What I Learned From Saying “No” for a Week as a Lifelong People Pleaser


Key Takeaways

  • Saying “no” to demands or requests for your time can feel uncomfortable if you aren’t respecting or prioritizing your boundaries.
  • For some people, people-pleasing is a trauma response. Many revert to “fawning” or people-pleasing when they feel unsafe. 
  • Start small—say “no” to one request this week—and see how it feels. You might just discover that protecting your time and energy is the best gift you can give yourself. 

If there’s one word that I struggle to say, it’s “no.” I’ve built a life around being accommodating. Need an extra set of hands on a work project? I’m your girl. Can’t find someone to help with last-minute plans? You can count on me.

There’s nothing wrong with helping people, of course. But I’d started to notice that my “yes” reflex was leaving me burnt out and feeling resentful.  

So when my editor popped into my inbox asking if I’d experiment with saying “no” to everything for a week, the thought gave me stomach pains. On the other hand, I imagined it’d be a great excuse to prioritize myself for a week (because, yes, I needed an excuse). 

So I said “yes” to the assignment—and said “no” to everything else for that week that didn’t align with my needs, priorities, or values.

Day 1: The Work Email

The first test of my “no” experiment came before I’d even finished my morning coffee. A client emailed asking if I could help take on an additional copywriting project with a tight deadline. 

Normally, I’d agree immediately and figure out how to deal with the stress later. But today, I hesitated. Did I really want to do it? Or was I saying yes out of habit?

For people-pleasers who are struggling to tune into their own wants and desires, Hunt suggests pausing before saying yes. 

“Use the pause to check in with your physical and emotional reactions,” Hunt says. “Ask yourself, ‘Does this feel genuine and authentic, or does it feel like something I should want?’”

If I felt excited about the assignment, I might’ve squeezed it into my schedule—but after pausing, I realized the subject matter was just not my vibe.

“Thank you for thinking of me,” I replied, “but I don’t have the bandwidth for this project right now.” I hit send before I could overthink it.

The result? The client was completely understanding, and they found another copywriter to help with the project. I felt a jolt of pride—and relief. Maybe saying “no” wouldn’t be so bad after all. 

Day 2: Family Favors

A text from a relative was my next challenge. She was job-hunting and wanted help creating a resumé.

Usually, I wouldn’t mind helping—but I had a bunch of things on my plate. I briefly considered doing it on my lunch break or after work, when I was meant to be studying for a course I was taking. 

But then I thought about how tired I was, and how badly I needed to rest. 

I texted her back and explained I wouldn’t get a chance to help with her resume until the following week. I also wished her luck in her job search. She completely understood. Win!

Something I said yes to, though? Grabbing pizza and watching a movie with my partner and friends that evening. I realized that, if I’d said yes to helping my relative, I’d have had to say no to this much-needed quality time.

Day 3: Social Pressures

On Wednesday, a friend asked if I wanted to make plans for the weekend. 

I typically enjoy having social engagements on the weekends. I’m a community-oriented person, and my friendships mean a lot to me. I was also hesitant to say no to them because it’s a relatively new friendship—while I feel more comfortable asserting boundaries with my closest friends, I worry about making new friends feel rejected or unwanted. 

But I had my final yoga teacher training practicals on the weekend, which meant I’d be physically and emotionally tired. I knew that if I agreed to a dinner, I’d either cancel on the day or I’d feel too tired and nervous to fully enjoy it.  

Saying ‘no’ didn’t make me a bad friend; it just made me an honest one.

I thanked them for the invite but explained that I wanted to focus all my attention on my yoga course. To my surprise, they weren’t just understanding—they were super excited for me. We both agreed to catch up next month. 

I realized I’d been overthinking people’s reactions to my boundaries. Saying “no” didn’t make me a bad friend; it just made me an honest one. 

Day 4: The Walk

My neighbor and I had plans to do an hour-long walk on Thursday evening. 

I told my neighbor I was considering canceling, as I was pretty exhausted. She compassionately encouraged me to reschedule if I needed to. It felt great to get this sort of support from her. 

I reminded myself of my reasons for this experiment: to prioritize myself. I used an AI-powered journaling app called Rosebud to help me make a decision, and it helped me parse out the pros and cons. 

Eventually, I decided to go on the walk. And I’m glad I did—the conversation, exercise, and fresh air did me good.

As much as the week was about saying “no,” I also wanted to say “yes” to things that served my needs and well-being. 

Day 5: Saying “No” to Myself

On Friday, the challenge turned inward. 

I’d been significantly tired all week—which I interpreted as a symptom of burnout.

For this reason, I decided to take Friday off work. After sleeping in and hitting the sauna, I felt better and immediately considered piling tasks on my plate: housework, personal admin, and work. 

I knew I needed more rest, but I also felt terribly guilty about not working (which is an issue in itself). 

Ross shared some words that I found really helpful for this situation. “When our own house is in disarray, we can’t make space for other people’s perspectives without defensiveness or fear,” she says. “Setting boundaries is an act of self-care because it enables me to operate at full capacity and be present enough to practice empathy when needed.”

Setting boundaries is an act of self-care because it enables me to operate at full capacity and be present enough to practice empathy when needed.

I know what I’m like when I’m burned out: it’s a terrible experience for me and those around me. I slack on house chores, I miss deadlines, and I’m way too cranky to be there for my loved ones. 

The solution here is self-care. This can be tricky if you’re not used to taking care of yourself, of course. “I would invite folks to think of true self-care as something that energizes your body, mind, and soul,” Ross advises. “What do you need to recharge, reset, take a break, shift your thinking, use a different part of your brain?”

For me, it was cuddling my dog, doing crafts, and watching Netflix—simple, but soothing. 

Day 6: A Boundary Push

Saturday brought my biggest challenge yet: a friend who wouldn’t take “no” for an answer. They kept pressing me to join a group activity, even after I’d politely declined. I found myself wavering, tempted to give in just to avoid conflict.

But instead, I simply repeated my “no” and changed the subject.

I felt terrible, to be honest, partly because they were clearly upset with me.  

While the interaction felt uncomfortable, it was a lesson in holding my ground even when others resist.

Day 7: Reflection

By Sunday, I felt empowered.

Saying “no” hadn’t turned me into a villain, nor had it alienated my loved ones. I managed to take time off work, focus fully on my yoga teacher training, and feel more in control of my time and energy. And I did that all without harming any of my relationships!

That’s not to say there weren’t challenges. Saying “no” can be uncomfortable, especially if you’re used to over-accommodating. 

But the benefits—reduced stress, increased self-respect, and a clearer sense of priorities—were undeniable. 

Will I Be Saying “No” More Often?

