Xanax Withdrawal: Symptoms, Timeline, & Treatment

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Key Takeaways

  • Suddenly stopping Xanax can lead to severe and dangerous withdrawal symptoms; never adjust your dose or quit taking Xanax without talking to your doctor first.
  • Xanax withdrawal can occur even when medication is taken as prescribed, but treatments are available that can help.

Xanax (alprazolam) is a common anti-anxiety medication. Doctors prescribe it for patients struggling with insomnia and mental health issues such as excessive worry, panic attacks, and post-traumatic stress disorder (PTSD).

Xanax can help people who are in acute distress, but it is not intended for long-term use. The long-term use of benzodiazepines like Xanax can potentially create problems with dependence and withdrawal.

 Verywell / JR Bee

Overview of Xanax Withdrawal

Even if you only take Xanax for a period of several days, you may develop a physical dependence on the drug. This means that you will likely experience Xanax withdrawal, or the uncomfortable physical and mental symptoms of discontinuing the drug. The intensity of your symptoms depends on your dosage, or how much Xanax you’ve been taking and for how long.

Xanax withdrawal can also be medically serious. If you have been taking Xanax several times a day, then quitting is going to take time, patience, and determination. The only safe way to quit is to slowly taper down your dose under the direction of a doctor.

Quitting cold turkey can increase your risk of extreme and dangerous withdrawal symptoms, including delirium and grand mal seizures.

Delirium is a state that involves temporary, abrupt changes in cognition and behavior characterized by agitation and disorientation. A grand mal seizure (also known as a tonic-clonic seizure) involves violent muscle contractions and a loss of consciousness.

In 2017, doctors wrote nearly 45 million prescriptions for Xanax (alprazolam). Statistics suggest that one in 20 people in the U.S. fill a prescription for benzodiazepines each year.

Reckless prescribing practices have contributed to thousands of cases of dependence and misuse. Research shows that in 2018, an estimated 5.4 million people over the age of 12 misused prescription benzodiazepines like Xanax.

Xanax Withdrawal Symptoms & Signs

The signs and symptoms of Xanax withdrawal vary from person to person. Research indicates that roughly 40% of people taking benzodiazepines for more than six months will experience moderate to severe withdrawal symptoms. The remaining 60% can expect milder symptoms.

Physical

  • Headaches

  • Insomnia

  • Hyperventilation

  • Muscle spasms

  • Racing pulse

  • Seizures

  • Sweating

  • Tremors

Xanax is a high-potency drug, which makes its withdrawal symptoms more intense than symptoms of withdrawal from other types of benzodiazepines such as Valium (diazepam).

What Does Xanax Rebound Mean?

Xanax’s potency is linked with increased rebound effects. A rebound effect is the reoccurrence of a symptom after a person stops taking the medication that was treating it. For instance, someone taking Xanax for anxiety is likely to have a reoccurrence of their anxiety symptoms during withdrawal. This is sometimes called Xanax rebound anxiety.

Depending on the severity of your symptoms, the level of anxiety you experience during Xanax withdrawal may be more intense than what you experienced before taking Xanax. It is common to feel nervous, jumpy, and on-edge during your taper.

Many people experience irritability and agitation, which can cause problems at home, work, or school. You might be easily annoyed or short-tempered with family or friends. Insomnia, another symptom, can also contribute to these feelings of anxiety and agitation.

How Long Does Xanax Withdrawal Last?

The symptoms of Xanax withdrawal typically appear within 8 to 12 hours of your last dose. If you fail to taper your dose, your withdrawal symptoms will grow increasingly intense. Withdrawal is generally at its worst on the second day, and improves by the fourth or fifth day; however, acute symptoms can last significantly longer.

  • Early withdrawal symptoms: These symptoms usually occur within the first two days after your last dose. They usually include: headaches, insomnia, anxiety, restlessness, and/or panic attacks.
  • Acute withdrawal symptoms: Symptoms tend to peak between the third day and the fifth or sixth day after your last dose. Additional symptoms may include: hallucinations, aggression, confusion, memory problems, high blood pressure, muscle aches, nausea, tremors, and more.
  • Late withdrawal: After about a week of Xanax withdrawal, the physical symptoms may become more tolerable; however, other symptoms may occur after this period which includes Xanax cravings, anxiety or depression, insomnia, and/or suicidal ideation.

Protracted Withdrawal

Estimates suggest that about 10% to 25% of people who use benzodiazepines long term experience what’s known as protracted withdrawal.

Protracted withdrawal is a prolonged withdrawal experience marked by waves of mild psychological symptoms that come and go over the course of several months. Protracted Xanax withdrawal can last up to one year.

Factors That Affect Xanax Withdrawal

Xanax withdrawal isn’t the same for everyone—there are unique factors that come into play. Be sure to consult with a healthcare professional if you have any mental health conditions including but not limited to:

  • Panic disorder: One small study found that 15 out of 17 patients with panic disorder who were treated with alprazolam experienced panic attacks again (some at higher levels than pre-treatment) after discontinuing Xanax. These patients were tapered off of Xanax after four weeks, yet this rebound effect still occurred.
  • Post-traumatic stress disorder (PTSD): In another small study, all eight patients with PTSD who tapered off of Xanax after eight weeks experienced worsened anxiety, sleep disturbance, nightmares, irritability, rage, and homicidal ideation.
  • Pregnancy: If you are pregnant, you are at an increased risk of Xanax withdrawal symptoms, including seizures.

Coping & Relief for Xanax Withdrawal

The best way to try to lessen the severity of your Xanax withdrawal symptoms is by slowly tapering down your dose of Xanax. Tapering means taking progressively smaller doses over the course of several weeks. It is not recommended to taper without the assistance and recommendations from your prescribing doctor.

Xanax is a short-acting drug, which means your body metabolizes it very quickly. Tapering Xanax is challenging because the amount of the drug in your system quickly goes up and down with each dose. To help you avoid these peaks and valleys, doctors often switch you from Xanax to a long-acting benzodiazepine such as Valium (diazepam).

Switching from short-acting Xanax to its longer-acting cousin Valium will make it easier for you to quit. Once you are stabilized on a dose of diazepam, your prescribing doctor will help you slowly taper down a little bit at a time. This gives your body and mind the time to adjust to life without Xanax.

Alleviating Symptoms of Breakthrough Withdrawal

If you have breakthrough withdrawal symptoms when your dose is reduced, your prescribing doctor can pause or stretch out your taper. It’s up to you and the doctor to figure out the best tapering schedule for your individual needs. The doctor may also recommend one or more of the following treatment types:

Warnings About Xanax Withdrawal

Unlike many other withdrawal syndromes, benzodiazepine withdrawal can be complicated and, occasionally, life-threatening.

