendly, structured interactions with therapy dogs can be associated with subjective experiences of comfort and pain relief. Beyond psychotherapy, therapy dogs are frequently used in hospitals , rehabilitation centres, and care settings to provide comfort and reduce distress. In educational contexts , the non-judgmental presence of a dog can create a sense of safety  that helps children with reading or listening tasks, and therapy dogs are increasingly brought into schools and universities during high-stress periods such as exams. Image Source: Sabina Fratila via Unsplash “Man’s Best Friend” Today, when I read studies on cortisol curves or oxytocin release, I often think back to that small girl at my grandparents’ place, comforted by a dog who had no idea she was already performing an intervention. Science has given me the vocabulary like co-regulation, autonomic balance, biopsychosocial pathways, but the experience itself remains beautifully unchanged. Dogs don’t fix our problems by talking or training our cognitive patterns. They simply remind our system how to soften. And sometimes, that is the most healing thing of all. Caroline (the author), around seven years old, with her dog Flora. Photo taken by her grandfather

When psychedelics take hold, even your inner voice can disappear – and with it, the brain’s usual balance between its two sides. Lost for words Most of us have felt “lost for words” – during moments of heartbreak, awe, or pure surprise. But under the influence of psychedelics like psilocybin, the active compound in magic mushrooms, this experience can go much further. People often describe a strange silence within their minds. Words slip away. Sentences dissolve. Even the very sense of self begins to fade . As someone who has just completed a PhD in neuroscience, my research has focused on how the brain’s wiring supports language and shapes one of our most striking cognitive features: language lateralisation – the way our brains tend to rely more on one side of the brain, usually the left, for language. For years, I studied how the two sides of the brain communicate through the bundles of nerve fibres, like the corpus callosum , which acts as a bridge between them, and how subtle differences in these connections influence whether someone is left-dominant, right-dominant, or somewhere in between. Image Source: Ieva Andrulyte Now, as psychedelics move from cultural taboo to scientific frontier, a profound question is emerging: how do these substances affect language, and what happens to our very sense of self when our inner voice falls silent? This question is more than an abstract curiosity. By studying how psychedelics temporarily reconfigure the brain’s language networks, we may uncover how the brain adapts after injury – and potentially improve recovery for those who have lost speech following brain injury, such as stroke. At the same time, these altered states offer a rare opportunity to observe how tightly language, consciousness, and identity are normally bound together. The two sides of language Language is not just a means of communication – it shapes our inner world. The constant stream of words in our minds helps us plan, reflect, and define who we are. For most people, the left side of the brain leads in managing language, while the right provides support, particularly for rhythm, metaphor, and emotional nuance. This left dominance is so common that around ninety percent of people show it clearly in brain scans. Yet this balance is not universal. About 8% of individuals display right-dominant or more bilateral organisation. These profiles are more common among left-handers but also occur in some right-handers. Atypical lateralisation is not a disorder: right-dominant individuals can speak, read, and write just as well as left-dominant ones. Lateralisation is also not fixed. In infancy , language is represented more equally across both sides of the brain. If a young child suffers damage to the left side of the brain, the right can completely take over language functions, often with excellent outcomes. This plasticity diminishes with age, but even in adulthood, the brain retains some ability to reorganise. Stroke patients, for instance, sometimes regain speech by recruiting regions on the right side of the brain, though recovery is often partial and highly variable. Image Source: Egor Kamelev on Pexels These findings reveal a striking truth: the two sides of the brain maintain a dynamic relationship rather than a rigid division of labour. Altered states of consciousness, including those induced by psychedelics, can also disrupt and reshape this balance. Psychedelics and the brain Classic psychedelics such as psilocybin, LSD, and DMT profoundly alter brain activity. Imaging studies show that they loosen the usual boundaries between networks, allowing regions that rarely communicate to become highly interconnected. This produces a state of heightened entropy, in which brain activity becomes more flexible and less constrained, helping to explain the vivid perceptions, unusual thoughts, and expansive insights people often report. One of the most dramatic effects is ego dissolution – the sense that the boundary between self and world has blurred or even disappeared. Alongside this, many people notice striking changes in language. Speech may become fragmented or even disappear entirely. Sometimes, even inner speech – that steady stream of words narrating our experience – falls silent. A compelling new theory, the HEALS hypothesis ( Hemispheric Annealing and Lateralisation under Psychedelics ), offers a potential explanation. It suggests that in typical consciousness, the two sides of the brain work in parallel but with a left-leaning predominance. Under psychedelics, this hierarchy is temporarily reversed, with the right side of the brain released from inhibition by the left. This shift creates a more balanced and flexible pattern of activity, which may help explain why psychedelic experiences often feel expansive and difficult to put into words. Since the left side of the brain provides much of the foundation for language and identity, its quieting could explain why words, and the stable sense of self they support, seem to dissolve during a psychedelic experience. Neuroimaging studies support this: psilocybin increases blood flow in right-frontal and temporomedial areas of the brain, while decreasing activity in left posterior regions. Functional MRI scans, which track how different parts of the brain communicate, show stronger connections between the two sides of the brain. This suggests that psychedelics