Absolutely. 

But I’m not going to lie: I don’t think saying “no” is a skill I’ve mastered yet. It makes me very uncomfortable, and I still have a sense of guilt about Saturday’s interaction. 

“Guilt is common when trying something new, especially when it challenges deeply held beliefs,” Hunt advised. She advises starting by setting small boundaries to build up your confidence. “With practice, you’ll start to internalize that boundaries are about respecting yourself, not disrespecting others.”

I’ll need more practice before I feel confident. But I think I’ve made some progress. 

That said, I’ve also learned to balance this newfound assertiveness with flexibility. Not every “yes” is a bad thing. Sometimes it’s worth saying “yes” to opportunities that align with your values.

Why Is It So Hard To Say No?

I’m not a textbook people pleaser—I can be grumpy, blunt, and headstrong. But I often agree to do things I don’t want to do because I’m afraid of conflict and rejection. Classic people-pleasing behavior, right?

“Generally speaking, people-pleasing develops from a deep longing for validation and acceptance,” says Jessica Hunt, LCSW. “It’s a coping mechanism from growing up in environments where love or safety felt conditional and acceptance was earned by being agreeable, helpful, or compliant.” 

If that description feels like a personal attack, you’re not alone. Hunt says that many people learn that self-sacrifice is a good thing. “This eventually leads to prioritizing others’ needs over their own out of fear of conflict or rejection,” she says.  

There’s a term for this: pathological altruism. And research shows that healthy selfishness is better for you, psychologically and socially, than pathological altruism.

Beyond feeling rejected, one of the reasons why I find it hard to say “no” is because I genuinely can’t tell whether I’m being callous or not. 

So, I asked Maria Ross, an empathy advocate and author, how to tell the difference between being empathetic and people-pleasing. 

She gave me a helpful perspective: that people-pleasing doesn’t typically come from empathy, but from a place of fear. “When you default to people-pleasing, that is not empathy, It’s submission,” Ross says. “It’s about your own needs and desires to feel good.”

When you default to people-pleasing, that is not empathy, It’s submission.

“When others make an ask of us, we often react immediately from our own needs, whether we immediately say no because we’re stressed and busy or immediately say yes because we want to make the other person happy,” Ross says. In other words, when we people-please, we’re still acting based on our own desires. 

On the other hand, empathy is about considering another person’s perspective. Ross advises that there is a compassionate, empathetic way to hold boundaries.  

Final Thoughts

Here’s what I’ve learned from this experiment:

  • People-pleasing is not empathy. “Empathy is a way of being that is not about sacrificing your own needs and priorities,” Ross says. “That is not empathy, that is submission and acquiescence.”
  • Guilt is normal—but temporary. Learning to set boundaries means challenging old patterns, which can stir up guilt. Be patient with yourself.
  • Boundaries are a form of self-care. As Ross explains, saying “no” protects your emotional energy and helps you prioritize what matters most.
  • Saying “no” can strengthen relationships. Honesty and authenticity often lead to deeper connections.
  • It’s OK to pick your battles. Not every situation requires a “no.” Focus on saying “no” where it matters most.

If people-pleasing is causing you significant stress, it’s a good idea to consider speaking with a therapist, Hunt says. “Therapy can help you explore and identify these patterns, challenge them, and introduce helpful tools like mindfulness exercises, distress tolerance techniques, and self-compassion practices, which can be incredibly helpful for habitual people-pleasers.”


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MDMA (Ecstasy or Molly): Side Effects and Risks


Key Takeaways

  • While some research has found potential therapeutic effects with MDMA, this research is still in the early stages.
  • MDMA can cause lasting side effects like anxiety, depression, and memory problems.
  • Overdose from MDMA is rare but can be severe and require immediate medical attention.

MDMA, also known as ecstasy or “molly,” is a synthetic drug known primarily for its hallucinogenic and stimulant effects. MDMA is short for its chemical name 3,4-methylenedioxymethamphetamine. It is a derivative of amphetamine and has a similar structure to methamphetamine (“meth”).

While MDMA or ecstasy was initially used primarily in nightclubs and raves, its use has now spread to a wider range of populations. According to a 2021 survey by the National Institute on Drug Abuse, 0.8% of the U.S. population over the age of 12 reported using this drug in the previous 12 months.

If you or someone you love uses MDMA, it’s important to understand its potential impacts and side effects. We also share signs of usage, how to identify the drug, and what research says about its potential as a therapeutic.

This article is purely informational and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider if you think that using ecstasy or “molly” is right for you.

Signs of MDMA (Ecstasy) Use

According to the National Institute on Drug Abuse, MDMA causes a range of effects including:

  • Anxiety
  • Attention problems
  • Confusion
  • Decreased libido
  • Depression
  • Impulsiveness
  • Insomnia
  • Irritability
  • Memory problems
  • Reduced appetite

The effects of MDMA typically last for three to six hours. However, in some cases, you may continue to feel the side effects of ecstasy or “molly” the day after you take it. The symptoms may even persist for up to a week or more, especially if MDMA is mixed with other drugs such as marijuana.

If you experience lasting effects after taking ecstasy, seek help from a medical professional as soon as possible.

How to Recognize MDMA

MDMA or ecstasy is usually found in tablet or capsule form, but it can also be swallowed as a liquid or snorted as a powder.

  • Tablets: MDMA typically comes in a tablet form and is often imprinted with graphic designs or commercial logos.
  • Powder: The popular nickname molly (which is slang for “molecular”) is often used for the supposedly “pure” crystalline powder form of MDMA. However, molly is often combined with other substances, like synthetic cathinone (bath salts), according to the National Institute on Drug Abuse.

Unlike other recreational drugs such as cocaine and nicotine, which are derived from plants, MDMA or ecstasy is synthesized by altering the structure of the amphetamine molecule. Because of the way it’s made, its purity can vary substantially, and other compounds can be easily combined into the same tablet.

Ecstasy additives and contaminants often include methamphetamine, caffeine, ephedrine, and ketamine.

Potential Therapeutic Uses for MDMA

MDMA was explored as a therapeutic drug in the 1970s as some psychotherapists believed it opened people up and enhanced their potential for empathy and understanding of one another. This use was interrupted by ecstasy being classified as a Schedule I drug in 1985.

This classification means that the substance has a high potential for abuse and is not approved by law to treat medical conditions. However, there has been renewed interest in the medical use of MDMA alongside psychotherapy to treat conditions such as anxiety disorders—specifically social anxiety disorder (SAD) and post-traumatic stress disorder (PTSD).

For example, a 2021 study found that the use of medical MDMA in autistic adults with social anxiety disorder helped reduce social anxiety symptoms such as perceived social threat, self-criticism, and shame.