  • Xanax withdrawal seizures may occur in some people—especially in those undergoing unsupervised and untreated withdrawal from Xanax.
  • If you have been diagnosed with a serious mental illness in the past, such as a panic disorder, PTSD, bipolar disorder, or borderline personality disorder (BPD), then great care should be taken when coming off of Xanax. In such cases, a doctor’s help will be invaluable. It can be difficult to predict which dormant symptoms, if any, may return when Xanax is removed from the equation.
  • People with a history of complicated withdrawal syndromes and people with underlying health issues should also work closely with a doctor.
  • Older adults and people with cognitive decline should also work closely with a doctor as there are unique risks for these groups.

If you plan to or have become pregnant, you will need to discuss your options with a doctor. Part of that conversation should include reviewing the risks and benefits of continuing versus tapering benzodiazepines during your pregnancy. Some people continue taking benzodiazepines throughout their pregnancy while others follow a dose tapering schedule.

If you are using Xanax without a prescription, you can still work with a doctor to taper down your dose. Start by visiting a primary care doctor or urgent care center and tell them that you are in or are planning to be in benzodiazepine withdrawal. If you don’t have insurance, visit a community health center.

If you are concerned about the risks involved in Xanax tapering for any reason, discuss these concerns with a doctor. You may be better suited for inpatient detoxification. While inpatient treatment is typically more expensive, it is covered by many insurance plans.

Long-Term Treatment for Xanax Withdrawal

When it comes to the long-term management of getting off benzodiazepines, there are two directions you can go. Research shows that most stable, healthy adults will achieve long-term abstinence after completing a taper.

The key to achieving this goal is to follow the tapering schedule to the very end. By the end of your taper, you might be cutting pills into halves or quarters.

Some people may be better suited for a harm reduction approach, in which the taper leads to a maintenance dose rather than abstinence.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055

  2. U.S. Department of Justice, Drug Enforcement Administration, Drug & Chemical Evaluation Section. Benzodiazepines.

  3. Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL. Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013. Am J Public Health. 2016;106(4):686-688. doi:10.2105/AJPH.2016.303061

  4. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.

  5. Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK. Benzodiazepine dependence and its treatment with low dose flumazenil. Br J Clin Pharmacol. 2014;77(2):285–294. doi:10.1111/bcp.12023

  6. Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. J Addict Med. 2018;12(1):4-10. doi:10.1097/ADM.0000000000000350

  7. Edinoff AN, Nix CA, Hollier J, et al. Benzodiazepines: Uses, dangers, and clinical considerations. Neurology International. 2021;13(4):594-607. doi:10.3390/neurolint13040059

  8. Páll A, Becs G, Erdei A, et al. Pseudopheochromocytoma induced by anxiolytic withdrawal. Eur J Med Res. 2014;19(1):53. doi:10.1186/s40001-014-0053-9

  9. Cato V, Holländare F, Nordenskjöld A, Sellin T. Association between benzodiazepines and suicide risk: a matched case-control study. BMC Psychiatry. 2019;19(1). doi:10.1186/s12888-019-2312-3

  10. Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152–155. doi:10.18773/austprescr.2015.055

  11. Darker CD, Sweeney BP, Barry JM, Farrell MF, Donnelly-Swift E. Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. Cochrane Database Syst Rev. 2015;(5):CD009652. doi:10.1002/14651858.CD009652.pub2

  12. Cardinali DP, Golombek DA, Rosenstein RE, Brusco LI, Vigo DE. Assessing the efficacy of melatonin to curtail benzodiazepine/Z drug abuse. Pharmacol Res. 2016;109:12–23. doi:10.1016/j.phrs.2015.08.016

  13. Chakradhar T, Mondal S. Review on drug interactions of alprazolam on pharmacodynamic and pharmcokinetic actions. European J Biomed Pharm Sci. 2019;6(1):657-662.

  14. Shyken JM, Babbar S, Babbar S, Forinash A. Benzodiazepines in pregnancy. Clin Obstet Gynecol. 2019;62(1):156-167. doi:10.1097/GRF.0000000000000417

Additional Reading

By Corinne O’Keefe Osborn

Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology.


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How to Forgive Your Partner and Let Go

by with No Comment Dating Tips, Guide and Advice


Key Takeaways

  • Forgiving your partner can help lower stress, improve your health, and make your relationship stronger.

  • Be patient with yourself; forgiveness takes time and requires a conscious decision.

Knowing how to forgive your partner and let go of past hurts is a critical tool in any relationship. Forgiveness is also healthy for you, both emotionally and physically. In fact, forgiving and letting go may be one of the most important ways to keep your relationship going strong.

While some transgressions are so harmful that a relationship can’t survive, forgiveness can still play a role in helping you move past the hurt. This article discusses how to forgive your partner who has hurt you and move forward with your life.

Benefits of Knowing How to Forgive Your Partner

Holding onto old hurts, disappointments, petty annoyances, betrayals, insensitivity, and anger wastes both your time and your energy. Nursing your hurt (whether real or perceived) for too long can eventually turn it into hate and bitterness. 

Being unforgiving takes a physical and mental toll. Resentment gains momentum and chips away at the foundation of your well-being and relationship. Instead, share your feelings.

Health experts at Johns Hopkins report that the act of forgiveness can reduce the risk of heart attack, lower cholesterol levels, improve sleep, reduce pain, lower blood pressure, decrease levels of anxiety, depression, and stress, and provide other benefits.

How to Forgive Your Partner

Various techniques can help you foster forgiveness when you have experienced betrayal. The kind of hurt you have suffered can make a difference in which works for you.

Certainly, it is more difficult to forgive someone for years of infidelity than for a minor mistake, such as forgetting to pay a bill. Be patient with yourself as you experiment with different strategies.

  • Be open and receptive to forgiveness.
  • Make a conscious decision to forgive.
  • Think of a calming place or do something else to distract yourself when flashbacks of the betrayal trigger negative thoughts.
  • Refrain from throwing a mistake back in a remorseful partner’s face or using it as ammunition in an argument.
  • Accept that you might never know the reason for the hurtful behavior.
  • Refrain from seeking revenge or retribution. Trying to get even will only extend the pain and probably won’t make you feel better anyway.
  • Remember that forgiveness does not mean that you condone the hurtful behavior.
  • Be patient with yourself. Forgiveness takes time. Don’t hurry the process.
  • Seek professional counseling if you are still unable to forgive or stop dwelling on the hurt.

How to Ask for Forgiveness

If you are the partner who has caused hurt, begin your efforts to rebuild trust by asking for forgiveness. Give yourself and your partner time when working through the process.

  • Show true contrition and remorse for the pain you’ve caused.
  • Make a commitment to not hurt your partner again by repeating the hurtful behavior.
  • Accept the consequences of the action that created the hurt.
  • Be open to making amends.
  • Make a heartfelt and verbal apology. This should include a plan of action to make things right.
  • Be patient with your partner. Don’t dismiss your partner’s feelings of betrayal by telling them to “get over it.”

How Forgiving Your Partner Affects Your Relationship

Close relationships need forgiveness to thrive. Everyone makes mistakes, and everyone needs to forgive and be forgiven.

