Why Do Antidepressants Fail For Some?

Author Article

Serotonin is the chemical messenger that has a major impact on feelings of happiness and wellbeing.

Scientists have long suspected that disruption in serotonin brain circuits is a key factor in major depressive disorder. Selective serotonin reuptake inhibitors (SSRIs) are a significant class of drug that seeks to remedy this disruption by increasing serotonin levels at nerve junctions.

However, for reasons that have been unclear, SSRIs do not work for around 30 percent of people with major depression. Now, researchers from the Salk Institute for Biological Studies in La Jolla, CA, and the Mayo Clinic in Rochester, MN, may have solved the mystery.

A Molecular Psychiatry paper describes how, by studying cells from hundreds of people with major depression, the team uncovered differences that could explain resistance to SSRIs.

“These results,” says senior study author Fred H. Gage, who is president of the Salk Institute and also a professor in their Laboratory of Genetics, “contribute to a new way of examining, understanding, and addressing depression.”

He and his colleagues believe that their findings also offer insights into other psychiatric illnesses that involve disruption of the brain’s serotonin system, such as schizophrenia and bipolar disorder.

Depression and nerve cell response to SSRIs
Depression is a leading cause of disability that affects all ages and contributes in a major way to the “global burden of disease,” according to the World Health Organization (WHO). The United Nations agency estimate that there are around 300 million people worldwide living with this widespread psychiatric condition.

In the United States, the National Institutes of Health (NIH) suggest that in 2017 around 17.3 million adults, or 7.1 percent of all adults, reported having “at least one major depressive episode” in the previous 12 months.

The FDA approve esketamine nasal spray for severe depression
The FDA approve esketamine nasal spray for severe depression
U.S. regulators have approved a prescription nasal spray for the treatment of depression that does not respond to other drugs.
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For the recent study, the scientists took skin cells from more than 800 people with major depression and turned the cells into stem cells.

They then coaxed the stem cells to mature into “serotonergic neurons,” which are the nerve cells that make up the brain circuitry for producing and using serotonin.

The team compared serotonergic neurons of “SSRI non-responders” with those of “SSRI responders.” The non-responders were those individuals with depression whose symptoms showed no improvement, while the responders were those whose symptoms showed the most dramatic improvement to treatment with SSRIs.

In previous work, the researchers had demonstrated that cells from SSRI non-responders had more serotonin receptors, causing them to overreact to the chemical messenger.

Structural differences in nerve cells
The new study explored a different facet of SSRI non-response at the cell level. It found no differences between SSRI responder and non-responder cells in terms of the biochemistry of serotonin. However, it did reveal some fundamental structural differences in the cells.

These differences were in the shape and growth of neurites — or projections — that carry signals to and from nerve cells.

The development of the nervous system relies on tight control of neurite growth. Disruption of this process, according to a 2018 study, can lead to “developmental and neurological disorders.”

The team found that the nerve cells of SSRI non-responders had much longer neurites than those of SSRI responders. Genetic analysis also uncovered much weaker expression of the genes PCDHA6 and PCDHA8 in the non-responder cells.

These two genes belong to the protocadherin family and play a key role in the growth and formation of nerve cells and brain circuits.

When they silenced PCDHA6 and PCDHA8 in healthy serotonergic neurons, the researchers found that these also grew unusually long neurites, just like the nerve cells of SSRI non-responders.

Having neurites of the wrong length can disrupt communication in serotonin brain circuits with some regions having too much traffic and others not enough. This could explain, says the team, why SSRIs sometimes fail to treat major depression.

“This paper,” Prof. Gage concludes, “along with another we recently published, not only provides insights into this common treatment but also suggests that other drugs, such as serotonergic antagonists, could be additional options for some patients.”

The team now intends to take a closer look at the role of the two protocadherin genes in SSRI non-responders.

“With each new study, we move closer to a fuller understanding of the complex, neural circuitry underlying neuropsychiatric diseases, including major depression.”

Prof. Fred H. Gage

How to Boost Your Sex Drive When You’re on Antidepressants

Author Article

According to the American Psychiatric Association, about 1 in 9 Americans are currently taking antidepressant medication, and this number is said to be steadily rising. While there is absolutely no shame in taking prescribed medication to alleviate depression, for many (myself included), the side effects can make other areas of life, well, sad.

