The Dunning-Kruger Effect: An Overestimation of Capability


Key Takeaways

  • The Dunning-Kruger effect is when people overestimate their skills because they don’t know enough to see their own lack of knowledge or ability.
  • To better understand your abilities, ask for feedback and learn more about the topic.

The Dunning-Kruger effect is a type of cognitive bias in which people believe they are smarter and more capable than they are. Low-ability people do not possess the skills needed to recognize their own incompetence. The combination of poor self-awareness and low cognitive ability leads them to overestimate their capabilities.

The basic idea behind the Dunning-Kruger effect is this: if you don’t know something, you also don’t have the ability to recognize that you don’t know it.

The term lends a scientific name and explanation to a problem that many people immediately recognize—that fools are blind to their own foolishness. As Charles Darwin wrote in his book The Descent of Man, “Ignorance more frequently begets confidence than does knowledge.”

Keep reading to learn more about how the Dunning-Kruger effects works, the history of research on this phenomenon, and why people may overestimate their skills. Also, explore some of the ways you can avoid overestimating how much you really know about a subject.

Understanding the Dunning-Kruger Effect

You’ve probably experienced this phenomenon in real life. An example of the Dunning-Kruger effect is a situation that many have perhaps experienced around the dinner table at a holiday family gathering.

Throughout the meal, a member of your extended family spouts off on a topic at length, boldly proclaiming that they are correct and that everyone else’s opinion is stupid, uninformed, and just plain wrong. While it may be evident that this person has no idea what they are talking about, they prattle on, blithely oblivious to their ignorance.

The effect is named after researchers David Dunning and Justin Kruger, the two social psychologists who first described it. In their original study, they performed four investigations into this psychological phenomenon.

People who scored in the lowest percentiles on grammar, humor, and logic tests also tended to dramatically overestimate how well they had performed (their actual test scores placed them in the 12th percentile, but they estimated that their performance placed them in the 62nd percentile).

The Research

In one experiment, for example, Dunning and Kruger asked their 65 participants to rate how funny different jokes were. Some participants were exceptionally poor at determining what other people would find funny—yet these subjects described themselves as excellent judges of humor.

Incompetent people, the researchers suggested, were not only poor performers but were also unable to accurately assess and recognize the quality of their work. This is perhaps why students who earn failing scores on exams sometimes feel they deserve a much higher score. They overestimate their knowledge and ability and cannot accurately assess their performance.

People who aren’t good at something have a hard time recognizing other people’s skill and competence levels. That’s why they consistently view themselves as better, more capable, and more knowledgeable than others.

“In many cases, incompetence does not leave people disoriented, perplexed, or cautious,” wrote David Dunning in an article for Pacific Standard. “Instead, the incompetent are often blessed with an inappropriate confidence, buoyed by something that feels to them like knowledge.”

How It Affects Behavior and Decisions

Th Dunning-Kruger effect can have a profound impact on what people believe, the decisions they make, and the actions they take.

In one study, Dunning and Ehrlinger found that women performed equally to men on a science quiz—yet women underestimated their performance because they believed they had less scientific reasoning ability than men. The researchers also found that these women were more likely to refuse to enter a science competition due to this belief.

Dunning and his colleagues have also performed experiments in which they asked respondents if they were familiar with various terms related to subjects such as politics, biology, physics, and geography. Along with genuine subject-relevant concepts, they interjected completely made-up terms.

In one such study, approximately 90% of respondents claimed they had at least some knowledge of the made-up terms. Consistent with other findings related to the Dunning-Kruger effect, the more familiar participants claimed that they were with a topic, the more likely they were also to claim they were familiar with the meaningless terms.

Why the Dunning-Kruger Effect Happens

So what explains this psychological effect? Are some people simply too dense to recognize their shortcomings? Dunning and Kruger suggest that this phenomenon stems from what they refer to as a “dual burden.” People are not only incompetent; their incompetence robs them of the mental ability to realize just how inept they are.

Incompetent people tend to:

  • Overestimate their skill levels
  • Fail to recognize the genuine skill and expertise of other people
  • Fail to recognize their own mistakes and lack of skill

The very knowledge and skills necessary to be good at a task are the same qualities that a person needs to recognize that they are not good at that task. So if a person lacks those abilities, they remain not only bad at that task but ignorant of their inability.

This effect has been attributed to a number of different explanations, including:

An Inability to Recognize Lack of Skill and Mistakes

Dunning suggests that deficits in skill and expertise create a two-pronged problem. First, these deficits cause people to perform poorly in the domain in which they are incompetent. Secondly, their erroneous and deficient knowledge makes them unable to recognize their mistakes.

A Lack of Metacognition

The Dunning-Kruger effect is also related to difficulties with metacognition.

Metacognition refers to the ability to step back and look at one’s behavior and abilities from outside of oneself.

People can often only evaluate themselves from their own limited and highly subjective point of view. From this limited perspective, they seem highly skilled, knowledgeable, and superior to others. Because of this, people sometimes struggle to have a more realistic view of their abilities.