This is especially true if the person who hurt you is attempting to make amends and gain forgiveness. It’s more difficult if your partner is not remorseful, but you might still find value in offering forgiveness.

No healthy relationship, especially a marriage, can be sustained over a long period of time without forgiveness. But remember: Forgiveness isn’t absolution.

Forgiveness is a conscious decision to release feelings of resentment. It’s a crucial tool in processing hurt and moving on. Even though you may find forgiveness difficult, it’s essential for the long haul.

When Forgiveness Is Not Enough

If your partner abuses you, continues to betray or lie to you, or makes no real effort to change their behavior, it may be time to split. This kind of behavior calls for serious evaluation.

According to psychiatrist Karen Swartz, MD, forgiveness does not always mean reconciliation. “Having a relationship with someone in the future is about whether they are reliable and dependable and trustworthy,” she says. Sometimes, trust is broken in such a way that it’s not in your best interest.”

In situations involving an extended period of abuse or betrayal that’s no longer occurring, forgiveness may take longer, and that’s OK. You both must be open to talking about and continuing to process it. This might include seeking guidance from a licensed professional counselor or another mental health professional.

Frequently Asked Questions

  • How do you forgive someone who has hurt you so deeply?

    Deep hurts can be difficult to forgive. It is essential to acknowledge the harm that was done and recognize the impact it had on you. Allow yourself to feel upset and grieve. Remind yourself that forgiveness can be a way of releasing the hold that act has over you. It does not absolve the other person or suggest that the offense was acceptable; instead, it allows you to move one from the hurt and relinquish the pain that it has caused.

  • How do you heal from a partner who hurt you?

    After a hurt or betrayal, it is important to let yourself acknowledge the pain. Strategies like writing in a journal or talking to a friend can help you release your emotions without slipping into rumination. Focus on caring for yourself and treating yourself with compassion and kindness. In some cases, you may find it helpful to talk to a therapist, either individually or together with your partner.

    Remind yourself that there will be ups and downs on your path toward healing. Things might not be the same again, but you can move forward with strength and resolve.

  • Can you forgive someone who is still hurting you?

    You can forgive someone who continues to hurt you or let you down. An example might be a parent forgiving an adult child who keeps relapsing to addiction. In such cases, creating boundaries, letting go of the need for control, and viewing the other person with compassion can help.

    In cases where a person makes no effort to change despite knowing how badly they are hurting you, it is important to consider the future of the relationship. While you might be able to forgive, that doesn’t mean that you need to stay. Ending the relationship can allow you to practice forgiveness, protect yourself from future hurt, and move on in a more positive way.


Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Toussaint LL, Shields GS, Slavich GM. Forgiveness, Stress, and Health: a 5-Week Dynamic Parallel Process Study. Ann Behav Med. 2016;50(5):727–735. doi:10.1007/s12160-016-9796-6

  2. He Q, Zhong M, Tong W, et al. Forgiveness, Marital Quality, and Marital Stability in the Early Years of Chinese Marriage: An Actor-Partner Interdependence Mediation Model. Front Psychol. 2018;9:1520. Published 2018 Sep 4. doi:10.3389/fpsyg.2018.01520

  3. Sandler L. The Healing Power of Forgiveness. Johns Hopkins Medicine.

Additional Reading

By Sheri Stritof

Sheri Stritof has written about marriage and relationships for 20+ years. She’s the co-author of The Everything Great Marriage Book. 


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DUI Tests to Assess Drunk Driving

by with No Comment Dating Tips, Guide and Advice


Key Takeaways

  • Field sobriety tests, like the walk-and-turn and one-leg stand, help police check if a driver is drunk.

  • Failing a field sobriety test can lead to a breath or blood test to check blood-alcohol content (BAC).

Field sobriety tests are tests used by police to determine if a driver is impaired. The tasks assess balance, coordination, and the ability of the driver to divide his attention to more than one task during the field sobriety test.

The tests have been scientifically proven to validate legal intoxication in drivers suspected of drunken driving in 90% of cases if administered by a trained officer. The results of the test are admissible as evidence in court.

This article discusses the three types of field sobriety tests that may be administered and the essential information you should know about these DUI tests.

The Three Field Sobriety Tests

National Highway Traffic Safety Administration defines and describes the three parts of the field sobriety test in detail. If the driver fails any of the field sobriety tests, the officer will then ask the suspect to take a breath test or a chemical test to confirm their blood-alcohol content.

The Standard Field Sobriety Test (SFST) is a battery of three tests that include the horizontal gaze nystagmus (HGN), the walk-and-turn, and the one-leg stand tests.

Horizontal Gaze Nystagmus

Horizontal gaze nystagmus is an involuntary “jerking” of the eyeball which happens to everyone when the eyes are rotated at high peripheral angles. When a person is intoxicated, however, the jerking of the eyes becomes more exaggerated and occurs at lesser angles.

Turning the HGN test, the officer will ask the driver to follow a moving object, such as a pen or flashlight, slowly from side to side. The officer looks to determine:

  • If jerking is distinct when the eye is at maximum deviation
  • If the angle of jerking onset is within 45 degrees
  • If the eye cannot follow the object smoothly

If four or more clues appear between the two eyes, the driver is likely to have a blood-alcohol content (BAC) 0.10 or greater. Research from the NHTSA shows this test to be accurate in 77% of test subjects.

Walk-and-Turn Test

For the walk-and-turn test, the officer asks the driver to take nine steps, heel-to-toe, along a straight line, turn on one foot and return nine steps in the opposite direction. During the test, the officer looks for seven indicators of impairment. A subject may be impaired if they:

  • Begin before the instructions are finished
  • Cannot keep balance while listening to the instructions
  • Do not touch heel-to-toe
  • Lose balance while turning
  • Stop while walking to regain balance
  • Take an incorrect number of steps
  • Use arms to balance

According to the NHTSA, if the driver exhibits two or more of these indicators during the test, there is a 68% likelihood of a BAC level of 0.10 or higher.

One-Leg Stand Test

For the one-leg stand test, the officer asks the driver to stand with one foot about six inches off the ground and count from 1,001 (one-thousand-one, one thousand two, etc.) until the officer says to put the foot down. During the next 30 seconds, the officer looks for these four indicators:

  • Hopping to maintain balance
  • Putting the foot down
  • Swaying while balancing
  • Using arms to balance

If the driver exhibits two or more of the above indicators, there is a 65% chance they have a BAC of 0.10 or greater, according to the NHSTA.

Signs of Intoxication

If you suspect that you or someone else might be intoxicated, there are some signs to watch for. Indicators that someone is drunk and may fail a field sobriety test include:

  • Feelings of confusion
  • Lethargy
  • Impaired walking
  • Becoming very talkative or euphoric
  • Lack of inhibition
  • Slurred speech or other problems speaking
  • Vomiting

Alcohol affects people differently. Even if you don’t feel drunk, do not operate a motor vehicle if you have been consuming alcohol.