One of those side effects? Sexual dysfunction. Not only is sex a key way to build intimacy in our relationships, it’s pretty great for improving our moods by releasing a slew of feel-good hormones. And not to mention, it’s also really freakin’ fun. But if you’re struggling to get in the mood or climax because of your medications, don’t worry. You’re not alone, and there are a few things you can do to boost your sex drive and life back up.

1. Take CBD

CBD, or cannabidiol, is a compound found in hemp, hops, and marijuana that’s nonpsychoactive, meaning it won’t get you high. While I still take two antidepressant medications daily, I never leave home without my CBD staples: select vape pens, topical rubs, and Pro tincture oils from Receptra. CBD takes the edge off of anxiety, gently guides me to sleep, and even relieved some my post-op pain after a recent surgery all without the psychoactive properties of weed itself.

In addition to transforming my mood, CBD has also benefited my sex life, too. Three spritzes of Karezza’s In the Moment plant-based mind and body elevation oral spray 15 to 20 minutes before being intimate kicks my drive up a few notches. The spray’s unique blend of CBD from organic, full-spectrum hemp oil plus a multitude of traditional arousal-enhancing herbs, adaptogens, and essential oils is formulated to promote relaxation and fires up my senses. It helps me turn my mind off and truly enjoy myself, taking intimate experiences to the next level.

2. Get Sweaty

If your libido is a bit low, try hitting the gym, yoga mat, or sign up for a kickboxing class. It’s well-known that exercise helps to significantly reduce stress and improve your mood by producing feel-good endorphins and lowering cortisol levels, both of which are necessary for a healthy sex drive. But there are even more benefits to your sweat session. A study by the University of Texas demonstrated that “exercise enhances physiological sexual arousal in women.” Looking and feeling your best boosts your self-confidence, and when you feel good, you’re much more open to being intimate and exploring your sexuality.

3. Communicate With Your Partner

Open communication is one of the best things you can do to increase satisfaction and pleasure during sex, so speak up! Sex doesn’t have to be taboo anymore. Try talking to your partner about what you like, what typically gets you to climax, and how they can help get you there. It takes two to tango, so you both should feel equally satisfied during your intimate times together. Feeling comfortable and supported is necessary to letting go under the sheets.

4. Experiment and Explore

Want to take your intimate time to the next level? Have more fun, because, yes, sex should be fun! Stuck in the same rhythm and routine? Switch it up and try something new! Whether it’s perusing a sex shop together for new toys, donning lingerie, or even moving it outside the bedroom (kitchen table, anyone?), changing up the norm adds an element of excitement and can help relieve pressure on the act itself — which leads to more pleasure for you both.

5. Talk to Your Doctor

If you’re finding that your sex drive is still in a dip or you’re still experiencing more lows than highs, it’s time to chat with a health professional. Schedule an appointment with your doctor, therapist, or psychiatrist ASAP. It’s important to be honest with your doctor about what’s going on with your lifestyle so they can offer solutions catered to your needs. Feeling comfortable with your mental health team is key to recovery, health, and happiness.

Image Source: Getty / svetikd

 

10 Common Signs And Symptoms Of Depression—And When To Get Help

See Author Article Here
By Hallie Gould

According to the National Alliance on Mental Illness, approximately 18.5% of adults in the United States experience mental illness every year. That’s a significant portion of our population—one in five people—yet the stigma and misunderstanding that surround mental health remain. If you are feeling symptoms of depression, talk to your doctor to learn more about treatment options.

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PHOTO:

STOCKSY

 

We throw around the phrase “I’m depressed” to describe a stressful situation at work or the end of a relationship. But just like the word “crazy,” for which the etymology has shifted over time, depression can often be mistaken for a way to characterize an emotion rather than a mental health issue. It trivializes those who suffer from the disorder, a real chemical imbalance that creates negative and difficult circumstances beyond our control.

Because it all can seem convoluted, the definitions melting into each other, it’s often challenging to know when to seek help. “Treatment should be sought for depression when the symptoms are interfering with the quality of your life,” says therapist and mental health expert Scott Dehorty, LCSW-C. “Depression is treatable, and there is no reason to suffer in silence.”