temporarily return the brain to a more symmetrical state like in early childhood, that is, before language becomes mostly controlled by one side of the brain. Language and the self By temporarily changing the balance of activity between the two sides of the brain, psychedelics not only alter perception but also the way language structures our thoughts and, with it, our sense of self. The link between language and selfhood runs deep. Philosopher Ludwig Wittgenstein described language as a “form of life,” while modern neuroscience suggests that language actively constructs our sense of reality rather than merely describing it. Professor Jeremy Skipper has argued that our inner voice acts like an architect of the self, weaving memories, perceptions, and plans into a continuous story of who we are. When psychedelics disrupt language networks, they may temporarily dismantle this narrative scaffolding, producing a radically altered mode of experience. Many describe this as profoundly liberating, while others find it disorientating or even distressing, as though reality itself is less structured by familiar concepts and words. This idea echoes philosopher Thomas Nagel’s famous question: “What is it like to be a bat?” Nagel argued that consciousness has an irreducibly subjective quality – there is always a what it is like to experience the world from a particular point of view. By altering the balance of activity within language-related brain networks, psychedelics may temporarily shift that perspective, producing experiences that feel less filtered or organised by familiar linguistic categories. Similarly, people with aphasia , a condition caused by brain damage that impairs the ability to produce or understand language, often report profound changes in consciousness, describing a deep inner silence and a sense of self that feels altered. These experiences mirror, in some ways, the temporary dissolution of language and identity seen under psychedelics, highlighting that language is central in shaping our awareness and experience of reality. Why it matters Studying how psychedelics affect language networks may also provide insights into how the brain reorganises after injury or surgery. As mentioned above, following a stroke or neurosurgical procedures affecting the left side of the brain, language functions sometimes shift to the right side, but this process varies greatly between individuals and is hard to predict. By observing how psychedelics temporarily induce shifts in language dominance toward the right side, researchers can study these transitions under controlled conditions. Linking these temporary changes to the brain’s network structure could reveal which patterns are associated with different pathways of recovery. This knowledge could help clinicians better predict how a specific individual’s brain is likely to adapt after stroke, epilepsy surgery, or other neurological conditions. At present, however, much of this work remains conceptual rather than clinical. While neuroimaging and theoretical models offer compelling insights into how psychedelics may reshape language networks and the balance between the two sides of the brain, direct evidence linking these transient changes to therapeutic benefit is still limited. Further research will be needed to establish whether such experimentally induced states can be safely and systematically used to inform clinical models of language recovery or brain surgical planning.

Author’s Note:  A typical workday brings many common thoughts and emotions for an adult. Sometimes, you’ll think ungenerous, intrusive thoughts about the people you interact with. Sometimes, random waves of anxiety will attack you when you’re just performing an everyday task. And you are always,  always  fatigued, by your professional work and by societal changes outside of your control. My Teacher is an ordinary adult just trying to get through the day. Image source: Getty Images on Unsplash The Teacher came across the Mother outside the bathroom in the corridor. The Mother was furiously jiggling the bathroom’s door handle, which stubbornly refused to concede to her wishes. Below, at the Mother’s knee-level, a distressed girl-child hopped up and down in painful desperation. “Mommy, I have to  go!”  she wailed. “Open the door!” The helpless, haggard-looking mother seemed on the verge of tears, which quickly receded when the Teacher, at that moment a saving grace, a miracle worker, a Messiah bringing salvation, produced from her pocket a set of keys attached to a swirly, purple rubber wristband. “Here, I’ll unlock it for you,” the Teacher offered. “Oh, thank you!” The Mother’s relief and gratitude felt almost too much for the Teacher. After all, The Teacher was there to use the bathroom too. She hadn’t swooped in purposefully the way a protective vigilante spotting a robbery-in-progress would. She was simply at the right place at the right time. And yet the Teacher unlocked the door in a heroic fashion. The Mother and daughter rushed in at once. In the bathroom, the Teacher, perched on the toilet, uncomfortably overheard the Mother in the stall next to hers, guiding her fidgety youngster through the process of going.   The Teacher had no children of her own and privately wondered where such mothers stored their endless supply of patience. She also thought the child looked old enough to be fully potty-trained already. But of course, she didn’t know for sure. She was just a Teacher, after all. Not a Mother. At one of the sinks, the Teacher rigorously scrubbed her hands clean, her mind already abandoning the Mother and the daughter. It confronted academic matters instead. Students’ homework that needed marking, students’ essays that needed evaluating. The Teacher visualised the stack of work undone as a paper mountain wobbling, threatening to topple over at the slightest wind of breath. A Tower of Pisa that wasn’t going to pass the test of time and attract generations of tourists. The dread crept into her hands, tingled under the hot cascade of water. It slithered up to her shoulders, which tightened accordingly. At this point, it was an all-too-familiar dance of nerves. In the mirror, the Teacher regarded the tender violet circles under her eyes with resigned courtesy – as if they were an irksome colleague she had to be civil to, because they weren’t going anywhere, and neither was she. Soon, the door behind her squeaked open, and the Mother and the daughter appeared at the sink next to hers. The Mother had to hoist her child up to reach the water streaming from the faucet. The daughter dutifully held out her hands to