A Little Knowledge Can Lead to Overconfidence

Another contributing factor is that sometimes a tiny bit of knowledge on a subject can lead people to mistakenly believe that they know all there is to know about it. As the old saying goes, a little bit of knowledge can be a dangerous thing.

A person might have the slimmest bit of awareness about a subject, yet thanks to the Dunning-Kruger effect, believe that they are an expert.

This is why people who say that they’ve “done their research” arrive at erroneous and misinformed conclusions. Because they lack the requisite background knowledge and skill, they aren’t able to recognize their own gaps in knowledge.

Other Factors That Play a Role

Other factors that can contribute to the effect include:

  • The use of heuristics, or mental shortcuts that allow people to make decisions quickly
  • A tendency to seek out patterns even where none exist

Our minds are primed to try to make sense of the disparate array of information we deal with daily. As we try to cut through the confusion and interpret our abilities and performance within our worlds, it is perhaps not surprising that we sometimes fail so completely to judge how well we do accurately.

Are You Less Competent Than You Think?

So, who is affected by the Dunning-Kruger effect? According to the researchers, everyone is prone to this effect. This is because no matter how informed or experienced we are, we all have our areas of ignorance. You might be smart and skilled in many areas, but no one is an expert at everything.

Everyone is susceptible to this phenomenon, and most of us probably experience it with surprising regularity. Genuine experts in one area may mistakenly believe that their intelligence and knowledge carry over into other areas in which they are less familiar.

A brilliant scientist, for example, might be a very poor writer. For the scientist to recognize their lack of skill, they need to possess a good working knowledge of grammar, composition, and other elements of writing. Because those are lacking, the scientist in this example cannot recognize their poor performance.

One Important Note

The Dunning-Kruger effect is not synonymous with low IQ. As awareness of the term has increased, its misapplication as a synonym for “stupid” has also grown. The fact is that it is something that affects all of us, no matter how smart we (think) we are. It is, after all, easy to judge others and believe that such things simply do not apply to us.

Is the Dunning-Kruger Effect Real?

Not everyone agrees that the Dunning-Kruger effect actually exists, however. Instead, some critics have suggested that the effect is actually a data artifact. In mathematical studies, researchers were able to replicate the effect using computer-generated random data. Such studies found that experts and amateurs overestimate or underestimate their abilities at about the same rate. 

However, the research found that experts tend to be better at assessing their abilities and that women generally make more accurate self-assessments than men.

A 2022 study also suggested a statistical explanation for the effect that does not rely on a psychological explanation. According to the researchers, the effect exists, but it is not the result of human nature.

Dunning-Kruger Effect vs. Imposter Syndrome

So, if the incompetent tend to think they are experts, what do genuine experts think of their own abilities? Dunning and Kruger found that those at the high end of the competence spectrum did hold more realistic views of their own knowledge and capabilities. However, these experts actually tended to underestimate their own abilities relative to how others did.

Top-scoring individuals know that they are better than the average, but they are not convinced of how superior their performance is to others. The problem, in this case, is not that experts don’t know how well-informed they are; they tend to believe that everyone else is also knowledgeable.

This can sometimes lead to the opposite of the Dunning-Kruger effect—imposter syndrome. Since the Dunning-Kruger effect involves overconfidence in one’s abilities, the opposing tendency would involve underconfidence in one’s abilities. In imposter syndrome, competent people doubt their own abilities and fear that others will discover them to be frauds.

How to Overcome the Dunning-Kruger Effect

Is there anything that can minimize this phenomenon? Is there a point at which the incompetent actually recognize their own ineptitude?

According to Dunning, we are all what he calls “engines of misbelief.” While we are all prone to experiencing the Dunning-Kruger effect, learning more about how the mind works and the mistakes we are all susceptible to might be one step toward correcting such patterns.

As people learn more about the topic of interest, they begin to recognize their lack of knowledge and ability. Then as people gain more information and become experts on a topic, their confidence levels begin to improve again.

What can you do to gain a more realistic assessment of your abilities in a particular area if you are unsure you can trust your self-assessment?

Keep Learning and Practicing

Instead of assuming you know all there is to know about a subject, keep digging deeper. Once you gain greater knowledge of a topic, you will likely recognize how much there is still to learn. This can combat the tendency to assume you’re an expert, even if you’re not.

Ask Other People How You’re Doing

Another effective strategy involves asking others for constructive criticism. While it can sometimes be difficult to hear, such feedback can provide valuable insights into how others perceive your abilities.

Question What You Know

Even as you learn more and get feedback, it can be easy to only pay attention to things that confirm what you think you already know. This is an example of another type of psychological bias known as the confirmation bias.

To minimize this tendency, keep challenging your beliefs and expectations. Seek out information that challenges your ideas.


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Milgram Experiment: Overview, History, & Controversy


Key Takeaways

  • The Milgram experiment showed that people often obey authority figures, even when it goes against their values.
  • Ethical concerns about the experiment include the use of deception and not fully informing participants.

How far do you think people would go to obey an authority figure? Would they refuse to obey if the order went against their values or social expectations? Those questions were at the heart of an infamous and controversial study known as the Milgram obedience experiments.