Ongoing clinical trials also suggest that ecstasy may help treat chronic post-traumatic stress disorder (PTSD). Results of a Phase 3 trial found that 88% of participants who received MDMA-assisted therapy experienced a meaningful reduction in PTSD symptoms, with 67% no longer qualifying for a PTSD diagnosis after treatment.

It is important to note that this research is still in the early stages. More research is needed to fully understand the effectiveness of medical MDMA. The medical use of MDMA is highly regulated and only administered by healthcare professionals in regulated settings.

In 2017, the Food and Drug Administration granted MDMA breakthrough therapy status due to the preliminary evidence of its efficacy in the treatment of PTSD. This status helps expedite the development and review of substances for the treatment of serious conditions.

This does not mean that ecstasy is available as a treatment. However, it may increase the speed at which the drug gains approval and becomes available to treat certain conditions.

Impact of MDMA

MDMA works by influencing the activity of three chemicals in the brain: dopamine, norepinephrine, and serotonin. These chemicals play a role in several different functions in the body, impacting a person’s energy levels, mood, emotions, and sleep.

The immediate impact of ecstasy begins within about 45 minutes of taking a dose. People typically experience an increased sense of well-being and emotional warmth. Other effects include feeling greater empathy toward others and enhanced sensory perception.

As a stimulant, MDMA produces feelings of higher energy. As a hallucinogenic drug, it distorts a person’s sense of time and perception. Ecstasy can also cause body temperature to rise to a potentially fatal level, and its long-term use has been associated with issues related to learning and memory.

Risks of Ecstasy

MDMA is associated with a number of adverse impacts, including:

  • Disorganized thoughts
  • Feelings of detachment
  • Increased anxiety
  • Increased heart rate
  • Irritability
  • Nausea
  • Poor appetite
  • Sweating and hot flashes

Another significant danger is the fact that people taking ecstasy don’t know what they are actually ingesting. In one study, researchers found that only 60% of samples contained any MDMA at all and many were mixed with so-called “fake cocaine,” a substance typically made with synthetic cathinone. In nearly 25% of the samples, the researchers were unable to identify what was actually in the tablets.

MDMA Addiction, Overdose, and Withdrawal

Although ecstasy affects many neurotransmitters in the brain impacted by other addictive drugs, the National Institute on Drug Abuse notes that research has not determined whether MDMA is addictive. The American Society of Addiction Medicine shares that the definition of addiction is continued use despite harmful consequences.

That said, one study found that ecstasy use is associated with changes in the dopamine and serotonin systems linked to increased impulsivity and substance use disorders. Reports also suggest that people who use ecstasy exhibit symptoms and other markers of addiction including tolerance, drug cravings, and withdrawal.

MDMA Overdose

Overdose is rare but can be life-threatening. Ecstasy overdose symptoms can include faintness, panic attacks or extreme anxiety, high blood pressure, and seizures. When ecstasy use is followed by vigorous physical activity, it can lead to a potentially dangerous rise in body temperature known as hyperthermia.

How to Get Help for MDA Use

While there are no specific treatments for ecstasy addiction, the National Institute on Drug Abuse suggests that cognitive behavioral therapy (CBT) is the most effective option. This type of intervention helps change how people think and behave to support addiction recovery. CBT also teaches people coping skills so they can better manage the stress that contributes to substance use.

There are currently no FDA-approved medications to treat ecstasy addiction. Twelve-step recovery programs and support groups may be helpful, particularly when used in conjunction with cognitive behavioral interventions.

History of Ecstasy

MDMA was initially developed in 1912 as a pharmaceutical compound that could be used in the preparation of other pharmaceuticals, and it was patented in 1914. But once the drug’s hallucinogenic properties were discovered, further development was stopped for several decades.

Ecstasy was one of several drugs tested in a military context decades after. It was then re-synthesized, first by Gordon Alles and then by Alexander Shulgin, who tested it on himself, his wife, and his friends. Shulgin went on to develop a range of new compounds, including MDMA and PMMA (paramethoxymethamphetamine), many of which ended up as versions of street ecstasy.

It was many years after this that MDMA eventually appeared on the streets as a recreational drug. It became popular during the 1960s and 1970s. In the 1980s, MDMA showed up in the nightclub and rave scene and its use grew among college students, “yuppies,” and in the gay community.

Due to concerns about the health risks associated with ecstasy, it was made illegal in the United Kingdom in 1977, way ahead of its popularity in that country.

Molly was made illegal in the United States in 1985 when it was classified by the Drug Enforcement Administration (DEA) as a Schedule I drug according to the Controlled Substances Act.

For a few years, in an attempt to circumvent the law, different versions of ecstasy were synthesized. This production was eventually outlawed but re-emerged as a problem around the year 2000 with the popularity of homemade crystal meth.


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The Psychology of Racism


Key Takeaways

  • Racism is not just individual prejudice, but is embedded in systems and cultures.
  • Teaching children about inclusion and empathy can help them identify and challenge racism.

The psychological study of racism can be summed up in one word: evolving. How society thinks about race and racism has changed and with it, the psychological discourse has changed as well.

Many Americans, particularly White Americans, were complacent going into the year 2020. When the coronavirus pandemic started, the complacency started to wane and was replaced with fear and a sense of unrest. When George Floyd was killed in police custody on May 25, 2020, a bright spotlight was redirected to an uncomfortable reality that most BIPOC Americans already knew: Racism is still alive and well in America.

With the added spotlight has come a renewed interest in understanding racism. In order to combat racism, it’s vital to recognize its effects and take steps to understand the factors that contribute to it. Keep reading to learn more about the psychology of racism, including historical perspectives and more current views on the individual and systemic nature of racism.

Psychological History of Racism

The psychological understanding of racism has historically been focused on individual psychology—how racism is driven by the beliefs and behaviors of individual people (the social-psychological approach). But there are severe limitations to viewing racism solely through this lens.

Today, some researchers are using and advocating for a cultural-psychological approach, which views racism as ideas and practices embedded in culture, where individuals shape culture and culture shapes individuals.

Early Theories of Racism

Early psychological theories of racism justified the domination of one race over another because of Charles Darwin’s concept of survival of the fittest. It was theorized that there was some survival advantage to being racist. However, modern hunter-gatherer tribes were not found to exclude out-groups (people not included in a particular group), and this problematic theory was rejected.

Then, race psychology theorized that there were brain differences between races and that intelligence tests and segregation were the answer. Later in 1954, American psychologist Gordon Allport argued in his book, “The Nature of Prejudice,” that people use categories to understand their world better and that racism was simply an artifact of that process.

