Category: Treatment Therapies

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How to Deal With Depression: 9 Proven Recovery Methods

Depression can feel like an invisible weight, making even the simplest tasks seem overwhelming. If you’re wondering how to deal with depression, you’re taking an important first step—and effective help is available. 

Recovery from depression is entirely possible through a combination of professional treatment, self-care strategies, and support from others. Here, we outline 9 proven strategies that have helped countless people living with depression reclaim their mental well-being. 

Illustration featuring the quote 'Depression tries to convince you that you’re the storm — but you’re really the one weathering it,' with an image of a sad person standing under rain, imagining an umbrella.

1. Understand the Condition: Recognizing Depression’s Impact

Depression is a common and serious mental health condition that affects how you feel, think, and handle daily activities. Globally, depression impacts 5% of the adult population1 and 13% of adolescents. Also known as major depressive disorder or clinical depression, it can cause persistent feelings of sadness, hopelessness, and a loss of interest in activities once enjoyed.

Adolescents can be especially vulnerable to depression due to hormonal changes, academic and social pressures, identity development, and increasing exposure to social media and cyberbullying. For teens, the prevalence of major depressive episodes2 was also higher among females at 29.2%.

Dr. Kay Redfield Jamison, a clinical psychologist and professor of psychiatry at Johns Hopkins University who has written extensively about her own experience with bipolar disorder and depression, shares in her memoir An Unquiet Mind:3

Depression is awful beyond words or sounds or images. It bleeds relationships, blanches pleasure, eats memory, peace and self-respect.

While it can be one of the most challenging mental health conditions, when we understand what depression is and other aspects, it can help support long-term and sustained recovery.

Infographic titled 'How to Start Small When You Have Depression,' featuring simple coping strategies like opening a window, drinking a glass of water, putting on clean socks, stepping outside for one minute, brushing teeth, writing down one feeling, playing one calming song, and sitting up in bed. Includes an illustration of a person sitting under a raincloud holding a checklist.

2. Assess Personal Risk Factors: Customizing Your Recovery Approach

Depression is a complex mental health condition that can affect individuals of any age, gender, background, or income level. However, certain factors may increase the risk of developing depression:​

  • Family history of mental illness or mental health problems: Individuals with a family history of depression or other mental disorders are at a higher risk of experiencing depression themselves. ​
  • Chronic medical conditions: Living with chronic illnesses,4 such as heart disease, can elevate the likelihood of developing depression.
  • Exposure to trauma: Experiencing traumatic events,5 especially during childhood, significantly increases the risk of depression.
  • Substance use: The misuse of substances6 like alcohol and drugs is closely linked to the onset and severity of depression.

Understanding these risk factors is crucial for early identification and intervention, which can lead to more effective management and treatment of depression.

How has managing depression—either personally or professionally—shaped your understanding of mental health and well-being?

As a trauma therapist, I’ve learned that depression often isn’t just a chemical imbalance; it’s a nervous system response to overwhelm, loss, or disconnection. Professionally, supporting clients through depression has deepened my belief that healing comes through safety, self-compassion, and co-regulation. It’s taught me to honor slowness and softness as valid forms of strength.

Amanda Stretcher, MA, LPC-S | Crescent Counseling

3. Identify Your Depression Type: Targeting the Right Treatment

There are several types of depression, each with distinct characteristics:

  • Major depressive disorder (MDD): Severe symptoms that interfere with daily life. MDD is characterized by a persistently low mood, anhedonia (loss of interest or pleasure), feelings of guilt or worthlessness, fatigue, and other symptoms that impair daily functioning.7 Diagnosis requires at least 5 symptoms present most of the day, nearly every day, for a minimum of 2 weeks. It’s one of the leading causes of disability worldwide.
  • Persistent depressive disorder: Long-term (2 years or more) symptoms that may be less severe but still disabling. This chronic form of depression8 involves a depressed mood lasting for at least 2 years in adults (one year in children and adolescents), accompanied by additional depressive symptoms that may not meet the criteria for MDD but still cause significant distress.
  • Bipolar disorder: Involves episodes of depression9 alternating with mania. Bipolar disorder includes episodes of depression alternating with periods of mania or hypomania. The depressive episodes share similarities with MDD, but the presence of manic symptoms distinguishes bipolar disorder from unipolar depression.
  • Postpartum depression: Occurs after childbirth. This type of depression occurs after childbirth, characterized by sadness, fatigue, changes in sleeping and eating patterns, reduced libido, and crying episodes. It’s more severe and longer-lasting than the “baby blues.”
  • Seasonal affective disorder (SAD): Related to changes in seasons, typically starting in the fall or winter. SAD is a subtype of depression10 that occurs at a specific time of year, usually in the fall or winter, and remits in the spring. Symptoms include low energy, hypersomnia, overeating, weight gain, and craving for carbohydrates.
Infographic titled 'Change the Script: Reframing Your Thoughts in Depression,' showing examples of shifting negative thoughts like 'I'm lazy' to 'I'm struggling' and 'I'm weak' to 'I'm surviving something hard,' alongside an illustration of storm clouds parting to reveal sunshine.

4. Monitor Your Symptoms: Tracking Progress for Effective Recovery

Persistent Feelings of Sadness or Hopelessness

This isn’t just “feeling down” for a day or 2. It’s a heavy, lingering sadness that doesn’t seem to lift, even when good things happen. You might wake up with a pit in your stomach or go to bed feeling like nothing will ever get better. Hopelessness can feel like your future has disappeared into fog.

Loss of Interest in Hobbies and Activities

Things that once brought you joy—music, cooking, hiking, spending time with friends—start to feel meaningless. You might force yourself to participate, but it feels like going through the motions. It’s not laziness; it’s as if your connection to pleasure has been cut off.

What treatment strategies or coping tools have you found most effective in reducing symptoms of depression and improving day-to-day life?

In order to effectively treat symptoms of depression, evidence-based treatment suggests engaging in behavioral activation. This is activating one’s brain through different activities, specifically geared towards enjoyable, valuable, and routine activities. When someone becomes depressed, there is decreased brain activity, so it is helpful for one to engage different parts of their brain through several types of activities. Will this cure depression? No, but this will help activate the brain into a non-depressed state for a temporary period of time, which, over time, will help to lift one’s mood overall.

Jennifer Chicoine, MA, LCPC | Peaceful Healing Counseling Services

Sleep Problems (Insomnia or Oversleeping)

You might lie awake for hours, exhausted but wired with worry. Or, sleep might become your escape, and even after 10–12 hours, you still feel tired. Either way, it disrupts your rhythm and makes the days feel even harder to face.

Weight Loss or Weight Gain

Your appetite may vanish entirely, or food might become a form of comfort. You may notice clothes fitting differently, but not care enough to do anything about it. These changes can be subtle or dramatic, but they often reflect deeper emotional shifts.

Fatigue or Low Energy

This isn’t just being tired—it’s like your body has run out of fuel. Even small tasks, like taking a shower or replying to a text, can feel overwhelming. It’s frustrating because you want to do more, but the energy simply isn’t there.

Difficulty Concentrating

Reading a book or following a conversation can feel like trying to think through fog. Your brain just won’t focus. You may find yourself rereading the same sentence or zoning out in meetings, which adds to feelings of guilt or inadequacy.

Feelings of Worthlessness or Guilt

You might start believing you’re a burden or that you’ve let everyone down. Even small mistakes can spiral into overwhelming self-criticism. These thoughts don’t come from truth—they come from depression distorting your self-image.

Thoughts of Self-Harm or Suicidal Thoughts

In the darkest moments, depression can convince you that the world would be better off without you. These thoughts are serious and require compassionate, immediate support. You’re not alone, and help is available—even if it’s hard to ask.

These symptoms must last for at least 2 weeks to be considered a depressive episode.
But if you’re experiencing even one or 2 of these symptoms persistently, it’s worth talking to a mental health professional. If you are having thoughts of self-harm or suicidal ideation or thoughts, please reach out for emergency medical care. You are not alone.

The 988 Lifeline is a resource for you at any time of the day, every day of the week.

5. Identify Root Causes: Understanding Depression’s Origins

Depression results from a combination of genetic, biological, environmental, and psychological factors. Common causes and risk factors include:

  • Imbalances in brain chemicals like serotonin
  • Traumatic life events or prolonged stress
  • Chronic medical conditions or pain
  • Substance use or withdrawal
  • Low self-esteem or negative thoughts
  • Family history of mental health conditions

What message would you share with someone currently experiencing depression who may feel hopeless or unsure about seeking help?

People often mistake sadness for depression. The capacity to feel sad when experiencing a loss of some kind is emotionally healthy. Sadness, like all emotions, has a rhythm of its own and will pass in time. Depression, however, is emotional constipation, i.e., being numb, detached, and unable to feel sad, and it is very responsive to a ‘laxative’, or treatment, such as psychotherapy. For someone who is unsure about seeking help, the best way to find a good therapist is to start by asking trusted friends and family if there is someone with whom they’ve had a good experience. I recommend that you get a few names and meet with those therapists until you find what feels like a good fit for you.

Avrum Weiss, PhD

6. Seek Proper Diagnosis: Working With Healthcare Professionals

A health care provider or mental health professional diagnoses depression by evaluating your symptoms, personal history, and mental well-being. Tools like the PHQ-9 questionnaire may be used, and blood tests may help rule out underlying medical conditions.

  • Self-report questionnaires: These are completed by the individual and ask about the presence and severity of depressive symptoms over a specific period (usually the past 2 weeks).  
  • Patient Health Questionnaire-9 (PHQ-9): This is a widely used, brief, 9-item self-report questionnaire. It directly corresponds to the DSM-5 criteria for major depressive disorder. It helps in diagnosing depression, assessing its severity (minimal, mild, moderate, moderately severe, severe), and monitoring treatment response. A score of 10 or higher is often used as a cut-off for indicating clinically significant depression. The PHQ-2, a shorter 2-item version, is often used as an initial screening tool.  
  • Beck Depression Inventory (BDI): This 21-item self-report inventory assesses the severity of depressive symptoms. Individuals rate the presence of various symptoms on a 0-3 scale. Higher total scores indicate more severe depression. It’s suitable for individuals aged 13 to 80 and has been validated across various populations.  
  • Center for Epidemiologic Studies Depression Scale (CES-D): This 20-item questionnaire was initially designed for use in the general population but is also used in primary care settings to screen for depressive symptoms. It asks about the frequency of symptoms in the past week, rated on a 4-point scale. It can be used for a wide age range, including children.
  • Edinburgh Postnatal Depression Scale (EPDS): This 10-item self-report questionnaire is specifically designed to screen for depression in women after childbirth. It asks about symptoms experienced in the past week.  
  • Geriatric Depression Scale (GDS): This scale is specifically designed for older adults (60 years and over). It is available in different lengths (e.g., 30-item, 15-item, and a shorter 4-item version) and typically uses a yes/no format for responses, making it easier for some older individuals to complete.  
  • Clinician-administered rating scales: These scales are administered through structured interviews conducted by a healthcare professional. 

Many behavioral healthcare providers use the DSM-5-TR to provide diagnostic criteria. For example, here is an example of the criteria for major depressive disorder.11

A diagnosis requires the presence of 5 or more of the following symptoms during the same 2-week period, with at least one of the symptoms being either depressed mood or loss of interest or pleasure: 

  1. Depressed mood most of the day, nearly every day
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day  
  3. Significant weight loss or weight gain (when not dieting or an increase/decrease of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day  
  4. Insomnia or hypersomnia nearly every day
  5. Psychomotor agitation or retardation nearly every day (observable by others.  
  6. Fatigue or loss of energy nearly every day
  7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day
  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
  9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning and not be due to the direct physiological effects of a substance or another medical condition.  

