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Narcissists are self-involved and thrive on bringing everyone around them down in order to build themselves up. Despite any other indication, their effort to do so is not actually vindictive, though many of their behaviors will be. Adults who are narcissists typically grew up in a household where adults where narcissists and the pattern can be traced back. Crippling low self-esteem drive the narcissist to exact their own childhood revenge on their children, tying the way they love and validate their children into an extension of themselves. Rather than love and appreciate children for the unique individuals that they are, a narcissistic parent uses shame, guilt, anger, humiliation, and manipulation to try and turn children into who the narcissistic parent wants them to be. As a result, children who are raised in a narcissistic home grow up understanding that love is conditional. If you satisfy the narcissistic parent, you might earn their love and adoration. If you don’t, you won't’.

It is a remarkable and wonderful feat of technology to be developing the field of telehealth or e-therapy. Everything from chat rooms, smart phone apps, and artificial intelligence “bots” on social media messaging platforms are providing proven therapeutic techniques to those in need. Therapy is not accessible by everyone and can still be effective when it is not done in person- depending on the diagnosis. New research suggests that for binge eating disorder, in person therapy is the most effective in promoting remission. Published in JAMA Psychiatry, the University of Leipzig Medical Center found that “...while an internet-based self-help program did help people binge eat less often, face-to-face therapy led to a larger and faster reduction in binge eating episodes,” reports Reuters. In person therapy proven to be the most effective of binge eating disorder includes cognitive behavioral therapy and traditional psychotherapy. Though the online therapies being offered are based on cognitive behavioral therapy, they are not the same as cognitive behavioral therapy which can be conducted in person by a professional therapist. Binge eating disorder is the most common of eating disorders and one of the only eating disorders more heavily populated by men. Though the diagnosis is new to eating disorders, the experience of uncontrollable eating is not new to those who have been struggling with it. This study proves that spending time in a treatment program where you can work with a therapist, multiple therapists, in person every day is a better chance at full recovery. In addition, there is another face to face component of treatment that is helpful for recovery: supporting peers.

Many of the world’s most famous creatives struggled with mental health issues. Often the existence of their mental health as a contributor to their creativity is overlooked because their struggles become just another part of the glamorized story of their lives. When they pass because of alcoholism, drug addiction, or suicide, they are immortalized through their memory as an artist. What people are quick to forget is the fact that behind the creativity and perhaps the fame was an individual, a human being like anyone else, who was struggling with mental illness. The Big Think examines the relationship between creativity and mental illness. A 1931 study, the article cites, interviewed over 800 well known creative “geniuses” at the time and found that a small percentage, the minority, of participants had no struggles with mental health. Recent research supports the finding. Bipolar disorder, for example, is highly correlated with high intelligence and creativity. A screening of over 700,000 teens in Sweden, the article explains, found that “exceptionally creative” teens were four times more likely to have bipolar. Other studies have found that people who are highly creative are highly likely to have bipolar disorder or another personality or mood disorder. Writers are the most likely to struggle with a severe mental illness like anxiety, depression, or schizophrenia. Additional research has found a scientific link through neuroscience. Though many of these studies point to a correlation, the article points out, none draw a definitive line of causation. Creativity and mental illness may be linked, which is why creative and expressive art therapies are helpful in mental health treatment. The mind is full of genius, finding ways to express itself other than words. Music therapy, art therapy, drama therapy, dance therapy, and other creative forms of therapy help clients express what they might not otherwise be able to express. Creatives in the spotlight who struggle with mental illness use their gift of creative talent to communicate a human experience that cannot be understand by anyone else other than those who also struggle. Yet, with their music, their art, their creativity, they are able to spread awareness, touch lives, and make an impact. Still beneath the surface they are people struggling with challenging symptoms in need of understanding, love, and care.