Whatever the history of the psychology of racism is in the United States, the actual history of racism is that White people have been and continue to be afforded benefits in society because of a system that was set up for their benefit. Racism is real regardless of whether White people recognize or accept it.

Recap

Early explanations of racism were often inherently racist. Modern views on racism don’t simply focus on individual acts of racism but also look at how racism is perpetuated at a societal and cultural level.

Prejudice vs. Racism

Many people misunderstand and confuse the definitions of racism and prejudice. Though related, they are different.

Prejudice

Prejudice is a negative preconception or attitude toward members of a group based on shared characteristics such as race, ethnicity, sex, sexuality, age, religion, language, class, or culture. Prejudice can be racial, but it can also be sexist, ageist, or classist, for example.

Prejudiced beliefs are usually learned early in life and can affect behavior in subtle and overt ways. For example, a teacher with prejudice might hold the belief that girls aren’t good at math. That belief would then affect the teacher’s behavior with their students, whether consciously or subconsciously.

Racism

In contrast, racism is directed at a particular racial group and is based on systems of power and oppression. Racism is often seen as being a problem with individual racial prejudice, but it is important to recognize that it is much more multifaceted and systemic.

People commonly think of racism in terms of overt individual actions and ideologies (the social-psychological understanding), but it also exists within systems, organizations, and cultures (the cultural-psychological understanding). In this way, racism is embedded in the reality of everyday life.

Since racism is part of daily life, cultural patterns, and historical narratives in the U.S., it is often difficult for people to see how familiar and normalized ideas promote racialized views and behaviors.

Racism isn’t just about individuals demonstrating racial prejudice or engaging in direct acts of racial discrimination; it is often less immediately obvious and much more insidious, affecting institutions like the justice system, in which Black defendants regularly face harsher sentences than White defendants for the same crimes, for example.

Phia S. Salter, Glenn Adams, and Michael J. Perez in “Current Directions in Psychological Science”

Decreases in overt expressions of racial bias might suggest that racial prejudice (and therefore racism) is less extreme in modern America; however, many psychologists suggest that racial bias has gone underground, and they have mounted substantial evidence that it instead thrives in subtle forms.

— Phia S. Salter, Glenn Adams, and Michael J. Perez in “Current Directions in Psychological Science”

While most blatant individual demonstrations of racism are no longer tolerated or viewed as acceptable in “mainstream” contemporary American society, our society’s understanding of what is racist continues to evolve. In reality, our institutions are not so far removed from the years of colonialism, slavery, and segregation, and racism is still ignored, condoned, or even actively supported in many facets of American life.

Recap

In order to better understand how racism operates, it’s important to look beyond individual psychology to the systemic and cultural practices that continue to uphold racism.

Cultural Tools That Perpetuate Racism

The dominant American culture’s discomfort with race and racism continues to result in harmful beliefs and sentiments that promote ignorance about racism and uphold the racial status quo. Perhaps you’ve heard someone say that they are “color-blind,” “don’t see color,” or that “race doesn’t matter.” Maybe you’ve even said something to that effect yourself.

This denial of the significance of race is a tool that allows the dominant racial group to legitimize the effects of racism under the guise of individual merit. Through this lens, people in positions of power can credit their successes to their own hard work while positioning the disadvantages oppressed racial groups face to personal rather than systemic failures.

Continuing to support this individualistic American narrative results in blindness to the realities of America’s racist systems. For example, research has shown in no uncertain terms that Black Americans experience disparities in income, employment, education, and health. But research shows that White Americans still tend to be less aware of these racial realities than people who are part of racial minority groups.

Ignoring racism doesn’t make it go away. Rather, it perpetuates it, effectively shutting down the possibility of moving forward by not having important conversations about the problems and possible solutions.

Explanations for Racism

As more attention is being given to the racism ingrained in our society, many more people are seeking explanations for it. Is it survival of the fittest, or a psychological defense mechanism to help people identify with a primary group and feel more secure? Below is a list of possible psychological explanations for why racism exists.

Personal Insecurity

It’s true that those who lack an identity and struggle with insecurity may seek group membership. Consequently, after finding a group, members of the group may start to alienate non-group members. Sometimes, hostility arises toward those people who have been alienated.

While in a clique, people tend to think and behave more like the people they surround themselves with. It becomes much easier to attack others when you’re among people who share the same viewpoint.

Racism comes in when groups are formed based on characteristics like race, bolstered by beliefs of superiority, and supported by systems of oppression.

Lack of Compassion

Alienation of others eventually leads to less compassion for those who have been ostracized. People begin to only show compassion and empathy for those they regularly associate with.

Consider, for example, television segments asking viewers to donate to causes that support food security for families in Africa. These messages may be easier for a person to dismiss if they don’t identify with the group or culture in need. This dismissal may or may not be overt racism, but it begins with a lack of empathy.

Projection of Flaws

When people feel bad about themselves or recognize their shortcomings, instead of dealing with them and trying to fix them, they may project their self-loathing onto others. Alienated groups can easily become scapegoats for those who ignore their own personal flaws.

Poor Mental Health

Is racism a sign of poor mental health? Not necessarily, but it can be. For example, paranoid personality disorder and narcissism are both mental health disorders that are characterized in part by feelings of insecurity, which may make a person more likely to hold racist beliefs or engage in racist behaviors.

But it’s important to recognize that racist beliefs and actions are certainly not limited to people with mental health disorders.

Hatred and Fear

Extreme hatred is almost always based on fear. People may feel threatened by people they view as “different” or “foreign.” They may fear losing power. To combat this fear, some people may seek social support from others with similar fears, perpetuating the cycle.

Recap

Racism is not a mental illness, but it is certainly related to psychological adaptation. Factors such as personal insecurity, lack of empathy, and projection may contribute to racism.

Factors That Contribute to Racism

In a 2020 paper published in the journal American Psychologist, Steven O. Roberts, a Stanford psychologist, and Michael T. Rizzo, a New York University postdoctoral fellow, discuss what leads to racism. With their paper, the authors aimed to provide an overview of several of the major factors theorized to contribute to racism in America. Those factors are the following.

Categories

Humans learn to group people into categories based on race from a young age. Roberts and Rizzo hold that racial categories are not inborn but become significant because “they are federally sanctioned (e.g., by the U.S. Census Bureau), easily employed by individuals, and because they directly tell people which racial categories to form.”

Category labels can support a belief that category members have a shared identity, which promotes stereotypes. This categorical grouping and the concept of shared identity later lead to factions.