It’s important to note that while these tools are valuable for screening and assessing the severity of depressive symptoms, a diagnosis of depression should always be made by a qualified healthcare professional based on a comprehensive evaluation, including a clinical interview, the individual’s history, and the consideration of other potential medical or psychological conditions.

Screening tools help identify individuals who may need further evaluation and support from a trained medical or treatment professional.

7. Explore Treatment Options: Finding Your Path to Recovery

Psychotherapy (Talk Therapy)

  • Cognitive behavioral therapy (CBT): CBT is a widely used form of therapy that helps individuals recognize and change negative thought patterns and behaviors. It’s especially effective in treating mild to moderate depression and can prevent relapse. Research supports CBT as one of the most effective interventions for depression.12
  • Interpersonal therapy (IPT): IPT helps people improve communication and relationships, often disrupted by depression. It focuses on current interpersonal issues like grief, role transitions, or conflicts.
  • Behavioral activation: This approach encourages individuals to engage in meaningful activities to increase positive reinforcement and reduce avoidance, a common symptom of depression.

Medication (Antidepressants)

Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline are commonly prescribed and have been shown to relieve symptoms in people with moderate to severe depression.

The National Institute of Mental Health highlights that antidepressants can take 4-8 weeks to work13 and should be closely monitored by a healthcare provider.

Lifestyle Changes and Self-Care

  • Regular exercise: Exercise boosts endorphins and supports neurogenesis, or the growth of new brain cells. It can be as effective as medication for mild depression.
  • Sleep hygiene: Improving sleep routines can help stabilize mood and reduce depressive symptoms. Going to bed and waking up at the same time each day is a good place to start.
  • Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids supports brain health. Some studies suggest that dietary interventions may reduce depressive symptoms.

Social Support

  • Group therapy and peer support: Talking with others facing similar struggles can reduce isolation and increase motivation. Group settings also allow for shared coping strategies.
  • Family involvement: Involving supportive family members in the recovery process can improve outcomes and ensure a more stable environment.

Advanced and Emerging Treatments

  • Mindfulness-based cognitive therapy (MBCT): MBCT combines mindfulness techniques with cognitive therapy to reduce relapse in those with recurrent depression.
  • Transcranial magnetic stimulation (TMS): TMS uses magnetic pulses to stimulate areas of the brain associated with mood regulation. It’s FDA-approved for treatment-resistant depression.
  • Ketamine and esketamine (Spravato): These medications offer rapid relief of symptoms and are typically used when other treatments haven’t worked. They must be administered under medical supervision.

8. Practice Prevention Strategies: Building Mental Health Resilience

Can I prevent depression?

While you can’t always prevent depression, there are ways to reduce your risk. Building up protective factors can help build resilience for this condition. However, often times, treatment is needed for long-term recovery and positive outcomes.

These are a few healthy coping strategies that you can try:

  • Stay connected with a support group or loved ones
  • Manage stress through mindfulness14 or gratitude practices
  • Maintain a healthy lifestyle with regular exercise and good nutrition
  • Seek help early when experiencing symptoms
  • Avoid alcohol and drug use, which can worsen mental health

With proper treatment and support, most people recover from depression. However, it can be a recurring condition, and managing long-term well-being is key. Early intervention improves outcomes, and ongoing support can help prevent relapse.

9. Develop Daily Management: Living Well Despite Depression

When should I see my healthcare provider about depression?

Depression isn’t just feeling sad—it can affect every part of your life. If you’re not sure when to ask for help, here are some key signs it’s time to reach out to a doctor, counselor, or mental health professional:

You should see your healthcare provider if:

  • Symptoms last more than 2 weeks. Things like persistent sadness, fatigue, or loss of interest in activities you used to enjoy.
  • You’re struggling with daily life. This might look like trouble at work, in relationships, or just keeping up with basic self-care.
  • You have thoughts of self-harm or suicide. These thoughts are serious and deserve immediate attention. You are not alone, and help is available.

You are not alone. Many people—just like you—face depression. Healing is possible. And reaching out is a brave and important step toward recovery. Talk to someone you trust—a friend, pastor, or mentor—and let them know how you’re feeling.

Schedule an appointment with a primary care provider or therapist. You don’t need to have all the answers—just take the first step. Use support resources if you’re in immediate danger or need someone to talk to.

If this sounds like what you’re going through, take one small step today. Reach out to a professional or supportive friend. You are worth it. And help is just a conversation away.

FAQs

Q: What are the best ways to deal with depression?

A: Effective treatment for depression often includes a combination of therapy, antidepressant medications, physical activity, and support from loved ones. Working with a mental health professional can help you develop a personalized plan that addresses your specific needs.

Q: What triggers depression?

A: Depression can be triggered by a range of factors, including genetics, traumatic life events, chronic stress, substance use, medical conditions, and imbalances in brain chemistry, such as low serotonin levels.

Q: How to get out of depression naturally?

A: Some people find symptom relief through natural approaches like regular exercise, mindfulness meditation, healthy eating, sleep routines, and maintaining social connections. While these can be helpful, severe depression often requires professional treatment.

Q: How do you cope with a depressed person?

A: Offer support by listening without judgment, encouraging them to seek help, and being patient. Avoid trying to “fix” them. Suggest professional resources like a mental health provider or the 988 Lifeline.

Q: What are the symptoms of depression?

A: Common symptoms include persistent sadness, loss of interest, fatigue, changes in sleep or appetite, difficulty concentrating, and thoughts of self-harm or suicide.

Q: What are the different types of depression?

A: Types include major depressive disorder, persistent depressive disorder, postpartum depression, seasonal affective disorder, and bipolar disorder (which includes depressive episodes).

Q: What is the link between smoking and mental health conditions?

A: Smoking is more common among people with mental health conditions and may temporarily relieve stress, but it often worsens mental illness symptoms over time and is linked to higher rates of depression.

Q: What is substance use disorder?

A: Substance use disorder (SUD) is a mental health condition characterized by the uncontrolled use of substances, such as drugs or alcohol, despite harmful consequences. SUD often co-occurs with depression.

Q: When should I call my healthcare provider?

A: Call if you notice depression symptoms lasting more than 2 weeks, if they interfere with daily life, or if you or a loved one has suicidal thoughts.

Q: How can I help a loved one who is depressed?

A: Be present, listen with compassion, encourage professional help, and check in regularly. Avoid minimizing their pain. Share resources like the 988 Lifeline or a mental health provider.

Q: Can exercise help alleviate depression symptoms?

A: Yes. Studies show that regular physical activity boosts mood, reduces anxiety, and supports long-term mental health by increasing endorphins and serotonin.

Q: Are there effective self-help strategies for managing depression?

A: Yes. Journaling, setting small daily goals, practicing gratitude, and limiting social media use can support emotional well-being.

Q: Are there lifestyle changes that can help alleviate depression?

A: Yes. Healthy nutrition, consistent sleep, reducing alcohol and substance use, and nurturing social relationships can all help improve mental health and ease depression symptoms.

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How Do I Stop Being Codependent? 5 Expert-Backed Steps to Transform Your Relationships

How to stop being codependent.

Do you find yourself constantly putting others’ needs before your own? Are you the person everyone relies on, even when it drains your energy and emotional resources? You might be experiencing codependency—a pattern where your own sense of purpose and self-worth become tangled up in another person’s life and problems

Codependent relationships create strong emotional patterns. “Helping” people can become almost addictive, even though it leaves you feeling empty and exhausted in the long run. Breaking free from these patterns takes time. But with consistent effort, you can build a healthier relationship with yourself and others. 

Here are 5 key steps you can start taking now:

1. Recognize Your Codependent Patterns

The first step toward change is becoming aware of your codependent behaviors.1 Start paying attention to situations where you feel responsible for others’ emotions or problems. Notice when you automatically put someone else’s needs before your own or when you feel anxious about setting boundaries.

Try keeping a journal to track moments when you feel resentful, exhausted, or unappreciated. Look for the situations or relationships that typically trigger these feelings. You can ask yourself questions like: “Am I doing this because I want to, or because I’m afraid of the consequences if I don’t?” You can even use journal prompts for codependency to help.

Pro tip: Keep in mind that awareness doesn’t mean judgment. These patterns developed for a reason—often as ways to cope with difficult situations. Observing them with curiosity rather than criticism will help you make lasting changes.

Illustration featuring a quote that reads, “You shouldn’t set yourself on fire to keep someone else warm.” The image shows a distressed man surrounded by flames and a relaxed woman lounging under an umbrella, symbolizing the emotional toll of codependency and the importance of self-care.

What Is Codependency?

Codependency is not officially recognized as a mental illness, but it is taken seriously by mental health professionals, who define it as “an unhealthy devotion to a relationship2 at the cost of one’s personal and psychological needs.” It describes a relational pattern where you become so focused on the problems and needs of others that you neglect your own well-being. It’s more than just caring deeply—it’s when your emotional state, identity, and sense of purpose become excessively wrapped up in someone else’s life.

  • Codependency in Romantic Relationships: In romantic relationships, codependency can look like constantly sacrificing your own preferences, walking on eggshells to avoid conflict, or feeling responsible for your partner’s happiness. You might stay in unhealthy situations because you believe your love can “fix” the other person.
  • Codependency in Family Systems: Within families, codependency often appears as enmeshment—where boundaries between family members become blurred. You might feel obligated to solve everyone’s problems, shield relatives from consequences, or struggle to make decisions without family approval. This is often the case when one family member is struggling with substance abuse.3 
  • Codependency in Friendships: In friendships, codependent behaviors include being the perpetual advice-giver or emotional support while rarely asking for help yourself. You might maintain one-sided friendships because you feel needed, even when these relationships drain you.

How can you discover the signs of being codependent?

Codependency is often rooted in an attachment wound where the nervous system learned early on that safety comes from attuning to others, sometimes at the expense of self. It can look like feeling responsible for managing other people’s emotions while ignoring your own. Another sign is the feeling of unease or even panic when someone is upset with you, leading to people-pleasing or over-functioning in relationships. This can present as feeling tightness in your chest, a constant state of hypervigilance, or struggling to feel grounded in your own body.

Amanda Stretcher, MA, LPC-S | Crescent Counseling

2. Work on Building Self-Esteem

Codependency and low self-esteem usually go hand in hand. When you don’t value yourself, you might look for validation through helping others or staying in unhealthy relationships.

You feel good about yourself mainly when you’re helping others or when people need you. Instead of feeling relieved when a loved one says they don’t need your help, you feel hurt or like you don’t matter anymore.

Start building your self-worth by practicing self-compassion.4 Talk to yourself the way you would talk to a good friend—with kindness and understanding. Make a list of your positive qualities that have nothing to do with what you do for others.

Small acts of self-care also build self-esteem. When you treat yourself with respect—by keeping promises to yourself, taking time for activities you enjoy, or meeting your physical needs—you send yourself the message that you matter.

Pro tip: Daily affirmations can help you shift away from negative self-talk and toward a more positive sense of self. Simple statements like “I’m worthy of love and respect” or “My needs matter” can start to shift your perspective when you say them regularly.

Infographic titled “Common Codependency Behaviors,” showing eight heart-shaped rope loops with icons and labels: people-pleasing, lack of boundaries, excessive care-taking, fear of abandonment, low self-esteem, fixing instead of supporting, and ignoring your own needs. Visual metaphor emphasizes emotional entanglement in codependent relationships.