Can You Fail a Field Sobriety Test While Sober?

There are many reasons that people who are not intoxicated might not be able to perform the above tests successfully. These include certain medical conditions, disabilities, age, injury, and taking a certain medication.

The officer usually will ask the driver if there is a reason that they may not be able to pass the test and makes a note of their answer in the arrest report.

If there is a legitimate reason, medical or otherwise, why you might fail one or more parts of the field sobriety test, make sure you mention it so that the officer notes it in the official record. It might be helpful to you in court later.

Tests for Marijuana and Other Substances

Field sobriety tests can be used to check for signs of intoxication and impairment. However, they cannot determine specifically what substances a person has been using.

HGN tests are commonly used to look for signs of marijuana intoxication. However, research indicates it is not a reliable tool for detecting cannabis use. Officers may also look at the individual’s pupils to see if they are unequal, have unusual movements, or are extremely dilated or constricted.

Laws about driving under the influence of cannabis vary. Some states utilize “per se” laws similar to alcohol intoxication, suggesting that a certain level of THC (the psychoactive compound delta-9-tetrahydrocannabinol) corresponds to alcohol intoxication.

However, research indicates that specific THC levels do not correlate with specific levels of impairment. Even low levels of THC may cause significant cognitive and psychomotor impairments.

Can You Refuse a Field Sobriety Test?

While you have a right to refuse a field sobriety test or breathalyzer test, the state also has a right to penalize you for doing so.

A field sobriety test helps provide evidence that an individual is intoxicated. If someone refuses the tests, however, police can still arrest a person that they believe is intoxicated and then conduct further testing. They can also still arrest someone who passes field sobriety tests if they suspect the individual is under the influence.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Buddy T

Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.


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How to Find a Narcissistic Abuse Support Group

by with No Comment Dating Tips, Guide and Advice

Key Takeaways

  • Recovering from the impacts of narcissistic abuse can be lonely, frustrating, and challenging, but healing is absolutely possible.

  • You can find a narcissistic abuse support group by asking your mental health provider for referrals.

  • Domestic violence centers often have support groups for survivors of intimate partner violence, which includes narcissistic abuse.

Joining a narcissistic abuse support group can be helpful if you have experienced narcissistic abuse from someone in your life. Such groups offer emotional support, empathy, and information that can help you understand what you’ve experienced.

First things first: Abuse is never your fault. Every individual deserves the right to have a healthy, safe, and supportive relationship, and no one should have that right violated.

If you are in an abusive relationship or have been in one in the past, getting help healing is extremely important. It isn’t uncommon for folks to be unaware of the various types of abuse.

Abuse isn’t only physical harm that leaves bruises and scars. It can also be emotional and psychological abuse that can leave you feeling scared, unsure of yourself, and completely dependent on your abuser. 

What Is Narcissistic Abuse?

Narcissistic abuse is a form of emotional and psychological abuse that utilizes manipulation, coercion, scare tactics, and control. This abuse can have devastating effects on the survivor’s relationships, finances, and self-image.

Narcissistic abuse is classified as a form of domestic violence, meaning it can be inflicted on intimate partners and family members like children and elders. It is perpetrated by those who present with narcissistic traits and by those who experience Narcissistic Personality Disorder (NPD).

Narcissism is a term that is thrown around freely in our society, but it is important that both narcissistic traits and NPD are understood when identifying narcissistic abuse.

First, narcissistic traits are more than someone who is simply obsessed with themselves and is power-hungry. Narcissistic traits refer to some of the traits of NPD, such as lacking empathy, requiring those around them to praise them, and having an inflated sense of self.

Someone with NPD exhibits all those traits, amongst others, to the point of impairing their interpersonal relationships. 

The Cycle of Narcissistic Abuse

Narcissistic abuse is covert and hard to spot at times. However, there is a cycle of abuse particular to narcissistic abuse in romantic relationships. Those with narcissistic traits tend to seek out sensitive and empathic individuals. 

Early Stages

The early stages of a relationship where narcissistic abuse is present can seem like a fairy tale, with the narcissistic person lavishing the survivor with praise, gifts, adoration, and grand plans for the future.

In turn, the survivor often fosters a deep admiration and love for their abuser. This plays into the narcissistic desire to be adored and to exert a level of control over others.

Middle Stage

After the early stage of over-the-top romance, the emotional abuse will begin to present itself through deprecating language, humiliation, and dismissive communication that aims to chip away at the survivor’s self-esteem.

Final Stage

The final stage of narcissistic abuse is characterized by a complete withdrawal from the partner. The abuser may begin to engage in infidelity, spread lies to the survivor’s loved ones, cut all contact, or even gaslight the survivor.

Narcissistic abuse in nonromantic environments follows a similar theme: an intense adoration for the survivor, a stretch of time when the survivor is devalued, then the survivor is discarded. This is true among family members and friendships and can even occur in the workplace.

Seeking a Support for Narcissistic Abuse

Emotional abuse can have devastating effects. Research has shown that people who experience emotional abuse in childhood are more likely to experience anxiety, stress, depression, and neuroticism in adulthood.

Social media can be the first place a survivor finds information that helps them make sense of the abuse they just experienced.

Due to the manipulative nature of narcissistic abuse, it can be very hard for the survivor to understand their own emotional reality.

Uncovering information about narcissistic abuse can be helpful for those who are grappling with accepting and believing their lived experiences after being fed lies by their abuser. It can also help survivors realize the abuse never was and never will be their fault.

Aside from digital support, social support is very important. A huge component of narcissistic abuse is complete isolation. When survivors realize they aren’t alone upon hearing others share about what they’ve overcome, they can begin to realize they aren’t alone and healing is possible. 

What to Expect from a Narcissistic Abuse Support Group

A narcissistic abuse support group is a safe space where survivors come together to support each other while they heal from the abuse they’ve been subjected to.

Some groups are peer-led, meaning there is a rotating leadership from members of the group. Others may be led by a licensed psychotherapist. 

You can expect a space where you will be heard, validated, and supported by others who have survived experiences similar to yours. These support groups are great additions to psychotherapy and can end up being an integral part of your healing journey.

How to Find a Narcissistic Abuse Support Group

There are multiple ways to find a narcissistic abuse support group.

Talk to a Mental Health Provider

First, you can reach out to a mental health provider and ask them for referrals for any narcissistic abuse support groups near you. They are likely to have some information to share with you, and in the rare event they don’t, they can point you in the right direction.

Domestic Violence Centers

Domestic violence centers typically run support groups for survivors of intimate partner violence (IPV) and narcissistic abuse qualifies as a form of IPV.

Family Support Groups

It isn’t uncommon for those experiencing NPD and narcissistic traits to also have addiction issues and it is worth assessing if the perpetrator of abuse suffers from addiction. If so, Al-Anon, the 12-step program for friends and family of alcoholics, may be a good fit for you.