be washed. Yet another something this child just couldn’t seem to accomplish on her own. There was a tremble in the Mother’s arms as she performed as her daughter’s almighty pillar. The child was reaching that age where she was getting too heavy to be lifted anymore. The day was coming when the Mother would set her child down and never lift her up again. The child would finally have to learn how to lift herself. “Can I ask,” ventured the Mother to the Teacher. “Why was the door locked? It wasn’t locked before. We’ve used this bathroom a million times before.” Ahh. There   was a question the Teacher could answer. “There were too many people coming into the building off the streets and using this bathroom,” the Teacher explained as she reached for a paper towel. “Now, only the businesses here have keys.” The businesses in question were a chiropractor’s office, a lawyer’s office, an art studio, and the tutoring centre where the Teacher worked afternoons and evenings. It was a busy building, with a constant stream of people trailing in and out like trampling ants. “Oh, that makes sense.” The Mother set her daughter down, and the Teacher courteously passed her a paper towel to wipe her daughter’s hands with. “I should have guessed. Well, it looks cleaner in here now for sure. Nobody’s bringing their dirty brats in to mess it up!” The Teacher didn’t respond. She wondered what a “dirty brat” looked like in the other woman’s mind, when her daughter had shirt sleeves colourfully stained with paint and couldn’t go to the toilet by herself. The Teacher shoed away that thought immediately. No, that’s not fair. Nothing was fair, really. The locked bathrooms were a nuisance for everyone in the building, but especially in the tutoring centre, where five students at once could beg for the bathroom key. At best, three out of those five could be trusted to remember to bring the key back afterwards. “Thanks again,” repeated the Mother. “Don’t mention it,” replied the Teacher. Back in the tutoring centre, the Teacher deposited the bathroom key back into the little glass jar on the receptionist’s desk. The Teacher herself had brought that little glass jar to work. It had once held a gourmet cheesecake from a bakery in her neighbourhood that had previously been a discount store. Where that old store and all its inventory had fled to, no one knew. That shiny new bakery with its delicate little pastries topped with cream and berries had sprung up overnight like a candy-coloured tulip, much to the delight of the Teacher’s mother, who’d come home with two cheesecakes on a whim. One for her, one for her daughter. A Friday night treat. Once its contents were devoured, the jar would have ceased to serve a purpose if the Teacher hadn’t thought it could be a useful receptable for paper clips or bits of eraser broken off by bored, weary students who bent and twisted whatever was in their fingers. So many, too many students had restless fingers like that, fingers that always had to be playing with something, or there wasn’t a chance in the world they had absorbed a word she said. “Can I use the bathroom now?” The Teacher’s student asked the very moment she sat down. The Student had heard the clink  of the key in the little glass jar. Like the blare of the school bell, it gave them wordless permission to leave their seat. Outside the tutoring centre there was a new wail, of the tired-child variety. It was the Mother’s child. Again. “Moooooom, I want to go home!” A sharp rebuke followed. “Your brother’s not done his class.” “Why does he have to have class?!” shrieked the Child. “Be quiet, or you’re not going swimming on Saturday!” countered the Mother. “Yes, you can go the bathroom,” the Teacher said to the Student, suddenly feeling very tired herself.

Photo by Priscilla Du Preez  on Unsplash What is music? Is it a form of art, an expressive masterpiece, or a therapeutic treatment? For a long time, I saw music as purely performative — a way to entertain and express. But over time, I realised that my dedication to music went deeper than just for show; it was a form of escape, an unrecognised tool for maintaining my mental health. My interest in this field truly ignited when I met a woman with schizophrenia, a condition that impacts thoughts, emotions, and behaviours. She told me that the only way to drown out the voices from her hallucinations was to sing and listen to loud music. Witnessing the impact music had on her symptoms made me wonder: could music therapy be a lifeline for others as well? In this piece, I will explore how musical creativity can enhance mental health, delving into the power of music as a therapeutic tool.   The Science of Sound Music therapy is a unique, evidence-based approach that uses music to help people reach their health and wellness goals. It can look different depending on the individual — sometimes it involves actively making music, like singing or playing an instrument, and other times it can be based on listening to music and focusing on the experience. Music therapy is able to stimulate brain functions involved in movement, cognition, speech, emotions, and sensory perceptions. But how does it work? It all comes down to how music interacts with the brain. Research shows that listening to or creating music releases ‘feel-good’ chemicals like dopamine and naturally occurring opioids, which help lift mood and reduce stress . When we engage with music, it results in the activation of various brain structures — regions linked to memory, emotion, and even movement . More holistic approaches such as the use of music can impact people in ways that regular talk therapy cannot, particularly for those dealing with cognitive or motor challenges. Photo by Magic Bowls on Unsplash The use of music, for more than performance, can be dated back to thousands of years ago, with music and sound playing a significant role in spiritual and healing practices across cultures. Religious traditions have recognised music as a tool for well-being, with examples like Gregorian chants  in Christian monasteries, intended to elevate the soul, and Shamanic drumming  (rhythmic drumming) in Indigenous ceremonies to induce meditative or trance states. Another form , Tibetan and Himalayan singing bowl therapy , uses harmonic vibrations from metallic or crystal bowls. This  encourages relaxation and mindfulness, aligns the body’s energy, and reduces stress, as well as physical impacts such as breathing regulation and blood pressure reduction. Singing bowl therapy, introduced to Western culture by Peter Hess , is still used in the 21st century as a form of meditative practice. In the early 20th century, particularly after World Wars I and II, musicians played for soldiers recovering from physical and emotional stress. The positive impact on morale and healing was noticed, inspiring the development of music therapy programmes, and leading to the establishment of professional organisations like the American Music Therapy Association . These traditional methods are now combined with contemporary science in music therapy, which provides a method of applying music to promote mental, emotional, and physical well-being.   