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Wellbeing

Can Science Stop Aging? A Look At The Strange Science Of Senolytics

We’d like to think we’re going to live forever, but realistically speaking, that’s…well, unlikely.
In 2016, American life expectancy declined for the second year in a row, per data (link opens a PDF) gathered by the National Center for Health Statistics. That’s largely due to various worsening health problems like heart disease and stroke. In any case, the news is pretty grim; the average American will live to be 78.6 years old, a whole two decimal points fewer than in 2014. Women can expect to live for about 81.1 years, while men can expect to live a measly 76.1.
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Nobody likes to think about getting old, but that’s exactly why some scientists are obsessed with the concept. Someday, we might be able to slow down the aging process or even halt it entirely—and, according to a recent research review, that day might come sooner than we think.
The piece, which was first published in The Journal of American Geriatrics, attempts to evaluate the clinical potential of senolytic drugs. A team led by James L. Kirkland MD, PhD, outlined testing guidelines for senolytics (and yes, we’ll explain exactly what that means in a moment). These drugs would be the first substances designed specifically to target the aging process, and if they’re effective on humans, they could change the way doctors treat age-related diseases (and make parking at Denny’s much more difficult).

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Before you break out the sparkling grape juice and celebrate, we should note that we’re a long way from turning society into some sort of elder-run utopia. We don’t have proof that senolytics work, and if you’re hoping to head to your local supermarket and pick up a big bottle of senolytic pills, you’re going to be disappointed.

The purpose of the paper was merely to establish practices for clinical trials. Still, the authors note that medicine that targets fundamental aging processes “could transform geriatric medicine by enabling prevention or treatment of multiple diseases and functional deficits in parallel, instead of one at a time.”
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In other words, instead of treating diseases linked to aging, like Alzheimer’s or cancer, doctors would target aging itself. We decided to look into the science to try to determine whether a magical anti-aging pill is really right around the corner. Hint: It’s complicated.

Buckle up: Here’s how proposed senolytic drugs would work.

Senescence occurs when a cell stops dividing; it essentially dies but remains in the body. Senescence is thought of as a natural part of the cell aging process because, if cells replicated forever, they’d eventually become cancerous.
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“The purpose of this … is to make sure that these cells do not maintain their damaged genomes any further in the organism,” Ira Pastor, CEO of regenerative medicine company Bioquark and member of the World Economic Forum’s Human Enhancement Council, tells HealthyWay.
The problem is that senolytic cells don’t just disappear after they’ve stopped working. They hang around and secrete signals called SASPs (senescence-associated secretory phenotype, in case you’re studying for an advanced biology test), which tells the body to get rid of them. Those SASPs also contribute to the various negative processes we associate with aging.

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Eventually, the body eliminates the senescent cells, but by that time, the damage is done. As we get older, our bodies become less efficient at getting rid of the senescent cells, feeding the aging process.
“The core belief … is that as we get older, and as the elimination of these senescent cells is slowed down, the SASP secretion is detrimental to the surrounding tissues and can cause a range of other problems, such as inflammation, tissue damage, and degeneration, therefore speeding up aging processes,” Pastor says.
That’s where senolytics come in.

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“Senolytic therapeutic substances are being developed to see if it is possible to selectively induce [or] enhance the elimination of these senescent cells from the body.”
Senolytic substances could potentially compel the body to speed up its elimination processes, turbocharging the garbage collection and allowing us to stay young, fit, and beautiful forever (or at least slightly younger and fitter than we’d be otherwise).

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That all sounds pretty good to us. Unfortunately, the aging process isn’t exactly simple, and scientists don’t think of cell senescence as purely bad—or good, for that matter. Yes, this next section is a bit of a bummer.

There’s a pretty strong argument against senolytics.

Here’s the thing: Cell senescence is complicated, and it’s not exactly spontaneous.

“It is important to understand that senescent cells don’t just pop up out of the blue,” Pastor says. “There is a whole ‘upstream’ system of tissue-level architecture dynamics—tissue membrane potentials, forces of mechano-transduction, signals from the microbiome, visco-elasticity of interstitial fluids, molecular crowding/variability, etc.—that controls their production and deposition.”

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Dizziness aside, here’s what we got out of that: Senescence isn’t a random occurrence, and getting rid of the senescent cells won’t necessarily stop your body from producing them.

“Just like we are now understanding that cancer is no longer just about random single cells that have ‘forgotten to die,’ but more of a tissue-level disease that produces cancer cells, the same can be said for senescent cells,” he continues.
An article by Jan M. van Deursen, first published in the journal Nature, supports the idea that senescence is a multifaceted process—and, at times, an extremely useful one.
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“It’s also important to understand that senescent cell bio-dynamics are also very beneficial in many facets of our life and in keeping us alive,” Pastor says. “Aside from being beneficial in preventing cancerous transformation, they are important in human wound-healing dynamics, certain components of human regeneration, and—probably most importantly—in various aspects of tissue patterning, especially during embryonic development.”
Wait, embryonic development? That seems kind of counterintuitive if senescence is associated with aging.
“Paradoxically, embryos are full of senescent cells during their development, and this represents the exact opposite of aging, where the new fetus is becoming more robust and resilient,” Pastor says.
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This is a type of programmed senescence; during normal development, embryos produce a high number of senescent cells, which allows them to remodel their tissues. To put it plainly, you wouldn’t want to eliminate senescence entirely.

With that said, there’s still some hope for the therapy.

At this point, the arguments on both sides of the issue are pretty much theoretical, but experiments are underway to determine whether stopping senescence can extend health in old age. Some animal testing, reported Scientific American, indicates that senolytic substances are safe and potentially effective in mice, but Pastor believes that those studies are misleading.

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“Humans never experience the ‘flood’ of senescent cells in our bodies that are seen in the genetically engineered animal models,” he explains. “We have actually very few at any given point in time, as our bodies are very good at getting rid of them.”
“So, ultimately, I believe that it is not the senescent cells that are causing these diseases of aging, but the actual reverse: In diseased tissues, senescent cells are being created or ‘hijacked’ as part of the grander disease and pathogenic tissue remodeling processes, orchestrated from many other factors which truly represent a complete process of biological aging.”
Therefore, eliminating senescent cells might not be effective in humans, since our bodies will quickly replace them.
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“Our belief is that just killing them off faster will probably not do much beyond opening up space for more to be created. One still needs to turn off the disease processes upstream that are causing their formation in the first place. Still, time will tell which approach is correct.”
We should note that Pastor’s view isn’t universally shared among scientists; the aforementioned Scientific American piece points to the fact that some believe removing senescent cells will cause the body to create new tissues, thereby slowing down the aging process.

For now, the best way to slow the aging process is pretty straightforward.

Unfortunately, our advice isn’t as exciting as “take this medication and enjoy decades of brilliant youth.” At this point, the only ways to reduce the effects of aging are to get plenty of sleep, eat well, exercise, and wear plenty of sunscreen.

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There’s even some research that suggests drastically reducing caloric intake for a few days a month can help extend your lifespan. Note, however, that even the researchers behind these findings don’t recommend extreme changes in what you eat for any length of time.
“Life is difficult enough without engaging in some bonkers diet,” Rozalyn Anderson, a co-author of one of these studies, told Scientific American. “We really study this as a paradigm to understand aging. We’re not recommending people do it.”
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We’ll go a step further and recommend against it. Aging is the decline of health; if you want to fight it, it’s best to practice healthy habits.

Unfortunately, the visible effects of aging rely on your genetic profile, so for the time being, there’s not much else you can do—but if senolytics do turn out to be an effective form of therapy, that could change in a hurry.
“In the coming years, we will see whether this strategy of increasing their elimination impacts human diseases and thus healthy aging,” Pastor says. “[At Bioquark], we do not much believe in the concept.”
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Still, human trials might begin sooner rather than later. If senescence really is the gateway to the real-life Fountain of Youth, it’s an exciting time to be alive (and, more importantly, to continue to be alive).

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Health x Body Wellbeing

Psoriasis Treatments: A Guide To Natural And Mainstream Options

Something that looks like a rash might not seem like cause for alarm, but psoriasis is a chronic disease that needs to be diagnosed by a medical professional. Although there is currently no cure for psoriasis, there are a number of conventional and at-home psoriasis treatments out there that can make living with the disease a little easier.
Psoriasis is a genetic, autoimmune, inflammatory condition, in which your skin cells divide too quickly and do not shed quickly enough, creating inflamed, itchy, thick, white, scaly plaques, most classically on the scalp, elbows, and knees,” says Tsippora Shainhouse, MD, a board-certified dermatologist, fellow of the American Academy of Dermatology, and a clinical instructor at the University of Southern California.
Psoriasis is a chronic disease, and while it can’t be cured, it can be managed. “Psoriasis is a lifelong disease that can wax and wane but usually does not resolve completely or forever,” says Shainhouse. “Many of our newer medications are able to achieve a 90 to 100 percent skin clearance while [the person is] on the medication, but it is not a cure.”
Fortunately, thanks to a number of psoriasis treatments, the symptoms can be managed. Here’s what you need to know about treating psoriasis.

What causes psoriasis?

“The causes of psoriasis are not completely understood, but it is thought to be an autoimmune disease, which means that your body’s defense—your immune system—is overactive and actually working against itself,” says Jeanette Jacknin MD, a holistic dermatologist specializing in topical cannabinoids for skin disorders. “One-third of psoriasis patients have a family history of the disease, so there also appears to be a genetic component for the disease.”
Even if you are genetically predisposed to carry psoriasis, you might or might not get it. There are often certain factors trigger the psoriasis, Shainhouse says. These triggers might cause the first outbreak or aggravate the existing symptoms of your psoriasis.
Stress is another potential trigger, according to the scientific research. Jacknin mentions that severe stress often precedes the first emergence of psoriasis and 70 percent of flare-ups.
Other potential triggers include skin infections and injuries to the skin, according to the National Psoriasis Foundation. Even a small pinprick can trigger or aggravate psoriasis, a reaction called the Koebner phenomenon. The Koebner phenomenon could also trigger psoriatic arthritis (more on that later).
In addition to having a number of triggers, there are a number of different types of psoriasis, categorized by where and how they appear on the body.

Types of Psoriasis

Guttate Psoriasis

Guttate psoriasis is characterized by a “sudden eruption of small, pink, scaly spots all over the trunk,” Shainhouse says, adding that the “trigger” for guttate psoriasis is often strep throat: “for some reason, the body recognizes strep antigen as psoriasis and turns it on.”

Plaque Psoriasis

Also known as psoriasis vulgaris, plaque psoriasis is the most common type, accounting for 80 percent to 90 percent of psoriasis cases. The American Academy of Dermatologists (AAD) notes that plaque psoriasis is accompanied by a scaly, silver, thin layer covering the skin and a thick buildup of plaque, usually on the scalp, elbows, knees, and lower back.

Inverse Psoriasis

Most commonly found in the underarms or groin, Shainhouse says, inverse psoriasis occurs where hair touches skin. Skin will appear raw and it will feel swollen and sensitive.