Why is boundary setting important in healing from codependency?

When it comes to codependency, one tends to slip away from autonomy, creating enmeshment with the enabler. Setting healthy boundaries, such as adopting and maintaining one’s own intellectual boundaries in a new relationship, is crucial for healing codependency. While maintaining codependency, and therefore not setting boundaries, one loses one’s own identity and essentially forgets how to behave independently due to the behavioral and emotional habits developed through the codependent relationship. Setting boundaries will contribute to an increased sense of self, more confidence, and may even decrease anxiety or depressive symptoms, which can significantly enhance the relationship as a whole.

Jennifer Chicoine, MA, LCPC, CCTP | Peaceful Healing Counseling Services

3. Set and Enforce Healthy Boundaries

Boundaries allow you to create rules or set limits that define where your responsibilities end and another person’s begin. They protect your emotional well-being while allowing you to support others in healthy ways.

Setting boundaries can be uncomfortable at first, especially when you’re not used to it. As you do so, keep in mind that boundaries are for you,5 says boundary expert Nedra Glover Tawwab, LCSW:

Changing your behavior and not forcing others to change can be a significant part of setting boundaries…It would be nice if everyone automatically knew how to respect our boundaries. We often have to communicate them clearly and enforce consequences when they are not respected. So, when someone crosses one of my boundaries, I will take action to protect myself and my needs.

Be clear and direct when communicating boundaries. Use “I” statements that focus on your needs rather than accusing the other person. For example, “I need some alone time to recharge” works better than “You’re demanding too much of my time.”

Prepare yourself for pushback. Some people in your life may resist your new boundaries because they benefit from your codependent behaviors. Remember that their reaction isn’t your responsibility, and temporary discomfort is part of creating lasting change.

Consistency is key. When you set a boundary, follow through with it. Each time you maintain a healthy boundary, even when it’s difficult, you’re building new patterns that will eventually replace codependent ones.

4. Learn to Prioritize Your Needs

For many people with codependent tendencies, identifying their own needs can feel foreign. Get in the habit of asking yourself: “What do I want right now?” or “What would feel good to me in this situation?”

Practice making decisions based on your preferences. Start with small choices like what to eat for lunch or what movie to watch, then work up to bigger decisions.

Prepare phrases for when you need to put yourself first. Simple statements like “I need to take care of myself right now” or “I’ll need to check my schedule before committing” give you space to consider your own needs.

Pro tip: Remember that prioritizing your needs isn’t selfish—it’s necessary for your well-being and actually leads to healthier relationships. When you’re not depleted from ignoring your own needs, you have more genuine energy to share with others.

Codependency vs. Interdependence

Unlike healthy independence—where 2 people mutually rely on each other while maintaining individual identities—codependency creates an imbalance. Healthy relationships involve give-and-take, with both people supporting each other while respecting boundaries. Both parties feel free to express needs, disagree respectfully, and maintain outside interests and relationships.

The key distinction here is that interdependence strengthens both individuals, while codependency tends to diminish at least one person’s wellness and autonomy over time.

Does your partner or loved one exhibit signs of being codependent?

“Loving someone who is codependent can feel like an emotional roller coaster, but it’s important to remember—you can’t fix them. Their actions often come from a place of love, but they struggle to put themselves first. The best thing you can do is communicate your needs clearly, set firm yet compassionate boundaries, and encourage them to cultivate their own interests. By modeling self-care, independence, and balance, you show them what a healthy, fulfilling relationship looks like.”

Rebecca Tenzer, MAT, LCSW, CCTP, CGCS, CCATP, CCFP, CIMPH | Astute Counseling & Wellness Services

Signs of Codependency

Spotting codependent patterns6 in your life is the first big step toward making real change. Everyone’s experience with codependency looks a bit different, but here are some common signs you might recognize in yourself:

  • Excessive caretaking: You almost always put other people’s needs ahead of your own, even when it hurts you. For example, you might stay up all night helping a friend with their project even though you have an important meeting tomorrow, cook fancy meals for your family while you just eat whatever’s left over, or say “yes” to additional tasks when you already feel overburdened.
  • Difficulty setting boundaries: You find it really hard to say “no” when people ask you for favors or your time. You may cancel plans you were looking forward to because a coworker asked for help at the last minute, or you let family members call you during your workday for things that aren’t emergencies.
  • People-pleasing tendencies: You make decisions based on what will make others happy, not what’s best for you. You might agree with someone’s opinion even when you actually think differently, just to avoid any conflict. Or you might take on extra tasks because you’re scared of letting someone down.
  • Fear of abandonment: A codependent person will often work extra hard to keep relationships going because they’re scared people will leave them. This could mean putting up with someone treating you badly or staying in relationships that don’t make you happy because the idea of being alone feels too scary to face.
  • Controlling behaviors: In an attempt to be helpful, you try to control situations or people out of anxiety. This can look like constantly offering unsolicited advice or getting frustrated when someone doesn’t follow your suggestions about how to handle their problems.
  • Difficulty identifying your own feelings: You’re tuned into others’ emotions but disconnected from your own. You might be able to sense when your partner is upset before they even realize it but struggle to answer when someone asks how you’re feeling.
  • Unhealthy attachment to drama or crisis: You feel most purposeful when solving problems and might even unconsciously create or seek out chaotic situations where you can play the rescuer. When times are crisis-free, you may feel anxious, uncertain, or uncomfortable.
Infographic titled “Examples of Boundaries: Small to Big Ways to End Codependency,” illustrating five progressive steps: don’t offer unsolicited help, say no to favors, speak up about your needs, disagree without fear, and walk away from toxic dynamics. A person walks upward across rising blocks symbolizing personal growth.

5. Seek Support and Professional Help

Overcoming codependency is challenging work, and you don’t have to do it alone. Professional support can make a huge difference in your healing journey.

Therapy, especially with someone who specializes in codependency, family systems, or trauma, can help you understand the roots of your codependent patterns and develop strategies to change them. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are particularly effective approaches for addressing codependency.

Support groups like Codependents Anonymous (CoDA)6 offer connection with others facing similar challenges. Spending time around others who share your experiences can reduce shame and provide insights for your recovery.

Self-help books about codependency, boundaries, and self-esteem can supplement other forms of support. Look for resources by recognized mental health professionals that offer practical exercises alongside information.

Pro tip: Codependent No More2 and its accompanying workbook by codependency expert Melody Beattie are classics on the topic, and a great place to start. There are also treatment resources available.

Life Beyond Codependency: Your Journey to Emotional Freedom

Breaking free from codependent patterns opens the door to relationships where you can truly be yourself. Working with a professional can accelerate your progress, giving you tools that fit your specific situation and background. Whether you choose one-on-one therapy or a structured program, having expert support gives you the guidance and follow-through that helps make real, lasting change possible.

FAQs

Q: Is it possible to stop being codependent?

A: Yes, codependency is a learned behavior that can be unlearned with self-awareness, therapy, and personal growth. According to Mental Health America, addressing underlying self-esteem issues, setting boundaries, and seeking support are key steps toward breaking free from codependency.

Q: How do you break the codependency cycle?

A: Breaking the cycle of codependency involves recognizing unhealthy relationship patterns, developing self-worth, and learning to set and maintain boundaries. Codependents Anonymous recommends a 12-step recovery process, while therapy and support groups can also be helpful in fostering independence and healthier relationships.

Q: What triggers codependency?

A: Codependency often stems from childhood experiences, such as growing up in an environment where emotional needs were not met or where a caregiver had addiction or mental health struggles. Other triggers include fear of abandonment, low self-esteem, and seeking validation through others.

Q: How do you heal codependent tendencies?

A: Healing from codependency involves building self-esteem, practicing self-care, and learning healthy communication. The National Center for Biotechnology Information suggests cognitive behavioral interventions can help individuals develop healthier thought patterns and coping strategies.

Q: How do you prevent a codependent relationship?

A: Preventing codependency starts with self-awareness and setting clear boundaries. Maintaining individual interests, fostering self-worth, and communicating openly with partners or loved ones can help establish interdependent, rather than codependent, relationships.

Q: How does a codependent person feel?

A: A codependent person may feel anxious, responsible for others’ happiness, or emotionally drained. They often struggle with low self-esteem and fear abandonment, leading them to prioritize others’ needs over their own.

Q: Does your partner or loved one exhibit any signs of being codependent?

A: Signs of codependency in a loved one may include excessive caretaking, difficulty setting boundaries, fear of being alone, and reliance on others for self-worth. Mental Health America highlights that codependency can occur in romantic relationships, friendships, or family dynamics.

Q: Why did I develop codependent tendencies?

A: Codependent tendencies often develop from early childhood experiences, such as growing up in a family where emotional neglect, addiction, or controlling behaviors were present. Research indicates that past trauma and adverse childhood experiences significantly contribute to codependency.

Q: How do you overcome codependency?

A: Overcoming codependency requires self-awareness, boundary-setting, and shifting focus to personal well-being. Therapy, support groups, and mindfulness practices have been found to be effective in fostering emotional independence.

Q: What are narcissistic traits?

A: Narcissistic traits include a lack of empathy, an inflated sense of self-importance, manipulation, and a need for excessive admiration. Codependents often find themselves in relationships with narcissistic individuals due to their caretaking tendencies.

Q: What steps can I take to stop being codependent?

A: Steps to stop being codependent include recognizing unhealthy patterns, building self-esteem, practicing self-care, and seeking therapy or support groups. Developing hobbies and interests outside of relationships can also help foster independence.

Q: What are effective strategies to stop being codependent?

A: Effective strategies include therapy (such as cognitive-behavioral therapy), practicing mindfulness, learning assertiveness skills, and setting firm boundaries. Research suggests that increasing self-awareness and engaging in self-affirmation exercises can aid in breaking codependent habits.

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The CBT Triangle: How Behaviors Influence Your Recovery

The cognitive behavioral therapy (CBT) triangle uses the interconnected nature of emotions, thoughts, and behaviors to positively change thoughts and mood, primarily through behaviors. 

According to the CBT triangle, you have the majority control of your behaviors and actions1. You have some control of your thoughts. And you have zero control over your emotions. So you can’t control how you feel, but you can control how you think and behave.

Leveraging this has been revolutionary for many people in treatment, and long-term recovery.

Leveraging The CBT Triangle

Since the 3 elements of emotions, thoughts, and behaviors feed into each other, the CBT triangle2 posits changing your behaviors (which you have the most control over) will change your thoughts and emotions. Similarly, changing your thoughts can also positively affect your emotions and behaviors.

For example, someone experiencing depression may think, “I can’t get out of bed. I’m too depressed.” This could lead to emotions of helplessness and self-hatred. 

Getting out of bed proves your control of what you do, even if you don’t feel like doing it. Realizing your abilities can lead to more positive emotions and helpful thoughts. You may even be encouraged to tackle another difficult task…creating a snowball effect.

As you get more practice, you’ll likely become more aware of unhelpful thoughts AND how you act on them. As awareness grows, you’ll have more opportunities to correct untrue thoughts or act opposite to your thoughts and feelings.

The CBT triangle helps with multiple conditions3, too. These include depression, anxiety, obsessive compulsive disorder (OCD), addiction recovery, and trauma.

Behavioral Activation: Valued, Routine, and Enjoyable Activities

Behavioral activation (BA) centers on doing something even if you don’t feel like it, not waiting for motivation or to “feel better”4—and in doing so, you can actually feel better. Scheduling activities or doing them as-needed can offer symptom relief by breaking the negative emotions-thoughts-behavior pattern of depression.

