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A case study is an in-depth investigation of a person, group, or event used to understand behavior or identify patterns. In psychology, this involves closely examining a subject’s history, experiences, and responses to gain detailed insights that other methods may not capture. While case studies can reveal valuable insights, their findings are often subjective and may not generalize to broader populations.

How Case Studies Help and Where They Fall Short

A case study can have its strengths, but that doesn’t mean that it’s right for every situation. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

Pros

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the ‘how,’ ‘what,’ and ‘why’ of something that’s implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

Cons

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population.
• It cannot demonstrate cause and effect.
• It may not be scientifically rigorous.
• It can lead to bias.

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

Examples of Famous Psychology Case Studies

There have been numerous notable case studies in the history of psychology. Much of Freud’s work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O: Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud’s, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria, and found that talking about her problems helped relieve her symptoms. Her case played an essential part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage: Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie: Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

In Genie’s case, her horrific abuse denied her the opportunity to learn a language at critical points in her development. This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

Different Types of Case Studies

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies: These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies: These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies: These are often used for causal investigations. In other words, researchers are interested in examining factors that may have caused certain events.
• Exploratory case studies: These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses.
• Instrumental case studies: These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies: These are cases in which the researcher has a personal interest in the case. Jean Piaget’s observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies help researchers explore unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be helpful for looking at several cases simultaneously.

Where Do You Find Data for a Case Study?

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records: Census records, survey records, and name lists are examples of archival records.
• Direct observation: This strategy involves observing the subject, often in a natural setting. While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents: Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews: Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation: When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts: Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

How to Write a Psychology Case Study

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information: The first section of your paper will present your client’s background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem: In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis: Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client’s symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach: Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach: Describe a humanistic approach that could be used to treat your client, such as client-centered therapy. Provide information on the type of treatment you chose, the client’s reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach: Describe how a psychoanalytic therapist would view the client’s problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach: If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

Discussion

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Low self-esteem means struggling to see your own worth, which can lead to self-doubt, lack of confidence, and feeling you don’t belong. It involves more than just generally disliking yourself and affects how you value your needs, trust your abilities, and even how you let others treat you.

How to Recognize Low Self-Esteem

While not a mental illness, poor self-esteem can still affect a person’s thoughts, emotions, and patterns of behavior. Sometimes, its signs can be fairly apparent. Other times, low self-esteem symptoms are much more subtle.

For example, some people with low self-esteem talk negatively about themselves, while others go out of their way to make sure other people are pleased with them. In either case, a lack of personal worth and value can have a negative impact on life and wellness.

Some common signs or symptoms of low self-esteem include:

1. Lack of confidence
2. External locus of control
3. Negative social comparisons
4. Trouble asking for help
5. Worry and doubt
6. Difficulty accepting compliments
7. Negative self-talk
8. Fear of failure
9. Poor outlook for the future
10. Lack of boundaries
11. Being a people-pleaser

Poor Confidence

People with low self-confidence tend to have low self-esteem, and vice versa. Low self-esteem can play a role in causing a lack of confidence, but poor confidence can also contribute to or worsen poor self-esteem.

Being confident in yourself and your abilities allows you to know that you can rely on yourself to manage different situations. This self-trust means that you feel comfortable and confident navigating many different things you might encounter in life, which can play an important role in your overall well-being.

Finding ways to gain confidence in yourself and your abilities can be helpful. Acquiring and practicing new skills is one tactic you might try. This may even help reduce feelings of anxiousness as research connects a lack of confidence with higher anxiety levels, especially when under stress.

Lack of Control

People who have low self-esteem often feel that they have little control over their lives or what happens to them. This can be due to the feeling that they have little ability to create changes in themselves or in the world. Because they have an external locus of control, they feel powerless to do anything to fix their problems.

Research has found that in situations where people have little control over what happens, having higher self-esteem can help relieve some of the negative effects of this loss of control, which ultimately benefits mental health.