Composing Targeted Therapies Anxiety and Depression Music therapy has emerged as a powerful tool for alleviating symptoms of anxiety and depression, significantly reducing stress levels, and promoting emotional well-being. A meta-analysis found that music interventions can lead to a decrease in anxiety and depression symptoms, with the greatest effects observed in individuals who participated regularly . The soothing properties of music can activate the brain's reward centres, enhancing feelings of pleasure and relaxation. Performing and practising music in a group setting also encourages participants to communicate with others, thus promoting a more social setting, which can increase mental health. Music therapy encourages individuals to express their feelings by providing an emotional outlet, thus facilitating healing. Memory and Dementia Music therapy has also proven effective in supporting individuals with cognitive disorders, particularly Alzheimer’s disease and dementia. This is thanks to music's ability to trigger memories and emotions, making it a powerful tool for recall. When I worked for a Singing For Lung Health Choir, the primary purpose of the choir was to improve symptoms of pulmonary disorders such as COPD (Chronic Obstructive Pulmonary Disorder). However, a vital secondary impact was memory improvement; all participants were over 60 years old, and most suffered from memory loss. Singing requires active use of memory due to the demand of repeating tunes, rhythms, and lyrics. Songs can also promote memories by triggering links to a past experience or person. In these ways, musical activities uniquely stimulate memory and emotion in the brain, thus providing a therapeutic tool for cognitive reinforcement in individuals with memory loss. Psychosis and Schizophrenia For individuals managing schizophrenia or psychotic disorder, music therapy can help mitigate auditory hallucinations (hearing sounds and voices that are not there). Research indicates that music can serve as a grounding tool, providing a sense of reality and focus. A study demonstrated that participants using classical music therapy experienced reduced auditory hallucinations . Most studies investigating this seem to use classical music — I would like to see future research in this field exploring the impact of different musical genres or using patients’ preferred music style to see if musical nostalgia or favouritism could also impact symptom mitigation. Motor Skills In individuals with neurophysiological motor disorders like Parkinson’s disease, music therapy can play a vital role in improving motor function. For example, the rhythmic elements of music help to enhance motor skills through techniques such as rhythmic auditory stimulation (RAS). In a three-week at-home-based RAS training programme, patients showed improvement in their "gait velocity" (walking speed) by 25% and stride length by 12%  compared to those who participated in a self-paced programme who showed a 7% increase in their gait velocity . The rhythm and beats in music can serve as cues, aiding in movement initiation and coordination, and helping individuals regain confidence in their motor abilities. Photo by Mike Giles on Unsplash Music is a powerful tool for connection and healing, it allows us to use the influence of sound to treat a range of mental, emotional, and physical issues. The development of research in this field shows an increasing body of studies supporting the therapeutic effects of music. I believe that its full potential has not yet been reached, with evidence already ranging from boosting motor abilities and memory recall to reducing the symptoms of sadness and anxiety.   In the future, music therapy should adopt a multidisciplinary strategy, integrating conventional and holistic techniques under the direction of neuroscientific research. Combining music therapy into healthcare practices honours its historical roots and paves the way for innovative treatments. In addition to becoming widely accepted, I see music therapy being incorporated into treatment plans alongside other artistic mediums like dance, art, and meditation. This collaboration will empower people, providing a greater sense of agency in recovery but also in general health, providing a comprehensive model of wellness.

Image Source: Wesley Tingey on Unsplash While ongoing research continues to sound alarm bells that mental health diagnoses are consistently and dependably rising in the UK, this does not seem to have translated into panic and action, and one could be forgiven for thinking it has fallen on deaf ears. In the last 10 years there has been a 20% increase in the number of adults being clinically assessed to have a common mental health condition; in young adults the increase is even more stark, at 47% within the same period. This population are also increasing demand on mental healthcare resources, with the number of people accessing treatment for these conditions doubling since the year 2000. Optimists might suggest the increase in diagnoses is evidence of a collective improvement in education and awareness concerning mental health conditions, and a shift away from historic stigma and shame. Pessimists might counter that this progress is not linear, and that the public’s knowledge of mental health conditions in 2024 regressed to the level seen 15 years previously. Cynics might take a view currently popular in the culture that this increase is due to a younger, softer, generation who would just as readily broadcast their mental health difficulties as their breakfast on social media. However, they might be surprised that 72% of 25–34-year-olds surveyed reported a reluctancy in discussing their struggles with mental health, compared to 28% of over 75s. Image Source: Peter Thomas on Unsplash Whatever the cause, the cost is undeniable . Impaired mental health is estimated to contribute 20% of all disease burden in the UK- in England alone the economic cost is £300 billion. This figure accounts for loss of productivity, healthcare costs and ‘human