Pustular Psoriasis

Commonly appearing on the hands and feet, pustular psoriasis includes the development of pus-filled bumps accompanied by red, swollen skin, according to the AAD. This type of psoriasis can be extremely painful.

Erythrodermic Psoriasis

A rare but serious and life-threatening form of psoriasis, erythrodermic psoriasis involves large patches of red, raw-looking skin covering the body. This is accompanied by chills, a fever, and flu-like symptoms. This is usually developed by people who have another kind of psoriasis.

Generalized Pustular Psoriasis

When pus-filled bumps and scales appear all over the body and not just on the hands and feet, it could be generalized pustular psoriasis. Again, this is a rare but life-threatening form of psoriasis. It’s often accompanied by flu-like symptoms.

Nail Psoriasis

Nail psoriasis is frequently accompanied by discoloration of the nails, tiny dents or pits in your nails, and blood or build-up in the nail bed, according to the AAD. The nails might come away from the skin.

Conventional Psoriasis Treatments

If you have psoriasis, it’s most likely plaque psoriasis, which is manageable. But it’s important to keep an eye out for any symptoms of the more serious forms of psoriasis described above. The psoriasis treatments prescribed by your healthcare provider will depend on the type of psoriasis you’re experiencing.
[pullquote align=”center”]“Once you understand your skin disease and know which treatments work for you, you can treat flares at home as needed and see your dermatologist when you need help.
—Tsippora Shainhouse, MD, FAAD[/pullquote]
If you have a flaky, itchy rash that doesn’t go away, contact a medical professional, says. “You should see a dermatologist to discuss treatment options and long-term management,” she advises. “Once you understand your skin disease and know which treatments work for you, you can treat flares at home as needed and see your dermatologist when you need help.”
Depending on the severity of your skin and whether or not you have systemic symptoms, including psoriatic arthritis, your doctor will prescribe topical treatments or even oral or injectable medications,” Shainhouse explains.
Shainhouse says that there are a number of topical psoriasis treatments. You might be prescribed a vitamin D analogue topical cream, which slows down the production of new skin cells so that a thick scale won’t build up on your skin. Another option is a topical steroid or a topical tar, which helps to calm the inflammation, redness, and itch. A retinoid might also be prescribed; this helps to normalize cell division so that old cells can shed instead of building up.
Oral medications are usually prescribed for moderate to severe cases of psoriasis. “Oral medications reduce inflammation, reduce the immune response, and/or regulate skin cell production,” Shainhouse notes.
In the last decade, biologics (injectable medications) have become a popular psoriasis treatment. “A biologic is a protein-based drug that blocks the action of a specific type of immune cell (called a T cell) or blocks proteins in the immune system,” Jacknin says. “Patients on biologics have to be monitored closely for side effects.”
Keep in mind that the psoriasis treatment that is prescribed for you depends on the nature and severity of your symptoms and that it’s best to see a dermatologist about psoriasis to receive the necessary medication. With that being said, certain natural or at-home remedies can help with your psoriasis treatment.

Natural Psoriasis Treatments and Lifestyle Changes

Get a little sun.

Soaking up the sun—in moderation—might help with your psoriasis symptoms. “UV light is generally a no-no in dermatology, since we know that too much can be associated with the development of skin cancer and melanoma,” Shainhouse says. “However, it has an anti-inflammatory effect in psoriatic skin and is a very useful option for reducing skin disease/symptoms.”

Keep your skin from drying out.

Dry skin can aggravate the symptoms and discomfort associated with psoriasis. You can prevent dry skin by staying hydrated, avoiding very hot showers or baths, and using an air humidifier. Dry air dries your skin out, and an air humidifier helps to counter that issue.
Moisturizing regularly is also important—just ensure that your moisturizer is free of fragrance, as fragrance might irritate the skin more. Many people swear by using moisturizers containing Oregon grape for psoriasis. Also known as mahonia aquifolium, Oregon grape has been proven to be an effective and helpful moisturizer for people with psoriasis.
Another great moisturizing agent is aloe vera, Jacknin says. “Research shows aloe vera can help reduce the redness and scaling of psoriasis,” she says. Moisturizers containing 0.5 percent aloe are your best bet.
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Soak in a tub.

Although psoriasis is itchy, scratching is a bad idea, as it can exacerbate the problem. “Rubbing and picking at the skin will actually worsen the spots,” Shainhouse says. “Psoriasis tends to develop in sites of skin trauma, including cuts and scratches.”
Instead, you’ll want to relieve the itchiness in another way. The National Psoriasis Foundation recommends a number of natural treatments for itchiness. This includes soaking in the tub with a natural remedy such as oats. If you’re not keen on letting the oats float in your bathwater, put some in a clean sock or a small sachet, tie it closed, and let it soak in your bath.
A bath with Dead Sea salts or Epsom salts might also help relieve itchy skin, Jacknin says. It’s best to moisturize just after getting out of the tub to avoid drying your skin out, she adds.
Rinsing with apple cider vinegar can help reduce itchiness on your scalp, but avoid it if you have any open wounds.

Invest in CBD oil.

Plants related to the cannabis genus—including hemp and what we refer to as cannabis—contain cannabinoids, which have a range of health benefits. “Recent studies have suggested that cannabinoids may treat psoriasis by interfering in many of the inflammatory and immune pathways that exacerbate or trigger psoriasis,” Jacknin notes. She points to research that suggests cannabinoids may slow the development of skin cells called keratinocytes, which lead to psoriasis symptoms.
[pullquote align=”center”]“Based on the research, I believe that the anti-inflammatory properties of CBD can dramatically improve symptoms for many patients with psoriasis.”
—Jeanette Jacknin MD[/pullquote]
Cannabidiol (CBD), a type of cannabinoid, is particularly helpful for people with psoriasis, Jacknin says. This is because it has anti-inflammatory properties. “Based on the research, I believe that the anti-inflammatory properties of CBD can dramatically improve symptoms for many patients with psoriasis,” Jacknin says.
CBD comes in the form of ingestible oils and tinctures, which can be consumed orally, or in topical treatments. Hemp-derived CBD is legal throughout the United States. Jacknin suggests using third party–tested CBD oil derived from U.S.-grown hemp, such as MedTerra CBD oil.

Avoid alcohol and smoking cigarettes.

Research shows that drinking alcohol and smoking cigarettes can aggravate psoriasis symptoms, so it’s best to avoid both alcohol and cigarettes.

Eat anti-inflammatory foods.

Certain foods have anti-inflammatory properties, and stocking up on these anti-inflammatory foods can help treat psoriasis. Anti-inflammatory foods include kale, ginger, sardines, and beets. Jacknin strongly recommends integrating turmeric into your diet: Eat it in your food or have some in pill form.
Some people have an inflammatory reaction to dairy, so consider avoiding dairy products and monitor whether your symptoms improve.
Remember that these remedies and lifestyle changes should complement your prescribed psoriasis treatment, not replace it. In other words, while there are measures you can take at home to reduce your psoriasis symptoms, it should primarily be treated by a healthcare professional.

Diseases Related to Psoriasis

Psoriasis is more than just skin deep—which is why you need to see a healthcare professional if you suspect you have it. According to the National Psoriasis Foundation, up to 30 percent of people with psoriasis are at risk for developing psoriatic arthritis, a kind of inflammatory arthritis that could cause permanent joint damage if left untreated for too long. If you have psoriasis, be on the lookout for sore, stiff, and swollen joints, as this symptom could be caused by psoriatic arthritis.
After being diagnosed with psoriasis by a dermatologist, you might have to be tested for these related diseases. Shainhouse says that a rheumatologist could address issues with psoriatic arthritis. “There should be communication and joint patient care with the primary care practitioner, because there are medical conditions that must be screened for and monitored in patients with psoriasis,” she adds.
If you have psoriasis or psoriatic arthritis, you’re at greater risk for certain diseases. Studies have suggested that people with psoriasis are more likely to develop cancer, cardiovascular diseases, depression and anxiety, metabolic syndrome, liver disease, and inflammatory bowel disease, among other conditions. The reason that psoriasis is linked to those diseases isn’t fully understood, although it’s thought to be because of the chronic inflammation and compromised immune system associated with autoimmune diseases such as psoriasis.
Living with psoriasis isn’t easy, but a combination of the right medication and positive lifestyle changes can greatly improve the symptoms. Consult a dermatologist before pursuing any home remedies or natural psoriasis treatments, as psoriasis could be indicative of another serious disease or medical condition.

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Happy x Mindful Wellbeing

8 Good Podcasts To Listen To For An Empowering Commute

Driving to work can be a drag. Whether you’re headed to a confining cube or you’re going to the job of your dreams, a long commute doesn’t exactly rev you up for the 8+ hours of work you have ahead of you. That’s why we’re recommending some majorly inspiring and interesting podcasts (all lady-led, of course) that’ll give you some real-life motivation, advice, and entertainment to empower you before you dive into the daily grind.

1. Girlboss Radio

Former Nasty Gal CEO Sophia Amoruso talks to other—you guessed it—girlbosses. When you’re heading into a job, whether you love or hate it, this podcast will motivate you to keep up the hustle. Not to mention, these successful ladies have some kickass advice for your day-to-day life too.

Our Episode Picks

For the Pop-Culture Junkie: Sarah Jessica Parker, actress, producer, entrepreneur
For the 60-Hour Workweek Warrior: Arlan Hamilton, founding and managing partner of Backstage Capital
For the Workout-Legging Addict: Tyler Haney, CEO of Outdoor Voices

2. Happier with Gretchen Rubin

Gretchen Rubin, a writer who studies happiness and human nature, and her sister, Elizabeth Craft, discuss the ins and outs of finding happiness in the chaos of daily life. They give straight-up advice for boosting happiness and discuss the value of self-reflection. For practical-minded women, these tidbits of advice and insights give tangible steps for increasing happiness and fostering good habits.

Our Episode Picks

For the Realist: “Remember, This Is Supposed to Be Fun”
For the Post-It Queen: “Write It Down (Really)”
For the Yoga-Pants Zealot: “Wear ‘Clothes’ Every Day”

3. Almost 30

Friends Krista Williams and Lindsey Simcik, a playful duo from Los Angeles, chat about the fun of transitioning into adulthood and all that comes with it. For those approaching 30 (which can seem daunting), there’s so much—too much!—to figure out. Regardless of what you’re feeling uncertain about (whether it’s your health, your career, your relationships, your mental state, or all of the above), you can find a relatable episode that’ll encourage you and let you know you’re not alone.

Our Episode Picks

For the 420 Friendly: “Cannabis 101 + Why It’s Important”
For the Yogi: “The Beats, The Sweat, The Tribe”
For the Foodie: “‘Genius Foods’ + How Eating for Optimal Brain Health Will Make You Happier and More Productive”

4. Forever 35

If you’re over 30 and interested in what wellness can look like for you in this chapter of your life, listen to these two friends and self-described wellness addicts discuss how people in the real world (i.e., not wellness influencers) are trying their very best to be comprehensively well. They talk to women who are engaged in the pursuit of wellness from all angles—from maintaining practices that focus on their physical bodies to working with their minds and souls.