Al-Anon is a supportive group for folks who are healing from the harms of alcoholic behavior. It offers a space to share your feelings, connect with others, and even have one-on-one peer support in the form of something called sponsorship.

While Al-Anon isn’t specifically for narcissistic abuse survivors, if your abuser is an has an addiction, it may be the support you’re looking for.

Resources for Narcissistic Abuse

Below are other resources that may be helpful to you:

  • National Domestic Violence Hotline: This organization offers a hotline, textline, and online chat for those seeking support in unsafe relationships. They also have a tool on their website that can help you find resources, including support groups, in your area.
  • Help Within Reach: Founded by therapist Pamela Raphael, Help Within Reach offers a variety of narcissistic abuse support groups. The groups are conducted virtually and are open to anyone regardless of location.
  • I Believe Your Abuse: I Believe Your Abuse is an online guide to recovery from narcissistic abuse. They offer a directory of therapy and support group resources organized by state.
Julia Childs Heyl headshot

By Julia Childs Heyl, MSW

Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.


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Psychopathology: Definition, Types, and Diagnosis

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Key Takeaways

  • Psychopathology is the study of mental health problems and their causes, development, and treatment.

  • Mental health disorders are often diagnosed using the DSM-5-TR or ICD-11, which are systems to classify these conditions.

  • Treatment for psychopathology can include therapy, medication, lifestyle changes, and support systems.

Psychopathology is the study of mental health conditions and other problems that are connected to mental health. The goal is to better understand how people think, feel, and act, particularly when these patterns are outside of the norm and lead to distress or dysfunction.

An early use of the term “psychopathology” dates back to 1913, when Karl Jaspers, a German/Swiss philosopher and psychiatrist, introduced the idea in his book General Psychopathology. This new framework for understanding individuals’ mental experiences followed a long history of varied attempts to make meaning out of “abnormal experiences.”

Whether it involves anxiety, depression, or serious mental illnesses, psychopathology looks at the underlying causes and patterns behind these conditions. The goal is to recognize the associated symptoms, develop tools for categorizing and diagnosing these conditions, learn more about the causes, and utilize strategies to treat and even prevent mental health problems.

The road to understanding the causes and presentations of mental illness has been long, and we still have much to learn. Today, however, we have a much better understanding of the factors that contribute to mental health problems—as well as ways to help.

What Does Psychopathology Mean?

How do we currently define psychopathology? In short, this discipline can be understood as an in-depth study of problems related to mental health. Just like pathology is the study of the nature of disease (including causes, development, and outcomes), psychopathology is the study of the same concepts within the realm of mental health (or illness).

This study of mental illness can include a long list of elements: symptoms, behaviors, causes (genetics, biology, social, psychological), course, development, categorization, treatments, strategies, and more.

In this way, psychopathology is all about exploring problems related to mental health: how to understand them, how to classify them, and how to fix them. Because of this, the topic of psychopathology extends from research to treatment and covers every step in between. The better we can understand why a mental disorder develops, the easier it will be to find effective treatments.

Verywell / Brianna Gilmartin 


Signs of Psychopathology

Signs of psychopathology vary depending on the nature of the condition. Some of the signs that a person might be experiencing some form of psychopathology include:

  • Changes in eating habits
  • Changes in mood
  • Excessive worry, anxiety, or fear
  • Feelings of distress
  • Inability to concentrate
  • Irritability or anger
  • Low energy or feelings of fatigue
  • Sleep disruptions
  • Thoughts of self-harm or suicide
  • Trouble coping with daily life
  • Withdrawal from activities and friends

Diagnostic Systems

Professionals engaged in research and treatment of psychopathology must use systems to arrive at conclusions regarding the best course of action for treatment. These systems are used to classify what are considered mental health disorders. Currently, the most widely used systems for classifying mental illness in the United States are the following:

Diagnostic and Statistical Manual of Mental Disorders (DSM)

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is created by the American Psychiatric Association (APA) as an assessment system for mental illness. The DSM-5-TR (Text Revisions) published in 2022 is the current edition and includes identifiable criteria that mental health professionals use to arrive at a specific diagnosis.

The criteria and list of disorders sometimes change as new research emerges. Some examples of disorders listed in the DSM-5-TR include major depressive disorder, bipolar disorder, schizophrenia, paranoid personality disorder, and social anxiety disorder.

International Classification of Diseases (ICD)

The ICD is a system similar to the DSM. Now in its eleventh version, the ICD was developed over a century ago and was taken over by the World Health Organization (WHO) when it was founded in 1948. So, how does the ICD-11 differ from the DSM-5-TR?

First, the ICD-11 is produced by a global agency (the World Health Organization), while the DSM-5-TR is produced by a national professional association (the American Psychiatric Association). The ICD-11 is approved by the World Health Assembly composed of health ministers from 193 WHO member countries.

Second, the goal of the ICD-11 is to reduce the burden of disease globally. It includes medical as well as mental health diagnoses. Third, the ICD-11 is freely available on the Internet. In contrast, the DSM must be purchased, and the American Psychiatric Association derives revenue from sales of the book and related products.

Still, the DSM-5-TR is the standard for classification among American mental health professionals and is generally used for treatment planning and insurance purposes.

Research Domain Criteria (RDoC)

Beyond these standard systems for classifying mental disorders, there also exists a burgeoning area of research and theory that moves away from the checklist format of making diagnoses. Since it’s possible to have symptoms of a mental illness but not meet the criteria for an official diagnosis, studies of descriptive psychopathology hold promise for a better system of understanding.

The RDoC is a research framework initiative by the National Institute of Mental Health (NIMH) based on translational research from areas such as neuroscience, genomics, and experimental psychology. In this way, the RDoC is involved in describing the signs and symptoms of psychopathology rather than grouping them into disorders as has been historically done with the DSM and ICD.

The RDoC is primarily aimed at planning and funding research.

Who Works In Psychopathology?

Just as the scope of psychopathology is broad-ranging from research to treatment, so too is the list of types of professionals who tend to be involved in the field. At the research level, you will find research psychologists, psychiatrists, neuroscientists, and others trying to make sense of the different manifestations of mental disorders seen in clinical practice.

At the clinical level, you will find many types of professionals attempting to apply the diagnostic systems that are in place to provide effective treatments to individuals living with psychopathology. These can include the following and more:

Identifying Psychopathology

How do psychologists and psychiatrists decide what extends beyond normal behavior to enter the territory of “psychopathology?”

Psychiatric disorders can be conceptualized as referring to problems in four areas: deviance, distress, dysfunction, and danger.