costs’ of reduced quality of life and wellbeing. Despite this, the proportion of NHS funding on mental health care has fallen this year and is set to fall again next financial year, indicating that despite the seemingly worsening state it is not considered a priority for improvement by the government. Increased spending in mental healthcare might not be immediately palatable to the public, despite spending on effective prevention likely saving on treatment later. To combat this, the government might employ the strategies below to reduce antipsychiatry attitudes people might have, such as a lack of trust or faith in the work of mental health services. Raising awareness; reducing stigma In general, prejudices that people hold are a result of a lack of experience with the entity they malign. In terms of mental health, people might be fearful, judgemental or dismissive of certain disorders because they have not had the opportunity to learn about and understand them. 46% of people surveyed said that people with schizophrenia should be able to “pull themselves together”, which contradicts so sharply with reality, it can only be concluded that these views are born out of a lack of exposure to people suffering with schizophrenia. Image Source: Kenny Eliason on Unsplash Education could be incorporated into high school curriculums, including video testimonials of people with lived experience of mental health disorders. This could be a relatively cost effective but far-reaching strategy that helps young people understand and develop empathy for those who suffer with mental health disorders. Similar resources could also be implemented in workplaces. If volunteers were available (perhaps through the Lived Experience Advisory Network), in-person question-and-answer sessions to allow a judgement-free environment for people to respectfully ask about things they are curious to know more about could begin to break down barriers of shame and ignorance. Targeting misinformation and harmful depictions in the media The power of entertainment media as a communication tool should not be underestimated, both in terms of its risk and its benefits. “Informative” videos of medical experts sharing their advice on platforms such as TikTok are unregulated and often designed to grab attention and generate profit. This has led to a spread of misinformation , with an estimated 84% of mental health TikTok videos found to be misleading and 14% to be potentially harmful, such as giving advice on medication. One way in which this might be tackled is enforcing unbiased fact checking on posts which can add context. Image Source: Marten Bjork on Unsplash On the other hand, when depictions of mental health conditions on screen are made in a truthful, informed and engaging manner, they have shown the potential to not only make captivating art but to help people acknowledge these struggles within themselves . 1 in 5 adults reported feeling encouraged to seek help for a mental health problem after seeing a storyline in a TV show or movie that they related to. Government promotion of links between media production companies and resources such as Mind’s Media Advisory Service can provide writers, researchers and producers with information resulting in more accurate portrayals of mental health conditions. Taking accountability and addressing previous shortcomings The stigma of mental health disorders and the services that provide for them vary across different communities and are influenced by past practices that have been implemented in the name of Psychiatry. This variation, in part, is perpetuated by ongoing inequalities that certain minority groups face. For example, Black people are still more likely to be subjected to restrictive practices such as seclusion, physical restraint and rapid tranquilisation than white people. Homosexuality and transgender identities have been reconceptualised repeatedly in diagnostic manuals , which previously have labelled these identities as pathologies. However, this reconceptualisation can be seen as hopeful, and a demonstration that psychiatrists are willing to review the evidence and grow with society. Admittedly this strategy would likely require an adept PR campaign to avoid producing the opposite effect of stoking anger and distrust towards psychiatrists and breaking down relations with these communities. In the long-term, owning up to past mistakes and showing a desire to improve would hopefully inspire more confidence in the speciality. Education, honest media portrayal and accountability for past harms are not complete solutions, but they form a realistic starting point for reducing antipsychiatry attitudes. Together, they can restore public confidence and create the conditions for the investment that modern mental healthcare will undoubtedly require. This piece has received the South London and Maudsley NHA Trust Training Programme - "Lade Smith Essay Prize"

Eight years ago, I went to a friend of mine in distress. I had a lump or a bump or a cough or a premonition. “I am dying,” I told her. I was certain of it. “Or, are you just about to put an album out?” she asked. My name is Charlee, and for the better part of twelve years, I’ve been a willing participant in the love-hate relationship most artists have with the music industry. The music industry is a peculiar trigger in my life. Anytime I move forward - record new music, release new music, make new plans - I backwards dance into old anxieties of mine. Particularly, health anxiety. Image source: Victoria Romulo on Unsplash Health anxiety is something of an actor. It’s quite convincing. Of course, there’s a surplus of information tying the psychosomatic mind to material symptoms, but it always felt uniquely devastating in the moment. I’d have a stress-related, mid-back ache, and suddenly I was storming my physical therapist’s office wondering if she could feel a tumor between my vertebrae. I felt a strange sensation anywhere—and I mean anywhere —in my abdomen, and I was contemplating not boarding my plane because, “What if my appendix had burst?” Routine as that procedure may be, the timeliness of any ER visit was important. I’m not sure how it works really—this tie between my health anxiety and my music—only that there is something tremendously disquieting about the affair of sharing my work. Looking back, it’s as though I saw in it a hidden meaning, a certain reward that felt unearned. When I put my first EP out in 2014, I was convinced it would be a posthumous release. It didn’t feel deserved unless, of course, there was something to even the scales. I told my mother repeatedly, as I spiraled in my apartment, of which I rarely left, “I have Leukemia.” “I have breast cancer. “I have lymphoma.” She was a dutiful listener, but nothing she—or anyone else—ever said quelled the fear.  