Our Episode Picks

For the Minimalist Mom: “Mother of Intention” with Emily Gould
For the Naturalista: “Talking Natural Beauty” with Jessa Blades
For the Serum Devotee: “Skincare Questions” with Courtney Chiusano

5. On Being with Krista Tippett

For the deep thinkers, Krista Tippett will get your gears turning as she discusses life’s big questions with interesting people. If you’re looking to go on a deep dive into your mind, listen to On Being for your fix of profound reflection.

Our Episode Picks

For the Artist: “The Normal, Daily Things We Fall in Love With” with Maira Kalman
For the Self-Identity Seeker: “Finding My ‘I Am’” with Maria Shriver
For the Writer: “Soul Food, Sex, and Space” with Nikki Giovanni

6. By the Book

Each week, Jolenta Greenberg, a producer and performer in New York City, and Kristen Meinzer, an audio producer and host, live according to the advice of a self-help book to determine if these authors know what they’re talking about or if they’re just selling a gimmick. For those who frequent the self-help section of their local bookstore or the cynics calling BS on Malcolm Gladwell, this podcast assesses the power of such literature to revolutionize your life.

Our Episode Picks

For the Eternally Messy: The Life-Changing Magic of Tidying Up
For the Real Housewives Fanatic: Class With the Countess
For the Down-on-Her-Luck: You Are a Badass

7. Free Cookies

Hosted by real-life couple Kate Fagan, an ESPN reporter, and Kathryn Budig, a yoga teacher and foodie, this podcast shares “free cookies” about their respective areas of interest, plus deets on their relationship. Juicy.

Our Episode Picks

For the Sports Fan: “Abby Wambach Kicks Off Cookies”
For the Barre Class Enthusiast: “Curtain Calls & Cookies”
For the Yogi: “Cookies for Every Body”

8. Unladylike

Unladylike gets into the challenges, stigmas, and stereotypes women face in today’s society and what they’re doing to overcome them. Hosts Cristen Conger and Caroline Ervin bring on ladies who talk about self-empowerment and ignore the haters trying to tell them how to live their lives.

Our Episode Picks

For the Women Crushing on Fitness Influencers: “How to Get a Yoga Body” with Jessamyn Stanley
For the Working Mom: “How to Nanny Up”
With intelligent and genuine ladies like these paving the way, it makes sense that podcasts have become increasingly popular in the past couple of years. The right Beyoncé track can pump you up momentarily, but the right podcast can give you some sustainable motivation to work hard while making your daily commute more empowering.

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Wellbeing

Recognizing 4 Common Signs of Borderline Personality Disorder (And What To Do Next)

“I felt like he was going to leave me. I felt like everyone was going to leave me.”
Ashley, 32, was in a new relationship with a man she really liked. She had no reason to believe anything was wrong—and no reason to do what she did.
“For days, I tried not to let him out of my sight,” she says. “I tried to hold on, but I kept feeling more desperate. It didn’t matter. I was sure that he was going to leave, so I told him I was going to [hurt myself]. He told me to get help, and for once, I listened. I don’t know why. Maybe I thought that was the only way to make him stay.”

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Ashley had many of the signs of borderline personality disorder. She depended heavily on others for her identity, which led to dramatic moments where her relationships broke apart in front of her. She couldn’t regulate her emotions, and she couldn’t hold onto a stable sense of self.
According to the National Institute of Mental Health, about 1.4 percent of U.S. adults can be diagnosed with borderline personality disorder. That’s a shockingly high number—and it’s even more distressing considering the large amount of misinformation surrounding the condition.
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Borderline personality disorder (also known as BPD or emotionally unstable personality disorder) is a serious, long-term condition characterized by mood swings and dangerous behavior. Like many personality disorders, it’s extraordinarily complex, with environmental, genetic, and social factors contributing to the development and progression of the disease. Women are significantly more likely to suffer from BPD than men.
The good news is that the condition responds well to psychiatric treatment. The bad news: Because mood swings can accompany a variety of physiological diseases, people often misinterpret the signs of BPD.
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After all, it’s a hard distinction to make, even for a trained psychologist; is a person experiencing one of the dramatic breaks commonly associated with BPD, or are they simply going through a tough time? Will their behavior eventually change—or do they need professional intervention?
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To be clear, nobody should try to diagnose a mental illness on their own (or any other illness, for that matter), but recognizing the symptoms is the first step toward getting treatment. We looked into some of the commonly missed signs of this disease with the help of psychiatrist Alex Dimitriu, MD.

1. People with BPD have extreme instability in their personal relationships.

“Signs of BPD include unstable relationships, generally with significant drama,” Dimitriu tells HealthyWay.
Because people with BPD have difficulty regulating emotions, they have trouble maintaining a healthy baseline. That means their personal relationships become unstable—and, in a sense, they seek out and create that instability.

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“Unstable attachments can often manifest in splitting, or having very intense feelings that can quickly change from love to hate,” Dimitriu says. “Rage inevitably occurs, and people with borderline personality disorder can be very harsh on both themselves as well as those around them.”
For people who don’t have the illness, those changes can be extreme and frustrating. People with BPD might be emotionally cruel, or they might completely disengage from relationships.

2. That instability also carries over to their sense of self.

“I had hobbies [before I received treatment], but they changed all the time,” Ashley says. “If I had a new boyfriend or best friend—they were always ‘best’ friends—I was obsessed with whatever they were obsessed with. But my moods changed almost constantly, even throughout the day, which made it impossible to focus on anything other than those relationships.”

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Those symptoms are fairly common among people with BPD, who might even go so far as changing their beliefs, principles, and (gasp!) political affiliations in an effort to fit in.
“[Another symptom] is an unstable sense of self, resulting in ‘melting into’ various groups or fads, and outside observers may at times feel the borderline [person] is like a ‘chameleon,’” Dimitriu says. “Because of an unstable sense of self, combined with the intensity or rage episodes, it is not uncommon for people with BPD to do self-damaging things.”
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To put that another way, a person with borderline personality disorder might move from group to group in an effort to fit in and feel comfortable. They’re looking for an environment that will provide some sort of stability and sense of identity.
Ironically, moving from group to group will likely cause instability with their interpersonal relationships.

3. People with BPD often engage in self-damaging behaviors, which aren’t always easy to spot.

Generally speaking, BPD behaviors aren’t exactly subtle. However, they can be difficult to identify as symptoms of a mental illness. To friends and family members, a person with BPD might simply seem like they’re being unreasonable in the moment. As with other mental illnesses, it’s difficult to separate the disorder from the person.

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“[BPD behaviors] can range from impulsively sending an email that could result in getting fired, to fighting or being dramatic in relationships, to threats of suicide or self-harm in the form of cutting or medication abuse,” Dimitriu says.
Of course, a person can present some of those symptoms without having a mental illness, and psychologists don’t make a diagnosis from a single incident. One of the defining features of BPD is that it persists over long periods of time and through multiple relationships.
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“Most commonly, these symptoms or tendencies have been present for a long time, often since teenage years, and it is not uncommon to have a family relative with a similar coping or personality style,” Dimitriu explains.

4. People with BPD often have unstable upbringings.

That brings us to another common symptom—and a root cause—of BPD: a family history of unstable behavior. While a variety of factors contribute to the illness’s development, familial instability seems to be one of the bigger factors.
“On a most fundamental level, it is believed that borderline children never knew they could trust their caregivers to be present consistently,” Dimitriu says. “This leads to patterns of acting out, neediness alternating with rage, and fears of abandonment. Inconsistent as well as overly intensive parenting is sometimes to blame. These parenting conditions often result in a child’s distrust of their own self and ability to relate to people in the world.”

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According to a paper published in The Lancet, borderline personality disorder is frequently associated with adverse events that occur during childhood. Those events might be the result of parental negligence or abuse.
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Psychologists also believe that BPD has a genetic component. However, that doesn’t mean the situation is hopeless; while some people may be genetically predisposed to BPD, they can still respond well to treatment.

The good news: People with BPD have options for treatment.

There’s no standardized treatment for borderline personality disorder, but cognitive behavioral therapy (CBT) seems particularly effective. One paper found CBT provided a “gradual and sustained improvement” in outcomes for BPD patients, reducing serious incidents and improving social functioning.
CBT, by the way, is a type of psychotherapy administered by a trained psychologist. The patient is compelled to challenge negative thought patterns, eventually reducing the feelings of instability that drive their actions.

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“I was worried about taking medication, but for the most part, my [therapy] sessions were the biggest part of my treatment,” Ashley says. “It’s still a struggle. I think it’s always a struggle, but it’s a lot easier to get by when you understand where the negativity is coming from, and what you can do to sort of stick a wedge in it.”
With that said, before seeking treatment for BPD, it’s important to make sure a person actually has the condition. We’d really like to stress this point: Only an experienced psychologist or psychiatrist can make that diagnosis.
[pullquote align=”center”]“Don’t tell them that they’ve got this condition or that condition, just get them to a therapist’s office. There’s no reason to live in misery. My mental health problems don’t run my life—I run them.”
—Ashley, a 32-year-old diagnosed with BPD[/pullquote]
“Before anything is called a personality disorder, it is important to rule out true psychiatric conditions—such as depression, anxiety, or bipolar disorder—which can often overlap with BPD,” Dimitriu says. “Reducing stress and improving mood can play a big role in mitigating symptoms that may look like borderline personality.”
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As Dimitriu explains, psychological issues are complex, and a single self-harming incident doesn’t mean that a person has BPD or that they need to pursue a particular course of treatment. However, major mood swings should be taken seriously.

Don’t assume a person’s simply acting out to be dramatic.

“Desperate people do desperate things,” Dimitriu says, “and I often give the example to my patients of how irrational a drowning person may appear. There have been instances of a desperate drowning person drowning their rescuer [or] lifeguard; reducing depressive symptoms or anxiety can definitely lead to less desperate thoughts and actions, which can certainly improve, to some degree, the rage and instability seen in borderline behavior.”
Because the symptoms of BPD overlap with the symptoms of other conditions, psychologists will need a detailed patient history in order to recommend treatment.

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“An important point worth noting is a higher incidence of bipolar disorder in borderline personality,” Dimitriu says. “One key difference is that bipolar patients will have longer periods of time during which they appear ‘stable.'”
Bipolar disorder also needs treatment, of course. The most important takeaway: If you know someone who may have BPD or who experiences major mood swings, urge them to get help.
“Don’t tell them that they’ve got this condition or that condition, just get them to a therapist’s office,” Ashley says. “There’s no reason to live in misery. My mental health problems don’t run my life—I run them.”

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Healthy Relationships Wellbeing

Signs You’re In A Codependent Relationship (And What To Do About It)

Let’s face it: Relationships are hard. Trying to parse out the right balance between sharing our life with someone versus being joined by the hip can start to get fuzzy over time.
And if Grey’s Anatomy has taught us anything, it’s that spending every waking hour with our “person” can make it hard to decipher where they end and we begin.