To get a better understanding of the hallmark symptoms of depression, I reached out to two experts for their opinions and advice. Below, they detail 10 different, common warning signs to look out for. Keep reading for their thoughts.

Next Steps: 

“Any of these symptoms can occur with any of us at any given time, and that can be completely normal,” notes Lindsay Henderson, Psy.D., a psychologist who treats patients virtually via the telehealth app LiveHealth Online. “But if you are experiencing more and more of these symptoms, or they are growing in severity, start paying a bit more attention to how you are feeling overall. If you notice that these symptoms are impacting your overall functioning, it may be time to seek professional help. The good news is that help can come in many forms and individuals have options for how they address their mental health.”

We know that things like social activity, healthy eating, good sleep, and regular exercise all directly contribute to a healthier mood. If you notice yourself experiencing symptoms of depression, take a look at your daily routines and overall physical health to identify areas that can improve. “It can be beneficial to engage in therapy and talk with a mental health professional about what you are experiencing,” says Henderson. “Not only can a therapist help assess and diagnose the experiences you may be having, but they can also offer tips and tools to better understand, manage, and cope with the many complex emotions you feel.”

Here’s the thing: We know the idea of finding a therapist and getting to appointments can be overwhelming. Online therapy can be a wonderful way to break down many of the barriers that can get in the way of accessing therapy, as the appointment can take place wherever you feel most comfortable. Talk to your doctor to make the best plan for you and seek out an appointment with a psychiatrist. Your doctor may talk with you about the pros and cons of taking medication, which can be particularly helpful with depression and anxiety, but not for everyone. It’s best to talk first with a professional about your options before making any decisions.

Five Enlightened Ways To Think About Mental Health

See Psychology Today Article Here
By Hilary Jacobs Hendel 

It’s time to eradicate stigmas.

Life is hard even under the best of circumstances. Without physical and mental health, it’s difficult to enjoy life and to thrive. It makes good sense to take care of ourselves and that includes getting help when we suffer physically or psychologically. When we feel sick we get ourselves to the doctor. And when we feel so bad that we think about hurting ourselves or others, or when we cannot engage positively in work or in relationships, or we cannot accomplish what we want, we should seek help to feel better. That is what all of us deserve.

Mental health shouldn’t be a dirty word. Still damaging stigmas prevail allowing ignorance to end lives. Judging others or ourselves for our suffering is just plain harsh, not to mention counterproductive. When was the last time telling a depressed person to “get over it” worked? Try never! And using shame as a tactic to “encourage” someone to be what you think they should be only adds to a person’s suffering.

Mental health problems should be thought of no differently than physical health problems. In fact, they are completely related: mental health problems affect physical health and physical health problems affect mental health. We need a world where no one feels embarrassed or ashamed about their suffering. We need a world where suffering evokes only kindness, compassion, and a desire to help.

Here are 5 enlightened ways to think about mental health:

1. Everyone suffers.

I have never met anyone who is happy and calm all the time. It’s just not possible, no matter how good someone’s life looks like from the outside. Most people suffer at some point in their life from anxietydepressionaggressionPTSDshamesubstance abusedisorders, and other symptoms. And, if a person is lucky enough to never suffer psychologically, they surely love someone who does suffer in these ways. Instead of living lives of quiet desperation, to paraphrase Henry David Thoreau, let’s encourage honest talk. If someone gets uncomfortable with honest talk, we can talk about that too.

2. Mental health checkups are an important part of wellness.

Do you feel ashamed when you go for a check-up at your internist? Probably not. On the contrary, you’re likely to feel proud that you are taking care of your health. Yet most people are ashamed to call a psychotherapist for a consultation. This makes no logical sense. A mental health checkup is a great idea especially if you are suffering and not able to function the way you want. You should feel very proud for taking care of your mental health.

3. Gym for the brain.

That’s exactly how I describe therapy for my patients who come in feeling bad that they “have to come to therapy.” In our society, we praise people for working out at the gym. We think of them as maintaining their health and taking good care of themselves. Well, that’s no different for a person wanting to enhance their psychological wellbeing. Therapy grows new brain cell networks, calms the mind and body, makes it easier to meet life’s challenges, and helps us thrive as we become the best versions of our self that we can.