Negative Social Comparison

Social comparison can sometimes serve a positive function, enhancing a person’s sense of self. But comparing yourself to others can also damage self-esteem. People with low self-esteem may be more likely to engage in upward social comparison, or comparing themselves to people they think are better than them.

Upward social comparison isn’t always bad. For instance, these comparisons can be a source of information and inspiration for improvement. When people are left with feelings of inadequacy or hopelessness, however, it can inhibit self-esteem.

Social media can also contribute to such comparisons, exacerbating low self-esteem. If you often compare yourself unfavorably to others on social media sites like Facebook and Instagram, your self-esteem may take a hit.

Problems Asking for What You Need

When a person has low self-esteem, they may struggle to ask for what they need. Trouble asking for what you need can be caused by feeling embarrassed. Or you may feel that a need for assistance and support is a sign that you are incompetent.

Because their self-regard is low, someone with low self-esteem might also feel that they don’t deserve help. They don’t prioritize their own desires, so they struggle to assert themselves when they are in need.

Worry and Self-Doubt

Even after making a decision, people who have low self-worth often worry that they’ve made the wrong choice. They doubt their own opinions and may defer to what others think instead of sticking to their choices.

This can lead to a great deal of second-guessing and self-doubt. This makes it harder for people with low self-esteem to make decisions about their lives.

Trouble Accepting Positive Feedback

A 2017 study published in the Journal of Experimental Social Psychology found that low self-esteem is directly correlated to not being able to accept or capitalize on compliments from others.

Positive feedback is often met with suspicion and distrust. Complimentary words do not align with their self-beliefs, so people with self-esteem issues may feel that the other person is being flippant or even cruel. 

Negative Self-Talk

Low self-esteem causes people to focus on their flaws rather than their strengths. Rather than build themselves up with positive self-talk, they always seem to have something negative to say about themselves, engaging in negative self-talk instead.

When things go wrong, people with low self-esteem often blame themselves. They find fault with some aspect of themselves, whether it is their appearance, their personality, or their abilities.

Fear of Failure

Because they lack confidence in their abilities, people with low self-esteem doubt their ability to achieve success. Because they fear failure, they tend to either avoid challenges or give up quickly without really trying. 

This fear of failure can be seen in behaviors such as acting out when things go wrong or looking for ways to hide feelings of inadequacy. People with low self-esteem might also make excuses, blame external factors, or try to downplay the importance of the task. 

Poor Outlook

Low self-worth can cause people to feel that there is little chance that the future will be any better than the present. These feelings of hopelessness can make it hard for people with low self-esteem to engage in behaviors that will bring about positive changes in their lives. 

Self-sabotage is a common way of coping with such feelings. By finding obstacles to prevent success, people with low self-esteem are able to find something else to blame for not achieving their goals or finding greater levels of happiness in their lives.

Lack of Boundaries

The ability to set boundaries is often established early in life. Children with caregivers who show them that they are respected and valued are better able to create good boundaries in adult relationships. They are also more likely to have a more positive view of themselves in general.

A lack of healthy boundaries can create problems when others don’t respect a person’s space and time. The lack of respect not only adds to the person’s stress levels but may also make them feel less valued. 

Trying to Please Others

People-pleasing is another common symptom of low self-esteem. In order to gain external validation, people who don’t feel good about themselves may go above and beyond to make sure that others are comfortable and happy.

Pleasing others often involves neglecting their own needs. The person with low self-esteem winds up saying yes to things they may not want to do and feeling guilty about saying no. 

How Having Poor Self-Esteem Might Affect Your Life

Self-esteem plays an essential role in your ability to pursue goals, develop healthy relationships, and feel good about who you are. While everyone struggles with their confidence once in a while, low self-esteem can affect your ability to feel happy. It can even make you more susceptible to mental health conditions such as anxiety and depression.

Research suggests that low self-esteem has numerous effects. For instance, having lower levels of self-esteem is linked to a number of mental health issues, including:

Low self-esteem may even play a role in the development of certain mental health conditions, such as depression. Research has also shown that people with low self-esteem are more likely to be at risk for suicidal thinking.