There’s 3 types of BAs. Here they are in detail.

Valued BAs

Your valued BAs include activities related to what, where, or who you value. Your values are like north stars, guiding you through life. They might include spirituality, family, creative expression, friendship, and more.

Doing a valued BA could look like practicing a religion, spending purposeful time with family, engaging in social settings with friends, and creating art.

Symptoms of depression or other illnesses can make valued activities harder to do. Intentionally doing them, like attending church even if you don’t want to, can add value back into your life.

Enjoyable BAs

Enjoyable BAs are things you like to do. They bring you pleasure and add joy to your life. Examples could include cooking, painting, sports, hobbies, outings with friends, and eating good food.

One of the symptoms of depression is struggling to feel pleasure5, even if it’s something you used to love. Reincorporating enjoyable BAs can help you regain interest and pleasure in these activities.

Routine BAs

Your routine BAs include day-to-day tasks you must manage to stay healthy, employed, housed, and more. They may not be particularly enjoyable, but they’re important for maintaining a fruitful life.

Routine activities include paying bills, going to work, doing laundry, brushing your teeth, showering, doing schoolwork, and tidying up.

BAs and The CBT Triangle

Conditions like depression, trauma, and addiction can push many BAs off to the wayside, affecting your thoughts and emotions. You may not feel pleasure from your enjoyable BAs, and your symptoms could get in the way of routine and valued activities. Engaging in BAs can change your thoughts and emotions for the better, ending the cycle of negative effects. 

By starting with what you have the most control over, behaviors, you can change your thoughts and emotions and stop the cycle of negative thoughts/unhelpful behaviors.

For example, you may have emotions of sadness and thoughts of worthlessness because you can’t get anything done. But you exercise control of your behavior and get up and do the dishes, even though you don’t want to. This action challenges your thoughts of worthlessness and can change your sad emotions into neutral or encouraged ones. 

The CBT Triangle and Recovery Maintenance

When you use the connections of the CBT triangle to improve your mood by changing your thoughts and behaviors, you’ll likely notice your success isn’t infinite. Reaping continuous benefits from the CBT triangle takes repetition and practice. The more you do it, the easier it will be to keep doing it—like any other habit.

Once you feel you’re in the maintenance phase of your recovery, you can leverage the CBT triangle differently. Instead of using it to address symptoms, you can start using it to prevent symptoms.

For example, maybe you’ve learned to manage your depression symptoms. You know your warning signs and have a good grasp on what situations will trigger a negative mood or spiraling thoughts. You also know not going into the office makes you feel lonely and more isolated. When you start feeling like isolating, you proactively address this symptom by going to the office. Since you’re going in and not isolating, your feelings of loneliness don’t get the chance to fester and worsen to the point of redeveloping depression.

Leveraging the CBT triangle isn’t just a tool for depression, either. You can use it for substance use recovery, behavioral addictions, anxiety, and other emotions that aren’t serving you. Its benefits can be life-long.
For more intensive treatment options, use Recovery.com to find rehabs and outpatient clinics focused on depression recovery.

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Marijuana Misuse and Addiction: Signs, Symptoms and Treatment

Rolling a blunt one too many times can roll into a problem. Marijuana has the potential for addiction and bodily harm, and with it becoming legal in some states, now poses an even greater risk. 

Many people use weed regularly without understanding the possible risks. We’ll explore those here, plus signs of marijuana addiction and how to get treatment.

What Is Marijuana?

Marijuana comes from the dried leaves and flowers of the cannabis plant1. It grows around the world, mostly in tropical and humid places. The THC compound in cannabis (tetrahydrocannabinol) causes the mind and reality-altering effects2 associated with marijuana use. 

People typically smoke the dried leaves of the cannabis plant or the resin of its flowers. A rolled-up ‘cigarette’ of marijuana is called a blunt; some people roll and smoke their own or buy premade blunts. To smoke the more potent resin, people use bongs. People can also take edibles that take longer to set in but have longer-lasting effects (for example, pot brownies.)

Marijuana for medical use also occurs in some American states. For example, it can help cancer patients experience less nausea1 after chemotherapy. And Jamaican women commonly brew cannabis tea to relieve morning sickness3.

Is Marijuana Addictive?

Despite public perception touting weed as safe and nonaddictive, marijuana use can lead to an addiction4. It’s not safe, either. It can lead to addiction the same way other addictive drugs can: by altering the reward pathway in the brain4 and making changes in its functions. 

You can quickly build a tolerance to marijuana, meaning you need to take more to experience the same effects as your first experience. Taking more and more further alters your brain. Soon, you can start craving marijuana and experiencing intense urges to take it, until it becomes consuming and starts having pronounced negative effects on your life.

Ten percent of people who start smoking weed become addicted5; 30% of those who smoke it regularly meet addiction criteria. Those who start smoking earlier in life run a higher risk for addiction since marijuana can have a stronger effect on an adolescent brain6.

Effects of Marijuana Use

Marijuana has immediate and long-term effects. People often take marijuana for its immediate effects; to relax, fall asleep, or center their focus. Different strains of marijuana give different highs1, known as head or body highs. A head high is more conducive to focus while body highs offer a pronounced sense of relaxation. 

Immediate Effects

After taking marijuana, you’ll likely experience

  • A strong sense of relaxation and calm
  • Miscalculating time and distance
  • Paranoia
  • Red, bloodshot eyes
  • Food cravings

The initial effects of weed7 can last 2-10 hours, depending on its potency. Some people enjoy the effects, while others experience intense anxiety, paranoia, psychosis, and panic attacks.

Long-term Effects

Regular marijuana use leads to various long-term effects8, including

  • Memory damage
  • Schizophrenia
  • Lung cancer due to the carcinogens found in pot smoke3
  • Respiratory conditions from smoking, like bronchitis or regular coughing
  • Cannabinoid Hyperemesis Syndrome, which means continuous vomiting
  • Poor concentration
  • Poor coordination
  • Cognitive and executive dysfunction

The longer someone uses marijuana, and the more they take it, the more intense the long-term effects can be. For example, someone who has smoked marijuana once a week for several years likely won’t experience the same slew of negative effects as someone who’s smoked daily for the last decade.

Signs of Marijuana Use

Someone who’s ingested marijuana will show a few key signs, both physically and psychologically.

Physical Signs

  1. Red eyes, like they’ve been crying or rubbing at them.
  2. Seeming disconnected from reality, out of it.
  3. Unusually relaxed and giggly.
  4. Talking slowly and not comprehending when other people talk. 
  5. Smelling of weed, which has a mossy, skunky odor.

Psychological Signs

Someone may show psychological signs of marijuana use, either in addition to or instead of physical signs. Examples include

  1. Low mood
  2. Disinterest in their usual activities
  3. Becoming emotionally distant and reserved

Withdrawal Symptoms

Once the brain and body grow accustomed to marijuana, especially high amounts of it, stopping can lead to detrimental effects. Though marijuana withdrawals aren’t deadly and typically not harmful long-term, they’re still uncomfortable3 and can prompt further use to curb the negative effects. People often experience physical and psychological weed withdrawals3.

Physical Withdrawal Symptoms

  • Nausea
  • Insomnia
  • Runny nose
  • Sweating
  • Muscle cramps

Psychological Withdrawal Symptoms

Some people use marijuana to self-medicate anxiety and unease. These symptoms, and a host of other psychological symptoms, can occur once they stop.

  • Irritability
  • Restlessness
  • Discomfort and agitation
  • Pronounced return of anxiety as regular symptoms combine with withdrawals

Treatment Options for Marijuana Misuse and Addiction

Treatment options for marijuana addiction abound. You can go to a residential rehab, where you’ll stay for 28+ days to address underlying emotional issues and build coping strategies to maintain recovery outside treatment.

Rehabs typically combine 2 elements of care: behavioral and medical. You can access this care at an outpatient level, too, separately or concurrently. 

Behavioral Treatment

Therapy addresses the thoughts and feelings leading to marijuana use and, subsequently, marijuana addiction. For example, if your marijuana use started as a way to relax and mitigate anxiety, you’ll find a new approach to managing symptoms through therapies like CBT, DBT, and PE. Here’s what those mean:

  • Cognitive behavioral therapy (CBT) focuses on identifying and challenging untrue thoughts or beliefs before they can affect your emotional state and lead to unhealthy coping measures. 
  • Dialectical behavioral therapy (DBT) still helps you identify harmful thoughts and beliefs but focuses on accepting them, rather than challenging them, and managing your responses. 
  • Prolonged exposure9 (PE) works by exposing you to a trigger to help you become desensitized to it. People with post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) can find PE particularly effective for managing the intense emotional responses to triggers that might lead to substance use.

Holistic therapies can help, too. Many people benefit from a blend of evidence-based therapies, like the ones above, and holistic approaches like art therapy, yoga, and creative writing.

Medical Treatment

Medical treatment for marijuana addiction includes medication-assisted treatment (MAT) as needed. Some medications can alleviate withdrawal symptoms and speed up the onset3, helping the body return to homeostasis quicker. 

The Importance of Early Intervention

Intervening early is one of the best ways to prevent addiction. This applies to all drugs, marijuana included. The sooner someone takes steps to stop their use, the easier and less disruptive returning to sobriety can be. The intervention may come from within, from healthcare professionals, or loved ones.

Family Support Systems

Family members are often the first to notice a loved one’s struggle with marijuana use and addiction. Because of this, they can be the first to intervene through a formal intervention or a more casual conversation voicing their concerns and asking how they can help. How you approach the situation depends on your unique circumstances.

Family members (chosen family or related) also serve as a crucial support system in recovery. Education on addiction, mental health, and recovery can help them become stronger allies for their loved one’s healing.

Professional Help

A myriad of professionals can help people with a marijuana addiction recover. Your first stop may be your primary care provider, or the doctor you see for regular check-ups and arising health needs. They can guide you to the next steps in your treatment and recommend an effective path for you. This may include inpatient care or outpatient services, like therapy.

Therapists can alleviate the emotional factors contributing to marijuana use and addiction, using proven evidence-based methods (or holistic therapies) to treat disorders like anxiety, depression, and trauma. With these underlying causes addressed, you’re less likely to feel a desire for marijuana.

Attending a residential rehab or outpatient treatment for marijuana addiction offers a comprehensive healing package. Regular therapy sessions can too, as can peer support groups like 12-Step meetings or SMART Recovery meetings.

Find Rehab Centers for Marijuana Addiction

Many drug rehabs treat marijuana addiction, offering different approaches, therapies, and amenities to treat the causes and symptoms of addiction. The best rehab is the one that’s right for you.
You can use Recovery.com to find marijuana rehabs and see their insurance information, photos, reviews, and more all in one place.

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What is NAD Treatment?

Do you remember hearing mitochondria is the powerhouse of the cell? That’s because it synthesizes the energy you need to function, but it doesn’t do it without help. 

Nicotinamide adenine dinucleotide (NAD), a coenzyme found all throughout your body, is responsible for taking just the right electrical charges and reconfiguring them to create ATP1, better known as energy. Along with boosting ATP levels, NAD also affects parts of the DNA responsible for aging, opioid receptors in the brain, and can improve access to the neurotransmitters responsible for good mood, like serotonin. 

NAD levels shrink as you age or experience stressors like addiction. NAD treatment restores your levels of NAD and can subsequently improve a host of functions—even lowering withdrawal symptoms and cravings in recovery. It’s become a more well-known and used tool in addiction recovery; here’s why.