When you are given a mental health diagnosis you gain a new part of your identity. There is specific parts of that language to pay attention to. You gain a new part of your identity. When you are given a mental health diagnosis you do not gain a new identity. Often in mental health treatment and recovery we encourage people to work against the shame and stigma that comes from mental illness by telling them, “You are not your diagnosis”. Some people, however, embrace that identity. After struggling for years of their lives to understand what is going on with the state of their mental health, they are relieved to have a title. These individuals beat themselves up, shame themselves, and live by the stigma they have been given just for being different. Whatever shame and stigma comes with their specific mental health diagnosis, it doesn’t matter to them. Within the community of having a mental illness, being mentally ill, and meeting people with their specific diagnosis, they find belonging. The identity doesn’t wear them down, it helps build them back up. It’s a matter of person-first or identity-first language. Person-first language is saying “I have mental illness”. Identity-first language is saying “I am mental illness.” However, the language and name of mental health disorders complicates this. For example, you might say “I have narcissistic personality disorder” or “I am narcissistic”. Most often, however, the title appropriated is “They are a narcissist.” Yet, in comparison, someone with an anxiety disorder it wouldn’t make sense to say “I am anxious” because anyone can be anxious. They can say “I have anxiety disorder”. In further comparison- “I am bipolar” versus “I have bipolar”, “I am depressed” versus “I have depression”. Part of the reason this language dichotomy falls short, like in the case of depression, is that mental illness can be remitting. People can and with treatment often do fall into remission from depression.

Scientific Reports recently reported on the effect that sugar has on depression. 8,000 adults were followed for two decades plus, 22 years total, following men specifically. Researchers found that high quantities of sugar in the diet, a whopping 67 grams of sugar a day, created a 23% higher likelihood for being depressed with clinical depression after the onset of the study. Participants would fill out a survey every few years about the state of their diets, dietary choices and their health. Additionally, the men in the study answered questions about their mental health, like the development of any depression or anxiety. Interestingly, despite the increase of mental health diagnoses, there were no clinical diagnoses pre existing at the time the study began. It took five years for researchers to see a change in trend. Men who ate the high quantities of sugar, like 67 grams of sugar per day, were more often diagnosed with mental health disorders. Interestingly, when there were dietary changes, there was still a high prevalence of mental health disorder. This study might have answered an old ‘chicken or the egg’ inquiry in regard to sugar and mental health. Depression or anxiety does not cause a greater likelihood to consume sugar, but a high sugar diet might be creating depression and anxiety, which is then unchanged. Sugar is a stimulant substance which spikes the brain’s production of dopamine, much like drugs and alcohol does. Hyper and euphoric, the experience of consuming high amounts of sugar is a pleasurable one, until the sugar wears off. Sugar does create a spike in the experience of pleasure, but it creates a crash which takes all of the pleasure away. After producing such a strong amount of dopamine, the brain starts craving sugar immediately, to recreate that highly stimulated and euphoric experience. Spike and crash cycles eventually exhaust the brain, making it difficult to produce dopamine without sugar. This is how the cycle of substance use disorders start as well. The brain becomes dependent on a substance and cannot tolerate the crashes. It is possible that the constant presence of sugar creates an imbalance in the brain which contributes to the development of depression.

There’s no shortage of body shaming media available to consume and make yourself feel badly with. However, the world of the internet and the brave vulnerability of men and women have created a new movement in media that is “body positive” instead of body shaming. If the media you are looking at makes you feel like you are not enough, like you are meant to look like someone else, like the way you look is wrong in anyway, you are consuming the wrong kind of media. Images of bodies and the words used to describe those bodies should be empowering. Media about the human body should be all inclusive, positive, encouraging, and self-esteem boosting.

Post traumatic stress disorder and symptoms of trauma aren’t always obvious. If you’re misinformed about PTSD, you could be saying harmful things to someone who is struggling and needs your support.