Image source: National Institue of Allergy and Infectious Diseases on Unsplash The onus of the health-anxious is to understand that we have anxiety, and that our anxiety is cyclical. We uncover Something of Great Concern somewhere on or in our bodies, we fixate to the point of hysteria on the Something of Great Concern, the stress of this causes Something New of Great Concern to show up on or in our bodies, and the cycle continues. For my part, I rarely experienced a break in this action. There were no days off. I was always worried about something life-ending, and I walked around all day long like I was in wait of a court mandated death sentence. In John Green’s The Anthropocene Reviewed he writes, “I’ve always felt like I need a vice. I don’t know whether this feeling is universal, but I have some way-down vibrating part of my subconscious that needs to self-destruct, at least a little bit.” This seemed to describe part of the attachment I had to this chronic anxiety. The thing was, I didn’t think my body could be that affected. It was science-fiction—this idea that I could spiral so intensely and manifest Something of Great Concern. I could blame this on society and its inability to teach people how to be with themselves, how to tune in, how to listen to what their bodies had to say. The body, itself, is always speaking. I remember sitting in my therapist’s office a couple years ago when she mentioned that sometimes something shows up in our bodies for no reason at all. Or if there is a reason, it’s most likely harmless. This did not register for me. The body makes no sense to me. It seems so fragile. I sat with myself and all I could think was " how is it possible something isn’t wrong?"  Perhaps I could look back at my childhood, at the tumultuousness of my father, at his insistence that I had no work ethic because art, in his mind, isn’t work, and draw a line between putting out an album and dying from disease. My worth was all wrapped up in it. And by that, I mean the lack thereof. He told me, in a way, that I didn’t deserve to make art. So now I was evening the scales of pursuing this flimsy venture by dying. There is a lot for me in the general unfairness of the world. For a while, the question was, why someone else? Why not me?  It was never why me? There’s such a lack of compassion in this kind of anxiety. I battered myself all day long for all the good I felt was present in my world. Being overly concerned about joy entering made me the type of person to police my joy, to fear my joy. Eventually, I became addicted to chaos. As John Green further writes, “The pleasure of smoking for me wasn’t about a buzz; the pleasure came from the jolt of giving in to an unhealthy physical craving.” I would rather live in a constant state of panic, I would rather know something was wrong than wait around for something to go wrong. A Revelation in Yoga It was a passing, random moment in a yoga class that gave me pause. We sat as a collective in a long-hold, shaking, dripping, looking around the room at each other, and then to the teacher for some kind of indication that time had ticked down and we would be transitioning out of the pose soon. Instead of guiding us out, the teacher asked us to tune in. “We’ve been here before,” she said. So, too, had I been in the position of fearing for my life without true cause. So, too, had I sat overheating on the couch, my heart racing, thinking I was seconds away from cardiac arrest, only to work myself up without once acknowledging the likeness of every panic attack, which began with heat, then transitioned into a racing heart, then culminated in the rapidness of breath. Not once had the low pain in my abdominals been anything more than a cramp, flatulence, or a food item that didn’t agree with me. Acceptance can feel oddly similar to giving up. There’s a weaponised aspect to it. When we talk about the powers that be, there’s no sole perpetrator. I felt uncomfortable allowing my hypochondria to exist without having to name the cancerous potentiality of each and every material symptom. I’ve been taught to be at war with myself, with everyone else. I’ve been taught to live in fear, that there isn’t enough time, that good things can only be done when we’re young, that there was only so much resource to go around. Perhaps, what I’m getting at, is that anxiety, as genetically predisposed and chemically manufactured as it is, is also a weapon of society. As Maya Angelou said, “Art is not a luxury. The artist is so necessary in our lives. The artist explains to us, or at least asks the questions which must be asked.” And perhaps, keeping the artist down is the point. In 2013, my father told me he was uncomfortable helping me move to Nashville to pursue my music career “if you’re still dependent on therapy.” But what he was really telling me is this: anxiety is not normal. You shouldn’t need therapy. If you do, something is wrong with you. Image source: Toa Heftiba on Unsplash What if, instead, those without anxiety were the ones experiencing a rarity of circumstance? They were insulated, in some way, and the rest of us were true products of our environments? That’s how I started to see it, and it made me angry. He, being swayed by the ableist world at large, which undervalues the artist in every workable way, had led me to believe that I was othered. He made me feel, in a sense, that I had to even the scales by suffering in some way to bring my art into the domain. He had made me feel guilty for not being a cog in the machine. For having time on my hands to create. He had weaponised my freedom, the idle hours of my day, the moments of quiet connection with the self. What I came to find is that I don’t owe him or the world my suffering. Art does not need a reason to exist. I don’t have to account for the hours I spend working on something that’s self-interested. The best thing I could do is rebrand my condition to decentre myself in my own suffering. This is not my doing. This was done to me.  This article has been sponsored by the Psychiatry Research Trust,  who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