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Apparently, it’s a line that often gets crossed for couples. Although popular culture often glamorizes this kind of romantic enmeshment, according to psychologists, it can quickly devolve into an unhealthy dynamic called “codependency,” a tendency of over-reliance on others.
If you and your partner find it hard spending time apart or struggle to make even the most basic decisions without the other’s approval, read on.

Codependency for the Uninitiated

While most people automatically think of codependency as a generic term for any kind of dysfunctional relationship, the concept originally referred to the enabling behavior of the partners of those struggling with addiction. But the definition has since evolved within the mental health community. According to WebMD, codependency is a pattern of behavior where your entire sense of self revolves around your partner’s approval.

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Sara Stanizai, a licensed marriage and family therapist who specializes in working with high-functioning anxiety in couples, says that unlike independence, where each person is capable of meeting their own needs and then chooses to be present with their partner, “in codependence, people are not capable of meeting their own needs and require this from their partner.”
It impacts relationships because people have a hard time making even basic decisions on their own without consulting their other half. This means that on a deeper level, they are strongly influenced by their partner’s feelings and emotions.
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This is different from mutual dependency, says Claudia Luiz, a New York City psychoanalyst and author. “Codependency is very frustrating, like trying to walk through quicksand or being stuck in slow motion.”

Signs You’re in a Codependent Relationship

“It feels like playing a role as opposed to being a real person who is allowed the full spectrum of human experience,” says digital nomad Vironika Tugaleva, a Canadian life coach.

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Tugaleva, 30, has been in codependent relationships for most of her life. “Even the one I’m in now begins to curdle into those patterns,” she says, “and we have to claw our way out with self-awareness, honesty, and forgiveness.”
Many times, we don’t know what codependency looks like, as it’s often passed down as learned behaviors, says Keba Richmond-Green, a marriage and family psychoanalyst from Atlanta.
[pullquote align=”center”]“Codependency can wreak havoc on relationships and block someone from experiencing true intimacy.”
—Eliza Boquin, licensed marriage and family therapist[/pullquote]
In order to identify these patterns, she advises we take honest inventory of our relationship by asking ourselves the following questions: Do I always feel I get the short end of the deal? Am I worried about their opinion of me or my choices? Am I uncomfortable expressing my true feelings? Do I feel humiliation or like a child when I make a mistake? Am I passive? Do I keep quiet to avoid arguments?
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Taking stock of the answers that might arise isn’t easy, but here are other clear-cut signs to look for, according to experts:

Separation Issues

There is little to no privacy or personal time; you don’t spend time separate from one another. One of the resulting red flags is not having personal hobbies, only hobbies together. Another flag for this is when you have each other’s passwords for every account.

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This is the result of another symptom: One or both of you have difficulty setting or enforcing limits and boundaries. There’s constant texting or checking in with each other, and there’s panic if there’s no response to texts. There’s also a feeling of mistrust when spending time apart.

Needs and Emotions

You feel an overwhelming need to be liked and approved by the other person—this often results in you feeling emotionally and physically drained the majority of the time. Exacerbating this is the feeling that you can’t be happy unless the other person is happy.

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Oftentimes, you are unable to identify your own needs and desires and, consequently, not meeting them. You may also suffer from low self-esteem, feeling like you’re never good enough.
You’re easily swayed by your partner’s opinion or emotions, even when your instincts or feelings say otherwise. There’s a distinct fear of abandonment or exaggerated fear of the relationship ending.

How Codependency Inhibits Growth

Since intimacy is fueled by the perfect balance of distance and closeness, according to Eliza Boquin, a licensed marriage and family therapist from Houston, individuals in codependent relationships will often struggle to achieve the autonomy needed to experience the type of connection they so often desire.

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“Codependency can wreak havoc on relationships and block someone from experiencing true intimacy,” she says.
Tugaleva acknowledges that these dynamics have often held her back by not allowing her to explore a fuller range of emotions, but she also recognizes that these patterns have been embedded within her family for generations. In fact, research on codependency shows it’s trans-generational in nature and often stems from a child watching and imitating these behaviors from other family members.
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It’s also important to note that these symptoms can later be seen in a variety of different relationships and isn’t limited to those that are romantic in nature.
For someone prone to codependent traits—such as excessive caretaking or feeling the need to fix others—it’s easy to fall prey to toxic friendships where the person can initially feel both needed and appreciated. The danger here is in basing our sense of self-worth on our “friend’s” needs.

Likelihood of Thriving in Codependent Relationships

Sometimes couples can worry that they have “too much drama” to be happy, explains Stanizai. But if you and your partner have similar reactions to drama, then it’s not necessarily a problem. “For example, if you are both hot-headed or cool-headed, that’s a better situation than if one of you is very reactive and the other is cool as a cucumber.”

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One of the most important factors in making a relationship happy, she says, is if you and your partner match in communication styles, emotional patterns, etc. “Just feeling that you are codependent doesn’t necessarily mean your relationship is doomed,” Stanizai affirms. “There are many people in codependent relationships who have regular disagreements but still rate their relationship as very happy overall.”
Still, she cautions: “Codependency itself isn’t the best type of relationship to be in, so you should consider working together with a therapist, coach, or religious leader to help you manage your relationship.”
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Luiz agrees with her, saying an otherwise great relationship can often hinder a couple from working on the codependency. “It’s easier to sweep a problem under the rug when things are otherwise pretty okay.”

Making the Decision to Break Patterns

Giving each other space is the first step toward breaking these patterns.
The next, according to Boquin, is working with a licensed psychotherapist who specializes in healthy relationships and who can give you the necessary tools to identify and implement healthy boundaries. This also allows you and your partner to gain further insight into unhealthy relationship patterns and provide you with the necessary support to begin experiencing healthy relationships.

Young woman confronting her partner in a therapy session.
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However, experts offer a word of caution that not all relationships can be salvaged, especially if they are based on a foundation of toxicity or emotional abuse. “When two people trigger each other perpetually, cannot walk away when things get too angry, cannot be loving, can’t be heard, or [can’t] create a positive outcome, then the couple becomes tragically stuck in codependence,” says Luiz.
“But if the codependency is relegated only to a corner of the relationship,” she adds, “let’s say around food consumption, around having temper tantrums when there’s a particular trigger, or around not setting good boundaries with children perhaps, then the rest of the relationship may be fine.”
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She’s quick to note, however, that this doesn’t exempt a couple from the arduous task of working on their issues. “As a psychoanalyst, when a couple brings me their codependency issues, we are at the heart of everything that is unresolved for both people,” Luiz explains. “Like feeling unheard, being with somebody who is emotionally unresponsive, feeling loved, feeling respected, feeling in control, etc.”

Forging Independence

If you find yourself in a relationship that is (or could become) codependent, Stanizai recommends taking the following steps for improving autonomy:

Have personal hobbies, friends, or other things that are just for you.

Have separate gyms, Friday night happy hour, or certain events that are just fun for you. “Couples will have to negotiate what they are okay with,” Stanizai says, “but the idea is to deliberately spend time apart, take a risk, and cultivate trust.”

Self-soothe and calm yourself down when you start to get nervous.

If you partner hasn’t returned a text for a few hours or your mind starts to wander, counteract those negative thoughts with positive ones. It’s most likely not the worst-case scenario you think it is.

Practice active listening.

Believe your partner when they tell you something. You would want the same, right? When they tell you something, repeat it back to them until they are satisfied that you understand them. (This sounds weird on a daily basis, but it’s more useful after a disagreement.)

The good news: Codependency can be overcome!

Luiz reiterates that dependency in itself isn’t the problem. “Your dependence on each other should only be changed if it’s standing in the way of growth, productivity, or greater intimacy.”

Couple holding hands on a table.
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“This is an opportunity to scratch beneath the surface of the relationship,” she says, “and go deep into knowledge of each other to shake things up and come out ahead.”
Luiz recommends couples use their codependency to learn more about themselves; part of this means delving into uncomfortable truths about one’s past, such as exploring early childhood issues and their connection to current dysfunctional behavior patterns.


Working closely with a licensed psychotherapist can help you and your partner begin to turn things around and make significant strides toward improving your relationship—but equally important is turning an inward eye to where it all first started. While we can’t change events from our personal history, we can become more aware of the effects they have on our present and the ways we can reduce their impact.
Tugaleva now looks back on her prior relationships through the lens that time and introspection have given her. She says the more she’s allowed paradoxes into her experience, the more she’s been able to heal these negative patterns.

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She believes that in order to lead healthy relationships with ourselves and others, we must first be able to access the entire range of human experience when we need it. “I can be angry and sad, vulnerable and hard, strong and weak, loud and quiet,” Tugaleva notes. “I need to be all these things at different times.”
“Now that I am able to do so, I refrain from playing small, limited roles with others,” she adds. “I am free of needing them to act a certain way in order to be happy.”

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Wellbeing

How To Respond To The “When Are You Having Kids” Question

You’re sitting at dinner, just about to bite into that delicious macaroni salad, when your in-law casually throws out the old, “So…when are you two going to have kids?” It’s a question that’s been asked what seems like a million different times by pretty much everyone you know and in a multitude of very creative ways.
Maybe it’s something like, “It sure would be nice to have a grandchild…,” paired with a longing glance at a cute pair of baby-sized shoes. Or perhaps it’s a, “Wasn’t he cute as a baby?” wink-wink-nudge-nudge while flipping through old pictures in what you thought was an innocent and hilarious journey down memory lane. It could even be from an acquaintance you hardly know who cavalierly asks, “When do you think you’ll start popping ‘em out?”

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Here’s the thing. Whether someone has children is a deeply personal, highly intimate—and sometimes medically sensitive—decision made between two people. For some reason, though, it’s a topic that makes its way into the conversation with the kind of casualness with which you discuss the latest episode of Game of Thrones.
If you repeatedly find yourself on the receiving end of these questions and you’re straight up over it—or you’re someone who’s guilty of asking—the following breakdown will benefit you.

Why do so many people ask this intimate question?

Christen Reighter summed it up perfectly in a 2017 Ted Talk she gave about her decision to have a tubal ligation in her 20s. “I recognized the roles that were placed on me very early,” she said. “One persistent concept that I observed—existing in our language, in our media—was that women are not only supposed to have children; they are supposed to want to … There are countless reasons a woman may have for choosing to abstain from motherhood. The majority of them? Not self-prioritizing. But it is still socially acceptable to publicly vilify women as such because none of these reasons have made it into the social narrative.”