Factions

Categories lead to factions in which people are assigned to a racial group and begin to strongly identify with their racial ingroup. Positive perceptions of their assigned racial group and the desire to show cooperation, loyalty, and empathy to the group commonly lead to behavior that benefits the group, even to the detriment of another group.

Beyond loyalty to their own group, group members can also begin to show hostility toward other groups as a result of real or perceived competition or threats to their self-image, values, or resources.

Segregation

Being segregated from other racial groups greatly influences attitudes and feelings about race. Lack of contact with other racial groups tends to narrow and harden a person’s beliefs and opinions about others and offers few chances for negative beliefs to be challenged.

That is why segregation by race early in life can influence the development of racist attitudes.

Hierarchy

A hierarchical system assigns wealth, power, and influence unevenly across groups. Hierarchies are further reinforced by beliefs that attribute power and status to individual characteristics rather than systematic influences, ultimately resulting in the dominant group believing that they are, in fact, superior to non-dominant groups.

Power

Power grants groups the ability to build a society that benefits them. It also allows them to create what are considered to be culturally acceptable standards. They control resources and are allowed to exploit others and assume dominance. When power is distributed along racial divides as it is in the U.S., so are advantages.

Media

The media plays a role in sustaining racism. On one level there is simply representation (or lack thereof). When media consistently portrays a mostly White cast of actors in magazines, television shows, and movies, it makes the White culture the “dominant” or “normal” American culture.

On another level, there is how the media portrays racial groups. When media reinforces racial stereotypes in its representation of different racial groups, it also reinforces individual racial prejudice and the systems that perpetuate institutionalized racism.

Passivism

The final factor Roberts and Rizzo describe is perhaps the most important. It is the passive racism that results from ignorance, apathy, or denial. When racism is systemic and ingrained in social structures, all that is required to sustain it is inaction.

People do not need to be actively racist in their beliefs and actions to support racist systems—they simply need to do nothing to change those systems.

Recap

Research suggests that many factors contribute to racism on both individual and systemic levels. These factors include categorization, factions that pit people against each other, social hierarchies, power, and media influences.

Combating Racism and Promoting Anti-Racism

When faced with the sheer magnitude of racism in America, it can be easy to feel powerless. But there are things you can do on an individual level to influence both interpersonal racism and systemic racism. Below are some ways in which racism can be combated on an individual level:

  • Build a system of equity in which all communities are equally engaged.
  • Direct attention to the problem of racism instead of sweeping it under the rug or pretending that it does not exist.
  • When you hear racist attitudes, challenge them; ask people for the reason behind their thinking and encourage them to consider alternatives.
  • Remember that change does not occur overnight and be patient when it seems like the progress being made is slow; even small changes can lead to big results when you are consistent in your actions.
  • Teach children inclusion and empathy from a young age so that they grow up to be adults who can identify racism and challenge it.
  • Conduct psychological research on how social norms change and how best to implement systems that result in the changing attitudes of people in the dominant group so that systems will also be affected.
  • Design a curriculum that addresses the legacy of the United States’ history of racism and teaches students how to be aware of their own inherent biases.
  • Engage in contact in favorable conditions with other groups, and work toward shared goals with people from different races.
  • Seek and foster friendships across racial lines so that you can start seeing people as individuals rather than as just part of a race.

The way children learn about American history can affect their understanding of racism. For example, one study looked at how Black History Month was taught in predominantly White and predominantly Black schools. The researchers found marked differences in how information was presented.

In mostly White schools, students were exposed to displays and discussions that were highly abstract and focused more on individual achievements rather than addressing racism. At mostly Black schools, however, information more directly addressed racism and the effects of racial barriers.

Recap

Combating racism is about more than being “not racist,” which often equates to passive racism. Learning to be actively anti-racist is essential. For example, research has shown that taking a more direct, anti-racist approach to teaching children about history has a greater impact on their understanding of the real effects of racism.

For too long, racism has been relegated to the past or reduced to individual beliefs and actions. As a result, America’s lingering systemic and institutionalized racism has been overlooked and allowed to persist and progress. But cultural-psychological approaches to understanding racism challenge these ideas. Racism is in more ways a cultural phenomenon than an individual psychological occurrence.

What this means is that you do not need to be racist to uphold racist systems. We each have a personal responsibility to challenge racism on an individual level, but we also must look toward the cultural structures that perpetuate individual bias and the injustice that racism causes.


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Constipation After Quitting Smoking: Causes and Fixes

Key Takeaways

  • Constipation is common after quitting smoking, but it usually goes away in a few weeks.
  • Eating a diet high in fiber and drinking lots of water can help relieve constipation.
  • Exercise regularly to help your body adjust to the absence of tobacco and maintain regular bowel movements.

Quitting smoking can sometimes cause constipation and other intestinal difficulties. Along with constipation, nausea and gas are symptoms of withdrawal from tobacco products.

Fortunately, digestive issues usually resolve themselves in a matter of weeks. While they are unpleasant, don’t let the discomforts derail your quit program.

In addition to nicotine withdrawal, it is also possible that other changes you may have made since quitting tobacco are contributing to the constipation that you’re experiencing.

Symptoms of Constipation After Quitting Smoking

Signs of constipation include infrequent bowel movements that occur less than two to three times per week. Other common symptoms include:

  • Abdominal pain and discomfort
  • Bloated belly
  • Bloody stool
  • Hard stool
  • Pain while using the bathroom
  • Straining while passing stool

While not common, sometimes people may experience feelings of nausea or vomiting due to constipation. If this happens, contact a healthcare provider.

You may also experience other intestinal problems when quitting smoking, including feelings of nausea or gas that are related to nicotine withdrawal.

Causes of Constipation When Quitting Smoking

There are a number of different factors that can play a role in causing constipation when you are quitting smoking. These include nicotine withdrawal and other changes in your diet, activity, and stress levels.

Nicotine Withdrawal

Nicotine is the addictive substance in cigarettes that makes quitting so challenging. It also leads to withdrawal symptoms when you stop smoking, including constipation.

Because nicotine affects the small bowel and colon, your body needs to adjust when levels of the substance suddenly decrease or disappear.

How Long Will Constipation Last?

Because constipation is connected to nicotine withdrawal, it may gradually subside along with other withdrawal symptoms after a few weeks.

If constipation persists, it may be due to other factors such as medication side effects, changes in diet, stress, or activity levels.

Quit Aids

Two prescription quit aid medications list nausea and constipation as side effects: Chantix (varenicline) and Zyban (bupropion).

Research has found that taking varenicline for longer than six weeks was associated with adverse gastrointestinal effects including constipation, flatulence, and nausea. If you are using one of these, check in with your doctor for advice on how to proceed.