Introduction to NAD Treatment

Your body uses NAD for myriad of processes and functions, including,

  • Metabolism
  • Circadian rhythm
  • Lengthening telomeres, which slows aging 
  • Making energy
  • Repairing damaged DNA
  • Making DNA more resistant to damage and decay
  • Boosting physical and mental wellness
  • Reducing substance withdrawal symptoms

NAD treatment, typically administered through an IV, restores NAD levels that shrank naturally or because of poor health. Since it’s a natural coenzyme found throughout your body1, it’s readily accepted and processed. 

The Science Behind NAD Treatment

NAD synthesis energy in the mitochondria1 thanks to one tiny atom: hydrogen. Hydrogen has one positive charge (proton) and one negative charge (electron) that NAD picks up to form NADH. NADH picks up charges from hydrogen throughout the process of compounds like glucose going through chemical changes. The results of these changes mean the energy (ATP)-making process begins, which releases more NADH. 

In short, NAD takes charges from the hydrogen within various compounds (like glucose) and releases them into the mitochondria, which uses those charges to create ATP, or energy.

NAD affects other cells in different ways. Mainly, it strengthens DNA and enhances neurological and physical functions1, including your cognitive abilities. 

Biological Importance of NAD

NAD does even more than synthesize energy. It keeps several key functions running smoothly, and can slow down, or even reverse, age-related diseases2 by its effects on DNA. NAD restores damage to DNA and protects healthy strands from damage. It boosts immunity and strengthens your metabolism, and helps brain fog dissipate. As an antioxidant, it helps you resist pollutants3 from food, the environment, and substances.

How NAD Therapy Works

Clinics can administer NAD in 3 ways: an IV infusion, an injection, or through a nasal spray. The IV infusion typically takes the most time and is most comprehensive, as the solution includes vitamins to boost your wellness. 

  1. IV Infusion: Nurses or physicians insert an IV tube to administer NAD and vitamins over the course of a few hours. The time for each infusion can vary by the clinic and your dose; expect 2-5+ hours. During that time you can work on a computer, read a book, or enjoy another hobby. 
  2. Injection: Similar to getting a flu shot, a specialist will inject a syringe of pure NAD (no extra vitamins) into your bicep, thigh, or buttocks. You can leave once they’re done; this option takes just minutes.
  3. Nasal Spray: A nasal NAD treatment involves short bursts of the NAD solution sprayed into each nostril. If you’ve ever used a nasal spray for allergies, it’ll be just like that.

After an NAD treatment, many patients feel a boost in energy and mental clarity. Some only feel change after a few sessions. If you’re using NAD treatment for addiction, you may experience an immediate lessening in cravings and improved withdrawal symptoms. An addiction treatment center will likely stack your NAD treatments close together to help you navigate withdrawals as comfortably as possible. 

Benefits of NAD Treatment

A hallmark of NAD treatment is the lack of medication needed for its results. It uses a coenzyme your body creates naturally, not a man-made medication with their unavoidable lists of side effects. In essence, it uses tools from your body’s toolbox to improve multiple functions.

Anti-Aging Effects

NAD offers anti-aging effects2 in 2 ways: it lengthens telomeres (caps on strands of DNA) and improves your cognitive and physical functions, reducing the likelihood of age-related diseases like cancer.

Telomeres maintain the stability and health of your chromosomes4 by capping off strands of DNA and protecting them from damage. The longer the telomere, the more protected the DNA is and better resistant to the decay of aging. 

Addiction Recovery

NAD helps repair cells damaged by addiction and significantly reduce effects of withdrawals5. NAD also bonds to opioid receptors in the brain, which can ease withdrawal symptoms and cravings for drugs or alcohol.  

NAD, an antioxidant, detoxifies your body. This can speed up withdrawals and make the process more comfortable. NAD can also lower cravings long-term by repairing damaged cells5 in your brain’s reward pathway and changing your genetic expression through epigenetics (or, a new way your genetic code is read.) 

Chronic Health Conditions

NAD treatment improves your metabolism and immune system, which can alleviate symptoms for chronic conditions like fibromyalgia, chronic fatigue syndrome, and neurodegenerative diseases. Since it makes repairs to damaged DNA, it can change genetic expression6 and reverse, or improve, chronic conditions and their symptoms. 

What to Expect During NAD Treatment

Before your session, the clinic will set up an initial assessment to determine your eligibility and what current health struggles you may have. Even if you’re getting NAD treatment at an addiction treatment center, they’ll likely still ask a few clarifying questions on your health and what your goals are for the treatment.

NAD treatment consists of little more than resting and relaxing while the transfusion happens. To prepare for your session, drink water and eat a healthy meal to give the NAD a better workspace. Avoid alcohol or caffeine too.

At your first appointment, the practitioners will explain a bit more of what to expect, and then you’re ready to go. Depending on how they administer the NAD, you’ll either receive an injection, a nasal spray, or an infusion. Infusions are more common and comprehensive. They’ll insert a needle into the crook of your arm and hook you up to a baggie with the NAD solution inside. You’re free to work, rest, practice a hobby, or call up a friend during the transfusion. They can take anywhere from 2-5+ hours and occur 1-3 times a week for 8-10 weeks.

Wear comfortable clothes and shoes. The clinic will likely have guidelines on what they allow you to bring to sessions, like snacks, drinks, and entertainment. Check with them to make sure you’re optimizing your time and making it the best experience for you. Some clinics also bring the treatment to you, which means you can stay at home during the transfusion.

After The Session

Once the transfusion is complete, the presiding nurse or physician will remove the IV to disconnect you from the NAD baggie. They’ll put a bandage over the insertion point (like they do when you get your blood drawn), see how you’re feeling, and send you on your way. You may also schedule the rest of your sessions then, which happen on a cadence suited to your needs. It could be once or twice a week or every other week, lasting 10+ weeks or less.

Possible side effects from NAD treatment include pain and tenderness at the injection site, feeling lightheaded, and headache. The practitioners will ensure you feel okay after each session and not experiencing possible side effects at home.

Clinical Evidence Supporting NAD Treatment

Various studies have both shown NAD treatment has life-improving effects and low safety risks6. Any side effects experienced, like headaches or sleep disturbances, didn’t impact the overall health of participants. It was also found to reduce withdrawal symptoms and cravings5 in addiction recovery.

Scientists are still seeking to find the best delivery method for NAD7, whether that’s transfusion, injection, a nasal spray, or even a pill. Studies can also improve on showing the efficacy for NAD treatment and mental illnesses like depression, rather than a causal link in NAD and symptom reduction.

Comparing NAD Treatment to Other Therapies

NAD treatment is one of many tools available to treat addiction, chronic health conditions, mental illnesses, and more. It has its pros and cons, like other treatments.

Advantages Over Traditional Methods

NAD treatment generally has fewer side effects than traditional treatment methods, which typically involve medications to treat health conditions. Since it uses something your body makes itself, introducing more NAD is rarely an issue. 

This easy introduction, lack of withdrawals, and natural tolerance can make NAD treatment an advantage over medications. It can be especially beneficial for those in addiction recovery, as NAD can have similar withdrawal-reduction benefits as opioid-based medications5.

Limitations and Considerations

NAD has its benefits and impressive capabilities, but it may only work for some. Practitioners can’t easily prove the NAD’s effects for each individual, nor can they guarantee it will relieve certain symptoms. The way your body processes the extra NAD will vary person-to-person.

NAD treatment also takes time to see certain results, like anti-aging effects or improved cognitive function. It’s not always a quick fix, like medications or other interventions can be. It’s also not covered by insurance, as other medications may be.

Accessing NAD Treatment

Availability and Costs

As NAD treatment becomes a more mainstream treatment option, more and more clinics and providers aim to offer it. A quick Google search will tell you if a NAD clinic is nearby. You can even order a vial of the NAD solution and inject it yourself—with a prescription from your doctor and oversight. 

Costs vary depending on the number of milligrams used in an NAD session. A shorter session will use less NAD solution and cost less. Longer sessions cost more. On average, a 2-hour session will cost $350 and a 5+ hour session will cost $600+. The final cost can vary widely by clinic, solution add-ons, and more. For the total package of continued sessions, you can expect to spend anywhere from $5,000 to $15,000+. 

Insurance and Coverage

Insurance doesn’t cover NAD treatment; they view it as a complementary treatment and may only cover small portions through various plan benefits. You can push for reimbursement by submitting a request to your insurance provider with your need for NAD treatment documented by a clinician.

Next Steps

Consult with your doctor if NAD treatment sounds like a good option for you. It has its benefits and drawbacks, but can be a life-changing treatment for those in addiction recovery, those with chronic ailments, and those with mental health conditions. See what your doctor thinks and set up an appointment with the NAD clinic of your choice to start the process.
You can also browse rehabs for addiction on Recovery.com and see photos, reviews, insurance information, and more.

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Healing in Numbers: The Power of Group and Family Therapy in Recovery

We have an exciting new podcast with guest Dr. Claudia Black! We had an insightful and educational time discussing Dr. Black’s professional and personal experiences. We also explored what drew her to focus on behavioral health, adolescent treatment, and healing dysfunctional families. Dr. Black has authored multiple books on addiction, children of addiction, how families heal, and much more.

Listen to this fascinating episode with Dr. Black here!

Past Experience and Background

Dr. Claudia Black is the clinical architect of the Claudia Black Young Adult Center with the Meadows. She’s a renowned author and speaker, and a trailblazer in the field of addiction and family systems therapy. Her work shaped the awareness and healing surrounding adult children of parents with substance use disorders, and children from dysfunctional and abusive families. Clinicians around the world use her frameworks to understand, and treat, addiction and dysfunction within family systems. 

C Black scaled

Dr. Black grew up in a dysfunctional home herself, a child of a father struggling with alcohol use disorder. She deeply understands the effects dysfunction and addiction have on families, especially adolescents. Dr. Black brings a unique blend of empathy and clinical expertise to her treatment, books, and our conversation in this episode with host Dr. Malasri Chaudhery-Malgeri (Editor-in-Chief) and co-host Cliff McDonald (Chief Growth Officer).

Group Work as a Pillar in Successful Treatment

Dr. Black primarily works with adolescents, developing a campus and program specifically for young adults after recognizing they learn and respond to treatment much differently than older peers. For this age group and others, Dr. Black has seen profound benefits with group therapy. She notes,

“And…the advantages of group work, I think the biggest advantage is what I’ve really already stated. It is a major shame reducer. There is so much healing that comes with the possibility of connecting with somebody else who, on a gut level, knows exactly what you’re talking about.” 

She adds another truth patients often realize through group work: 

“It’s okay for me to be vulnerable because there is nothing wrong with me. And I understand that because there’s nothing really wrong with you. This is what happened to you. And I like you. You’re really an okay person. Therefore I must be okay too.” 

Dr. Claudia Black eloquently highlights the transformative power of group therapy in recovery, and how it can significantly reduce shame by connecting patients with others who truly understand their struggles. She also highlights a vital realization created in group settings: the acceptance of vulnerability. Patients learn that being vulnerable is acceptable because their core selves are intact and unblemished by their experiences. This mutual recognition of inherent worth helps patients accept themselves and others, creating a supportive community where everyone can feel truly ‘okay’.

Healing Emotional Abandonment in Dysfunctional Families

Much of Dr. Black’s work focuses on healing emotional abandonment, which can take many forms and roles. Her books and speeches cover the realities of growing up with parents with substance use disorders, abusive parents, and emotionally unavailable parents. Dr. Black defines emotional abandonment, stating,

“Emotional abandonment is when you have to hide a part of who you are in order to be acceptable.”