What causes an addict or alcoholic in recovery to pause at the sight of temptation? It is something that people who have never lived with drug and alcohol addiction on a chemically dependent level can't understand. Addicts and alcoholics go through a lot of trauma in their addictions, due the addiction itself and trauma they face before. Addiction itself is a traumatic experience. Often, addiction is a manifestation of trauma- a self-inflicted, repetitive pain coupled with intrusive thoughts and compulsive behaviors. Coping with trauma often leads to substance abuse to numb the pain, quiet the thoughts, and bring some relief. After everything that addicts and alcoholics go through, it is baffling to others that they would consider picking up a drink or drug again The way addiction rewires the brain creates a lack of regard for consequence. Yet, in the face of consequence like trauma and temptation, the brain enters a paralysis. In the face of a threat- like encountering a traumatic situation such as sexual assault, or temptation like encountering an opportunity to use drugs and alcohol, there is a freeze. Despite months of treatment and therapy, building confidence and self-esteem, learning tools and techniques, there is a freeze. Some professionals refer to it as “victim paralysis”. During physical trauma, there is an inability to fight back. During temptation of substances, there is an inability to leave or say no. Acta Obstetricia Gynecologica Scandinavica published a study on a phenomenon they call “tonic immobility” which is the temporary paralysis experienced. Interestingly, the study found that the individuals most likely to experience the tonic immobility were also more likely to have experiences of mental illness symptoms afterward. PTSD and depression were likely to happen. Shame, guilt, and a toxic pressure to have acted differently, contributes to the development of symptoms of PTSD and depression which can, in turn, inspire more substance abuse, and further tonic immobility. Coping with the experience of not being able to make a rational decision, fight back, stand up to what isn’t right, or act on better knowledge is devastating. After recovery, especially, it can feel like all of the effort and work was worth nothing. That isn’t true. The research proves that tonic immobility is a real life psychological phenomena that is normal.

How many times do we tell ourselves we can’t do something, then prove ourselves right? We set up defeatist limits for ourselves all of the time. In a moment of clarity, perhaps what some might call hope, faith, or courage, we tell ourselves we can do something and- we do it. What changed? Our mental state did. There is no greater example of this than with people who come to recovery from drug and alcohol addiction. The prospect of having to go through withdrawals, detox from drugs and alcohol, then learn to live without them is dim when we are addicted. We tell ourselves a number of lies in order to avoid it. We couldn’t possibly survive. We can’t stay sober. We won’t be able to finish our treatment programs. We’ll just relapse and fail, disappointing ourselves and others. Then, in a moment of bravery and what many people call divine intervention, we tell ourselves we have to try, that we might be able to make it, and then we do. In one moment, we quit drugs and alcohol. Every moment from there on out, we keep changing our mindset to tell ourselves that we can do it, we can stay sober, and we can change our lives. Once we are in recovery, we learn how to keep an attitude of gratitude, maintain positivity, and use a number of little sayings to keep our outlook toward the future healthy. One day at a time, keep it simple, this too shall pass, don’t take yourself too seriously. All of these are reminders to keep our chins up and take life as it comes, recognizing that with each passing moment it is getting easier and easier to stay sober. Outlook is everything when we are in recovery. As soon as we slip into that familiar desperation, we are risking our sobriety.  The Sydney Morning Herald reported on a recent research experiment in which researchers found that optimism had an effect on physical strength. Six separate experiments examined more than 1300 people and how their outlook on the future affected them. Researchers compared the participants outlook on their future to their physical capabilities. Optimism, the researchers found, “was a ‘cornerstone’ of recovery”. Additionally, there is no one way to approach optimism. Across all the experiments conducted, researchers found that more clearly and concretely participants envisioned their future, the more successful their physical health. “...Our recommendation is that you do need to think about and plan for your future and the way you think about and imagine that future is important in terms of generating the optimism that is going to be successful in terms of pushing you through to a successful recovery,” the researchers explained.