Yale University psychologist Stanley Milgram conducted these experiments during the 1960s. They explored the effects of authority on obedience. In the experiments, an authority figure ordered participants to deliver what they believed were dangerous electrical shocks to another person. These results suggested that people are highly influenced by authority and highly obedient.

More recent investigations cast doubt on some of the implications of Milgram’s findings and even the results and procedures themselves. Despite its problems, the study has, without question, made a significant impact on psychology.

History of the Milgram Experiments

Milgram started his experiments in 1961, shortly after the trial of the World War II criminal Adolf Eichmann had begun. Eichmann’s defense that he was merely following instructions when he ordered the deaths of millions of Jews roused Milgram’s interest.

In his 1974 book “Obedience to Authority,” Milgram posed the question, “Could it be that Eichmann and his million accomplices in the Holocaust were just following orders? Could we call them all accomplices?”

Procedure in the Milgram Experiment

The participants in the most famous variation of the Milgram experiment were 40 men recruited using newspaper ads. In exchange for their participation, each person was paid $4.50.

Milgram developed an intimidating shock generator, with shock levels starting at 15 volts and increasing in 15-volt increments all the way up to 450 volts. The many switches were labeled with terms including “slight shock,” “moderate shock,” and “danger: severe shock.” The final three switches were labeled simply with an ominous “XXX.”

Each participant took the role of a “teacher” who would then deliver a shock to the “student” in a neighboring room whenever an incorrect answer was given. While participants believed that they were delivering real shocks to the student, the “student” was a confederate in the experiment who was only pretending to be shocked.

As the experiment progressed, the participant would hear the learner plead to be released or even complain about a heart condition. Once they reached the 300-volt level, the learner would bang on the wall and demand to be released.

Beyond this point, the learner became completely silent and refused to answer any more questions. The experimenter then instructed the participant to treat this silence as an incorrect response and deliver a further shock.

Most participants asked the experimenter whether they should continue. The experimenter then responded with a series of commands to prod the participant along:

  1. “Please continue.”
  2. “The experiment requires that you continue.”
  3. “It is absolutely essential that you continue.”
  4. “You have no other choice; you must go on.”

Results of the Milgram Experiment

In the Milgram experiment, obedience was measured by the level of shock that the participant was willing to deliver. While many of the subjects became extremely agitated, distraught, and angry at the experimenter, they nevertheless continued to follow orders all the way to the end.

Milgram’s results showed that 65% of the participants in the study delivered the maximum shocks. Of the 40 participants in the study, 26 delivered the maximum shocks, while 14 stopped before reaching the highest levels.

Factors That Influence Obedience

Why did so many of the participants in this experiment perform a seemingly brutal act when instructed by an authority figure? According to Milgram, there are some situational factors that can explain such high levels of obedience:

  • The physical presence of an authority figure dramatically increased compliance.
  • The fact that Yale (a trusted and authoritative academic institution) sponsored the study led many participants to believe that the experiment must be safe.
  • The selection of teacher and learner status seemed random.
  • Participants assumed that the experimenter was a competent expert.
  • The shocks were said to be painful, not dangerous.

Later experiments conducted by Milgram indicated that the presence of rebellious peers dramatically reduced obedience levels. When other people refused to go along with the experimenter’s orders, 36 out of 40 participants refused to deliver the maximum shocks.

More recent work by researchers suggests that while people do tend to obey authority figures, the process is not necessarily as cut-and-dried as Milgram depicted it.

In a 2012 essay published in PLoS Biology, researchers suggested that the degree to which people are willing to obey the questionable orders of an authority figure depends largely on two key factors:

  • How much the individual agrees with the orders
  • How much they identify with the person giving the orders

While it is clear that people are often far more susceptible to influence, persuasion, and obedience than they would often like to be, they are far from mindless machines just taking orders. 

Another study that analyzed Milgram’s results concluded that eight factors influenced the likelihood that people would progress up to the 450-volt shock:

  • The experimenter’s directiveness
  • Legitimacy and consistency
  • Group pressure to disobey
  • Indirectness of proximity
  • Intimacy of the relation between the teacher and learner
  • Distance between the teacher and learner

Ethical Concerns in the Milgram Experiment

Milgram’s experiments have long been the source of considerable criticism and controversy. From the get-go, the ethics of his experiments were highly dubious. Participants were subjected to significant psychological and emotional distress.

Some of the major ethical issues in the experiment were related to:

  • The use of deception
  • The lack of protection for the participants who were involved
  • Pressure from the experimenter to continue even after asking to stop, interfering with participants’ right to withdraw

Due to concerns about the amount of anxiety experienced by many of the participants, everyone was supposedly debriefed at the end of the experiment. The researchers reported that they explained the procedures and the use of deception.

Critics of the study have argued that many of the participants were still confused about the exact nature of the experiment, and recent findings suggest that many participants were not debriefed at all.

Replications of the Milgram Experiment

While Milgram’s research raised serious ethical questions about the use of human subjects in psychology experiments, his results have also been consistently replicated in further experiments. One review further research on obedience and found that Milgram’s findings hold true in other experiments.