Emotional abandonment can skew what children believe about themselves, especially as they grow into adults. For example, they may believe showing emotion is weak or being kind to others opens them up for attack. Dr. Black adds,

“So what are these parts of self that I’m having to hide? Was it okay to make a mistake in this family? Or did you learn that if you did anything less than perfect, there was something wrong with you? Was it okay for you to have feelings?” 

As a result of emotional abandonment from abuse, emotional detachment, or absent parenting, children can turn to substances and illicit practices to find comfort and community. 

This quote poignantly addresses the deep-seated fears and insecurities many people carry into adulthood, often stemming from their familial environments. It challenges us to reflect on the parts of ourselves we’ve felt compelled to hide, questioning whether our upbringing allowed room for mistakes or if perfection was the unattainable standard. This introspection helps us understand and heal the internalized beliefs that may hinder our personal growth and emotional well-being.

Substance Use to Numb Emotional Pain

One of Dr. Black’s books, It Will Never Happen to Me!, highlights the connection between children of addiction and becoming a substance user themselves, despite seeing the effects and damage of addiction first-hand.

She notes how children of addiction almost always experience emotional abandonment, which can lead to substance use as a way to cope with the pain and manage their emotions on their own. As they get older, children of addiction and/or abusive parents may also use substances to numb painful memories and the trauma of their experiences. Even if these children, who watch their parents suffer with addiction, vow to live differently, they can end up following the same pattern. Dr. Black says, 

“If becoming addicted was an issue of willpower, children of addiction would be the last ones to become addicted. But it has nothing to do with willpower. What happens is alcohol or drugs can do something for this child that it doesn’t have to do for somebody else. It can give them a greater sense of confidence. It can give them courage. It can give them a sense of empowerment against the powerlessness in their life.”

The Role of Family Therapy and How It Works

Family therapy is an important part of treatment for all age groups, but especially young adults. Dr. Black deftly explains the importance of family therapy, anxieties and misconceptions family members may have, and how the patient and their loved ones can optimize the experience for their collective healing. 

Dr. Black notes common fears loved ones have coming into treatment:

“Anybody who walks into the treatment setting is very scared. It’s very vulnerable, in a way that is foreign to them.” … “So they’re, they don’t want to be part of a treatment program because they feel so guilty or they feel like they’re going to be blamed.”

These anxieties and fears are some of the reasons why Dr. Black and many other treatment providers focus on creating a welcoming, non-judgemental space for families to learn more about the condition their loved one has and discuss their experiences. What this reaps is:

“…the patient, the identified patient, the client themselves who goes to treatment, probably has a better chance of recovery typically when family members participate in family programming and ultimately experience their own recovery process.”

Sessions with loved ones often center on education, helping them understand each aspect of the patient’s behavior and conditions. It also helps them understand their own needs and recovery process. Dr. Black says, 

“Most of the family members, when they leave, will walk away saying, I couldn’t believe that I’d have a recovery process. I didn’t even know that I had something that I needed to recover from.”

“People Are So Resilient”

Dr. Black describes the inspiring sense of resilience each person has, and how that contributes to their recovery journey. She also describes real stories of resilience in her book Undaunted Hope. On resilience, she says, 

“So being able to recognize that some of what was survivorship is where our resiliency is today, as well. You get to keep the strengths that you created. A lot of dysfunction or a lot of trauma in your life, you get to keep the strengths. You just want to take away the rigidity of those strengths.”

Dr. Black gives an example of someone used to taking control and taking care of others. They turn out to be a natural leader, which is an inner strength, but can be over controlling and micro-manage. Loosening the reins allows this person to still lead, but be a better listener, more receptive to feedback, and gentler in how they communicate. 

Promising Trends and Innovations in Addiction Treatment

Dr. Black pointed out new trends in addiction treatment and suggestions for how providers can offer better care. One, she suggests new providers read her book Undaunted Hope for the real-life experiences highlighted in the book and stories of resilience. She adds,

“You have to know addiction. You don’t have to specialize in the field of addictive disorders. But you can not, as a mental health professional, work in this field and not know addiction and be open to the fact that that could be what it is that’s going on.”

As far as emerging trends and needs, Dr. Black says, 

“I think that we need to pay more attention to long term, what supports long term recovery and that, from an inpatient treatment standpoint, 45 days is not enough. It’s a wonderful start, but I don’t think that we’ve given credence to those next handful of months into this first couple of years.”

Dr. Black sheds light on evolving trends in addiction treatment and offers critical guidance for care providers. She emphasizes the importance of a deep understanding of addiction, regardless of a provider’s specialization, highlighting that it is essential knowledge for any mental health professional. Dr. Black also advocates for a reassessment of treatment times, pointing out that while a 45-day inpatient program is a good start, it doesn’t always support long-term recovery. She stresses the need for extending care well beyond these initial stages, which can significantly bolster recovery outcomes.


This episode was rich in information and wisdom. To find out more about this episode and Dr. Claudia Black’s work, listen to her podcast here!

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Addiction Education in Rehab: Empowering Recovery Through Knowledge

Understanding addiction and mental health provides crucial stepping stones to long-term recovery. That’s why many rehabs provide psychoeducation, which teaches patients about behavioral health conditions. In a psychoeducation class, you’ll learn more about particular substances, how they work, their long-term effects on your brain and body, and why cravings happen. It also explains the connection between addiction and mental health conditions.

Gaining this understanding of yourself and your recovery journey can better prepare you for the road ahead, helping you feel confident in your ability to identify triggers, coping mechanisms, and relapse risks. 

Introduction to Addiction Education

Addiction education1 teaches the biological, psychological, and social aspects of addiction. The goal is to demystify the process of addiction recovery and provide vital insights into treatment. Learning about addiction can help people feel more empowered in their recovery and in supporting loved ones.  

Psychoeducation raises awareness about the nature of addiction, including how drugs impact the brain, the progression of tolerance and dependence, and the addictive cycle. Understanding the scientific basis of addiction can help people acknowledge the chronicity of the disorder and why long-term management plays a crucial part in their recovery.

Addiction education in rehab also emphasizes and teaches coping skills for relapse prevention. Patients learn how to recognize triggers, handle cravings, and navigate high-risk situations (like acute stress) without resorting to substances as a coping mechanism. It prepares them for “real-world” settings to bolster confidence in their recovery.

What It Looks Like

Psychoeducation in rehab looks a lot like a regular classroom. You’ll sit in a circle, at tables, or in rows with a whiteboard or screen up front. A “teacher” leads the lessons; they may be therapists, counselors, psychologists, doctors, or someone with lived experience. You’ll commit an hour or so to learn, potentially watching videos and engaging in discussions with the teacher and your peers. Your teacher may also encourage you to take notes.

Core Topics Covered in Addiction Education

Addiction education typically covers the neurological effects of substances, the impact of mental health conditions, the health risks of addiction, and how to recognize and cope with triggers. These topics can go in-depth, like learning how addiction rewires the brain, or broadly address ideas and themes. Classes may also focus on a specific substance, like cocaine or fentanyl. 

Methods of Delivering Addiction Education

Peer interaction, group discussions, and lecture-style lessons provide addiction education. Videos and written projects also contribute. You may watch videos or animated depictions of how substances affect the brain, for example. The educator will likely ask questions or prompt group discussions each session. You and your peers are encouraged to voice questions throughout the lesson to help yourself and others learn.

Psychoeducation may also include interactive workshops, where you and your peers have a more hands-on experience by acting out scenarios or seeing creative depictions of them. For example, you might study a plastic brain to see where addictive substances impact the reward system. Cartoons and drawings help visual learners1 understand and relate to information.

Learning could take place individually, in a group, or in a family setting2. The exact setting will depend on your program and how they structure psychoeducation.

The Impact of Addiction Education on Recovery

Learning about addiction helps you become more self-aware1 and make better-informed choices on your recovery journey. Knowing what triggers cravings can help you avoid them. And, you’ll learn coping tools to manage cravings both long-term and in the moment. These tools, gained by psychoeducation, can strengthen your recovery and empower greater confidence in your journey.

Psychoeducation has been found to improve treatment outcomes1 by reducing relapses and promoting abstinence. It also improves treatment compliance, which can help people stay in treatment longer and get the healing they need.

Integrating Education with Other Treatment Modalities

Psychoeducation in addiction treatment flows in tandem with therapy, medical care, and holistic therapies. It complements each facet of treatment by helping patients better understand the process and how each component works towards recovery.

For example, psychoeducation can educate patients on the medications they’re taking. They’ll learn more about the medication and what it does, helping them understand its benefits, potential side effects, and commit to taking it as prescribed. 

Overcoming Challenges in Addiction Education

Participants can run into challenges in psychoeducation, despite its many benefits. Challenges won’t necessarily make addiction education ineffective, but they can limit how much patients engage in the lessons. Here are some examples of common challenges in addiction education:

  1. Unengaging teaching styles 
  2. Unenthusiastic facilitators
  3. Poorly designed and confusing lessons distracting from the content itself
  4. Mental health and/or learning conditions affecting learning abilities
  5. Peers not getting along
  6. Bias, prejudice, and lack of cultural competency from facilitators

To face these challenges, providers can ensure they assign competent, enthusiastic teachers with clearly defined lesson plans that patients can access beforehand to know what to expect. A syllabus, for example, would detail what patients can expect to learn and keep their lessons moving toward defined goals and milestones.

Teachers should also have access to a variety of learning materials, helping them adapt to various learning styles and meet the needs of their ever-evolving students. Additional training on inclusivity, diversity, and anti-bias can help facilitators create more welcoming environments students feel comfortable engaging in.

Continuing Education and Support Post-Rehab

Addiction education doesn’t end after rehab. You can keep learning every day, in big or small ways. 

Educational Courses and Training

Online training or college courses can deepen your knowledge of addiction and earn you a certification or degree. Your classes will mimic psychoeducation classes in rehab but with graded homework and assignments or other completion requirements. Colleges may offer these courses or platforms like Coursera. 

Support Groups

You can find local or online support groups by searching the internet or connecting with your local community. For example, you could check with your community center for guidance and see where local groups take place. Alcoholics Anonymous (AA) or other 12-Step groups likely exist in your area and actively welcome new members. Online groups connect you to others in your state, country, or worldwide to share and receive support.

Community Engagement

Your town or city may have activities and groups for those in recovery, like monthly dinners or sports clubs. Even if they’re not geared toward people in recovery, you can still join a group that seems fun to you and meet new people, learn about their experiences, and build your support system.

Learning to Hope

Addiction education in rehab serves as a powerful tool in recovery. It helps you understand how addiction works, what it does to your brain, and why certain triggers cause cravings. Psychoeducation helps you create relapse-prevention strategies centered on your new knowledge of your addiction and contributing factors, like mental health conditions, to empower your recovery.

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Employee Wellness: What It Is And Why It Matters

Employee wellness means more than good job performance. It means you are well as a mother, father, child, spouse—as a person. Employee wellness focuses on your mental health, your physical health, your work satisfaction, and ensuring you have access to all available health resources in your company. 

Good job performance is a byproduct of employee wellness, as is a positive company culture and employee retention. Several platforms cater to employee wellness and mental health literacy to encourage this, including Spirence. 

Listen to our podcast episode with Spirence’s Vice President, Laura Kunz, to learn more about the platform and how it came to be.

What Is Employee Wellness?

Employee wellness broadly refers to the overall health and well-being of employees. Well-being is your ability to “address normal stresses, work productively, and realize one’s highest potential.” People with intact well-being perform better1 at work and other areas of life, including their overarching health. 