Another effect of low self-esteem is that you may find it more difficult to achieve your goals and form healthy, supportive relationships. It might also make you more sensitive to criticism or rejection.

Where someone with high self-esteem is likely to be able to shake off negative feedback, someone with poor self-value might take it more personally. This can also make people with self-esteem issues more likely to give up when faced with challenges or obstacles.

Research has found that people with low self-esteem often engage in behaviors that are designed to help preserve their limited self-worth. Actions such as acting sad or sulking are used to garner support from others.

Why Your Self-Esteem Might Be Low

What causes lower self-esteem in some individuals? Several factors could be at play, some of which include:

Specifically, social media can have negative effects if it is used as a way to measure your popularity or likability. But if you use social media to share your interests with like-minded individuals, its impact can be more positive.

Physical health and appearance are additional factors contributing to low self-esteem. For instance, one study found that having missing teeth or untreated dental decay negatively contributes to self-esteem.

Ways to Cope When Your Self-Esteem Is Low

Building or fixing low self-esteem often takes time. But there are things you can do to help protect your mental well-being while taking steps to improve your self-regard.

Focus on Hopeful Thoughts

Spend a little time each day focusing on positive, hopeful thoughts. Notice the little things that you are good at and allow yourself to feel proud of them.

Also, think about times in the past when you made it through something really difficult. Remind yourself that even though you might not feel your best right now, you have the ability and strength to get through it.

Care for Yourself

Poor self-esteem can sometimes leave you feeling like you don’t deserve care and consideration. Work on reminding yourself that you need care and look for things that you can do to show kindness to yourself, no matter how small they may be.

One way to practice self-care is to spend some time doing something that you enjoy. Go for a walk, chat with a friend, or engage in a hobby. Caring for yourself also involves regularly making time to rest and relax, giving your body and mind time to recoup and regroup.

Get Outside Support

If you have low self-esteem, it can be helpful to share your struggles with someone who offers unconditional support. This might be a friend or family member, but it can also be a healthcare provider, therapist, teacher, or clergy member.

Having a network of caring people who value you and want you to value yourself can be beneficial as you work toward improving your self-esteem.

Steps to Build Stronger Self-Esteem

If you are dealing with low self-esteem, there are several things you can do to help improve how you feel about yourself.

• Notice your thoughts: Start paying attention to the automatic negative thoughts you have each day. When these negative thoughts take hold, work to actively identify cognitive distortions, such as all-or-nothing thinking and jumping to conclusions. Then, replace these distortions with more positive thoughts.
• Forgive yourself: If you tend to ruminate over your mistakes or failures, learn how to forgive yourself and move on. Doing so can keep you focused on what you can do better in the future rather than on the negative things that have happened in the past.
• Practice self-acceptance: Let go of the idea that you need to be perfect to have value. If this is how you feel, it can be helpful to work on accepting who you are today. Self-acceptance can still mean there are things you want to work on, but it allows you to it’s recognize that you are worthy of love and esteem—from yourself and from others—exactly as you are right now.
• Value yourself: Spend time reflecting on the things you have accomplished and are proud of. Allow yourself to appreciate your worth and talents without comparing yourself or focusing on areas you’d like to improve. You don’t need to be better to value yourself—but learning to value yourself can help you work toward your goals.

It can be helpful to think of yourself as you would a friend. How would you treat someone you care about who was in the same situation? In many cases, you may find yourself giving them understanding, patience, empathy, and kindness. Show yourself the same unconditional support instead of beating yourself up. 

Additional Ways to Increase Low Self-Esteem

Here are a few additional things you can do to help boost your self-esteem:

• Do something that makes you feel good.
• Stay physically active—exercise can help improve mood.
• Think about something you are good at.
• Keep a gratitude journal.
• Challenge negative thoughts.
• Spend time with people who make you feel good about yourself.
• Volunteer to help others.
• Remember that everyone makes mistakes.
• Celebrate your accomplishments, both the big and the small achievements.