4. Education in emotions is a game-changer.

We live in a challenging society because it is not very nurturing. That’s why rates of anxiety, depression, and substance abuse disorder have skyrocketed. According to a new disturbing report from the CDCsuiciderates are steadily increasing. At the very least, our society could provide an accessible and understandable education on emotions. This would help us all understand how our childhood experiences translate to directly affect our adult mental health (for better and for worse). Emotion education debunks myths like “emotions are just for weak people” and we can control our suffering with “mind over matter.” Our schools should be teaching us trauma-informed tools like the Change Triangle. Our educational institutions should be teaching skills for managing relationships and interpersonal conflicts constructively so bullying, for example, would become a thing of the past. Parents should be taught about emotions so they don’t unwittingly create shame and anxiety in their children. Education on emotions and how emotions affect the brain, body, and mind depending on how we work with them, has great power to change society for the better and even reverse the current epidemic in depression, anxiety, and addictions.

5. Question assumptions, judgments, and fears around mental health and mental illness.

Many of us fear difference. When people feel, act or look different than we do, we tend to judge them. Judgment, while a form of misguided emotional protection achieved by distancing ourselves from those we fear or don’t understand, is destructive for all of us. Judgment is the basis of stigma and justifies the horrible way we treat people who suffer mental illnesses and substance abuse disorders. Judgment shames those who suffer, and that is all of us. No wonder shame-based depressions are rampant in our society. Instead of judging others for emotions and suffering, can we instead be curious about our assumptions and question where we learned to judge or fear people who struggle psychologically?

Most suffering can be eased with support, proper treatment, and a variety of resources. Let’s be proud to grow our collective and individual mental health. What a difference it makes to wholeheartedly say to someone seeking help, “Good for you! I could use some help for myself too!” Because we all can.

Which Mental Illness Is Most Disabling?

Psychology Today Link Here

While there is no consensus on the exact definition of disability (especially psychological disability), there is greater recognition these days that, like physical disease, psychological conditions can cause functional impairment and dysfunction—some more so than others. In a paper, published in the November issue of Social Psychiatry and Psychiatric Epidemiology, Edlund et al. conclude that among the 15 mental health conditions examined, mood disorders (e.g., depression) are associated with the greatest functional impairment and disability.1

The Mental Health Surveillance Study
Data for the present research came from the Mental Health Surveillance Study (MHSS). The MHSS is a sub-sample of 2008-2012 National Survey on Drug Use and Health (NSDUH), an annual survey of non-institutionalized US civilians 12 years or older. MHSS, however, includes only individuals aged 18 and over.

For the Mental Health Surveillance Study, researchers conducted phone interviews with participants, utilizing the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV-TR. Of the original NSDUH 2008-2012 sample of 220,000 adults, 5,653 completed the MHSS interview (48% men; 67% White, 14% Latino/Hispanic, and 12% Black).

Using these interviews, researchers attempted to determine if participants met the criteria for any of the following 15 psychiatric conditions:

Mood disorders (major depressive disorder, mania, and dysthymic disorder), anxiety disorders (post-traumatic stress disorder, panic disorder, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, and generalized anxiety disorder), alcohol use disorder, illicit drug use disorder, intermittent explosive disorder, adjustment disorder, and psychotic symptoms.

Other conditions (e.g., eating disorders) were not examined because of their low prevalence in the sample.

Three measures of disability
Functional impairment was assessed using three measures (modified for this investigation):

Global Assessment of Functioning (GAF)
Days-out-of-role (DOR)
World Health Organization Disability Assessment Schedule 2.0 (WHODAS)
Scores for GAF range from 0 to 100 (higher means better functioning). GAF scores are based on both functional impairment and symptom severity (whichever happens to be worse).

StockSnap/Pixabay
Source: StockSnap/Pixabay
Unlike GAF, which is determined by clinical judgment and thus has a subjective element, WHODAS and DOR are based strictly on objective criteria and the patient’s responses.

DOR measures the number of days in the past year when an individual could not function at all because of mental health issues.

WHODAS assesses cognitive abilities (e.g., memory, concentration), social relations, social participation, self-care, and ability to do one’s duties (whether related to work, home, or school). In this study, a 0-24 score range was used, with the higher score meaning worse functioning.