Employee wellness involves more than just the employee’s at-home efforts to better their health; it centers specifically on what companies can do to improve the workspace and the well-being of their employees. 

To do this, companies often offer an Employee Assistance Program (EAP). These include resources for therapy, stress reduction, and tips for general well-being.

Why Does It Matter?

A positive workplace culture that prioritizes employee wellness offers a host of benefits. It reduces turnover, as employees are most likely to quit a job over toxic workplace cultures2. Studies found poor company cultures are more likely to lead to resignations than low pay or burnout. 

Toxic workplace cultures contribute to higher percentages of depression2, stress, anxiety, and physical health conditions like heart attacks and high blood pressure. These issues follow employees home, affecting their free time and families. 

Even in healthy workplace cultures, heavy workloads, stress, and a lack of mental health resources can drive employees to a better opportunity. Offering them solutions in-house can prevent resignations and foster healthy cultures, healthy employees, and happier home lives. 

Improved Quality of Life

A positive workplace culture that prioritizes employee wellness can improve their overall quality of life. Plus, feeling positive toward work can make non-work hours more enjoyable and enable you to actually rest on days off, contributing to a better quality of life. You’ll have more time and mental energy to focus on who and what you love. 

Since work takes up a majority of our waking hours (⅓ of our lives3), positive or negative experiences there can dictate your well-being outside the office. Negative work environments and poor employee wellness can also affect virtual employees4. Focusing on their wellness and nurturing a positive culture benefits all employees, all the time. 

Higher Work Performance

Happier, healthier employees can connect more with their work and meet the standards set by themselves and their employers. Better mental health and well-being leads to improved productivity5, which benefits both the employee and their employer. Employees get more done and employers can focus more on their business, not rehiring employees. 

Better Overall Health

Poor well-being caused by negative work environments can affect your overall health6 via chronic stress and mental health conditions. Chronic stress can lead to conditions like cancer, heart disease, autoimmune flare-ups, and more. Conditions like depression and anxiety can also develop.

These issues are less likely to affect employees in a positive work environment, improving their overall health.

Tools And Programs for Employee Wellness

Many corporations, big and small, leverage tools and programs to improve the well-being of their employees. Employee Assistance Programs (EAP), for example, connect employees to resources about benefits, mental health, and other workplace issues. However, EAPs don’t always meet the needs of employees seeking support, but not clinical mental health services. They may want to learn more about their options or ask questions on behalf of a loved one—not go to counseling or connect with an inpatient program. 

New subclinical products can meet these needs and offer the educational tools needed to improve mental health literacy. Platforms like Spirence offer live webinars, bite-sized informational pieces on mental health, and weekly family sessions to help employees needing acute and non-acute support.

These types of platforms are designed to prevent mental health crises and the need for clinical care. Using them, employees can learn more about mental health and wellness as a whole, understand their treatment options, and pose questions to behavioral health experts. Other employee-wellness platforms include:

  1. Calm’s Corporate Well-Being Program
  2. headversity
  3. Headspace
  4. Limeade
  5. Starling Minds

Education as a Key Component

Many employee platforms share one key component: education. Webinars, articles, videos, and even games educate employees on mental health and treatment options in case their wellness suffers a drop. As their mental health literacy increases, employees can enjoy greater peace of mind knowing how to care for their mental health and well-being.

Platforms like Spirence also provide the option to pose questions to professionals, like therapists, psychologists, and coaches (for free).

The Trickle-Down Effect of Caring Employers

Offering an employee wellness platform, especially a comprehensive one, can make employees feel seen and cared for by their employer. This can build a positive work culture and psychologically safe work environment. In a culture like this, employees are “healthier, happier, more productive, and less likely to leave3.” Profits increase for the company, with higher productivity and less turnover.

Positive work environments contribute to a sense of belonging3, helping employees feel like their contributions and well-being matter. Employee wellness tools can go a long way in fostering this environment. 

How Employees Can Prioritize Their Well-being in and Outside of Work

Employee wellness platforms aren’t the only way to improve and prioritize your mental health and well-being. Here are a few strategies and practices that can protect your wellness and bolster your mental health literacy:

  • Set boundaries at work with clear office hours.
  • If a request beyond your role’s responsibilities comes in, communicate what is and isn’t your job to do.
  • Avoid water-cooler gossip to distance yourself from potential drama and stress. 
  • At-home employees can designate an area of their home solely for work, like a desk in a guest bedroom vs. working on the couch.
  • Seek mental health support through therapy.
  • Educate yourself on mental health and well-being through books, articles, podcasts, and more.

Educational Resources for Mental Health Literacy

These are a few options you can check out to teach you more about mental health in the workplace and beyond.

Books 

Podcasts 

Articles

Progression and Promises in Positive Workplaces

Creating positive work environments, healthy workplace cultures, and improving mental health literacy offer a much-needed shift in employee well-being. Wellness platforms can contribute to a healthy workplace by connecting employees to invaluable clinical and subclinical resources—and they show employers care. 

Self-education through books, podcasts, and articles can also bolster your mental health literacy and well-being. With these tools and resources, you can grow and maintain your wellness.

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What Is ASMR?

Autonomous Sensory Meridian Response (ASMR) is a sensory response to specific audiovisual stimuli. Watching and listening to ASMR can cause relaxation1, reduce stress, and alleviate anxiety. Physically, ASMR can create tingling sensations in the brain and down your back and arms, which is why the ASMR experience is often called “getting tingles.”

Not everyone will experience ASMR, as its effect varies from person to person. Some people will only respond to specific “triggers,” like tapping, and not other sounds or stimuli. You can even become desensitized to ASMR, often called “tingle immunity.” New sounds or stimuli can restore its effect. 

ASMR can improve sleep, mental focus, and general relaxation. It’s become increasingly popular as a study tool or holistic sleep method. ASMR creators–or ASMRtists–upload videos on social media, including TikTok, Instagram, and YouTube to make their content easily accessible. Videos range from a few minutes to 10+ hours. 

The Science Behind ASMR

Emerging study results back the claims of ASMR fans who swear by its relaxing, comforting effects. 

Understanding the Physiological Response

One study on the effects of ASMR used functional magnetic resonance imaging (fMRI) to observe brain activity. The results showed ASMR triggers can decrease heart rate and increase skin conductance levels, a measure of the body’s response to stimuli. This suggests ASMR elicits a reaction similar to comforting interpersonal attention, which can create an overall sense of well-being, relaxation, and happiness—supporting the experiences of ASMR fans.

Benefits of ASMR

ASMR was found to reduce symptoms of depression and insomnia2 by relieving stress and promoting comfort. ASMR also offers a sense of personal connection3 and friendliness between the ASMRtist and the viewer, especially as viewers narrow their preferred style of ASMR and find their favorite ASMRtists. Some creators make specific videos tailored to personal attention and comfort, like simulated make-up applications, reassuring conversations, and repeated words of affirmation. 

Non-personal attention can also comfort the viewer, like watching someone get their back scratched, their hair combed or receive a soothing spa treatment. This relaxed environment and the viewer’s ability to put themselves in the subject’s shoes can almost feel as comforting as receiving the treatment themselves. 

The overall effects of ASMR can improve sleep and promote relaxation, calmness, and comfort. Viewers with mental health challenges, acute stress, and sleeping disorders often find ASMR particularly beneficial as a non-pharmaceutical, at-home remedy for their symptoms.

Common ASMR Triggers

ASMR triggers usually fall into these categories: sound-focused, visual-focused, and an intentional blend of both. 

Sound-Focused Triggers

A sound-focused video features a close-up view of an ASMRtist’s hands and their microphone. You’ll watch them manipulate, scratch, and tap items to make certain sounds, either holding them by the mic or placing them on a flat surface. The focus isn’t on ASMRtist’s hands, body, or movements; rather, the sounds the item makes. Here are a few common sound triggers:

  • Tapping
  • Whispering
  • Brushing the mic or object with a soft brush
  • Scratching
  • Using an item to tap/touch another item
  • Any triggers done ear-to-ear (binaural stimulation) with a special head-shaped mic

Visual-Focused Triggers

Visual-focused videos center on movement, sometimes without any sound at all (besides gentle background music, potentially). For example, an ASMRtist may move their hands and fingers in repetitive, flowing movements to stimulate ASMR. Visual-focused ASMR could also include painting, simple crafts, and eye-tracking ‘games’ hosted by the ASMRtist. Makeup destruction is also popular, as is organizing and cleaning.

Blended Triggers

Many ASMRtists blend visual and sound-focused triggers for a more comprehensive experience. For example, they may use rhythmic hand movements to comb someone’s hair, touch or tap an object, or whisper into their mic as they spin and pulse their hands. Some viewers strongly prefer the combination of visual and audio triggers and find them more effective.

An ASMRtist using blended triggers may also quietly narrate what they’re doing to help the viewer focus and connect. This is often called ‘whispered’, as in ‘whispered back scratch ASMR’. Some viewers prefer this, some find it distracting. ASMRtists often specify ‘non-whispered’ or ‘no talking’ on their video titles to help those viewers find the best ASMR for them.

Tactile Triggers

Though less common and accessible, some ASMR fans enjoy tactile triggers best. These include in-person touch, like hair playing or skin touches, that cause ASMR. Soft scratching or touching down the back and arms can cause the sensations of ASMR and its same positive effects. 

Experiencing ASMR

Knowing the benefits of ASMR, you may be more eager to experience it yourself. It’s okay if you don’t know where to begin—you can start in all sorts of ways. 

Finding Your ASMR Triggers

Start by watching ASMR videos. Try a variety, or begin with a compilation video of multiple (sometimes hundreds) of triggers in quick succession. This can help you find your preferences and discover new triggers even as a long-time ASMR fan. Your response to triggers should be immediate, so you’ll know right away what you prefer. Keep your mind open to new possibilities as you go, as what you like may surprise you.

You can peruse videos simply by typing ‘ASMR’ in the search bar on YouTube, which has longer videos. You can do the same on Tik Tok, Instagram, and other forms of social media to find snippets of longer videos. Once you know what kinds you like, your search could look like ‘slow tapping ASMR’, ‘back scratching ASMR’, or ‘unpredictable no talking ASMR’.

Many ASMRtists cater to deaf viewers or those with attention disorders. Read the title of each video or specify your search to find these types of videos. 

Creating an Ideal ASMR Environment

To get the benefits and effects of ASMR, your environment must align with rest and peace. For example, watching ASMR on a crowded subway likely won’t offer the same benefits as your environment would make it hard to stay focused and engaged with the content. 

Create a peaceful environment by dimming your lights, lighting a candle or incense, and getting comfortable. Ensure you won’t be disturbed by noises, people, or responsibilities. Your bedroom can be an ideal space to watch ASMR, especially for those who use it as part of their bedtime routine. Make yourself as comfortable as possible, and wear headphones if that gives you a better experience. Most ASMRtists recommend headphones for better sound quality and to experience binaural (ear-to-ear) audio.

ASMR for Relaxation and Sleep

ASMR can be highly effective in a sleep routine. Watching a video before bed can help you relax, process your day, and have a calmer mind before you shut your eyes with the intent to sleep.

To work ASMR into your nightly routine, start by watching a video every night. Set a timer for it to remind you, if needed. You could also pick out your videos for a whole week by saving them on YouTube. This can spare you the time and effort of picking a video each night, which can make it easier to integrate into your routine. 

If you have other nightly habits, like reading, you can watch ASMR after those activities. Try to do it right before you close your eyes to make sure your mind stays relaxed and calm as you shift into sleep. 