Changes in Diet

It is not unusual to experience dramatic changes in what you eat when you first quit smoking. Many people turn to food to bridge the gap between the hand-to-mouth activity that smoking was, as well as to use food for comfort when cigarette cravings hit.

Often, the foods that you choose might leave your daily diet less than balanced. This can then lead to digestive disturbances. Take a good look at what you’ve been eating since you quit smoking.

Certain foods such as high-fat meats, eggs, dairy, sugary sweets, and other foods low in fiber can contribute to constipation. Work on adding more high-fiber choices to your daily diet, including whole grains, fruits, and vegetables.

Increased Stress

Leaving cigarettes behind will eventually bring more peace to your life than you had as a smoker. But smoking cessation may increase the stress and anxiety you feel in the short term.

Emotional stress can have physical effects on your body, including digestion. If this strikes a chord with you, try incorporating some tension-tamers into your daily routine.

A few minutes of meditation when you wake up, deep breathing when stress bubbles up during the day, and a hot bath or time with a good book before bed will help you keep stress at bay.

Reducing your stress may then help keep your bowel movements regular.

Changes in Activity

Smoking cessation throws life out of whack for many people, both physically and psychologically. You might feel tired and cranky, and often, less active than normal.

While this is fine and to be expected, less exercise than what you are accustomed to, along with some or all of the other issues listed above, can be a significant contributor to constipation.

Aim for a half-hour of some form of exercise most days. It will help your body adjust to the absence of tobacco and beat back cravings to smoke as well.

If you haven’t been active recently, be sure to check in with a healthcare provider before starting a new exercise regimen.

Relief for Constipation After Quitting Smoking

If you are experiencing constipation related to quitting smoking, there are some ways you can find relief. Steps you can take include:

  • Making sure you are consuming enough fiber
  • Getting regular physical exercise
  • Drinking plenty of water
  • Avoiding foods that contribute to constipation, such as fried foods, dairy, and red meat

Other options that may help relieve constipation include over-the-counter fiber supplements and laxatives or prescription medications.

Before taking any of those, talk to a healthcare provider, particularly if: you are using a quit aid, you have other medical conditions, or your constipation is severe. If any symptoms of intestinal pain persist or increase over time, don’t hesitate to contact a doctor for a check-up.

Frequently Asked Questions


  • How long does constipation last after quitting smoking?

    Constipation usually gradually decreases within a few weeks. If your symptoms do not begin to improve or are severe, you should talk to your healthcare provider.


  • How can I relieve constipation from quitting smoking?

    Dietary fiber, exercise, and hydration can help. Over-the-counter fiber supplements or laxatives may also provide relief. Your doctor may also be able to prescribe medications that ease constipation.


  • Does the nicotine patch help relieve constipation when quitting smoking?

    Because nicotine has a stimulating effect on the intestinal tract, the amount delivered by the nicotine patch may help minimize constipation as you are quitting smoking. You should not rely on the patch for constipation relief, however.


  • Why does quitting smoking cause constipation?

    Because nicotine affects the bowel and colon, constipation is a common symptom of nicotine withdrawal as you quit smoking. Changes in diet, activity level and stress can also contribute to problems with constipation.

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. Lundström O, Manjer J, Ohlsson B. Smoking is associated with several functional gastrointestinal symptoms. Scand J Gastroenterol. 2016;51(8):914-22. doi:10.1080/00365521.2016.1174878

  2. Johns Hopkins Medicine. Constipation.

  3. Verschuere S, De Smet R, Allais L, Cuvelier CA. The effect of smoking on intestinal inflammation: What can be learned from animal models?. J Crohn’s Colitis. 2012;6(1):1-12. doi:10.1016/j.crohns.2011.09.006

  4. Leung LK, Patafio FM, Rosser WW. Gastrointestinal adverse effects of varenicline at maintenance dose: a meta-analysis. BMC Clin Pharmacol. 2011;11:15. doi:10.1186/1472-6904-11-15.

  5. Centers for Disease Control and Prevention. How much physical activity do adults need?


By Terry Martin

Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction.


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What to Do If You Feel This Way


Key Takeaways

  • Feeling like you hate your body can harm your mental health and lead to issues like eating disorders and low self-esteem.
  • You can start to appreciate your body by thinking about all the amazing things it does for you, like breathing and moving.
  • Talking to a therapist or doctor can help you build a better relationship with your body through therapy and sometimes medication.

Having a body is no easy task. Just like our minds, our bodies are pretty inescapable. And while having a body alone can be a tough thing, loving your body can sometimes be even more difficult. Whether because your body doesn’t work perfectly or you don’t like its shape or size, it’s common to feel that you don’t fully love your body. These feelings are normal and tend to come and go throughout life.

There comes a point, though, when you may be focusing too much on hating your body. It can impact the rest of your life, ruin your relationship with yourself, and even potentially lead to eating disorders or illness.

Signs of Negative Body Image

Whether you feel like you hate your body or have complex feelings about certain aspects of your physical shape, size, or appearance, there are some signs that you might have poor body image:

  • Avoiding certain activities because of your shape, size, or appearance
  • Hiding your body so that others cannot perceive the things you dislike
  • Engaging in frequent body checking, such as weighing yourself, checking your body in the mirror, or pinching parts of your body
  • Engaging in extensive and excessive beauty rituals to disguise the parts of your body you dislike
  • Thinking about your body in negative ways
  • Using unkind, harsh, or cruel language to describe your body
  • Thinking about your body or appearance causes you to feel negative emotions like anger or sadness
  • Wishing you looked like someone else
  • Having excessive plastic surgery to try to change your appearance

Many of us might recognize that we engage in some of these behaviors from time to time. Enjoying putting on makeup, wearing flattering clothing, and looking at yourself in the mirror are not necessarily signs of poor body image.

The difference lies in the degree and severity of these behaviors. A person with a body image problem may engage in these behaviors to the point that it interferes with their ability to function and maintain relationships.

What Causes You to Hate Your Body

Negative body image can stem from a variety of sources, and often it is a combination of influences that can cause you to feel like you dislike or hate your body. How you feel about yourself and your appearance starts to form in early childhood and your experiences and perceptions can impact your relationship with your physical body.

Research suggests that 40% to 50% of kids between the ages of six and 12 report being unhappy with some aspect of their body’s size or shape.

Some factors that might contribute to poor body image can include:

  • Unrealistic images and ideals perpetuated by movies, television, and social media
  • Negative experiences during childhood
  • Social rejection or criticism
  • Low self-esteem or poor self-image
  • Weight-related bullying
  • Being around others who express unhappiness with their bodies
  • Depression

Mental Health Effects of Hating Your Body

The toll of disliking your body can show up in many different ways in your life. Research suggests that feeling dissatisfied with your body can lead to a range of negative mental health outcomes. Problems linked to poor body image include:

  • Eating disorders
  • Low self-esteem
  • Mood disorders
  • Anxiety disorders
  • Self-harm
  • Body dysmorphic disorder

These are a few ways you can tell if your dislike of your body is negatively impacting your mental and emotional wellness.