Mental illness and disability: Results
Descriptive statistics revealed the sample’s average…

GAF = 74.1 (median 75)
WHODAS = 3.5 (median 1)
DOR = 6.7 (median 0)
Researchers performed a series of regression analyses, and concluded that among 15 mental health conditions, mood disorders were associated with the greatest functional impairment; anxiety disorders, with intermediate functional impairment; and substance use disorders, with less functional impairment.

For instance, in the fully adjusted model, the greatest decrease in GAF scores was seen in psychotic symptoms (22), followed by depression (16), and mania (13). In WHODAS modeling, mania (9), depression (6), and social phobia (5) had the largest coefficients. And, in the final analysis, only depression, adjustment disorder, and panic disorder, had a significant association with DOR.

These results are comparable with those of a 2007 study, which also included a nationally representative sample, used DOR, and employed similar statistical methods. In that investigation, mood disorders resulted in higher days-out-of-role than most other disorders examined.2

Commentary on use of disability measures
Aside from suggesting that mood disorders are associated with the greatest disability among conditions examined, the present investigation highlights the importance of using multiple measures in determining disability.1

Employing a single measure paints a misleading picture. For instance, as mentioned above, the median value for days-out-of-role was zero. Indeed, 70% of participants with one mental disorder, and over half of those with two disorders, had zero days-out-of-role. Only 3/15 disorders were statistically linked with DOR scores (8/15 with WHODAS; all 15 with GAF).

Therefore, DOR was the least sensitive of the three measures used. If we were to rely only on days-out-of-role numbers, we would miss significant dysfunction and disability.

darkerstar/Pixabay
Source: darkerstar/Pixabay
While GAF is likely the most sensitive of the three measures, it does not always assess functional status. As mentioned, GAF scores depend on functional impairment and symptom severity; when there is disagreement between the two values, GAF score is determined by the worse of the two. For instance, if symptoms are severe but functioning is okay, GAF scores will still be low.

Thus, it is important to use complementary measures of disability; doing so allows clinicians to achieve greater accuracy in determining a patient’s needs and in monitoring a patient’s progress. Use of complementary measures can also inform public policy and resource allocation. Physicians, politicians, and the public cannot make informed decisions about how to improve functional impairment if they fail to recognize disability in the first place.

Great Blogs For People With Mental Illness

Hi guys, so I wanted to compile a little collection of blogs out there that are about and/or for people with mental illness.

You can never have too many resources at your disposal.

12 Great Blogs for People With Depression

The Best Mental Health Bloggers You Need to Follow

8 Inspiring Blogs to Read Whenever You Feel Alone

Hope your Mondays were AMAAZING!

The Pain Will End, But You Will Not

*just keep swimming*
^Reblogged from

When people talk about mental illness, they always say people who are struggling need to reach out, but when you are struggling, reaching out can feel impossible. Reaching out can be the last thing you want to do.

There is an expectation that when someone is struggling with self-harm, suicidal thoughts, etc., it is their responsibility to reach out and tell someone.

But what happens when you’ve reached out time and time again, only to be met with criticism? What happens when you’ve reached out time and time again, only to be met with fear? Only to be met with anger or misunderstanding? What happens when reaching out isn’t helpful?

Telling someone about your struggles is difficult. You never know what reaction someone is going to have, and when you’ve had a negative reaction before, reaching out again seems even more difficult than before. It feels like a risk.

When you reach out to someone and don’t receive the help you need, remember these things:

You are important.

You are worth it.

No one is perfect.

Sometimes, people do not understand what you are going through. You will not always be met with perfect responses. People may make you feel broken or like a burden, but you are not. People might make you feel guilty for feeling what you feel, but you are only a human being.

Someone else’s inability to be there for you in a healthy way does not mean you are not worth it or cared for.

Needing to be reminded of your worth is okay. Needing to have someone hold your hand on the hard nights is okay. Needing people is okay.

Having needs is okay.

You are in a fight that feels like it’s never going to end, but it will.

Rain stops.

Snow melts.

Mountains crumble.

Walls can be broken down.

The pain will end, but you will not.

Suicide Attempt Survivors Speak: On Trying Again.

New Posts To Come! Preview For Tomorrow’s Post.

Tomorrow’s Snowboarding & Suicide Series will focus on what sort of internal conflicts or just what it is like for different people and their different failed suicide attempts. In this instance, it happens to be mine. I was sort of blasé about then situation (hence the featured image). I do not want my own experiences, perceptions, and general emotional opinion on the situation to overshadow those of other.