If you are experiencing symptoms of poor self-esteem, help is available. Consider talking to a healthcare provider or mental health professional to learn your treatment options. A therapist can help you change the thought patterns that contribute to low self-esteem, boosting your confidence and opinion of yourself and your abilities.

Raising your self-esteem may take some time and effort. But over time, you can learn to better see and appreciate yourself for who you are.

Committing to your forever person is meant to be a romantic and happy time. But as your wedding day approaches, you might find yourself overwhelmed by the future you’ve spent every waking minute planning. 

While some anxiety before a wedding is common, certain signs can indicate deeper concerns. If you’ve been feeling crushed under the weight of pre-wedding jitters, wondering why the pressure feels so unbearable when this is supposed to be the best day of your life, pause. It may be worth checking in and examining the question you might be afraid to say out loud.

1. Your Doubts About Your Partner Aren’t Going Away, They’re Getting Louder

“Temporary anxiety sounds like: ‘What if I’m not ready?’ ‘What if something goes wrong?’ It’s future-focused. It’s your brain trying to predict every possible thing that could go sideways,” holistic therapist Cheryl Groskopf, LMFT, LPCC, shares. “But underneath all that, you still want to marry this person.”

2. Getting Engaged Was Based on Expectations or Timing

Family expectations and societal norms often influence the decision to get married. If you’re more focused on meeting your obligations rather than your marriage readiness, it may not be the right time.

“Some couples base their decision to marry based on math—they’ve been together for X number of years, or because they are at a certain age, they fear that if they don’t get married right now, they won’t be able to in the future and will miss out,” therapist Shemiah Derrick, LPCC, says. “You need to be sure you love the person 1764631493 and not basing it off who they were in the past or who you hope they will be in the future.” 

3. The Wedding Planning Is Exposing Underlying Issues

The pressure of coordinating logistics can easily lead to arguments. For example, if one partner feels overwhelmed by planning, or if there’s heightened focus on how the process or day will appear on social media, tensions can rise.

Disagreements like these are common in wedding planning. What matters most is slowing down and acknowledging the stress and each partner’s wishes for a great day.

What might feel like small disagreements under pressure could simply be normal planning stress. However, persistent, unresolved conflict over wedding details can magnify differences in values, beliefs, lifestyle, priorities, or ways of handling stress. These disagreements may point to underlying misalignments that deserve attention before moving forward.

4. You’re Not Sure if You Can Grow Together

You might get along really well with your partner, but perhaps you’ve felt a quiet, lingering uncertainty about whether your futures truly align or if you share compatible lifestyles and mutual attraction. Sometimes, these intuitive feelings can get buried under the excitement and momentum of the relationship.

It’s a wise time to check in with those inner signals. They can provide valuable insight about whether moving forward feels right for you.

“Incompatibility doesn’t just show up during wedding planning; it’s usually been there for a while,” Groskopf says. “Anxiety can come and go; incompatibility usually doesn’t.” 

5. Your Intuition Is Telling You Not To Move Forward

“Ask yourself: If all the logistics disappeared—no guests, no parents, no money lost—would I still feel unsure? If the answer is yes, that’s not cold feet,” Groskopf says. “That’s your nervous system trying to get your attention.”

If your gut is warning you not to go through with it and you’ve been ignoring some yellow-to-red flags, that could be a sign that getting married might be a mistake. 

6. You’re Not Happy or Excited

Celebrating your union as a couple is a joyful, jubilant ceremony. If you find the process of creating this event mostly difficult, dreadful, stressful, or saddening, it’s worth checking in with your emotions to see if it’s the activity or the relationship itself that’s the problem. 

Is it a Mistake, or Are You Just Getting Cold Feet?

Getting cold feet before a wedding is common. A study in the Journal of Family Psychology found that two-thirds of couples had at least one partner who reported having cold feet. Sometimes, this is the result of natural anxiety that comes with the magnitude of being confronted with a lifelong commitment. 

“If you grew up in a home where no one talked about feelings, or where image and stability were prioritized over emotional honesty, then the idea of canceling a wedding might feel unthinkable—even if you’re deeply unhappy,” Groskopf says. “You’re not just breaking off an engagement. You’re breaking the rules your younger self learned about what it means to be loved, accepted, and ‘good.’”