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Those reasons can range from a concern about the ecological impacts and overpopulation to an inability to provide the right resources for a child. Or they may be medically-fueled concerns about passing on congenital or psychological traits—or simply being dealt a hand where they’re unable to conceive.
The question is consistently on the tip of people’s tongues. It often begins as small talk but, depending on your audience, can deteriorate into a debate that feels not just personal, but sometimes offensive.
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“The reason why it’s such a casual conversation topic is most likely influenced by values and conditioning of upbringing and personal beliefs that when two are together in a relationship, there is an assumption that children will be a part of the family,” notes Lisa Bahar, a licensed clinical counselor and marriage and family therapist based in Newport Beach, California.
If you’re often on the receiving end of this question, she says it’s important to try to understand that these are not personal attacks against you. Rather, they’re assumptions that the individual has been conditioned to believe (as frustrating as they may be).
https://twitter.com/afratheid/status/1016746195325276160
For those who are guilty of asking the question, really think about the reason why you’re asking to begin with. If you simply view it as small talk, there are certainly less personal conversations you can have with others, including about work, travel, and hobbies. You can avoid awkward conversations and potentially offending or striking a nerve with someone by removing the “when are you having kids” topic from your small talk arsenal altogether.
If you’re talking about it because it’s an interesting topic to you and you are eager to hear someone else’s perspective, broach it that way. Refrain from interjecting a “you should do it this (read: my/society’s) way,” and don’t prod or try to poke holes in the other person’s (highly personal) decision.
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We argue the best practice is to avoid this conversation altogether unless the other person brings it up. Then, if it does inadvertently come up, engage your empathy and be sensitive.
Whether you’re an asker or an askee, the below anecdotes might help broaden your perspective and equip you with a keener set of social skills when it comes to this topic.

Actively Choosing Not to Have Children

We’re living at a unique time in history when actively [linkbuilder id=”6805″ text=”choosing not to have children”] has become the more popular choice but still intersects with a strong societal conditioning that assumes women and couples automatically have a desire to procreate. As a result, the “we’re not having children” conversation has proven tricky to navigate.

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Sarah Feuerborn, 26, and her husband, 29, have been together for nine years and married for three. They decided years ago that they didn’t want to have children but still find themselves on the receiving end of this question.
“People ask us all the time when we’re going to have kids,” Feuerborn tells us. “Our families are fine with it at this point, but we still get the occasional ‘You’ll change your mind.’ With strangers, if they ask if we have kids, we usually politely respond with, ‘Oh no, no kids.’”
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If the conversation ends there, then all’s well, she says. However, that response usually leads people to ask when they will.
“I usually respond with, ‘Actually, we don’t really want kids.’ Sometimes I’ll add a ‘We may change our minds, but at this point, we don’t see them in our future.’ At that point, people usually say, ‘Oh you’ll change your mind! You’re still so young!’ which I respond to with, ‘Maybe!’”
“It’s definitely interesting to see how people react,” she says. “I don’t really argue with people much about it. If they’re insistent about it, I get more stern, but I typically say something to politely brush it off and try to change the topic. Many people, especially those with kids, get offended when I say I don’t want them, so I try to be as polite and delicate about the subject as possible.”
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Joanne Williams, 36, has a slightly more aggressive approach to this conversation. She made the decision to be child-free when she was 19 years old.
“I realized how life-altering children truly are to people and their lives,” she said. “I realized that I’m more career-oriented than I am maternal, and ultimately, I am too selfish to have kids. I like to have freedom to come and go as I please, without having to focus on the needs and commitment of others.”
While her parents and friends don’t pester her about her choice, having the conversation with those she’s never met before is a different story.
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“Strangers that have asked always seem slightly confused. It’s as if I’m alien since I have zero desire to have children. I’ve been pretty curt with the answer to this, [saying] that I simply do not, and never have, wanted kids. I feel like it’s been effective for the most part,” she tells us. “I have had a few friends’ parents, [including] my best friend’s mom, ask me when I’m going to get married and have kids. I’ve told her in jest that I’ll do it after her other daughter—who is three years younger than me—does first.”
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For Jenn Schaeffer, who’s in her 40s, the decision to not have children came later in life.
“I was never against having children and actually pictured myself as a mom quite often when I was younger. Though I am nontraditional in many aspects of my life, I had a traditional mindset when it came to having kids: I wanted to be married when I had kids,” she explains.
[pullquote align=”center”]“There have been—and continue to be—so many times that I feel like a failure, despite all of my other accomplishments, because I haven’t had children.”
—Jenn Shaeffer[/pullquote]
“Well, I didn’t meet my husband until I was 38, and we didn’t get married until I was 41. I had sort of a rule for myself that if I didn’t have children by the time I was 40, I wouldn’t have any. Yes, modern medicine has advanced so that you can have children at a very late age, but that wasn’t something I wanted to do.”
She says she gets the “When are you having kids?” question all the time, especially since she works with older people who are inclined to ask.
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“I had a woman even say, ‘Don’t you know it’s your obligation to populate the earth?’ Wait, what? A lot of times I kind of laugh it off and say that ‘We are sticking with fur kids.’ Oftentimes, though, I feel angry that people just expect me to have children because I am a woman,” she confides.
“There have been—and continue to be—so many times that I feel like a failure, despite all of my other accomplishments, because I haven’t had children. I am slowly coming to terms with not having kids, but it definitely has not been easy, especially when I am continuously asked why I don’t have kids. As if there is something wrong with me. Guess I will someday get used to being in the small club of not having children despite what society dictates.”


It’s easy to see from these personal experiences why this conversation topic can trigger a host of feelings ranging from frustration to guilt to even sadness. If you find yourself on the receiving end, understand that there really is no such thing as the perfect response. However, one route you might consider taking is simply being honest about your decision.
“The truth is the straightest path. Rather than make up reasons or ways to dodge the question, why not answer truthfully?” advises Alex Dimitriu, MD, a double-board certified psychiatrist based in San Francisco. “It helps to spend a minute—or 20—thinking this through and understanding one’s own reasons. With an understanding of what drives this decision, it should not be hard to express to someone. The truth shall set you free.”

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Behar agrees, adding, “Be open to talking, if you want, about your decision in a non-defensive way and think in terms of your truth and how that can help another expand their awareness of what it means to be having children.”
And if you don’t want to talk about it with someone at all? Politely tell them, “I’d prefer not to discuss it.” Most people will respect that, and if they don’t, you have every right to walk away.

When Medical Issues Interfere with a Desire to Have Children

Not having children isn’t always an active decision. For example, pregnancy or childbirth could lead to potentially life-threatening medical issues for the mother or result in passing down ailments or defects to their newborn. In some cases, not having children is an undesired reality for those who’ve desperately tried to conceive but have struggled with infertility.
In this situation, being joyfully asked, “When are you having kids?” can be particularly painful. This is something Rachel Schroeder can personally attest to.

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“I have struggled with infertility, and I’ve suffered a miscarriage,” she tells us. “I was diagnosed with polycystic ovarian syndrome (PCOS) when I was 19 and have had pain and irregular cycles and other related issues since then. PCOS is one of the leading causes of [linkbuilder id=”6803″ text=”infertility in women”], so I was prepared that pregnancy may be difficult for me. I also have complex regional pain disorder, a nerve condition that causes chronic, severe nerve pain. This condition may or may not be genetic, and if it is, I do not wish to pass it along.”
In the 11 years of marriage to her husband—along with 10 years working in childcare—she’s been asked countless times when she’ll have children of her own or why she hasn’t already.
“It’s a super personal question, and my answers have varied over the years as I have struggled to decide how much to share and with whom. And honestly, my answers have changed as I have come to terms with the fact that the plans I had as a child to be a parent have not happened and may not happen at all,” she says.
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“Sometimes, I simply say not yet. Other times, I am more forthright and say that it has been a struggle. Other times, I go into more detail about the financial and circumstantial roadblocks that have come our way as we considered adoption.”
An interesting perspective surrounding this topic—and one that isn’t often considered by askers—is that sometimes mothers who have one child experience medical issues that prevent them from having another. Such is the case for Ashley Kenney, whose child turns 12 this year. She had her son “accidentally” at the age of 19 and has since been diagnosed with PCOS. She also recently had a hysterectomy.
“I get asked at least once a week. I’m told that I should at least give my son one sibling. That only children aren’t as well adjusted. Or they will just straight up say, ‘Why aren’t you busy making that little boy a brother?’ which feels like such a personal question in so many ways. Are you asking me why I’m not having enough sex?” says Kenney, “It’s been really hard. My husband and I tried for six years before being told that it wasn’t going to happen and that I needed to take steps to prevent developing cancer.”
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She says she usually just responds as kindly as she can, explaining that her pregnancy journey hasn’t been an easy one. And that, as much as she’d love to give her child a sibling, it isn’t an option for their family.
“Most of the time, people feel awful for having asked,” she says. “I think people just think it’s all in fun for the most part, and until they meet someone who tells them otherwise, they just don’t think about what the underlying reasons might be. Recently, I had someone say they will pray for us to get pregnant. As though even without a uterus it could still happen by the grace of God. And I try to appreciate the sentiment, but mostly I just want to scream that it’s none of their damn business.”
[pullquote align=”center”]“There is so much focus on babies that mothers often get overlooked for the healing and caring process, but that’s a whole other issue. This continued battle I am fighting for my voice to be heard is hard enough without the constant ‘when’s the next child coming’ questions.”
—Lauren Christie-Veach[/pullquote]
Lauren Christie-Veach has a similar story. She had her daughter a year and a half ago and has been eager to have another, but medical roadblocks have made that journey difficult. She says she is overjoyed to have had a healthy daughter and easy pregnancy, but that birth “destroyed her body.” Within 14 months of having her child, she’s experienced a range of medical complications that include ovarian cysts and [linkbuilder id=”6806″ text=”thyroid problems”].
“I get asked all the time when we are having another. Usually, it’s, ‘She’s so sweet and happy. When’s the next one coming along?’ Usually, I just smile and make some stupid small talk comment, but the last time I was asked, I burst into tears,” she says. “There is so much focus on babies that mothers often get overlooked for the healing and caring process, but that’s a whole other issue. This continued battle I am fighting for my voice to be heard is hard enough without the constant ‘when’s the next child coming’ questions. We want another baby, but there is a chance it won’t happen.”
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While we wish we could make the habit of asking such a personal question disappear, we, unfortunately, cannot. However, for those who are asked this question under medically complicated circumstances, you have every right to respond with a simple, “I prefer not to discuss it.” Alternately, if you’re feeling up to it, you could take the “speak your truth” approach.
“Honesty helps bring awareness and also acceptance of the challenges of being medically unable to have children,” says Behar. “People can learn from one another if the answers are real and genuine.”

TL;DR?

If there’s one thing you take away from all this, it’s that asking someone when they’re going to have a child, or when they’ll have another, could affect them in ways you might not fully appreciate. And if you’re on the receiving end of the question, we know you’re frustrated, annoyed, and maybe even hurt every time you hear it. You have every right to feel that way. When the topic comes up, you can refrain from talking about it altogether, or respond from a place of honesty to further the progress regarding the topic at large. It’s a long road until these conversations are a regular and fully accepted part of the social narrative, but we’re getting there by having open conversations—like this one.