The ASMR Community 

ASMR has a large fanbase, especially as it continues to grow in popularity. YouTube hosts many ASMR videos and ASMRtists, as its long-form videos cater more to the length of ASMR videos. Many YouTube creators focus specifically on ASMR content and center on a niche, like tapping, back scratching, or organizing items. Some ASMRtists will show their face and talk to the camera during the video, commenting on the trigger, life updates, and more. ASMRtists like these can connect more personally with their audience and grow a unique following, though some viewers find conversation distracting and detracting from the experience.

ASMR fans often gravitate towards a handful of ASMRtists and join a community of others with the same preferences. Some ASMRtists have online groups for viewers to interact with them and other fans. You can even pay for specific ASMR videos that include your preferred triggers. Some fans also financially support their favorite ASMRtists with small monthly donations. 

The ASMR community as a whole provides a space of comfort and safety for many. ASMR’s focus on soothing, comforting, and healing touches every aspect of it, from its online communities to each unique video. Many ASMRtists with similar styles collaborate and create videos together, so you may see your favorites visit each other and make content.

Criticisms and Misconceptions of ASMR

Despite its growing popularity, ASMR faces skepticism. Some regard it as a sexual fetish due to the intimate nature of certain triggers, while others dismiss it as a pseudo-science4. However, for those who experience ASMR, it’s neither. It’s a personal, non-sexual, and subjective experience that varies person-to-person.

ASMR could also be seen as something only women can create and enjoy. But viewers and ASMRtists vary in all sorts of ways, from their age, race, gender, and sexuality. They live worldwide and represent unique cultures, languages, and demographics. 

Future of ASMR

ASMR could become even more of a buzzword and household practice in the coming years.

Research and Developments

As ASMR grows in popularity, more scientists and clinicians have begun publishing studies and reviewing its effects. This could broaden the medical community’s awareness of ASMR and make it more common practice to recommend it. For example, a particularly potent study could encourage doctors and mental health providers to recommend ASMR to their patients.

ASMR has been studied5 and likely will continue to be. As more studies and experiences reach the public, more people may try ASMR and incorporate it into their daily lives, similar to meditation and mindfulness. Apps and training courses now exist solely to help people meditate; the same could soon be true for ASMR.

Expanding ASMR Applications

Like other mindfulness practices, ASMR could be included in standard treatment plans for mental health conditions. For example, a therapy session could include watching an ASMR video to settle your mind before beginning. A therapist could also use it as a calming tool, similar to soothing music, during a session. 

Since ASMR can lower heart rates and improve mood5, it may become more mainstream in all types of treatment, from therapy to a calming pre-operation tool in the medical space. ASMR’s overall future and integration into the broad realm of healthcare seems promising.

ASMR’s Whispers of Hope

ASMR can be a highly beneficial tool for people with and without mental health conditions or sleep disorders. You can ask your friends and family if they watch ASMR and the types of benefits they feel. If you like ASMR, you’ll join a thriving community focused on comfort and healing. If you don’t, you’ll still have plenty of company. Try ASMR today to see how it can help you.

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Understanding Psychodrama Therapy: Techniques and Benefits

Psychodrama is a therapeutic method that uses dramatic techniques, such as role-playing, to help people understand and resolve their emotional conflicts1. During sessions, patient groups enact scenes from their lives or dreams to gain insights and practice new ways of being in the world2. 

The goal of psychodrama is for patients to gain mental clarity so they can learn new ways of thinking and cope with their feelings surrounding the event. Through these exercises, patients may see improved social skills, a boost in self-esteem, or a positive attitude shift3. Psychodrama can teach adaptive coping strategies, leading to resilience4. 

Incorporating psychodrama into your recovery plan can offer a new perspective on healing and a deeper understanding of yourself.

Origins and Development

Jacob Levy Moreno, a Romanian psychiatrist and psychoanalyst, invented psychodrama in 19215. Moreno studied the power of relationships and group interactions, seeing a person become the healing agent for another. His creation was inspired by improvisation theater and the rise of the psychoanalytic movement led by Sigmund Freud. It became the first form of group psychotherapy.

Moreno quickly developed one of the fundamental concepts, role theory, which shows how social roles shape behavior6. People take on different roles in their lives, and exploring these roles in a therapeutic setting can lead to insights and personal growth.

In the 1940s-60s, interest grew in psychodrama, and it became a therapeutic practice. Psychodrama was applied not only in clinical settings but also in educational and community settings. Today, psychodrama can be applied to family therapy, trauma work, and addiction treatment. It’s even being discussed as an alternative method of education in schools. 

Core Principles of Psychodrama

Psychodrama therapy is guided by several core principles. Moreno defined these principles7 as:

  1. Warming up: A process that creates an appropriate environment for spontaneity. This may look like physically shaking your body to loosen up, clearing any doubts, and having silly conversation. 
  2. Spontaneity: By being in the present moment, you can react to things without any preconceived notions. This can benefit role play.
  3. Creativity: Spontaneity helps catalyze creativity—it is born by reacting the way you normally would, a true-to-self reaction. When you are rooted in the here and now, there’s more opportunity for play, creativity, and new ways of thinking.
  4. Encounter: Meeting another person where they are at and mentally viewing the event from their perspective.
  5. Tele: Sensing the feeling/bond between 2+ people. During the first encounter between a group, the tele should be neutral. Then, a positive or negative feeling forms over time and between interactions.
  6. Co-conscious vs co-unconscious: These are states shared between 2+ people. A co-conscious state is when a particular feeling in a group is voiced or acted out, so it is known. A co-unconscious state occurs when 2+ people who are closely existing develop a normal atmosphere amongst themselves. This is created through shared and unshared feelings, actions, and beliefs, but it is not outrightly stated.
  7. Role: An identity that someone takes on in the moment, depending on the context. For example, the eldest sibling may assume the role of parent if the younger sibling is in distress and the parent is not nearby.
  8. Role vs ego: The ego is a concept that helps us balance between societal norms and our true desires. In psychodrama, the ego actively explores roles, emotions, and conflicts. It aims to strengthen ego function.
  9. Role reversal: Changing from your current role to the other person’s. This can help you gain insight.

Looking at all these principles, we can form the inner workings of psychodrama. Focusing on spontaneity and creativity while role-playing allows you to develop a new perspective on past events, feelings, and behaviors. 

Key Roles in Psychodrama

There are 3 key characters in a psychodrama session: the protagonist, auxiliary egos, and the director.

The protagonist takes center stage during a psychodrama session. They are the main focus and typically present an issue or situation they want to explore and work through. The protagonist enacts personal situations, bringing them to life through role-playing.

Auxiliary egos are people in the group who play roles within the protagonist’s enacted scenario. They may portray significant people, objects, or aspects of the protagonist’s internal world. Auxiliary egos offer alternative perspectives for the protagonist.

The director is the therapist or facilitator guiding the session. They set the stage, facilitate interactions, and ensure a supportive environment. The director leads warm-up activities, and they may intervene or suggest things to facilitate exploration and resolution.

Techniques and Processes: How It Works

In a psychodrama session, you may participate in various techniques to find the best for your healing. At the core, you will be role-playing as the protagonist or acting out specific roles or situations to explore emotions, thoughts, and behaviors. 

From there, you could practice mirroring, where the auxiliary egos copy your behaviors, emotions, or body language—this can foster self-awareness.

Another group member may practice doubling, voicing your thoughts and opinions for you. Speaking your internal feelings aloud can help deepen your understanding of the event. 

You may role reverse with another person, allowing you to experience the situation from a new perspective. 

Sometimes, you, as the protagonist, talk through your inner thoughts, providing insight into your internal dialogue and expressed emotions. This is called soliloquy.

Practices such as these can strengthen your emotional awareness. The director (your therapist) will ensure that the sociometry of the group is healthy and balanced, meaning the auxiliary egos are well suited to support the protagonist. As group dynamics grow, these techniques will become easier and easier, making room for deeper exploration.

The Role of Action and Enactment

Physically acting out past experiences is what sets psychodrama apart from traditional talk therapy. This approach is immersive and engaging, and activating all the senses can help patients work through buried feelings. Psychodrama pulls patients out of their internal world and allows them to experience emotions, thoughts, and behaviors directly.

Psychodrama can be particularly effective for patients who feel limited by traditional talk therapy. Reenacting certain events can provide insights and much needed emotional release.

Applications of Psychodrama

Psychodrama is commonly done in group therapy, although it can be used in individual and family therapy, as well. In a group or family setting, other participants in the group would help set the scene, while individual therapy usually involves the counselor and the patient engaging in this practice.

Psychodrama can be beneficial for specific conditions, such as trauma. Trauma affects both the brain and the body8, and it can be hard to find words to describe trauma (because Broca’s area, the part of the brain responsible for language, is less active when remembering trauma9), making it difficult to process in traditional talk therapy. Psychodrama provides an alternative way to connect the mind and body to work through trauma.

As this approach aims to boost self-esteem and self-sufficiency, psychodrama can improve depression and anxiety symptoms10. It can also aid addiction recovery. Role playing a patient’s addictive behaviors helps them understand the roots of their substance use and develop healthier coping strategies.

Any patient can benefit from psychodrama—it’s not only for self-proclaiming “creative” people. With the right guidance, engaging in these practices can improve communication, self-awareness, and promote healing.

Integrating Psychodrama with Other Therapies

Psychodrama can be integrated with other therapeutic modalities to create a well-rounded treatment plan. 

Cognitive behavioral therapy (CBT), one of the most common and effective therapies for addiction11 and mental health disorders, can combine with elements of psychodrama. Your therapist may use role-play or family of origin imagery12 (exploring mental images, memories, and perceptions of your family and childhood) in addition to CBT techniques that replace unhealthy thought patterns with more positive ones.

Psychodrama can also work in conjunction with Gestalt therapy. This therapy takes a “whole person” approach to healing and looks at many aspects of someone’s life that may have contributed to their struggles instead of just one event or trauma. Gestalt therapists can use role reversal and the empty chair method13 (similar to role-playing with an auxiliary ego, but instead, you interact with an empty chair) in addition to Gestalt techniques such as “I” statements.

Dialectical behavioral therapy (DBT) compliments psychodrama, as well. DBT has similar processes to CBT; however, there is an emphasis on mindfulness and healing in the present moment. While engaging in role play and other psychodrama practices, focusing on mindful words and movements can increase spontaneity and creativity—thus facilitating exploration and recovery breakthroughs. 

Questions to Ask Your Provider About Psychodrama

Before beginning psychodrama sessions, you may consider asking your provider a few questions, such as 

  1. How do you act as the director of the group? Can you give examples of how you mediate sessions?
  2. How do you determine who would be a good auxiliary ego for my role-playing session?
  3. How would you evaluate my progress in the sessions?
  4. Are there follow-up sessions to break down what we’ve learned in the psychodrama sessions?

Training and Certification

As a therapist, proper psychodrama training can ensure that your patients get the most out of your sessions. You can receive training through many organizations; some are in person, while others are virtual. At the American Board of Psychodrama14, you can learn the theory, master the techniques, and understand group dynamics to facilitate your patients’ healing.

If you’re seeking out a psychodrama therapist, ensure that they have this certification and proper experience and education—this should be a Master’s degree or higher, and their credentials can look like Psy.D., M.S.W., and L.M.H.C. Ask them questions such as

  1. What does a typical psychodrama session look like?
  2. How do you integrate psychodrama practices into other therapies?
  3. How will you manage the group dynamics?

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