Real-World Examples

One individual, Ralph, married his college sweetheart even though he was uncertain about their physical chemistry and emotional compatibility. “I never even thought of my own needs and feelings; my life was so preoccupied with making my partner or my parents happy, or not disappointing all my family, friends, and in-laws. I worried more about the shame I would feel for ruining a ‘picture perfect’ love–one that was actually hollow on the inside.

“Consequently, I wasn’t honest with myself, and I didn’t honor my own emotions. I went through with the marriage,” he said. “Years later, after having two children, our relationship ended in divorce—creating more pain and heartache for everyone I was trying to please—the very thing I had feared all along.”

A formerly engaged couple I spoke to decided to call off the wedding after realizing their wedding party was becoming bigger than the relationship itself. 

“We had been dating for years, and suddenly, we were at the right age to get married. But we knew something was wrong when we put more effort into planning a flawless wedding than we ever put into our actual relationship. We felt stressed out, anxious, and unhappy, and wondered where the excitement had gone.”

They couldn’t keep ignoring the growing distance. After having a few honest, painful conversations, they decided to call off the wedding. “We realized we were more in love with the idea of marriage than with each other. Breaking the news was brutal and embarrassing. But eventually, people moved on, and we did too. The relief we felt afterward told us we made the right choice.”

Steps to Take Before Making a Decision

“The pressure to follow through comes from a mix of cultural messaging and survival instinct,” Groskopf says. “Your brain is wired to avoid rejection, shame, and discomfort. So it makes sense that your body might panic at the idea of letting people down or being seen as someone who ‘couldn’t make it work.’

“But that panic doesn’t mean you’re doing the wrong thing,” Groskopf says. “It just means you don’t have a roadmap for what it looks like to choose yourself—yet.”

If you’re thinking about calling off a wedding, here are some steps to take.

Sit With Your Emotions

Pushing away your anxiety won’t get better, and might feel like a betrayal of your true feelings over time.

“Acknowledge the story you’re carrying: ‘If I walk away, I’m a failure.’ Then get curious with those narratives and gently challenge them,” Groskopf says. “What if the opposite is true? What if walking away means you’re finally listening to yourself? What if it means you trust your gut more than you trust a fantasy?” 

Open Up to Your Partner

“Set aside a conversation to talk about the doubts you each have. You may be shocked that the doubts are actually manageable and it doesn’t mean that the proposal or wedding has to be called off,” Derrick says. “It can be a beautiful opportunity to have some open, honest, and vulnerable communication about what you need and work together on plans to meet each other’s needs.”

If you’re able to say what feels like the unspeakable now, it’s a good sign that your relationship can handle bigger and more high-stakes conversations later on.

Go To Couples Therapy

“Going to couples therapy in a situation like this is like an opportunity to rewind and pinpoint where things got off track and decide what next steps look like in a way that genuinely feels right,” Derrick says. “Some couples reset, repair, and are still able to pursue marriage a little further down the road. Some decide to downshift and focus on friendship or just being in a committed relationship, and in some cases, some do decide to call it quits, but in a healthy way.”

Take Some Space

Paying the deposits, dealing with families, and constantly emailing your vendors can make everything feel urgent. But in these moments, think of the phrase slow is flow, and flow is fast.

It might feel impossible to step away for a day, but right now, your emotions are providing extremely useful data points to inform your decision.

Give yourself permission to slow down so you can make sense of it. Touch grass, take care of your body with movement, and confide in your trusted circle about what you’re experiencing. Clarity will emerge when you make time to breathe. 

Practical Considerations

“Calling off a wedding isn’t just an emotional decision—it’s a logistical nightmare, too,” Groskopf says. “You’ve got people to tell, money tied up, and a lot of expectations coming at you fast.”