Your Stress Is a Time Eater

Are you spending so much time thinking about how you hate your body that it interferes with the amount of time you have in general? This is a major sign that your hatred for your body is taking a toll on your mental health.

Even if it doesn’t feel like you’re spending all your time thinking negatively about your body, that doesn’t mean it isn’t affecting you.

Take a pause and think about how much time you spend actively feeling and thinking badly about your body, and about how often your body is on your mind.

Whether it’s a few minutes or a few hours a day, the result is undue stress that your thoughts are causing.

You Experience Dysphoria

Dysphoria is a state of feeling uneasy or unhappy. This could be related to anything, including financial situation, personal life, work life, as well as our bodies or gender.

Dysphoric feelings about your body could manifest as simple as feeling like your body just isn’t OK, or as complexly as taking physical action like undereating in hopes of changing your body.

Dysphoria can come and go, and doesn’t necessarily occur all of the time. If your feelings about your body ever reach the point where you feel hopeless, and like the discomfort of being in your body will never end, you have experienced dysphoria.

You Experience Dysmorphia

The word dysmorphia looks somewhat similar to dysphoria, but they are entirely different things.

While dysphoria is a feeling of deep uneasiness, body dysmorphia is the act of obsessively feeling that your body is flawed.

Often, people who experience body dysmorphia see their own bodies differently than other people see them. You may think that a part of you is disfigured when it isn’t, or that your body is larger than others’ even if it’s the same size.

Sometimes people with body dysmorphia experience eating disorders, but that isn’t always the case. Dysmorphia is centered around the inability to let go of the idea that your body, whether a part of it or all of it, is wrong and just not acceptable.

While you don’t have to always love your body, it is important to accept it.

You Feel Triggered By Body Discussion

This sign that your hatred of your body is negatively affecting your mental health is tricky, because in our society people say a lot of inappropriate things about other people’s bodies. In general, it’s best to simply never comment on another person’s body unless they invite you to. If you get upset when people talk about your body, that doesn’t mean you hate your body.

However, if someone discussing your body makes you upset in a way that’s hard to let go of, such as if it ruins your day or your week, or if it makes you act in a reactionary, negative way towards the commenter, your dislike of your body may be serious enough to be affecting your emotional wellness.

This is especially true if the comments made about your body would be considered benign, or even pleasant, by someone else, such as telling you that an article of clothing you’re wearing looks good on you.

How to Develop Love for Your Body

Feeling stuck and hopeless in your body is common, and it doesn’t have to be where your story ends. There are many things that you can do to begin the journey of loving, or at least appreciating and accepting, your body.

It’s important to have positive feelings about our bodies because having only negative feelings about a topic we can’t get rid of makes us feel stressed and upset, and that isn’t a productive way to go through life.

Moving into a space of loving, or at least accepting, your body helps you to have less stress in your life at large. It can help you be a happier person, too.

Make a List Of What Your Body Can Do

Sometimes we get so caught up in feeling like our bodies aren’t good enough, we completely forget about all the amazing things our bodies can do. When you’re in a place of feeling hatred for your body, it can be very helpful to detail out for yourself all the ways that your body is succeeding. This can help you feel proud of your body, and realize that it’s doing the best it can.

Some questions to ask yourself to get started include:

  • Are you breathing? The answer to this is probably yes, since you’re alive and conscious. Do you realize what an amazing feat that is? Your lungs are ingesting oxygen and expelling carbon dioxide, and that’s an amazing thing to be able to do. Your body is doing everything in its power to keep you alive right now. It is here for you, keeping you alive. Nothing else in this world has the sole function of keeping you with us, and that’s something to be thankful for.
  • Can your eyes see? If so, that’s great. If not, how have you learned to compensate for not having that sense? It’s a huge accomplishment to be able to use your body without that!
  • Are your legs able to walk? Or even run? If so, that’s great. If not, how have you learned to compensate for not being able to walk? It’s a huge accomplishment to be able to move through daily life in your body without being able to do that.

There are many more questions you can ask yourself, but those are some incredibly straightforward ones to begin this journey. The more we can appreciate what our bodies do for us, the easier it becomes to accept them as they are.

Practice Body Neutrality

Body neutrality is the radical notion of accepting your body and appreciating it for what it can do, regardless of how it looks or how it falls short in function. Practicing it can involve everything from eating more intuitively to not punishing yourself with exercise.

Practicing body neutrality has numerous mental health benefits. It can lead to having more empathy and less judgment towards others, and to lower stress levels.

It isn’t a quick thing to do, but it’s a worthwhile time investment because of these benefits. You can start by trying several body neutrality practices at once, or begin with just one at a time.

Do Kind Things for Your Body

With all our bodies do for us, it’s kind of strange how little we do purely for them. Our bodies are busy taking us places and functioning, and we often don’t do anything to thank them.

Thanking our bodies for all they do doesn’t have to be expensive or complex. You could thank your body for its work by taking a nice warm bath. You could relax for an evening instead of socializing when you feel tired. You could buy a new lotion and massage your arms and legs while you moisturize. Anything that you can do to give your body the love it deserves is excellent.

Create Boundaries Around Body Discussions

In a world where commentary about bodies is rampant, you can protect yourself from getting triggered by setting clear boundaries with friends and families. That might involve letting them know what topics of conversation are comfortable for you and which ones aren’t.

It might mean telling them that you don’t want your looks commented on. Or, it could be sending them information about how to discuss bodies in non-harmful ways.

Whatever you choose, it’s an empowering task that gives you more autonomy with your body.

Practice Stress Relieving Activities

Minimizing stress is one of the best things we can do for our mental wellness. It may not be possible to reduce or eliminate stress, but we can choose how we deal with it. Taking on a stress relieving activity, whether breathing exercises or taking a walk, is good for all aspects of ourselves.

Even just a few short minutes can have an effect on you for hours afterwards. Practicing stress relieving activities can also help you to think more rationally about your body, and to operate from a less upset mental space.

Treatment for Body Image Issues

If body image issues are contributing to distress, functional impairments, or mental health symptoms, consider talking to your doctor or a mental health professional. It can be hard to shift to a more positive mindset about your body, but there are treatments that can help.