You’re hungry, so you eat. You eat until you are full and then you stop. Sometimes, you might eat a little more than you really should. Feeling full, you might lament about the mistake you made eating so much food, wonder what you were thinking (or what you weren’t thinking) and vow not to do that again. It’s possible that you compensate. Maybe you take a pill, you change your diet the next day, or you spend extra time at the gym. This is all relatively normal. Now, take it to the extreme. You’re hungry and you start to feel paralyzed by anxiety that grows every time you get hungry. You get anxious when you’re hungry because you know there is a very real possibility that once you start eating you won’t be able to stop. You eat. Then you eat some more. You don’t stop eating until you feel so full you’re actually in pain. You don’t feel a little bit bad you ate so much. Intrusive and obsessive thoughts about what you’ve done, how horrible you are for doing it, and how you should punish yourself for it start to cloud your mind along with the euphoria of feeling so full. However, the euphoria is short lived because you are quickly consumed with overwhelming guilt which drives you to compulsive behavior. Instead of compensating in healthy ways like eating a bit healthier or going to the gym you purge. You purge because you have bulimia nervosa and this is it’s vicious cycle. Purging in bulimia nervosa can take many forms. Some people compulsively exercise, some people abuse laxatives, others induce vomiting. Researchers have tried for years to understand what compels someone with bulimia to participate in the behaviors they do. Recently, two studies in Journal of Abnormal Psychology gave some insight. A brain which has developed bulimia responds differently to triggers of stress with alterations in appetite and a disconnect in satiation. Meaning, people with bulimia have a hard time controlling their hunger and knowing when they’re full. Using MRI, one study found that the brains of people with bulimia have more reward circuitry when it comes to taste. Similar to the way an alcoholics is prone to a binge on alcohol after tasting their first drink, someone with bulimia is prone to a binge on food after their brain responds to the taste of it. As a result, people with bulimia eat beyond their capacity. Then compensate through controlling mechanisms because they feel they have been taken so out of control of their bodies.

The 12 steps of Alcoholics Anonymous were written in 1935 far ahead of our Western obsession with Eastern practices. The eleventh step of the twelve steps states “Sought through prayer and meditation to improve our conscious contact with God as we understood Him praying only for knowledge of His will for us and the power to carry that out.” The “12&12” literature describes meditation as a “step out into the sun” where “debate has no place”. “It helps to envision our spiritual objective before we try to move toward it,” the book explains, “And let’s always remember that meditation is in reality intensely practical.”

“That’s not good,” remarks main character Ellen in the highly controversial Netflix film To The Bone, as she steps off the scale in a morning weighing session at her residential treatment program. Ellen is portrayed by Lily Collins, an actress who has been open about her own struggles with eating disorders. The “not good” she is referring to is her very low weight, which is made obvious by her skin and bone structure. Ellen’s diagnosis is anorexia nervosa. Among all mental health disorders, anorexia nervosa has the highest rate of mortality. Heavy restriction and starvation deprives the body of the nutrients it needs, causing the body to take extreme measures for survival. Eating away at fat until the body eats away at muscle and bone, it will do whatever it has to do to gain its energy back and survive. The main character develops “furring”, a condition of anorexia in which the body starts growing extra hair in order to keep itself warm. Ellen is troublingly skinny. Her anorexia nervosa has gotten extreme and at one point in the movie she is on the brink of having a feeding tube. She also passes out and turns down food when it is offered to her after. Unfortunately, to movie viewers, Ellen is the stereotype of anorexia. She is caucasian, pretty, a female, and comes from a middle to upper class family. In her treatment, there are representations of other bodies and genders with different types of eating disorders. However, as many different articles criticizing the film points out, Ellen’s character represents a small percentage of the way people with eating disorders look. They aren’t always that severe but because that level of severity is what the media chooses to portray, that’s what millions of people believe they have to look like in order to be considered “sick”. One of the most dangerous statements people unknowingly make to someone who opens up about having an eating disorder is, “You don’t look like you have an eating disorder.” If you ask  said person just what an eating disorder is supposed to look like, you would probably get a description of someone like Ellen- emaciated and “to the bone”. Not all eating disorders cause severe weight loss. Bulimia nervosa doesn’t typically contribute to weight loss. Binge eating disorder causes weight gain. Orthorexia is focused on maintaining a “healthy” body. Mild to moderate cases of anorexia might not include severe weight loss either. Part of the problem with this stigma is that the non-severe eating disorders can be hard to find treatment for, despite the chronic stress one experiences mentally as well as physically.