In one study, researchers conducted a study designed to replicate Milgram’s classic obedience experiment. The researchers made several alterations to Milgram’s experiment.

  • The maximum shock level was 150 volts as opposed to the original 450 volts.
  • Participants were also carefully screened to eliminate those who might experience adverse reactions to the experiment.

The results of the new experiment revealed that participants obeyed at roughly the same rate that they did when Milgram conducted his original study more than 40 years ago.

Some psychologists suggested that in spite of the changes made in the replication, the study still had merit and could be used to further explore some of the situational factors that also influenced the results of Milgram’s study. But other psychologists suggested that the replication was too dissimilar to Milgram’s original study to draw any meaningful comparisons.

One study examined people’s beliefs about how they would do compared to the participants in Milgram’s experiments. They found that most people believed they would stop sooner than the average participants. These findings applied to both those who had never heard of Milgram’s experiments and those who were familiar with them. In fact, those who knew about Milgram’s experiments actually believed that they would stop even sooner than other people.

Another novel replication involved recruiting participants in pairs and having them take turns acting as either an ‘agent’ or ‘victim.’ Agents then received orders to shock the victim. The results suggest that only around 3.3% disobeyed the experimenter’s orders.

Recent Criticisms and New Findings

Psychologist Gina Perry suggests that much of what we think we know about Milgram’s famous experiments is only part of the story. While researching an article on the topic, she stumbled across hundreds of audiotapes found in Yale archives that documented numerous variations of Milgram’s shock experiments.

Participants Were Often Coerced

While Milgram’s reports of his process report methodical and uniform procedures, the audiotapes reveal something different. During the experimental sessions, the experimenters often went off-script and coerced the subjects into continuing the shocks.

“The slavish obedience to authority we have come to associate with Milgram’s experiments comes to sound much more like bullying and coercion when you listen to these recordings,” Perry suggested in an article for Discover Magazine.

Few Participants Were Really Debriefed

Milgram suggested that the subjects were “de-hoaxed” after the experiments. He claimed he later surveyed the participants and found that 84% were glad to have participated, while only 1% regretted their involvement.

However, Perry’s findings revealed that of the 700 or so people who took part in different variations of his studies between 1961 and 1962, very few were truly debriefed.

A true debriefing would have involved explaining that the shocks weren’t real and that the other person was not injured. Instead, Milgram’s sessions were mainly focused on calming the subjects down before sending them on their way.

Many participants left the experiment in a state of considerable distress. While the truth was revealed to some months or even years later, many were simply never told a thing.

Variations Led to Differing Results

Another problem is that the version of the study presented by Milgram and the one that’s most often retold does not tell the whole story. The statistic that 65% of people obeyed orders applied only to one variation of the experiment, in which 26 out of 40 subjects obeyed.

In other variations, far fewer people were willing to follow the experimenters’ orders, and in some versions of the study, not a single participant obeyed.

Participants Guessed the Learner Was Faking

Perry even tracked down some of the people who took part in the experiments, as well as Milgram’s research assistants. What she discovered is that many of his subjects had deduced what Milgram’s intent was and knew that the “learner” was merely pretending.

Such findings cast Milgram’s results in a new light. It suggests that not only did Milgram intentionally engage in some hefty misdirection to obtain the results he wanted but that many of his participants were simply playing along.

An analysis of an unpublished study by Milgram’s assistant, Taketo Murata, found that participants who believed they were really delivering a shock were less likely to obey, while those who did not believe they were actually inflicting pain were more willing to obey. In other words, the perception of pain increased defiance, while skepticism of pain increased obedience.

Recap

A review of Milgram’s research materials suggests that the experiments exerted more pressure to obey than the original results suggested. Other variations of the experiment revealed much lower rates of obedience, and many of the participants actually altered their behavior when they guessed the true nature of the experiment.

Impact of the Milgram Experiment

Since there is no way to truly replicate the experiment due to its serious ethical and moral problems, determining whether Milgram’s experiment really tells us anything about the power of obedience is impossible to determine.

So why does Milgram’s experiment maintain such a powerful hold on our imaginations, even decades after the fact? Perry believes that despite all its ethical issues and the problem of never truly being able to replicate Milgram’s procedures, the study has taken on the role of what she calls a “powerful parable.”

Milgram’s work might not hold the answers to what makes people obey or even the degree to which they truly obey. It has, however, inspired other researchers to explore what makes people follow orders and, perhaps more importantly, what leads them to question authority.

Regram

Recent findings undermine the scientific validity of the study. Milgram’s work is also not truly replicable due to its ethical problems. However, the study has led to additional research on how situational factors can affect obedience to authority.


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The First Week and Beyond


Key Takeaways

  • You may have side effects like nausea and trouble sleeping when you first start taking Lexapro.
  • Most side effects go away after one or two weeks, but talk to your doctor if they last longer.
  • Do not stop taking Lexapro quickly; it could cause withdrawal symptoms.