For example, if you were experiencing symptoms of depression and went to see a psychiatrist, you would be assessed according to a list of symptoms (most likely those in the DSM-5-TR):

  • Deviance: This term refers to thoughts, emotions, or behaviors that deviate from what is common or at odds with what is deemed acceptable in the society. In the case of depression, you might report thoughts of guilt or worthlessness that are not common among other people.
  • Distress: This symptom refers to negative feelings either felt within a person or that result in discomfort in others around that person. In the case of depression, you might report extreme feelings of distress over sadness or guilt.
  • Dysfunction: With this symptom, professionals are looking for the inability to achieve daily functions like going to work. In the case of depression, you might report that you can’t get out of bed in the morning or that daily tasks take you much longer than they should.
  • Danger: This term refers to behavior that might put you or someone else at some type of detrimental risk. In the case of depression, this could include reporting that you are having thoughts of suicide or harming yourself.

In this way, you can see that the distinction between normal versus psychopathological behavior comes down to how issues are affecting you or the people around you.

Often it is not until things come to a crisis point that a diagnosis is made when someone comes in contact with a medical or mental health professional.

Causes of Psychopathology

There is not a single cause for psychopathology. There a number of factors that can increase the risk of mental illness, including: 

  • Biological factors, including genes and brain chemistry
  • Chronic medical conditions
  • Family members with mental illness
  • Feelings of isolation
  • Lack of social support
  • Substance or alcohol use
  • Traumatic or stressful experiences

It is also important to realize that mental health can change over time. The Centers for Disease Control and Prevention (CDC) suggests that 50% of all people will be diagnosed with a mental illness at some point in their life.

Types of Psychopathology

Some of the different types of psychopathology include, but are not limited to:

  • Anxiety disorders
  • Bipolar disorders
  • Depressive disorders
  • Disruptive, impulse-control, and conduct disorders
  • Dissociative disorders
  • Eating disorders
  • Neurocognitive disorders
  • Neurodevelopmental disorders
  • Obsessive-compulsive disorders
  • Personality disorders
  • Schizophrenia spectrum and other psychotic disorders
  • Sleep disorders
  • Somatic symptom disorders
  • Substance-related disorders
  • Trauma- and stressor-related disorders

Dimensional vs. Categorical Definitions

It’s easy to see that there has been some disagreement historically about what constitutes mental illness. At the same time, even in the current field, there is disagreement about how mental illness should best be conceptualized.

Are all of the disorders in the DSM distinct, or are there higher-order overarching factors that play a role in mental illness and that might better explain why some people are diagnosed with many illnesses (called comorbidity)?

Some research suggests that there are neuropsychological dimensions that cut across current diagnostic categories, noting the problems inherent in the “checklist” approach to mental health.

It might be misleading to group disorders as separate when there can be so much overlap between people diagnosed with different disorders (and so many dissimilarities among people diagnosed with the same disorder).

Hopefully, in the future, better diagnostic systems will be developed that will take all these issues in the field of psychopathology into account.

History of the Study of Mental Illness

We’ve come a long way since the earliest beginnings of trying to make sense of mental illness. Although individuals with mental health issues still face stigma and a lack of understanding, things were very different in the past.

Hippocrates, the 4th century BC Greek physician, rejected the notion of evil spirits and argued instead that mental illness was a disease of the brain relating to imbalances of bodily humors, or chemicals in the body fluids. Around the same time, the philosopher Plato argued that mental distress involved issues of virtue, morality, and the soul.

If you lived in the 16th century with a mental health problem, chances are you would not have been treated very well. At that time, mental illness was often viewed from a religious or superstitious point of view. Accordingly, it was assumed that people demonstrating strange behavior must have been overtaken by evil spirits or demons. The cure? You might have been tortured to bring you back to sanity. If that didn’t work? Execution.

Later, in the 19th century, interest surged in the role of childhood and trauma in the development of mental illness. Following on the heels of this era, Sigmund Freud introduced talk therapy to deal with these unresolved childhood issues.

As of the present day, our understanding of mental illness has broadened, and so, thankfully, have the available treatments.

Treatments for Psychopathology

Treatments for mental health conditions are designed to help people overcome challenges, improve their ability to function, and reduce distress. The right treatment can vary depending on what condition a person is diagnosed with. Some different types of treatments that are often recommended when a person is experiencing psychopathology include:

  • Therapy: Talk therapies like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy focus on understanding and changing the patterns of thoughts, feelings, and behaviors contributing to mental health problems.
  • Medication: Certain medications can also be prescribed to help people manage the symptoms of mental disorders. Types of medications that may be prescribed include antidepressants, antianxiety drugs, and mood stabilizers. Such medications influence brain chemistry, which can help relieve symptoms.
  • Lifestyle changes: A number of lifestyle factors can affect psychopathology. Steps like regular exercise, enough sleep, and eating a balanced diet can help support good mental health.
  • Support: Solid support systems are also important for mental well-being. This includes a strong social support system, but it can also include more formalized support such as group therapy, peer support groups, and family counseling.

Remember, everyone’s situation is different; each treatment plan will be unique. In many cases, treatment will involve two or more of these methods.

The goal is to help improve functioning while also giving people the long-term skills they need to foster mental well-being.


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The Impact of Belief on Mental Health

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The famed psychoanalyst Sigmund Freud described religion as a form of wish fulfillment. However, modern psychology recognizes that religion can play an important role in an individual’s life and experiences and can even improve health and well-being. In fact, studies have shown that religion can help people develop healthy habits, regulate their behaviors, and understand their emotions—all factors that can affect your mental health.

According to an estimate by the Pew Research Center, 84% of the world’s population has some type of religious affiliation.

Types of Religion

There are many different types of religions, including the major world religious traditions that are widely known as well as much lesser-known belief systems of smaller populations. Some of these represent monotheism, or the belief in a single god, while others are examples of polytheism, or the belief in multiple gods.

Some of the types of religions include but are certainly not limited to:

  • Baha’i
  • Buddhism
  • Christianity
  • Confucianism
  • Hinduism 
  • Indigenous American religions
  • Islam
  • Jainism
  • Judaism
  • Rastafarianism
  • Shinto
  • Sikhism
  • Taoism
  • Traditional African religions
  • Zoroastrianism

Related to religion, animism is the belief in divine non-human beings, while totemism involves the belief in a divine connection between humans and the natural world. On the other end of the religious spectrum is atheism, which involves a belief in no god or gods, and agnosticism, which holds that the existence of god or gods is unknown or unknowable.

Religion vs. Spirituality

While religion and spirituality are related, there are differences between the two. Spirituality is an individual practice and belief, whereas religion is centered on a set of organized practices that a larger group shares. It is possible to be spiritual without being religious.

Why People Believe in Religion

The reasons why people believe in religion are not fully understood, but researchers have suggested a number of possible explanations.

The Psychology of Religious Belief

According to the most recent Gallup poll, 47% of adults in the U.S. have some type of religious membership. As to why people believe in religion, psychologists have proposed several theories.

  • Researchers have proposed that how the human brain works often predisposes people to believe. The human mind looks for patterns, purpose, and meaning, which may influence why people turn to religion to guide their belief systems.
  • Parenting and cultural influences also play an important role since people tend to belong to the religion in which they were raised.
  • The human need to belong, combined with the desire for social connection, also contributes to the desire to be part of something larger than oneself.