Categories
Happy x Mindful Wellbeing

Michelle Williams’ Post Has HealthyWay HQ Talking Mental Health And Therapy

This morning, HealthyWay’s video content strategist reached out to a group of ladies at HealthyWay HQ to ask if we could participate in a video shoot to promote our new community, the HealthyWay Collective. Am I available? Yes, and I also know the team produces gorgeous, attention-grabbing videos on sets that have a reputation for being super fun.
That said, I declined in the group message, explaining that I’m having a really hard time seeing myself on film right now. In fact, a few months ago when I saw a picture of myself in a HealthyWay IG story, I wound up lying in bed crying about it until I dozed off. I hated the way I looked and couldn’t wait for the story to expire. Thinking about having a GIF, or any picture of myself, for that matter, up on the whimsical (and wonderful!) About Us page was making me feel sick and keeping me up at night. I ultimately opted out and am using a selfie from two summers ago as my headshot. I don’t hate every picture of myself, but I can find something wrong with most of them, and yes, shying away from the camera, disliking outfit after outfit on many mornings, and feeling not sexy much of the time is taking a toll on my mental health and well-being.
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Fessing up to the situation in my therapist’s office and stomaching the shock of hearing, “That’s some serious body dysmorphia,” from someone I’ve been working with closely for over a year was hard. It felt like hearing, “Oh? One more thing that’s wrong with you!” But at the same time, it brought the gravity of my experience into focus and gave me the courage to tell my co-workers why I wouldn’t be at the video shoot rather than B.S.ing a reason why I couldn’t participate or just saying “no thanks” and leaving everyone wondering (i.e., contributing to the radio silence about about mental health that leaves so many of us feeling stigmatized when our needs and experiences come to light).
Ironically, while I was processing the fact that I’d just shared something relatively intimate in lieu of a generic, “Yes, I’m available Friday—see you there,” Destiny’s Childs’ Michelle Williams’ post about seeking out therapy was trending, with TMZ, ABC News, and even PEOPLE covering the story.

So, we’re talking about it openly and honestly (even the not-wanting-to-talk part).

This got us talking—not in the “Eek, I just dropped an awkward bomb that might’ve been completely TMI for co-workers” way, but very openly—about our struggles to seek out and keep up with therapy for the sake of our mental health.
[pullquote align=”center”]”Picking up the phone is hard when you are struggling.”[/pullquote]
While I’ve been seeing a therapist regularly and participating in group therapy—which has been truly life-changing for me—for over a year, the experiences of the ladies in the office are just as varied as those of our readers. Our discussion touched on significant challenges, from figuring out where to get started (especially if you’re new in town) to the feeling that our struggles are not “bad enough” to warrant therapy.
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And then there’s the challenge of staying in therapy rather than, as one of our editors put it, “ghosting on your therapist for the third time in a row,” which, let’s be honest, is tempting when there are a ton of of other things that need to be done and a pretty good chance that ugly, uncomfortable stuff will come to the fore that we’d rather deal with later—or never.

We realized we’re not alone—and neither are you.

All that said, sharing our experiences like Williams not only helps us get real and heal, but paves the way for others to get the care they need and feel supported even if they haven’t found the sanctuary of the right therapist’s office just yet. As one co-worker put it, “Realizing you’re not alone and figuring out how to get over that hurdle to get yourself into a therapist or psychiatrist are really difficult concepts if you struggle with mental health … Picking up the phone is hard when you are struggling.”
Another shares that realizing you’re not alone was a big factor for her personally and says that she can see how celebrities being open about mental health can be powerful for other women. While money and success don’t guarantee happiness, it is great to see women using their platforms and influence to get conversations about mental health and treatment going.

But what’s next?

We’re asking ourselves how we can continue prioritizing self-care while reaching out to and supporting others. Could online therapy, better understanding the symptoms of panic attacks and depression, or learning new breathing techniques be right for you? Today we’re taking cues from Williams and other celebrities, including office faves Kristen Bell and Lili Reinhart, and working with what we’ve got to get imperative conversations about mental health—and our treatment options—going.

Categories
Happy x Mindful Wellbeing

What Is Impostor Syndrome, And How Can I Overcome It?

Have you ever looked at your achievements and felt like you don’t really deserve them? Have you received an amazing award but felt like you got it based on luck, not merit? Do you worry that one day, everyone will realize you’re not as talented or smart as you seem?
You’re not alone. “Impostor syndrome,” as it’s known, is surprisingly common, especially among talented and high-achieving individuals. Also known as the imposter phenomenon, impostorism, or fraud syndrome, impostor syndrome involves feeling like a fraud who doesn’t really deserve their achievements.
Feeling like a fraud can weigh on your mental health and work performance. You might constantly feel anxious because you’re afraid of others “discovering” that you’re not truly talented, or you may feel the need to overwork yourself to prove your worth.
[pullquote align=”center”]”If left unchecked, imposter syndrome can be an insidious thought pattern that can lead to increased stress, anxiety, burnout, and even depression.”
—Desiree Wiercyski, life coach[/pullquote]
But it doesn’t have to be this way. Impostor syndrome can be overcome.
If you think you’re experiencing impostor syndrome, here’s what you can do about it.

What is impostor syndrome?

The concept of the impostor phenomenon was first explored by psychologists Pauline R. Clance and Suzanne A. Imes in 1978. They described it as “an internal experience of intellectual phoniness that appears to be particularly prevalent and intense among a select sample of high achieving women.” Since then, the term has been applied to more than just women.
Impostor syndrome isn’t classified as a mental illness, and it doesn’t appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the guidebook used to diagnose mental illnesses. That said, impostor syndrome can exacerbate disorders like anxiety and depression.
If left unchecked, imposter syndrome can be an insidious thought pattern that can lead to increased stress, anxiety, burnout, and even depression,” says Desiree Wiercyski, a life coach for ambitious and career-focused women. Wiercyski runs a self-guided course on working through impostor syndrome.
“When you have consistent negative thoughts cycling through your mind, it’s very likely that they can trigger other negative feelings and emotions, which can lead to an overall lower quality of life,” Wiercyski says, adding that impostor syndrome can negatively impact your work performance, turning those “can’t-do” thoughts into a sort of self-fulfilling prophecy.
Impostor syndrome can be accompanied by feelings of inadequacy and poor self-esteem as well as feeling overly modest about one’s achievements and accomplishments, says Robyn McKay, PhD, a psychologist and career advisor. McKay co-authored the book Smart Girls in the 21st Century: Understanding Talented Girls and Women.

Who experiences impostor syndrome?

Anyone can experience impostor syndrome, but Wiercyski says she finds impostor syndrome to be more prevalent in women and minorities. “When you go through life with any sort of minority status, you’re in a sense being constantly told that there are pieces of you that don’t fit in with the culture, that you’re not living up to pre-conceived standards,” she says. “If you’re constantly told to change, to bend and shift to adapt to expectations, then standing up in a situation where you are the expert, where you do need confidence, is so much more difficult.”
A 2017 study suggests there’s a link between discrimination and impostor syndrome in racial minority groups. In a New York Times article, Kevin Cokley, who co-authored the study, explained the correlation between imposter syndrome and discrimination. “Feeling like an impostor can exacerbate the impact of discrimination,” he said in the Times article. “This is what we found with African-American students in our study. I suspect that discrimination can also exacerbate the impact of impostorism.”
Even the most high-achieving, talented people experience it. “I work with women in tech and medicine primarily—and even those at the highest levels of leadership and influence report feeling at times like they’re going to get ‘found out’ as less intelligent or capable than what they’ve led their colleagues to believe,” says McKay.
Weircyski notes that impostor syndrome can be isolating, but it’s important to remember that if you’re experiencing these feelings, you’re not alone. Nobody wants to talk about the feelings associated with imposter syndrome because they fear being “found out,” and although there are few solid statistics on the number of people who experience impostor syndrome, both experts agree that it’s very common.

Do I have impostor syndrome?

As mentioned before, impostor syndrome isn’t believed to be a psychiatric disorder, so there are no strict criteria for diagnosis. However, Clance, one of the psychologists who coined the term “impostor phenomenon,” does have a self-guided test you can take if you believe you’re experiencing imposter syndrome.
People who have impostor syndrome might engage in the following:

Downplaying Achievements

“They may be overly modest about their accomplishments, and even unwilling to advocate for their career advancement because they don’t want it to seem like they’re bragging,” says McKay. When praised, they might respond by saying “I just got lucky!” or “Anyone can do it.”

Always Needing to Know More

People with impostor syndrome constantly feel doubtful of their knowledge. They might over-research something even if they’re very knowledgeable on the topic. “This isn’t a matter of faking it until you make it; folks who experience this have objective knowledge and expertise in a topic but will turn down opportunities to share their knowledge,” Wiercyski says.

Insisting on Working Alone and Micromanaging

Wiercyski says that people who have impostor syndrome often feel like they have to do all the work, not because they think they’re the only one competent enough to do it, but because they’re afraid other workers will realize they’re a fraud if they see how they work. As such, they might be afraid to share their work or delegate to others.

Perfectionism

People with impostor syndrome often want their work to be perfect before showing others. “This is because they feel like if it’s not perfect, then they’ll lose credibility or respect,” Wiercyski says. “Often, perfectionism can be one of the biggest things that fuels imposter syndrome. Either the perfectionist takes too long to get something done [or] it doesn’t happen, and that reinforces the idea that they’re a fake.”

Volunteering

They might take on too many responsibilities to prove their worth, or they might volunteer for jobs below their pay-grade, says McKay.

Being Excessively Shy in Meetings

“They may not speak up in meetings and may have difficulty finding places to add value to a project,” McKay says. They might believe they have no ideas or innovations and wonder why they were chosen for the team when others confidently contribute, McKay adds. “They might not sit at the table in meetings, but instead take a seat against the wall.”
[pullquote align=”center”]“When you spend time focused on your accomplishments, you start to feel the same way you felt when you achieved those things. This will help provide objective evidence of your capabilities and also help you feel more confident.”
—Desiree Wiercyski, life coach[/pullquote]

How can I overcome impostor syndrome?

If you’re experiencing impostor syndrome, you can overcome it by working on the following:

Acknowledge the thoughts and understand where they’re coming from.

It’s impossible to shift and reframe thoughts if you don’t have a crystal clear idea of what’s causing the thoughts and feelings,” says Wiercyski. Ask yourself where the feelings are coming from: What makes you believe you’re inadequate? Once you realize there’s no definite proof that you’re a fraud, and you see a lot of evidence to the contrary, it’s easier to remind yourself that you deserve your achievements.

Get a clear handle on your mission, vision, and purpose.

If you are unclear on your purpose, it’s easy to slip into the impostor syndrome,” McKay says. Remind yourself of where your passions and talents lie. When you’re fueled by your own purpose, that motivation might shake you out of the self-sabotaging habits associated with impostorism.

Keep a journal of your achievements.