Lexapro (escitalopram) is a type of antidepressant medication known as a selective serotonin reuptake inhibitor or SSRI. That means it works by blocking the reuptake of serotonin, making more of that neurotransmitter available in the brain. Lexapro is prescribed for the treatment of depressive disorders, anxiety disorders, and other mood disorders, sometimes in combination with other medications.

If you or someone you love is taking Lexapro or escitalopram (the generic version)—or the brand name Cipralex if you are in the UK—you should be aware of the common and serious side effects of Lexapro. People who use Lexapro may also experience withdrawal symptoms when stopping this medication, as well as a risk of overdose if it is taken in too-high doses.

What is the most important information I should know about Lexapro side effects?

  • You may experience side effects during your first week on Lexapro, including anxiety, difficulty sleeping, drowsiness, headaches, and nausea. These effects usually dissipate as your body adjusts to your medication.
  • Do not stop taking your medication abruptly if you do experience side effects, since doing so may cause withdrawal symptoms. Instead, contact your healthcare provider to discuss your best options.

Your First Week on Lexapro

You may experience side effects during the first week of treatment. During your first week of taking Lexapro, some of the most common side effects you might experience include:

  • Diarrhea
  • Dry mouth
  • Fatigue
  • Headaches
  • Increased sweating
  • Nausea
  • Nervousness
  • Restlessness
  • Trouble sleeping

How long will Lexapro side effects last?

These side effects will likely dissipate after your first one to two weeks of taking the medication. If they persist longer, talk to your care provider. They may adjust your dosage or prescribe a different medication altogether.

While you might be experiencing some side effects during your first week of taking Lexapro, you may also feel relief from physical symptoms of your mental health condition, such as improved energy and appetite. Mental health symptoms, such as depressed mood or lack of interest in activities, for instance, may take longer to improve (between six and eight weeks).

Common Lexapro Side Effects

It’s important to remember that side effects are normal and even expected. Roughly 75% of people taking antidepressant medications experience some type of side effects.

While there is a good chance you’ll experience at least *some* side effects, your physician may still prescribe this medication if they feel that the benefits outweigh the risks.

Some of the most common side effects people experience while taking Lexapro are:

  • Drowsiness or fatigue
  • Increased sweating
  • Insomnia
  • Nausea
  • Sexual issues (such as ejaculation disorder and decreased libido)

It is important to know that these side effects may appear within the first two weeks of taking the medicine and subside as your body adjusts to it. Additionally, if your Lexapro dosage is increased at a later date, side effects that went away prior to the increase are unlikely to reoccur.

Serious Lexapro Side Effects

If you experience any of the following side effects, contact your healthcare provider immediately or seek emergency medical care.

  • Bleeding or bruising: More likely to occur if you are also on a blood thinner or non-steroidal anti-inflammatory drug [NSAID]
  • Manic episode: Greatly increased energy, trouble sleeping, racing thoughts, reckless behavior like excessive gambling or shopping, inflated sense of self, rapid speech, or feeling extremely happy or irritable
  • Serotonin syndrome: Agitation, hallucinations, confusion, coma, coordination or balance problems, muscle twitching, racing heartbeat, high or low blood pressure, sweating, fever, nausea, vomiting, or diarrhea
  • Severe allergic reaction: Rash, difficulty breathing, fever, joint pain, or swelling of the mouth, lips, eyes, or tongue
  • Other serious side effects: Seizures, change in appetite or weight, low blood sodium levels, teeth grinding, and angle-closure glaucoma

This list is not intended to be all-inclusive or to replace information provided by your physician as other side effects can occur. If you notice any other effects, check with your care provider.

Black Box Warning

According to the black box warning (the strictest warning for prescription drugs issued by the FDA), taking Lexapro can result in an increased risk of suicidal thoughts and behaviors. This is of particular concern in children, adolescents, and young adults—especially when beginning treatment or changing the dosage.

Warning signs to watch for include new or sudden changes in mood, behavior, actions, thoughts, or feelings. Someone who is considering suicide may talk about feeling trapped or a burden to others, increase their drug or alcohol use, isolate from others, or change their sleep patterns, among other actions.

Lexapro Drug Interaction Side Effects

Taking Lexapro with other medications, supplements, or substances can also lead to unpleasant or potentially dangerous drug interactions. The following drugs have been known to interact with Lexapro and should be used with caution.

Blood Thinners

Lexapro can increase the risk of bleeding when used with blood thinners such as NSAIDs, aspirin, and warfarin. Warfarin has the potential to interact with several different types of antidepressants.

A study in the Journal of the American Osteopathic Association found that patients taking SSRIs are 40% more likely to develop severe gastrointestinal bleeding, especially if they are also taking NSAIDs.

Talk to your physician before taking NSAIDs such as Motrin (ibuprofen) or Aleve (naproxen).

Serotonergic Medication

Serotonin syndrome is a dangerous complication caused by excessive serotonin levels. Symptoms can be mild, but they can also be life-threatening in rare cases, which is why this condition is sometimes referred to as serotonin toxicity (aka serotonin syndrome).