The Purpose of Religion

Religion can serve a wide range of purposes. Religion can be a source of comfort and guidance. It can provide a basis for moral beliefs and behaviors. It can also provide a sense of community and connection to tradition. Some research even suggests that it may affect health.

The impact of religion on health and life expectancy has always been a tricky area of research. It seems (to some) that religious people—defined here as people who attend religious services regularly—seem to be healthier than those who don’t attend.

This has led to a line of research looking into the impact of religion on health to determine what, if any, positive benefit religion could have on life expectancy. This research is tricky, however, because of several factors that are difficult to control for, including:

  • People who attend religious services may simply be healthier than those who cannot attend.
  • The benefits may have more to do with social contact than religion itself.
  • Certain religions may encourage healthy behaviors.

As researchers look into the impact of religion, all these factors must be considered along with the possibility that religion itself influences health.

Impact of Religion

Religion can contribute to a sense of community, provide support, and offer guidance. It has also been shown to impact both physical and mental health.

Religion and Physical Health

One series of studies found that participants who were either religious or spiritual had a decreased risk of coronary heart disease (CHD), lower blood pressure (BP), better immune function, and longer lifespans when compared to people who were not religious or spiritual.

In these studies, people who were religious were also less likely to smoke, which put them at a lower risk of smoking-related illnesses such as all cancers, cardiovascular disease, and lung disease. Maintaining a healthy lifestyle is linked with a better quality of life as well as a greater lifespan.

Religion and Mental Health

Religion can also influence mental health in both positive and negative ways. Religion can serve as a source of comfort and strength when people are under stress. At other times, this connection may be less helpful—or even harmful—if it creates stress or acts as a barrier to treatment.

Studies suggest that religion has both the potential to help and harm mental health and well-being. On the positive side, religion and spirituality can help promote positive beliefs, foster community support, and provide positive coping skills. On the other hand, negative religious coping, miscommunication, and harmful negative beliefs that actually be detrimental to mental health.

Key Mental Health Benefits

Some mental health benefits of religion include:

  • Giving people structure
  • Building a community with a group
  • Creating a sense of belonging
  • Helping people cope with stressful events
  • Can encourage forgiveness, compassion, and gratitude

Religion can also play a role in helping people cope with mental health conditions. People often turn to their religious beliefs in order to cope with symptoms of mental illness and to help manage stress.

Research has also shown that religious people often first turn to religious clergy when they need treatment for mental health conditions. Religious and pastoral counseling can be an important resource for people of faith who want to incorporate their religious and spiritual beliefs into their treatment. Twelve-step addiction treatment programs such as Alcoholics Anonymous (A.A.) also sometimes take a faith-based approach to treatment.

Pastoral counseling is provided by religious clergy who have been psychologically trained to provide therapy services. These counselors integrate modern psychological practices with theological teaching to address problems that their clients are experiencing.

Is Religion Good or Bad for People?

There’s no doubt that religion has a complex influence on the lives of individuals and societies. Religion can help bring people together, but it can also be a source of division and stress, particularly for those who face discrimination within religious communities, such as people who hold differing beliefs from the rest of the group.

Research has also found that people who struggle with their religious beliefs may experience lower well-being and higher levels of anxiety and depression. Specific religious beliefs can also play a part in the potential benefits or drawbacks. People who believe in a merciful God are more likely to forgive themselves and treat their mistakes with self-compassion. In contrast, those who believe in a punishing or judgemental God may experience worsened health effects.

Given the potential benefits linked to religious affiliation, some may wonder if it might be a bad thing not to be religious. While studies suggest that religion may have health benefits, you don’t need to ascribe to a set of organized religious beliefs to reap these rewards. Taking steps to engage in healthy behaviors, form social connections with others, and strengthen your coping skills are steps you can take to obtain those benefits that religion often provides.

If you are concerned about religion’s impact on your life, discussing your concerns with a mental health professional may be helpful. Research suggests that religion can play a positive and supportive role in people’s lives in many ways. For some individuals who feel less supported or even excluded from religious practice, it is important to weigh the potential good with the potential harm.

Potential Pitfalls

Because these studies are observational (researchers watch what happens in the real world without actively controlling any of the conditions or randomizing the participants), it cannot be said with certainty that religious attendance increases life expectancy or that it doesn’t.

We can only conclude that there is an association between religious attendance and increased life expectancy. They are linked, but we don’t know why.

There could be a different reason to explain the life expectancy outcome in the study. In fact, other studies have shown that people who regularly attend religious services:

  • May be more likely to be employed
  • Tend to have larger social networks
  • Tend to be more positive
  • Are more likely to live in intact families
  • Are less likely to be experiencing disabling illness

Any of these factors could explain the difference in life expectancy observed in these studies. Another study suggested that religious involvement on its own should not be automatically assumed to improve health. People who share religious beliefs also usually share other characteristics including ethnic, cultural, and socioeconomic backgrounds.

Research also suggests that religion can sometimes become a barrier to mental health treatment. Religious attitudes toward mental health and treatment can play a role in whether people seek help when they are experiencing symptoms.

Some religious traditions instill the idea that problems are moral or spiritual failings rather than mental health issues.

According to this perspective, mental problems can be overcome simply through willpower or “heroic striving.” Because of this, people from such backgrounds may simply be less likely to seek professional help and support when they are having mental health problems.

Tips

If you are interested in exploring some of the potential benefits of religion or spiritual traditions, there are some things that may help:

  • Find a community that you connect with. Social support is an important part of well-being, so feeling a sense of connection with others in your religion can be beneficial.
  • Explore practices often utilized by religion. Meditation and mindfulness have been shown to have a number of wellness benefits.
  • Search for things that inspire you. Whether it is reading inspirational books, listening to beautiful music, or spending time enjoying nature, finding things that give you a sense of peace and inspiration can help improve your mental clarity and well-being.

The observation is real: People who attend religious services regularly tend to live longer and often experience better mental well-being. The tough question to answer is, why?

It may simply be that people who attend religious services tend to have more social and financial resources than non-attendees, or it could be that something about attending religious services (like making connections with others, prayer, or spiritual reflection) helps people to live longer and feel better. You’ll have to decide for yourself.


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How the Health Belief Model Influences Your Behavior

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Key Takeaways

  • The Health Belief Model helps predict health behaviors by focusing on people’s beliefs about their health and potential health problems.

  • Self-efficacy, or belief in one’s own ability, is crucial for making positive health behavior changes.

According to the health belief model, your beliefs about health and health conditions play a role in determining your health-related behaviors. Key factors that affect your approach to health include:

  • Barriers you think might be standing in your way
  • Exposure to information that prompts you to take action
  • Perceived benefit of engaging in healthy behaviors
  • Perceived susceptibility to illness
  • Perceived consequences of sickness
  • Confidence in your ability to succeed

This article discusses how the health belief model works, the different components of the model, and how this approach can be used to address health-related behaviors.