Here are some steps to help:

• Reframe your finances: “Handle the money piece like damage control, not punishment. Cancel what you can, resell what you can, and accept that you might lose some money,” Groskopf advises. “That sucks—but it’s still cheaper than years of being stuck in the wrong relationship. And no, spending money on a wedding you’re not having doesn’t mean you ‘failed.’ It means you made the best call you could with new information.”
• Get logistical support: You’ll need to inform your vendors, cancel bookings, and figure out wedding gifts. Take this as a project, break it down into manageable steps, and have your friends and family help you where you can.  
• Telling the guests: “You don’t owe anyone the full story,” Groskopf recommends. “Keep it simple: ‘We’ve decided not to move forward with the wedding, and we appreciate your support.’ That’s it. You don’t need to explain, justify, or fix how other people feel about your choice. Your job is to take care of yourself, not manage everyone else’s disappointment or opinions.”
• Prepare emotionally: Be ready for a range of emotions. “Some people will say the wrong thing. Some will avoid you. Some will project their own stuff onto you,” Groskopf says. Weddings are charged, and under stress, we don’t always show up as our best selves. People’s personal feelings can sometimes get in the way of their ability to empathize and be present with what you are experiencing. Try to redirect toward friends who can be supportive, kind, and understanding.
• Protect your peace: “Don’t talk to everyone about it. Pick a few close friends or family members who are safe—who listen without trying to fix or give advice—and let the rest go quiet for a while,” Groskopf suggests. “You’re allowed to go offline. You’re allowed to delete social media. You’re allowed to have boundaries.”
• Get professional help: Pre-marital counseling can offer couples a valuable space to explore their relationship, clarify shared values, and strengthen communication, especially when doubts or uncertainty arise. It can be a supportive platform for thoughtfully deciding whether to move forward with the wedding.
• Grieve the ending: “You’re allowed to feel overwhelmed about it. But don’t confuse grief with regret. Grief means you cared. Regret means you betrayed yourself—and that’s not what you’re doing here,” Groskopf says. “Even if you’re the one who made the call, it’s still a loss. You’re not just letting go of a person, you’re letting go of a story. Let yourself feel the sadness, the anger, the guilt. Remind yourself: Choosing to leave something that doesn’t feel right is not a reflection of your worth. It’s a reflection of your capacity to be honest and brave.”

Keep in Mind 

If you decide to call off your wedding, there are no villains or winners in this story—just two people in their truth refusing to settle for anything less. Breaking off the engagement may hurt your partner, but in time, they will come to see it as an act of love. Sometimes, planning the wedding can lift the veil on the reality that the shared future no longer makes sense.

This process reminds me of a line from one of my favorite Mary Oliver’s poems, “The Uses of Sorrow”: Someone I loved once gave me a box full of darkness. It took me years to understand that this, too, was a gift. 

“You don’t need a ‘perfect’ reason to walk away,” Groskopf says. “If something feels wrong and you’ve been trying to talk yourself into staying, that is the reason.”

People can experience a wide range of symptoms when they quit drinking alcohol, which can range from mild to moderate to severe. The decision to quit drinking is a big one, but you might wonder what the symptom stages for alcohol withdrawal are, so that you know what to expect.

However, know that there is no “normal” when it comes to alcohol withdrawal. Not everyone experiences withdrawal the same way, and symptoms can stop and start at different times for each person. Read on to see our readers’ comments about what they experienced in the first 30 days after quitting.

Symptoms During Each Stage of Alcohol Withdrawal

Alcohol withdrawal usually follows a three-stage timeline of symptoms ranging from mild to severe. Not everyone experiences all three stages, and a person’s experience will depend on their drinking history and other factors.

The symptom stages of alcohol withdrawal are:

• Stage 1 – Mild withdrawal: Stage 1 is considered mild withdrawal and involves symptoms such as headache, reduced appetite, insomnia, and heart palpitations. This stage usually starts within 6 to 12 hours of having your last drink.
• Stage 2 – Moderate withdrawal: This stage is characterized by symptoms seen in stage 1, along with other symptoms like excessive sweating, fever, increased systolic blood pressure, rapid breathing, and anxiety. Such symptoms tend to appear 12 to 24 hours after having your last drink.
• Stage 3 – Severe withdrawal: In addition to stage 2 symptoms, people in stage 3 also experience severe tremors and anxiety. Without treatment, this stage can progress to more complicated withdrawal characterized by potentially life-threatening symptoms like seizures and delirium tremens.