Medications that may increase the risk of serotonin syndrome include:

  • Antibiotics, like Zyvox (linezolid)
  • Anti-nausea medicines, including Zofran (ondansetron) and Reglan (metoclopramide)
  • Dietary supplements, namely tryptophan
  • Herbal supplements, like St. John’s wort and ginseng
  • HIV and AIDS medications, such as Norvir (ritonavir)
  • Illegal substances, including cocaine and amphetamines
  • Other SSRIs, such as Celexa (citalopram) and Prozac (fluoxetine)
  • Monoamine oxidase inhibitors (MAOIs), like Emsam (selegiline) and Nardil (phenelzine)
  • Mood stabilizers, such as lithium
  • Norepinephrine reuptake inhibitors, such as Wellbutrin (bupropion)
  • Over-the-counter cold and cough medicines that contain the ingredient dextromethorphan
  • Pain medications, like Ultram (tramadol) and Oxycontin (oxycodone)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine) and Effexor (venlafaxine)
  • Tricyclic antidepressants, such as Pamelor (nortriptyline) and Elavil (amitriptyline)
  • Triptans used for treating migraines, such as Imitrex (sumatriptan) and Axert (almotriptan)

The best way to avoid any possible drug interaction is to provide your doctor with a complete list of any prescription and over-the-counter medications (including supplements) you are currently taking.

Coping With Lexapro Side Effects

Lexapro’s side effects can sometimes be a bit unpleasant at first, but they are usually mild. In other words, they can be annoying at first, but they can be managed fairly easily. Talk to your doc about some of the things you can do to feel better until the worst of the side effects start to wear off. Som strategies they might suggest include:

  • Changing the timing of doses to reduce the effects; for example, taking your medication after meals if you experience gastrointestinal symptoms, before bed if it gives you insomnia, or after sex if you’re experiencing sexual side effects
  • Increasing physical activity to help manage side effects related to anxiety, sleep problems, or constipation
  • Practicing relaxation techniques like yoga or meditation to improve your anxiety or insomnia
  • Using lubricants to make sex more comfortable

Taking Lexapro Safely

Escitalopram is considered one of the safest antidepressants. That said, as with any kind of treatment, it is important to follow your physician’s instructions for medication use, including when to take the medication, whether it’s okay to increase the dose, what to do if you miss a dose, and medications, foods, and substances to avoid.

If you want to deviate from your treatment plan for any reason, talk with a healthcare provider first. They can help you make changes that provide the desired results without negatively impacting your treatment outcome.

Use As Directed

Always follow your doctor’s directions when taking Lexapro. The usual recommended daily dosage is 10 milligrams (mg). Doses higher than 20 mg are not approved by the FDA. You may take Lexapro as a tablet or an oral solution once daily, in the morning or evening, with or without food.

Depending on your diagnosis, your physician may prescribe Lexapro for a defined period (between six months and one year) or for an extended period (over many years). Ask them or a pharmacist if you have any questions about this medication.

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember, unless it’s close to the time for your next dose. In that case, don’t double up. Just skip the missed dose and make plans to take your next dose as usual.

Precautions When Taking Lexapro

You can reduce potential risks by being aware of who should not take this medication. The safety and effectiveness of Lexapro in children younger than 12 years of age have not been established, so this medication is not generally recommended for this age group.

The medication’s side effects may also be more severe in older adults. If you are in this group, your physician will need to carefully monitor your dose.

Prior to starting escitalopram or Lexapro, tell your care provider if you are allergic or hypersensitive to escitalopram oxalate or if you are pregnant or breastfeeding. It’s also important to alert them if you have a history of any of the following medical conditions:

  • Bleeding problems
  • Glaucoma
  • Heart disease or heart attack
  • Kidney or liver disease
  • Low sodium levels (hyponatremia)
  • Seizures

People taking Lexapro should avoid drinking alcohol and taking illicit drugs, as these substances can reduce the effectiveness of the medication and increase its toxicity.

Lexapro Withdrawal Side Effects

Once you start taking Lexapro, you shouldn’t stop taking it without talking to your doctor first. It’s never a good idea to stop your medication abruptly as this may cause you to experience withdrawal symptoms, such as:

  • Agitation and irritability
  • Anxiety
  • Burning, numbness, or tingling in the hands or feet
  • Confusion
  • Dizziness
  • Headaches
  • Nausea
  • Shaking
  • Sleep issues
  • Sweating
  • Tiredness

To reduce the risk of these effects, your doctor may reduce your dosage over the course of several days before discontinuing the medicine altogether. Tapering your medication slowly allows your body to adjust and minimizes the risk of withdrawal effects.

Signs of Lexapro Overdose

If you or a loved one has accidentally or intentionally overdosed on escitalopram, the symptoms will typically start out mild and non-specific, worsening over time. Signs of Lexapro overdose include:

  • Dizziness
  • Drowsiness
  • Fast heartbeat or pounding heart
  • Loss of consciousness
  • Nausea
  • Seizures
  • Vomiting

If you or a loved one show these symptoms and you suspect an overdose, call 911 or immediately go to the emergency room.