Write out every single accomplishment, training, and qualification you have as well as the praise you’ve received on big projects. “When you spend time focused on your accomplishments, you start to feel the same way you felt when you achieved those things,” Wiercyski says. “This will help provide objective evidence of your capabilities and also help you feel more confident.”

Talk about it.

When you realize you’re not feeling alone in your impostorism—and that many other people experience it—you’ll realize those negative thoughts don’t mean you’re actually ill-accomplished. We can’t all be frauds, can we? Wiercyski suggests talking to others about it like therapists, support groups, and friends. “Not only will you get the support you need and assistance from others in gaining perspective, you’ll also likely find that you’re not alone in experiencing those feelings,” she says.

Reframe the thoughts.

When negative thoughts come up, counter them with the evidence of your achievements, Wiercyski says. “For example, if you got a new job and the thought ‘I have no idea what I’m doing’ pops into your head, you can reframe and say, ‘They hired me based on my experience and knowledge, I have the key things I need to be successful.’”
Impostor syndrome is a common experience that can contribute to mental strain, but fortunately, it can be overcome with a little self-love and a lot of positivity.

Categories
Health x Body Wellbeing

Emergency Contraception Facts Every Woman Needs To Know

Let me just make a few things clear right out of the gate. Accidents happen. It’s hard to remember to take a daily birth control pill, much less remember to take it at the same time each day. Condoms can break. You may have miscalculated your fertile time if you’re practicing natural family planning.
There are about a thousand different reasons you might need emergency contraception, and there are approximately zero reasons you should feel bad about purchasing it.
Even though some forms of emergency contraception have been available without a prescription for over a decade, misinformation about emergency contraception abounds. So, with the help of emergency contraception experts, we’re here to help set the record straight.
Here are the emergency contraception facts every woman (and frankly, every man) needs to know.

How Emergency Contraception Works

Emergency contraception can help prevent unintended pregnancy in a couple of different ways.
One of the most popular forms of emergency contraception is the morning after pill, which delivers a large dose of hormones designed to delay or prevent ovulation from happening. If you don’t ovulate, there’s no egg to be fertilized, meaning you can’t get pregnant.
Another method of preventing pregnancy through emergency contraception is through a copper IUD. Essentially, copper is toxic to sperm. So, when sperm try to swim toward their goal, the copper in your cervical mucus from the IUD kills the sperm.

How Emergency Contraception Works With Your Menstrual Cycle

Here’s a quick refresher on the menstrual cycle:
“Most women have a menstrual cycle that lasts around 28 days from the start of one period to the start of the next (a few are longer and some are shorter in length),” explains Melissa Grant, chief operating officer of carafem Health. “On average, most fertile women ovulate around day 14 of this cycle, meaning they release one egg cell during this time, and it survives about one day. If a fertile man’s sperm comes into contact with a woman’s reproductive tract (through the vagina, cervix, and uterus to the fallopian tubes) the sperm cells can live in her body for up to five days. This means even if a woman does not have sex on the day she ovulates, it is still possible for sperm and egg to join in conception if live sperm are still in her reproductive tract on the day she ovulates.”
This window of opportunity for pregnancy to occur is why Adeeti Gupta, MD, the founder of Walk In GYN Care, cautions women that while emergency contraception pills do work to prevent pregnancy, it’s hard for most women to accurately pinpoint their exact ovulation date to know whether or not they may become pregnant. “The menstrual cycle is helpful [in preventing pregnancy] only if your cycles are regular like clock work,” says Gupta. “However, this should not be used a gauge to decide when and whether or not you need to take emergency contraception.”
So, to recap: If you have unprotected sex around the time that you normally ovulate, you are at risk of becoming pregnant, even if it wasn’t on the exact day of ovulation.

When to Use Emergency Contraception

Luckily, there’s no guesswork involved in knowing when you should take emergency contraception.
“Emergency contraception can be used any time there is unprotected intercourse, unless you are already on birth control pills or have an IUD,” Gupta explains.
According to both Grant and Gupta, you can take emergency contraception at any time during your menstrual cycle and any time that you’re worried you might become pregnant after sex.
Even though most kinds of emergency contraception, like Plan B, are typically effective within 72 hours of intercourse (and others are effective for longer periods), both Grant and Gupta urge women to act quickly after unprotected sex to prevent an unintended pregnancy, and they say the claims that emergency contraception is as effective on day one as it is on day five isn’t completely true.
It is variable. The efficacy also depends on the woman’s menstrual cycle, so it’s hard to predict,” Gupta says.
Still, research shows that all forms of emergency contraception should be taken as soon as possible after unprotected sex in order to be most effective.
And, if you were worried, this means that emergency contraception is not the same as having an abortion. I repeat: emergency contraception is NOT an abortion.
And if you’ve heard differently or are still unsure, take it from the expert:
An abortion ends an established pregnancy,” explains Grant. “Emergency contraception pills work to prevent ovulation and have no effect on an ongoing pregnancy.”

Purchasing Emergency Contraception: A Guide

Now that you know the key facts about emergency contraception, here’s what you need to know about the most popular forms of emergency contraception available and how to purchase them.

The Morning After Pill

The “morning after pill” is a term that describes a couple different forms of emergency contraception pills. This type of emergency contraception contains hormones that help prevent ovulation.

Levonorgestrel

Levonorgestrel is a type of progestin, one of the hormones that affects your menstrual cycle and pregnancy.
Most levonorgestrel emergency contraception options, like Plan B One Step (one of the most popular name-brand types of levonorgestrel emergency contraception), are single-dose options that are most effective when they are taken as soon after intercourse as possible.
Levonorgestrel Effectiveness
When taken within 72 hours, levonorgestrel is 89 percent effective in preventing pregnancy. However, efficacy rates decline the longer you wait to take the pill; by day five, you’re five times more likely to become pregnant.
You should know that some research has shown that the morning after pill is slightly less effective in women with higher BMIs. In fact, one study showed that in women with high BMIs, pregnancy was three times more likely to occur despite using emergency contraception; if you have a BMI greater than 25, it’s recommended that you do not take levonorgestrel. If you have a high BMI, don’t despair: The two other methods of emergency birth control are shown to be more effective overall, even if you have a higher BMI.
Levonorgestrel Side Effects
Because levonorgestrel is a large dose of hormones, it’s normal to experience nausea or even vomiting as a side effect. If you do vomit after taking the morning after pill, Gupta advises following up with a second dose. Other common side effects are similar to how you feel during PMS: bloating, fatigue, breast tenderness, and cramping have all been reported.
Where to Buy Plan B One Step
Plan B (and generic forms of it) can be found in the family planning aisle of most drugstores, so anyone age 17 or older can purchase it without asking the pharmacist or having a prescription. That means your partner, your best friend, or a stranger on the street could purchase the morning after pill for you, no questions asked. You can also buy the morning after pill online through most retail pharmacies, but be aware that shipping times vary, and you may not receive the pill within 72 hours when it is likely to be most effective.

ella (Ulipristal Acetate)

Ulipristal acetate, known on the market as ella, is another type of morning after pill. Ulipristal acetate is a progesterone receptor modulator. Gupta explains that ella also works to delay ovulation, “but works through a different mechanism of action. It goes into the cells and blocks the progesterone receptor to prevent progesterone surges and hopefully ovulation.”
Ella Effectiveness
One of the best things about ella is that it can also be taken up to five days after intercourse, but unlike levonorgestrel-only pills, has even rates of efficacy as time goes on.
In addition, ella has been shown to be more effective in women with higher BMIs, but not failsafe. In one study of over 2000 women, a total of 1.9 percent became pregnant after using ulipristal acetate, but among obese women in the study, the rate of pregnancy while using this form of emergency contraception jumped to 8.3 percent.
Ella Side Effects
Side effects of ella are similar to the side effects of other morning after pills on the market. You may experience symptoms similar to those during PMS, but they should subside after a couple of days.
Where to Buy ella
Ella is currently only available with a prescription, but that usually doesn’t require a visit to your doctor. Usually, your physician can simply call the prescription in to your pharmacy, and in some states, you can even get the prescription straight from the pharmacist. With a prescription, ella can be ordered online and shipped to most states.

Copper IUD

A copper IUD is the most effective form of emergency contraception at 99 percent efficacy up to 120 hours of insertion, regardless of BMI. Plus, unlike the morning after pill, a copper IUD can continue to act as birth control, preventing pregnancy for five to ten years or until you decide to have the device removed.
It only takes about five minutes to insert a copper IUD, and the experience is about as uncomfortable as having a pap smear or colposcopy. A speculum is inserted into the vagina, and then your doctor will use a special tool to place the IUD into your uterus.
Copper is toxic to sperm, so they prevent fertilization of an egg from taking place. Even if you ovulate, the IUD prevents implantation by impairing sperm motility.

How much does emergency contraception cost?

The Affordable Care Act requires insurers to cover FDA-approved contraception methods (thanks, Obama!). That includes emergency contraception, but there are restrictions, so your insurance may or may not cover the cost of emergency contraception. The best way to find out if your insurance covers emergency contraception is to call them directly.
If you go with the morning after pill, like Plan B, which can be purchased at any pharmacy, you’ll likely be paying out of pocket, though insurance may cover some of the cost. Generic brands of levonorgestrel-only emergency contraception have the same rates of efficacy, but are generally a little bit cheaper. You can also save money by visiting the Plan B website directly, as they usually offer online coupons that can be redeemed in stores. Since ella requires a prescription, insurance is more likely to cover all or a portion of the $50 cost.
The best bet for insurance-covered emergency contraception is the IUD, since it requires an in-office doctor’s visit. Without insurance, an IUD can be pretty expensive (think between $500 and $1,000), but insurance brings that cost down considerably.
If you need emergency contraception, but money is tight, you do have options. Visit your local health department or Planned Parenthood to find out about your options for receiving free or low-cost emergency contraception.

I found out I am pregnant after I took emergency contraception. Will it hurt the baby?

Sometimes women find they’re pregnant despite taking emergency contraception. This might be because ovulation had already occured when you took emergency contraception, or the emergency contraception may have been taken incorrectly.
Copper IUDs are 99 percent effective at preventing pregnancy, but while it is extremely rare, pregnancy can occur if the IUD malfunctions or was inserted incorrectly. Even more rare are adverse outcomes if you do become pregnant with an IUD. That said, studies have shown that the risk of ectopic pregnancy and miscarriage are much higher in women who become pregnant with an IUD in place.
That’s not the case with other forms of emergency contraception, though. If you find out you’re pregnant after taking emergency contraception, research has shown that the morning after pill likely has little effect on fetal development.
In fact, a 2009 study of over 600 women in China found that there were no statistical increases in the risk of miscarriage or other adverse pregnancy outcomes when women were exposed to levonorgestrel-only emergency contraception after becoming pregnant.
This may be because most OTC emergency contraception contain high levels of common hormones similar to pregnancy hormones like progesterone. So how can progesterone both promote and prevent pregnancy?
“Yes, progesterone is one of the hormones that surges during pregnancy,” Gupta says. “However, if we give that hormone from external sources [like emergency contraception] then it works through a mechanism called feedback suppression and suppresses ovulation.”
Basically, progestin is a synthetic hormone used in emergency contraception that mimics progesterone but is manufactured to act on the bodies progesterone receptors in a desired way, which is the feedback suppression Gupta mentioned. Grant further explains, “One effect of the type of progestin in emergency contraceptive pills is to inhibit ovulation (stop the release of an egg cell). The most commonly available emergency contraception pill in the United States contains the progestin levonorgestrel.”