What Helps Alcohol Withdrawal Symptoms?

Your body and mind are undergoing enormous change as you adjust to sobriety. A healthcare provider can prescribe medications that can help you manage symptoms such as shakes, anxiety, and insomnia.

Those who sought help from their healthcare providers and were given medications to alleviate their symptoms reported milder, shorter-lived symptoms overall than those who quit on their own. Benzodiazepines are typically used to treat seizures, but your healthcare provider may prescribe other medications to help treat other symptoms.

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Readers Share Firsthand Experiences with Alcohol Withdrawal

Almost 8,000 responses were gathered to the question, “What were your toughest withdrawal symptoms and how did you cope?” The comments reveal a wide variety of symptoms and experiences, even within the same days, from days one to 30 and beyond.

Whereas some experienced mild symptoms in the early days, others reported severe, sometimes frightening ones. Most of those who experience severe alcohol withdrawal symptoms do so because they’re going through their detoxification period “on their own” without the benefit of medical help.

Antidepressant fatigue happens when medications used to treat depression, like SSRIs, SNRIs, MAOIs, and NDRIs, make you feel tired. Given that depression itself can make you feel exhausted, it can be frustrating to find that the medication you’re taking to treat it isn’t helping your fatigue.

Antidepressants affect certain neurotransmitters that can cause fatigue and other unpleasant side effects. The good news is that you may still be able to take your antidepressant without constantly feeling like you need a nap.

What Is Antidepressant Fatigue?

Depression can be exhausting. Fatigue is a common symptom of this condition, but it turns out that it can be a side effect of the treatment as well. Antidepressants can be an important part of a treatment plan, but it’s important to recognize that they can also leave you feeling tired or sleepy.

Luckily, many of the side effects of antidepressants tend to subside as your body adjusts to the medication. Until that happens, however, it can be helpful to know what to expect and how to handle the feelings of fatigue that you might experience.

Whether you’re taking selective serotonin reuptake inhibitors (SSRI) such as Prozac (fluoxetine) or serotonin and norepinephrine reuptake inhibitors (SNRI) such as Cymbalta (duloxetine), you may notice your energy levels feel much lower than usual.

Which Antidepressants Cause Fatigue?

Fatigue is a common side effect of an older class of antidepressants known as tricyclic antidepressants. They include:

• Asendin (amoxapine)
• Elavil (amitriptyline)
• Norpramin (desipramine)
• Tofranil (imipramine)

However, doctors don’t often prescribe tricyclic antidepressants due to their other side effects, which include disorientation or confusion, increased heart rate, and the increased risk of seizures in people who already have seizures.

But, even the newer classes of antidepressants—including SSRIs and SNRIs—often cause fatigue. Some of the major SSRIs that cause fatigue include:

• Aropax, Brisdelle, Paxil (paroxetine)
• Celexa (citalopram)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Remeron (mirtazapine)
• Zoloft (sertraline)

Some of the major SNRIs that cause fatigue include:

Monoamine oxidase inhibitors (MAOIs) are another type of antidepressant. While they’re generally not the first to be prescribed (as newer classes of medications generally produce fewer side effects), a doctor may prescribe an MAOI if other antidepressants aren’t working.

MAOIs that may cause fatigue include:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Wellbutrin (bupropion) is another type of antidepressant known as a norepinephrine and dopamine reuptake inhibitor (NDRI). Wellbutrin may also cause fatigue.

Why Antidepressants Make You Tired

Certain antidepressants work by acting on brain chemicals called neurotransmitters—in particular norepinephrine and serotonin—causing them to linger in the spaces between nerve cells where they carry out their job of regulating mood.