Toxic and potentially life-threatening complications that can later emerge due to taking too much Lexapro can include:

  • Coma
  • Confusion
  • Delirium
  • Hallucinations
  • Increasingly worsening heart rate (dysrhythmia)
  • Involuntary eye movement
  • Respiratory distress
  • Seizures
  • Tremors
  • Unconsciousness

When to Seek Medical Attention

While most Lexapro side effects usually do not require medical intervention, you should report them to your healthcare provider if they continue for longer than one week or if they interfere with your daily routine. Your physician may decide to adjust your dosage or switch you to another medication entirely.

Also, while there are several fairly common side effects associated with escitalopram, you may find that you experience other less common side effects as well. If you do, alert your physician. You should never stop or change the dosage of your medication on your own.

Remember to consult your healthcare provider any time you’re unsure about any symptoms you experience while taking any medication. Most of the time, particularly in the case of antidepressants, other medication options are available.

Frequently Asked Questions


  • How does Lexapro make you feel the first week?

    Common side effects of escitalopram when you first start taking it include gastrointestinal issues, headache, dry mouth, and insomnia. These generally start to subside as your body begins to get used to the medicine. Talk with your physician if you’re concerned about any side effects you may be experiencing.


  • Can Lexapro cause anxiety?

    Some patients experience new or worsened anxiety when taking Lexapro. If you are taking Lexapro or escitalopram and feel like your anxiety is increasing, contact your physician to discuss whether this is the right medication for you or if the dosage should be adjusted based on these effects.


  • How long do Lexapro side effects last?

    Most side effects start to go away after the first week of taking Lexapro. If they don’t, or if the effects interfere with your ability to participate in your regular daily activities, talk to your physician. Your dosage may need to be adjusted or you may need to change medications.


  • What are the side effects of taking too much Lexapro?

    If you take more Lexapro than prescribed, you risk effects such as diarrhea, vomiting, drowsiness, pounding or racing heart, and loss of consciousness. If overdose is suspected, contact 911 or seek immediate medical attention.


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How Does Birth Order Shape Your Personality?


Key Takeaways

  • Birth order may affect behavior and relationships, but it is just one factor in development.
  • Firstborns often feel more responsible and focused on success, while middle children are seen as peacemakers.
  • Lastborns may be more fun-loving and carefree but can also be seen as immature.

Birth order refers to the order a child is born in relation to their siblings, such as whether they are first-born, middle-born, or last-born. You’ve probably heard people joke about how the eldest child is the bossy one, the middle child is the peace-maker, and the youngest child is the irresponsible rebel—but is there any truth to these stereotypes?

Psychologists often look at how birth order can affect development, behavior patterns, and personality characteristics, and there is some evidence that birth order might play a role in certain aspects of personality.

What Is Adler’s Birth Order Theory?

Early in the 20th century, the Austrian psychiatrist Alfred Adler introduced the idea that birth order could impact development and personality. Adler, the founder of individual psychology, was heavily influenced by psychoanalyst Sigmund Freud.

Key points of Adler’s birth order theory were that firstborns were more likely to develop a strong sense of responsibility, middleborns a desire for attention, and lastborns a sense of adventure and rebellion.

Adler also notably introduced the concept of the “family constellation.” This idea emphasizes the dynamics that form between family members and how these interactions play a part in shaping individual development.

First-Born Child

Adler’s birth order theory suggests that firstborns get more attention and time from their parents. New parents are still learning about child-rearing, which means that they may be more rule-oriented, strict, cautious, and sometimes even neurotic.

“Older siblings, regardless of gender, often feel more deprived or envious since they have experienced having another child divert attention away from them at some point in their lives. They tend to be more success-oriented,” explains San Francisco therapist Dr. Avigail Lev.

Firstborn children are often described as:

  • Leaders
  • High-achieving (or sometimes even over-achieving)
  • Structured and organized
  • Responsible
  • Mature

All this extra attention firstborns enjoy changes abruptly when younger siblings come along. When you become an older sibling, you suddenly have to share your parent’s attention. You may feel that your parents have higher expectations for you and look to you to set an example for your younger siblings.

Consider the experiences of the oldest siblings, who are frequently tasked with caring for younger siblings. Because they are often expected to help fill the role of caregivers, they may be more nurturing, responsible, and motivated to excel.

Such traits are affected not only by birth order but also by how your position in the family affects your parent’s expectations and your relationship with your younger siblings.

Research has found that firstborn kids tend to have more advanced cognitive development, which may also confer advantages when it comes to school readiness skills. However, it’s important to remember that being the oldest child can also come with challenges, including carrying the weight of expectations and the burden of taking a caregiver role within the family.

Middle Child

Adler suggested that middle children tend to become the family’s peacemaker since they often have to mediate conflicts between older and younger siblings. Because they tend to be overshadowed by their eldest siblings, middle children may seek social attention outside of the family.

In families with three children, the youngest male sibling is likely to be more passive or easy-going.

Middleborns are often described as:

  • Independent
  • Peacemakers
  • People pleasers
  • Outgoing
  • Adaptable
  • Attention-seeking
  • Jealous
  • Competitive
  • Insecure

While they tend to be adaptable and independent, they can also have a rebellious streak that tends to emerge when they want to stand apart from their siblings.