I was born on December 3rd, 1993, in Caracas’ busiest hospital. I spent my early years in a high-rise apartment at the top of a mountain in Manzanares, living a quiet, ordinary life. Everything changed when Hugo Chávez, once the face of a failed coup, rose to power. My dad saw what was coming, and we eventually left for the United States. Looking back, it's painful to see how the Venezuelan diaspora, my family included, was shaped by those decisions. What once seemed like a noble decision by my family for the sake of our democratic future became a nightmare with no end in sight. There's nothing left for me to do but chronicle why and how we arrived at our current state. The nostalgia of others colours my memories. At least that’s the Venezuela I know now, through the rose-coloured lens of my family’s memories and testimonies. A Venezuela that once thrived economically and socially. Venezuela, which used to host well-known artists from all over the world. A country whose complexities and eccentricities get left out of these imagined glory moments of the past. Much to my family’s disbelief, I still remember a lot from my life in Venezuela. More than they’d like to admit, anyway. I remember the hustle and bustle of a busy Caracas street. The smell of rust coming off my favourite slide on the playground my grandfather would take me to every weekend. I remember my room overlooking Cordillera de la Costa Central. I remember it all. It makes it harder to live with the dissonance between their nostalgia and my understanding of it now. That dissonance has only deepened in the wake of the events of January 3rd, 2026, when the Trump administration forced my memories out of nostalgia and into something harder to live with. Photo by Altamart on Pexels Uprooted And Upended  Political disarray has shaped my worldview. My family and I moved to the United States when I was 8 years old. We left a country on the brink of economic and societal collapse in search of a better life. Our immigration story, however, is quite mundane. We didn’t cross dangerous borders on foot, nor did we stow away in the back of trucks. Brave people did that. My family and I were fortunate enough to land safely on US soil after a three-hour American Airlines flight on August 11, 2001. Ironically, it was exactly a month to the day before the Twin Towers collapsed on September 11, 2001.  Deep unrest is all I’ve ever known before moving to another country, which is already one of the biggest uprooting anyone can do, especially at the age of eight. I still remember various birthdays held in front of the television during one of the  many elections held under Chávez, and more recently, under Nicolás Maduro .  My family would gather around, holding hands as they tried to will an alternative result. One where the authoritarian regime is flushed out of a country, begging for life. It never worked. It’s complicated and it always will be.  After January 3 rd , things have only grown more turbulent in my mind. How do I condemn the joy Venezuelans feel at the sight of Nicolás Maduro, a man deeply connected to their suffering — being taken away? Even when those same forces belong to an administration now roaming the streets of the United States, terrorising their own citizens? Masked men who drag people from their homes and off the streets into unmarked vans in unknown locations, never to be seen again? It sounds familiar, I’ve been here before. I once escaped this when I came to the US, or I thought I had.  Photo by Joel Santos on Pexels The Disarray of It All  Understanding the complexities of my background and our present political landscapes has become a world of landmines. Each is individually crafted to blow up at any moment. My anxiety is the trigger. As political tensions in Venezuela rose throughout the years, so did the  radicalisation of the Republican Party in the United States . With it, my family’s belief that right-wing ideology would save Venezuela from the clutches of an authoritarian socialist government one day. What they failed to see amid the deep political trauma is the same thing they were running away from would ultimately catch up to them, too.   I don’t know at what point my mind and the world around me merged into one messy ball of chaos. Was it the day we left Venezuela? Or the day I understood the complexities of my birth country and the one that now hosts me. I’ve yet to feel at home in the United States, even after over two decades.  Slowly, Gently Down My Mind Goes  The first time I had a panic attack, I was on my way to school. It was my first day at my new school in the US. I didn’t know what a panic attack was. I just assumed all the other kids being ushered into the classroom felt the same, and that they were just better at hiding it. Turns out, I was experiencing severe separation anxiety from my family. Being in a new country, a new school, with new people, and learning a new language. I had one new experience away from collapsing in front of my new second-grade teacher. It didn’t get any better as time went by.  Photo by RDNE Stock Project on Pexels My internal unrest slowly and intricately weaved itself with the unrest of my family. The conflict between my birth country and this new world is filled with contradictory ideologies. My anxiety is directly linked to my fear of leaving home, and this is no coincidence. Where is ‘home’ for me anymore? My family has succumbed to the dizzying rooms of smoke and mirrors Republicans have conjured to keep their base in check.  Brave New World  As I grew older, I grew weary of my family’s political stances. They parrot back to me conservative talking points with such conviction and clarity, much like some American progressives who seem to believe Venezuelans live in a socialist utopia. Both are so sure yet so wrong.   Living in a home where every conversation on politics feels like a test I’ll never pass is exhausting. My family’s paradoxical way of looking at the world has triggered a deep anxiety in me. How do I please my family’s political trauma but also stay true to what I know?  Their paranoia has been stoked by forces much larger than me. My family has been convinced to vote against their own self-interest. Against my own humanity. I am treated like an outsider in my own family because I leveraged them in the one thing they wanted me to have: an education.     I move through the world with extreme caution because of it. This has closed me off from others in a way I never anticipated. How can I ask for understanding of others when my family can’t even extend that courtesy to me? There’s no simple answer here, and there’s no clear winner. We live in a world where the word truth has lost all meaning. But I am able to manage, to survive.  Living in this brave new world my parents dreamt of for us seems impossible for me now.  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.