There is no black & white when it comes to depression & suicide. These things can appear different to everyone. Before publishing my own take on what it is like to have survived a suicide attempt, I wanted to share some resources that provide different points of view around the situation & some extra resources.

No one’s experience is “right” or “wrong” when it comes to any aspect of mental illness. This is no exception.

41 Secrets Of Suicide Attempt Survivors

7 Things I Learned After My Failed Suicide Attempt

After A Suicide Attempt, The Risk Of Another Try
*This one is pretty important, about 2 weeks after the first attempt. I was extremely close to trying again. Dangerously close. Don’t make the mistake I almost did.

 

 

Suicide Flashbacks

This fucked me up. It is almost an actual play-by-play of my failed suicide attempt. Except I got the cap off, & nothing fell on the floor. Dramatics are on point.

Now with the antidepressants having done some good, seeing this is really screwing with me. I can see the stress I saw in my boyfriend’s eyes, the almost word-for-word dialogue before he carried me to the bathroom, the reality of how she really isn’t just screwing around. That’s me.

I promise new Snowboarding & Suicide Series posts are on their way.  I was working on one when I saw this, & I need a minute. Dab pen time.

02 Snowboarding & Suicide Series: Identifying Depression (How It Took A Suicide Attempt To Show Me I Was Depressed)

*Just some of the symptoms of depression.
I always recommend doing some research yourself because depression looks different to each person.

Depression is a fickle bitch and her face looks different to everyone she meets. Sometimes you don’t even know her real name until she is eating at your table and sleeping in your bed. Sometimes she is loud and the center of attention… locking you in your room and cutting all ties, chaining you to the bed. Sometimes she is like a mom that pretends she’s cool and hip but really can’t let loose. Always nagging at you if you do anything that might be off the beaten path. Whether she restrains or reminds you, she is there.

It turns out I have high-functioning depression.


I really don’t know how I didn’t know I was so depressed at the point of killing myself. I have a B.S in Psychology, I am in Psi Chi – the International Honor Society in Psychology.. I scored in the top 1% in the nation on my Psychology exit exams and have some internship and doctorate training in Clinical Neuropsychology under my belt. This is kind of my thing. I had no idea how bad my mental state had gotten.

I have always had high-functioning anxiety, and some episodes of depression, but I was always convinced that I didn’t need antidepressants or anything – but my xanax is always by my side.

I was able to hold down a job, and manage to get through each day good enough to make myself believe that I was fiiiiiine. Sure, I had no sex drive, didn’t get out of bed if I didn’t have work, barely slept and didn’t do a goddamn THING unless I took a piece of my (prescribed) Adderall. I was getting by.

Why wouldn’t I be anything but happy?
I was number 1 in sales, case commissions, and wine club sign ups for 5 straight months. I was living in Oregon with my amazing boyfriend and our dog child. I was financially secure & had a great support system. What is there to not be happy about?

The thing I didn’t realize until after I tried to kill myself was that it was not that I wasn’t happy… I was numb. Going through the motions. I felt nothing at all. That’s why swallowing the pills and the actuality of how close I was to dying never really sunk in. It didn’t it even feel like it was me that tried that. TOTAL DETACHMENT. I just got back to my life as though it didn’t happen. My boyfriend knew better than to push it but I knew he was worried. Things had to change soon & I knew that, but where do you go when you can’t even grasp the heaviness of the situation and feel any emotion towards it?

The moral of the story is to check in with yourself. Yeah, some stuff in life is going to suck because that is just how it goes. But this shouldn’t be the norm. If you notice that shit that used to get you all excited sort of has a blunt affect then maybe do a little reflecting on how things are going in general.

Laziness, and regular tiredness are not the same as not showering or leaving your bed for three days with the excuse that they are your days off. Every daily situation shouldn’t feel like a hassle you want to escape from, I didn’t realize that wasn’t normal until the Lexapro finally kicked in and I actually had an enjoyable time GETTING HEALTH INSURANCE yesterday. Enjoyable and Health Insurance usually aren’t in the same sentence. That was eye-opening.

Regularly check in with yourself, your habits, and your feelings.