Middle child syndrome” is a term often used to describe the negative effects of being a middle child. Because middle kids are sometimes overlooked, they may engage in people-pleasing behaviors as adults as a way to garner attention and favor in their lives.

While research is limited, some studies have shown that middle kids are less likely to feel close to their mothers and are more likely to have problems with delinquency.

Some research suggests that middle children may be more sensitive to rejection. As a middle child, you may feel like you didn’t get as much attention and were constantly in competition with your siblings. You may struggle with feelings of insecurity, fear of rejection, and poor self-confidence.

Last Child

Lastborns, often referred to as the “babies” of the family, are often seen as spoiled and pampered compared to their older siblings. Because parents are more experienced at this point (and much busier), they often take a more laissez-faire approach to parenting

Last-born children are sometimes described as:

  • Outgoing
  • Fun-loving
  • Charming
  • Free-spirited
  • Immature
  • Manipulative
  • Self-centered
  • Dependent
  • Risk-taking

Adler’s theory suggests that the youngest children tend to be outgoing, sociable, and charming. While they often have more freedom to explore, they also often feel overshadowed by their elder siblings, referred to as “youngest child syndrome.”

Because parents are sometimes less strict and disciplined with last-borns, these kids may have fewer self-regulation skills.

“If the youngest of many children is female, she tends to be more coddled or cared for, leading to a greater reliance on others compared to her older siblings, especially in larger families,” Lev suggests.

Only Child

Only children are unique in that they never have to share their parents’ attention and resources with a sibling. It can be very much like being a firstborn in many ways. These kids may be doted on by their caregivers, but never have younger siblings to interact with, which may have an impact on development.

Only children are often described as:

  • Mature
  • Diligent
  • Thoughtful
  • Perfectionistic
  • High-achieving
  • Imaginative
  • Self-reliant
  • Sensitive

Because they interact with adults so much, only children often seem very mature for their age. If you’re an only child, you may feel more comfortable being alone and enjoy spending time in solitude pursuing you own creative ideas. You may like having control and, because of your parents’ high expectations, have strong perfectionist tendencies.

How Birth Order Influences Relationships

Birth order may affect relationships in a wide variety of ways. For example, it may impact how you form connections with other people. It can also affect how you behave within these relationships.

Dr. Lev suggests that the effects of birth order can differ depending on gender. 

“For instance, in a family with two female siblings, the younger one often appears more confident and empowered, while the older one is more achievement-focused and insecure,” she explains.

She also suggests that there is often a notable rivalry between same-sex siblings versus that of mixed-gender siblings. Again, this effect can vary depending on gender. Where an older sister might be less secure and the younger sister more secure, the opposite is often true when it comes to older and younger brothers.

“This could be because older sisters often assume a motherly role, while older brothers might take on more of a bully role. As a result, younger brothers are generally more insecure, whereas younger sisters tend to be more confident than their older siblings,” she explains.

Some other potential effects include:

Communication

Birth order can affect how you communicate with others, which can have a powerful impact on relationship dynamics.

  • Firstborns and only children are often seen as more direct, which others can sometimes interpret as bossy or controlling.
  • Middle children may be less confrontational and more likely to look for solutions that will accommodate everyone.
  • Lastborns, on the other hand, may rely more on their sense of humor and charm to guide their social interactions.

Relationship Roles

Birth order may also influence the roles that you take on in a relationship.

  • Firstborns, for example, may be more likely to take on a caregiver role. This can be nurturing and supportive, but it can sometimes make partners feel like they are being “parented.” 
  • Middle children are more likely to be flexible and take a more easygoing approach.
  • Lastborns may be more carefree and less rigid.

Expectations

What we expect from relationships can sometimes also be influenced by birth order.

  • Firstborns often have high expectations of themselves and others, sometimes leading to criticism when people fall short.
  • Middle children are more prone to seek balance in relationships and want to make sure that everyone is treated fairly and contributing equally.
  • Lastborns may place the burden of responsibility on their partner’s shoulders while they take a more laissez-faire approach.

“Generally, older siblings are more likely to be in the scapegoat role, while the youngest siblings often have a more idealized view of the family,” Lev explains.

Other Factors Play a Role

How birth order influences interpersonal relationships can also be influenced by other factors. Some of these include personality differences, parenting styles, the parents’ relationship with one another, and even the birth order of the parents themselves.

Debunking Myths and Limitations

While birth order theory holds a popular position in culture, much of the available evidence suggests that it likely only has a minimal impact on developmental outcomes. In other words, birth order is only one of many factors that affect how we grow and learn. 

While some research suggests that there are some small personality differences between the oldest and youngest siblings, researchers have concluded that there are no significant differences in personality or cognitive abilities based on birth order.

Birth order doesn’t exist in a vacuum. Genetics, socioeconomic status, family resources, health factors, parenting styles, and other environmental variables influence child development. Other family factors, such as age spacing between siblings, sibling gender, and the number of kids in a family, can also moderate the effects of birth order.


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