Photo by Alex Green on Pexels A diagnosis can feel like a key — unlocking understanding and access to help — or like a label that locks you into something you can’t escape. I was 35 when a psychiatrist gave me a diagnosis of borderline personality disorder (BPD)/ Emotionally Unstable Personality Disorder (EUPD). I am now 43, and I still have an ambivalent relationship with the diagnosis. I was diagnosed with depression and anxiety aged 18 and have had various forms of treatments. I have taken several different antidepressants. In terms of therapy, there has been intermittent support when it has got to crisis level, like CBT and counselling around self-esteem and anxiety. I am now in a position where I can afford private therapy, which has allowed me to identify that childhood trauma is the reason for my behaviours, thoughts and unhelpful coping mechanisms, the most significant event being the suicide of a parent. I am open about my diagnosis of depression and anxiety in my personal and professional life but not about my diagnosis of BPD/ EUPD. The only people who are aware are my wife, mother and sister. This is, I think, due to internalised stigma and a fear of reaction. It has made me a guarded person who finds it difficult to make and keep friendships.   My past experiences inspired my undertaking of a Social Sciences degree, as I wanted to understand the reasons for social inequality and discrimination, and my successive jobs as a Support Worker, Work Coach and Benefits Caseworker. I like to write; in a perfect world, I would make a living from writing full-time. EUPD is perhaps the most stigmatised mental health diagnosis. Conversations around mental health are becoming more common and there is a wider understanding of the long-term impact of trauma and adverse childhood experiences. As my therapy makes me realise how much stigma I feel, it is the right time to discuss how we talk about diagnosis and add my voice to the conversation. Debate about diagnosis sits at the heart of mental health discourse, between the need for validation and the risk of stigma. Below, I discuss the pros and cons of diagnosis, which drift towards focusing on the cons due to my own experience, not to say it will be the same for everyone. The Case for Diagnosis Within the clinical community, it is partly accepted that the diagnosis of BPD has limitations , particularly due to the high overlap of symptoms with other mental health conditions, such as bipolar disorder. However, it is still felt that diagnosis is overall beneficial. A benefit of diagnosis can be validation. I felt like an outcast for so long that having a diagnosis gave a satisfying sense of relief. Dialectical Behavioural Therapy is often the most effective treatment for EUPD. However, to access DBT through the NHS, a majority of hospital trusts require a diagnosis, or at least “strong traits” of EUPD. In these cases, having a diagnosis is essential. For some, including myself, even passing the barrier of having a diagnosis did not lead to support.            Research has also shown that, for some, diagnosis “facilitates self-understanding, self-legitimation and self-enhancement.” The Case Against Diagnosis Attitudes in society to people with a diagnosis of EUPD remain predominantly negative; those with EUPD are seen as dramatic, or worse, dangerous.   Society tends to focus on the observable behaviours (self-harm, impulsivity) rather than on the underlying trauma and emotional pain .       An argument against diagnosis is labelling.     Labelling can lead to a situation where the “problem” is seen as being with the person, rather than society's failure to recognise behaviour as a coping mechanism. Research has shown that negative psychosocial impacts of diagnostic labelling (stigma, changes to self-identity, relationship strain, social or professional discrimination) are common. Photo by Yankrukau on Pexels The key argument against diagnosis has to be stigma , which is both disempowering and frightening. This can be internalised, which can significantly impact an individual’s sense of self. I felt ashamed and blamed myself; I very much felt like there was something wrong with me, and it was too late to return to the manufacturer. This can be self-perpetuating and make recovery difficult.   That is not to say that diagnosis cannot be helpful: into the early 20 th century, Schizophrenia was generally seen as madness and sometimes as possession by the devil or evil spirits, and still is in some cultural settings. Medicalising the condition went some way to reducing stigma by seeing it as a treatable medical condition.          Stigma is often formed by representations in the media. There has never been a character with a diagnosis of EUPD in a British soap opera, despite it being diagnosed more often than schizophrenia, which has been portrayed often on tv. The soap opera Hollyoaks has perhaps had the character who has demonstrated the most significant traits of EUPD, Cleo McQueen, who has shown emotional dysregulation, impulsivity, identity disturbance, interpersonal difficulties and self-harm in the form of an eating disorder. EUPD was not explicitly mentioned.        This lack of representation is likely to lead to false beliefs and a lack of understanding. Mentions of EUPD in the media are predominantly negative and reinforce harmful stereotypes, as it is constantly portrayed as a character flaw or moral failing.              Given this, it is high time that representations in the media of those with EUPD change, and negative portrayals are challenged, particularly given the fact that research has shown that 54% of people say that seeing a well-known character on screen with a mental health condition has improved their understanding. Perhaps the reason for this lack of representation is a misunderstanding of the condition, or a fear of showing an emotionally complex person. I urge those in the media to challenge this. Accurate and compassionate portrayals could shift public understanding, as they once did for schizophrenia. What's in a name Borderline Personality Disorder has origins in the 1930s.  Borderline was used because people with this condition were thought to be on the border between neuroses and psychosis. As the term “borderline” was seen as archaic, and with the intention of reducing stigma, the term EUPD was introduced and is now widely used in the UK and Europe. There is a suggestion that this term is less stigmatising ; and a more accurate reflection of the condition. Personally, I still feel it has an overwhelming negative connotation, as it gives no nuance and suggests the person is permanently unstable.   I would explain EUPD as a response to events during childhood. We learn coping strategies that continue through to adulthood, these can be unhealthy and damaging to those around us, but should not be seen as bad behaviour or attention-seeking. They should be seen as maladaptive, but protective. For example, alcohol can, in the short term, calm a chaotic mind and avoidant behaviour can avoid facing challenging emotions.  If we understand EUPD as a response to trauma rather than a fixed disorder, diagnosis could become less about labelling and more about understanding.   Photo by Vie Studios on Pexels 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.