At the same time, these medications affect other neurotransmitters, including histamine and acetylcholine, sometimes leading to unpleasant side effects such as dry mouth, blurry vision, weight gain, and sedation.

It’s that last side effect—sedation—that may be responsible for the fatigue you experience when you take an antidepressant.

What to Avoid If Your Antidepressant Causes Fatigue

If you’re truly fighting to keep your eyes open, there are some important things to avoid doing. Excessive daytime fatigue can be dangerous if you don’t take precautions.

Steer clear of alcohol and any medications that also tend to be sedating. The combo of either with your antidepressant could make your fatigue worse.

How to Cope With Antidepressant Fatigue

You may be tempted to give in to exhaustion and set up camp on your couch, but there are other things you can do if your antidepressant is wiping you out. Here are some possibilities.

• Practice good sleep hygiene: Research suggests that having good sleep hygiene plays a big role in combating fatigue and excessive daytime sleepiness. This means not napping during the day if you can help it (so that you’re tired at night and ready for a whole night’s rest), and avoiding electronic devices a couple of hours before bed.
• Nap when needed: Of course, if you’re extremely tired, you may find it beneficial to take a quick nap. The National Sleep Foundation advises that the optimal length of a nap for adults is about 20 minutes and no more than 30 minutes (Napping too long may make you groggier).
• Exercise: Get some exercise. It sounds counterintuitive—how could moving possibly be helpful when it’s the last thing you feel like doing? Research has shown that light to moderate exercise may help reduce fatigue and increase energy levels. When fatigued, try going for a walk around your neighborhood or doing a low-impact activity like yoga or swimming.
• Take medications at night: You may be able to use fatigue to your advantage by taking your antidepressant at night. First, check with a doctor to be sure that it’s OK for you to take your medication at night; but, taking it at night may help you fall asleep more easily—you’ll get the rest you need to feel more alert during waking hours.
• Give it time: Typically, fatigue from antidepressants lasts for a few weeks after you start taking the medication. For most people, the side effects of antidepressants wear off as their bodies become adjusted to the medication.

A doctor will likely have you check back in with them after the first few weeks of taking the antidepressant to see if the fatigue continues. If it does, a doctor can formulate a solution for your excessive fatigue—either by changing your dosage or changing your prescription altogether.

When to See a Healthcare Provider

It’s best to report any side effects of antidepressants that you’re experiencing to your prescriber right away. They may tell you to check in after two to three weeks to see if the fatigue you’re experiencing has reduced.

If your fatigue hasn’t improved after a few weeks, they may lessen your dosage or prescribe a slower-release preparation of antidepressant.

Or, they may have you try a different antidepressant altogether. Because there is no one-size-fits-all antidepressant, it may take some trial and error before you are able to find a medication and dosage that work best.

In some cases, the provider may supplement your medication with a second drug that’s stimulating, such as Provigil (modafinil). However, there are additional side effects linked with stimulant use that include:

• Diarrhea
• Dry mouth
• Eye pain
• Gas
• Headache
• Loss of appetite
• Muscle shaking
• Nausea
• Nosebleeds
• Sleep problems

More serious side effects of Provigil include rash, blisters, mouth sores, hives, difficulty breathing, frenzied mood, chest pain, hallucinations, anxiety, depression, and suicidal ideation. Be sure to contact your prescriber if you experience these or any other side effects.

Safety Notes to Keep In Mind

Because antidepressants and stimulants increase serotonin levels, in rare cases, taking both types of medications together may result in serotonin syndrome. Symptoms of serotonin syndrome include:

• Agitation
• Restlessness
• Hyperthermia
• Nausea
• Vomiting
• Tremors
• Muscle rigidity

Most cases of serotonin syndrome are successfully treated by discontinuing the medications causing the illness. Benzodiazepines are sometimes used to treat symptoms like tremors. Cyproheptadine may also be used as an antidote.

You’re not alone if you find the side effects of antidepressants frustrating to deal with. But remember to always consult with your prescriber before making any changes to your current dosage. Under their supervision, you may try out different dosages, medications, and sometimes, combinations of medications to alleviate your symptoms.