What is the health belief model?

Scientists use the health belief model (HBM) to try to predict health behaviors. Originally developed in the 1950s and proposed by social psychologists Godfrey Hochbaum, Irwin Rosenstock, and Rosenstock and Kirscht, the health belief model is based on the theory that the willingness to change health behaviors primarily comes from health perceptions.

Components of the Health Belief Model

There are six main components of the health belief model. Four of these constructs were main tenets of the theory when it was first developed. Two were added in response to research on the model related to addiction.

Perceived Severity

The probability that a person will change their health behaviors to avoid a consequence depends on how serious they believe the consequences will be. For example:

  • If you are young and in love, you are unlikely to avoid kissing your sweetheart on the mouth just because they have the sniffles and you might get their cold. On the other hand, you probably would stop kissing if it might give you a more serious illness.
  • Similarly, people are less likely to consider condoms when they think STDs are a minor inconvenience. That’s why receptiveness to messages about safe sex increased during the AIDS epidemic. The perceived severity increased enormously. 

The severity of an illness can have a major impact on health outcomes. However, a number of studies have shown that perceived risk of severity is actually the least powerful predictor of whether or not people will engage in preventive health behaviors.

Perceived Susceptibility

People will not change their health behaviors unless they believe that they are at risk. For example:

  • Individuals who do not think they will get the flu are less likely to get a yearly flu shot.
  • People who think they are unlikely to get skin cancer are less likely to wear sunscreen or limit sun exposure.
  • Those who do not think that they are at risk of acquiring HIV from unprotected intercourse are less likely to use a condom.
  • Young people who don’t think they’re at risk of lung cancer are less likely to stop smoking.

Research suggests that perceived susceptibility to illness is an important predictor of preventive health behaviors.

Perceived Benefits

It’s difficult to convince people to change a behavior if there isn’t something in it for them. People don’t want to give up something they enjoy if they don’t also get something in return. For example:

  • A person probably won’t stop smoking if they don’t think that doing so will improve their life in some way.
  • A couple might not choose to practice safe sex if they don’t see how it could make their sex life better. 
  • People might not get vaccinated if they do not think there is an individual benefit for them.

These perceived benefits are often linked to other factors, including the perceived effectiveness of a behavior. If you believe that getting regular exercise and eating a healthy diet can prevent heart disease, that belief increases the perceived benefits of those behaviors.

Perceived Barriers

One of the major reasons people don’t change their health behaviors is that they think doing so is going to be hard. Changing health behaviors can require effort, money, and time. Commonly perceived barriers include:

  • Amount of effort needed
  • Danger
  • Discomfort
  • Expense
  • Inconvenience
  • Social consequences

Sometimes it’s not just a matter of physical difficulty, but social difficulty as well. For example, If everyone from your office goes out drinking on Fridays, it may be very difficult to cut down on your alcohol intake. If you think that condoms are a sign of distrust in a relationship, you may be hesitant to bring them up. 

Perceived barriers to healthy behaviors have been shown to be the single most powerful predictor of whether people are willing to engage in healthy behaviors.

When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to help people overcome perceived barriers is important. Disease prevention programs can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs.

Cues to Action

One of the best things about the Health Belief Model is how realistically it frames people’s behaviors. It recognizes the fact that sometimes wanting to change a health behavior isn’t enough to actually make someone do it.

Because of this, it includes two more elements that are necessary to get an individual to make the leap. These two elements are cues to action and self-efficacy.

Cues to action are external events that prompt a desire to make a health change. They can be anything from a blood pressure van being present at a health fair, to seeing a condom poster on a train, to having a relative die of cancer. A cue to action is something that helps move someone from wanting to make a health change to actually making the change.

Self-Efficacy

Self-efficacy wasn’t added to the model until 1988. Self-efficacy looks at a person’s belief in their ability to make a health-related change. It may seem trivial, but faith in your ability to do something has an enormous impact on your actual ability to do it.

Finding ways to improve individual self-efficacy can have a positive impact on health-related behaviors. For example, one study found that women who had a greater sense of self-efficacy toward breastfeeding were more likely to nurse their infants longer. The researchers concluded that teaching mothers to be more confident about breastfeeding would improve infant nutrition.

Thinking that you will fail will almost make certain that you do. Self-efficacy has been found to be one of the most important factors in an individual’s ability to successfully negotiate condom use.

Recap

There are six components of the Health Belief Model. They are perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy.

Examples and Uses of the Health Belief Model

One important aspect of public health is the design of programs that encourage people to engage in healthy behaviors, so understanding how the health belief model can apply to different situations can be useful.

For example, experts may be interested in understanding public attitudes about cancer screenings. Looking at factors such as perceptions of cancer risk, the benefits of being screened for cancer, and the barriers to being screened can help healthcare professionals look for ways to encourage people to get screened.

The health belief model may also be used for public health programs. Schools, for example, may rely on educational programs to help children understand challenges regarding health, substance use, physical activity, nutrition, and personal safety. Such programs are often based on the health belief model and work to educate, offer skills training, reduce barriers, and boost self-efficacy.

Recap

Healthcare professionals and public health experts apply the health belief model to create programs and interventions to help prevent health problems, encourage treatment behaviors, and support behavior change.

How Effective Is the Health Belief Model?

The health belief model has been used for decades to help produce behavior change interventions. Research suggests that the health belief model can help professionals develop strategies that promote healthy behaviors and improve the prevention and treatment of health conditions. 

A study published in Health Psychology Review found that, in studies looking at the health belief model, 78% reported significant improvement in behavior adherence. Of the studies they looked at, 39% reported moderate to large effects related to health interventions.

Criticisms of the Health Belief Model

Critics of the health belief model assert that it fails to address:

  • How habits can shape decisions
  • The fact that people often engage in actions for reasons other than health, such as social acceptance
  • Economic and environmental factors, such as living in a food desert or lacking resources to afford fresh fruits and vegetables
  • Individual beliefs, attitudes, and other characteristics
  • How to change health behaviors rather than merely describe them

Frequently Asked Questions


  • Who developed the Health Belief Model?

    The Health Belief Model was created by social psychologists Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal during the 1950s. It was developed for the U.S. Public Health Services to understand why people fail to engage in healthy behaviors.


  • What are the strengths of the Health Belief Model?

    One of the main benefits of the Health Belief Model is that it simplifies health-related constructs so they can be more readily tested and implemented in public health settings. Because it emphasizes some of the prerequisites for health behaviors, it can be helpful for addressing the things that need to happen before a person can successfully implement a behavior change.


  • How does the Health Belief Model differ from the Health Promotion Model?

    The Health Promotion Model is a multidimensional approach that takes into account how a person’s interaction with their environment affects their health choices. It is similar to the Health Belief Model in some ways, but where the HBM is focused on being health-protective, the Health Promotion Model focuses more on helping people improve their well-being and achieve self-actualization.



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