Frequently Asked Questions About Emergency Contraception

You asked, we asked the experts, they answered.

Does emergency contraception prevent STDs?

“No, emergency contraception does not prevent STDs,” says Grant. If you have unprotected sex, it’s always a good idea to get tested, just in case.

Is it safe to use emergency contraception more than once?

“Yes, emergency contraception is very safe, and can be used as needed,” says Grant. Unless you throw up immediately after taking the morning after pill, there’s no need to follow up with a second dose. Any time you have unprotected sex and are concerned about pregnancy, you may take emergency contraception.

Can you use emergency contraception as regular birth control?

“No, not at all,” says Gupta. “I do not recommend this method on a routine basis because it can cause irregular periods and high chance of unwanted pregnancy.”

Are you sure that emergency contraception isn’t the same as the abortion pill?

Yes! They have completely different compositions,” Gupta explains. “Ella is similar in chemical composition but it’s used differently and at a different dose for abortion.”

Will emergency contraception affect my menstrual cycle?

Maybe. “Emergency contraception can sometimes delay the cycle and cause unpredictable bleeding in the subsequent cycles,” says Gupta.

Does emergency contraception hurt?

“No,” says Gupta. “You may get some cramps, but it shouldn’t hurt too much.” See the side effects above so you know what to expect!

Is it safe to use emergency contraception if I recently started hormonal birth control?

“Yes, if your hormonal birth control is not yet effective and there is a risk of ovulation, emergency contraception pills can be a good way to further reduce the risk of an unintended pregnancy,” Grant explains.

If you take two morning after pills is it twice as effective?

Sorry, but nope. Plus, according to Grant, “The effectiveness of taking more than one EC pill has not been widely studied. Current recommendations are to follow the package directions.”

My period started right after I had unprotected sex. Do I still need emergency contraception?

“Some women bleed in the middle of a menstrual cycle and others may ovulate even during a period,” Grant explains. “If you have had unprotected sex and want greater protection from pregnancy, you can take emergency contraception pills at any time during your cycle.”

I feel HORRIBLE after taking emergency contraception. When should I call my doctor?

You shouldn’t feel bad after taking emergency contraception. If you do, Gupta says, “Call or go the nearest GYN office/ER right away. Your doctor needs to rule out pregnancy, ectopic pregnancy, or anything else that may be serious.”

Does emergency contraception affect fertility?

According to Grant, “Emergency contraception pills only prevent ovulation at the time you take them. They do not offer long-term protection against pregnancy, and they do not impact future fertility.”

Should I feel bad about using emergency contraception?

“The choice about when and whether to become pregnant or have children is one that is best decided by the people involved,” Grant says. “Having children when you feel ready is something to feel good about!”

Categories
Happy x Mindful Wellbeing

Positive Affirmations Actually Work: Here's How To Start

We all have inner voices within our minds. Sometimes those voices encourage us, but often they supply us with negative self-talk: I’m not good enough to get that promotion. I’ll never meet the right person. Ugh, I’m so lazy for not exercising yesterday.
Before we know it, we let these negative thoughts cloud our minds and absorb our energy.
According to Eckhart Tolle, best-selling author and spiritual teacher, “the primary cause of unhappiness is never the situation but your thoughts about it.” So what if we spend a little more time and energy working on changing our thoughts? We’d be much happier and, chances are, much more successful, too.
That’s where positive affirmations come in. They help redirect our brains to send us encouraging, uplifting statements—instead of negative ones. These positive affirmations build our confidence, boost our mood, and increase our productivity and happiness.
By implementing positive affirmations into your daily routine, you can change your mindset—and, ultimately, change your life.

What are positive affirmations?

Positive affirmations aren’t just feel-good statements. When done right, they can actually alter the neural pathways in our brains.
“The mental image we carry of ourselves and our mind is referred to as our self-image,” explains Tanya Ince, PhD, a money coach who helps individuals reach their highest potential. “Our self-image determines our actions, decisions, behaviors, and what we believe to be true.”
Positive affirmations are statements that help to change our self-image. Even though our self-image begins forming when we’re infants, we can make alterations to it as adults. For instance, if we believe we’re unlovable, we can form a positive affirmation to alter that belief.
“The average human thinks 40,000 to 60,000 thoughts per day, but it can be even more than that,” says Ince. “Most of these thoughts are unconscious and happen automatically, like when we’re driving our cars.” To take control of those 60,000 thoughts (and our lives!), we can use affirmations to install new beliefs that support our goals.
And if you’re totally new to positive affirmations or doubt their power, read on.

The Three Main Types of Positive Affirmations

Positive affirmations aren’t fluff: They remind our brains of what’s good, true, and helpful. They help us reach outside of those negative, circular thoughts. And they come in three main varieties.

Positive Affirmations for Your Identity

Affirmations about your identity speak to who you are. Do you believe you’re a good mother? A faithful friend? A thoughtful person?
[pullquote align=”center”]“Our self-image determines our actions, decisions, behaviors, and what we believe to be true.”
—Tanya Ince, PhD[/pullquote]
Even if you’re self-confident, you might carry doubts and deeply held beliefs about who you are or aren’t. Positive affirmations that target negative thoughts about your identity might look like: “I am a fun, likeable person” or, “My body is healthy and beautiful.”

Positive Affirmations for Your Capabilities

What you believe you can and cannot do are beliefs about your skills. As Henry Ford once said, “Whether you think you can, or you think you can’t—you’re right.”
Affirmations about your capabilities might sound like, “I have the skills to succeed at this project” or “I know how to host a dinner party for my friends.”

Positive Affirmations for Your Relationship With the World Around You

Do you see life as easy—or hard and full of problems? Are people on your side or against you?
What you believe about the world can be modified through affirmations to fit a more realistic, positive outlook. We can remind ourselves with affirmations like “The world has many good people in it” or “Life is full of little joys.”

How to Create Positive Affirmations That Actually Work

“Pre-made statements, like ones from a list of positive affirmations, aren’t very helpful and often times don’t work,” shares Katie Sanford, Licensed Professional Clinical Counselor, owner of Found Hope Counseling in Studio City, California. If you don’t believe your affirmation, it won’t resonate with you.
To build positive affirmations that will help manifest your dreams and change your life, follow these five key requirements.

1. Target an area where you want more balance.

“What area of your life would you like to expand or empower? Your health, career, finances, family life, or spirituality?” asks Ince. Develop a powerful affirmation to home in on the area where you’d like to see improvement.

2. Make it personal.

“Creating affirmations is an art. They must feel like they’re yours,” shares Ince. “Your affirmation has to create a feeling in order to change your neural pathways.” She shares an easy tip: Add your name to your affirmation, like “I, Melanie, find enjoyment in my work.”
[pullquote align=”center”]”Everyone has negative core beliefs, they just affect us differently. All of us can benefit from looking at what we’re believing.”
—Katie Sanford, Found Hope Counseling[/pullquote]

3. State your affirmation in the positive—avoid negative wording.

According to Ince, your positive affirmation shouldn’t include the phrases, “I don’t,” “I won’t,” or “I can’t.”
So rather than saying, “I won’t let people walk all over me,” your affirmation stated in the positive could be: “I am strong and my opinions matter.”

4. Resist comparisons to other people and moments in time.

The words “better,” “worse,” “less,” and “more” shouldn’t make an appearance in your affirmation. Don’t compare yourself with your past self or other people.
To make this easier, Ince explains that positive affirmations should be written in the present tense, not the future. Instead of “I will love myself,” say, “I do love myself.” Instead of “I’ll exercise more,” try: “I take care of my body every day.”

5. Be realistic, but stretch yourself.

“Your affirmations need to be realistic, or you’ll feel like you’re lying to yourself,” says Sanford. Your positive affirmation must be true yet helpful. In other words, it should feel attainable but push you toward empowerment and positive self-image.
If you don’t feel confident in a certain area, like your job, don’t create an affirmation that says you’re the next CEO. Instead, use an affirmation like, “I am skilled and resourceful. I can always figure things out.”

When and How to Implement Positive Affirmations

Now that we know how to create award-winning, life-changing affirmations, how the heck do we use them?
Combining a variety of methods works best, explains Ince. Aim to receive your affirmations visually and audibly as often as possible.
Write your affirmations on a sticky note and adhere them to your bathroom mirror or your computer monitor. “You can also record them using your cell phone and play them back to yourself,” shares Ince.
If you meditate regularly, repeat your affirmation over and over throughout your practice. “You can even write down your affirmation 10 to 15 times on a piece of paper. It can be surprising how well writing repetition works,” says Ince.
If you have a partner or friend who wants to help, they can even read or say your affirmation to you. When you hear your affirmation, like “Jasmine has fun in her life.” Respond with: “Yes, it’s true.” In this way, you’re both accepting and confirming your own affirmation.
“I’ve even used positive affirmations in group sessions. It’s helpful because as people are saying and hearing each other’s affirmations, they naturally begin to reaffirm them for each other. When someone says, ‘I’m capable,’ and a room full of people nod, the affirmation sinks in deeper,” Sanford says. She also notices that people’s postures change when they say their affirmations. Their heads are up and their shoulders are back.

The Best Time of Day for Positive Affirmations

Want your positive affirmations for success to really sink in? Start when you wake up, and end your day with them.
In the morning, our brains are the most open to change,” says Ince. So when you’re lathering up your hair with shampoo or washing your face, repeat your affirmation a few times.
Include your affirmation in your bedtime routine, too, because your subconscious mind helps to install your affirmations as you sleep, Ince explains.
Here’s to kicking negative thoughts and dreaming easier!

How long does it take for positive affirmations to work?

Ever since Maxwell Maltz published Psycho-Cybernetics in 1960, it’s been believed that it takes 21 days to form a new habit. Newer research out of the University College London indicates that it actually takes around 66 days, or about two months. “Changing your self-image or a long-held belief can take longer than that,” explains Ince. “It’s important not to give up when there’s some resistance. Keep going.”
Implementing a positive affirmation doesn’t have to be a super serious endeavor, either, encourages Ince. “Think of it as a playful exercise, an experiment.” Try repeating your affirmation for three to four weeks to see what happens. What new opportunities pop up? What new feelings or beliefs do you have about yourself and the world?
“It doesn’t take long to use your positive affirmations every day. A few minutes in the morning or throughout the day are all you need. The more reminders, the better—and the faster the change will happen,” shares Ince.
“Everyone has negative core beliefs, they just affect us differently. All of us can benefit from looking at what we’re believing,” says Sanford. “Everyone can benefit from positive affirmations.”