Therapy

Cognitive-behavioral therapy for body image and self-care (CBT-BISC) is a type of therapy that can be particularly helpful for fighting those negative thought patterns that make you feel so bad about yourself. Working with a therapist, you’ll learn how to spot these thoughts and replace them with kinder and more realistic thinking. 

Medication

Your doctor may also suggest medication to help combat symptoms of anxiety or depression that might accompany body image issues. Selective-serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), Lexapro (escitalopram), and Zoloft (sertraline) are sometimes prescribed off-label in the treatment of body dysmorphic disorder. 


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Definition and How Therapists Use It


Key Takeaways

  • Cognitive theory helps understand and change negative thought patterns to improve mental health.
  • Techniques like cognitive restructuring can help people challenge and change their negative thoughts.

Cognitive theory is an approach to psychology that attempts to explain human behavior by understanding your thought processes. For example, a therapist is using principles of cognitive theory when they teach you how to identify maladaptive thought patterns and transform them into constructive ones.

How Cognitive Theory Works

The assumption of cognitive theory is that thoughts are the primary determinants of emotions and behavior. Information processing is a common description of this mental process. Theorists compare the way the human mind functions to a computer.

Pure cognitive theory challenges behaviorism, another approach to psychology, on the basis that it reduces complex human behavior to simple cause and effect.

The trend of the last decades has been to merge cognitive theory and behaviorism into a comprehensive cognitive-behavioral theory (CBT). This allows therapists to use techniques from both schools of thought to help clients achieve their goals.

Uses for Cognitive Theory

Cognitive theory can be used in treatments for a wide variety of mental health conditions, including:

Using Cognitive Theory to Change Biases

Your therapist relies on cognitive theory if they highlight identifying the cognitive biases in your maladaptive thoughts as a part of your treatment plan. For example, two types of cognitive biases addressed in anxiety treatment include:

Attention Bias

Attention bias means that when you are experiencing your anxiety trigger, you pay attention to the negative signals instead of positive ones. For example, if you have a fear of public speaking, you only look at audience members with facial expressions you see as threatening, rather than seeking out the smiling faces.

Interpretation Bias

Interpretation bias, as the name implies, refers to misinterpreting information. At the podium, you might think an audience member with a negative facial expression is a reflection of how they feel about you when they’re really just tired.

Examples of Cognitive Theory

There are also different types of cognitive theories that are often used to explain aspects of human cognition.

Social Cognitive Theory

Social cognitive theory is a subset of cognitive theory. Therapists use it to treat phobias and other psychological disorders. It is primarily focused on the ways in which we learn to model the behavior of others.

Advertising campaigns and peer pressure situations are good examples.

Cognitive Learning Theory

This theory focuses on how people actively engage with thinking and problem-solving as they learn new information and acquire skills. This approach assumes that people seek information and learn best when they utilize their thinking abilities to figure things out vs. just learning through memorization and repetition.

Techniques Based on Cognitive Theory

A number of important therapeutic techniques that are used to treat different types of mental health conditions are based on cognitive theory. Some of these include:

Cognitive Restructuring

All three types of phobia fall into a larger group of psychological issues called anxiety disorders, which are the most common type of psychiatric disorder.

Cognitive restructuring, based on cognitive theory, is part of an effective treatment plan for anxiety disorder. It involves the therapist asking you questions, helping you analyze the answers to increase your understanding of your anxiety, and assisting you in “rewriting” your maladaptive thoughts.

The basic approach to cognitive restructuring put forth by leading cognitive theorist Christine A. Padesky, PhD, recommends that your therapist goes through four basic steps with you:

  1. Ask questions to identify the “self-talk” going on in your head when you feel anxious, and then facilitate a discussion to test if what you’re thinking is true.
  2. Listen to what you say with an empathetic ear and unconditional acceptance.
  3. Ask you to summarize the session’s main points to reinforce what you’ve learned and to let them address any misunderstandings.
  4. Ask yourself questions that allow you to synthesize and analyze the new and more realistic view of your anxiety so you can restructure your thought patterns.

Cognitive Reframing

While cognitive restructuring is typically done with the guidance of a therapist, cognitive reframing is a similar technique you can use on your own. 

When you are caught up in negative thinking, try shifting the frame or lens through which you see the situation. Ask yourself whether what you are thinking is realistic, and consider other ways that you might view the situation.

Exposure

Exposure involves confronting the source of your fear or anxiety. During treatment, people are slowly exposed to the things they fear. At the same time, they may practice relaxation techniques and coping skills that will help them manage their feelings of fear and anxiety.

Over time, exposure can help people become less fearful and feel more confident in managing their emotional responses.

Behavioral Experiments

Behavioral experiments are experiences that can help people test whether their negative or unhelpful thoughts are valid. These planned activities allow people to be exposed to an anxiety-provoking situation. This enables people to test the accuracy of their beliefs and the helpfulness of new ways of thinking and coping skills.

Types of Therapy Based on Cognitive Theory

Various therapeutic approaches are rooted in cognitive theory. Cognitive-behavioral therapy (CBT) is one of the most widely used and empirically validated treatments. Other therapies that utilize aspects of cognitive theory include:

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. American Psychological Association. Cognitive psychology.

  2. Li J, Ma H, Yang H, Yu H, Zhang N. Cognitive bias modification for adult’s depression: A systematic review and meta-analysisFront Psychol. 2023;13:968638. doi:10.3389/fpsyg.2022.968638

  3. Barry TJ, Vervliet B, Hermans D. An integrative review of attention biases and their contribution to treatment for anxiety disorders. Front Psychol. 2015;6:968. doi:10.3389/fpsyg.2015.00968

  4. Beard C, Amir N. Negative Interpretation Bias Mediates the Effect of Social Anxiety on State Anxiety. Cognit Ther Res. 2010;34(3):292-296. doi:10.1007/s10608-009-9258-6

  5. Yoon HJ, Tourassi G. Analysis of Online Social Networks to Understand Information Sharing Behaviors Through Social Cognitive Theory. Annu ORNL Biomed Sci Eng Cent Conf. 2014. doi:10.1109/BSEC.2014.6867744

  6. Padesky CA, Mooney KA. Strengths‐based cognitive–behavioural therapy: A four‐step model to build resilience. Clin Psychol Psychother. 2012;19:283-290. doi:10.1002/cpp.1795

  7. Crum J. Understanding mental health and cognitive restructuring with ecological neuroscienceFront Psychiatry. 2021;12:697095. doi:10.3389/fpsyt.2021.697095

  8. Jacquart J, Abramowitz J, Arch J, Margraf J, Smits JAJ. The basics of exposure therapy. In: Smits JAJ, Jacquart J, Abramowitz J, Arch J, Margraf J, eds. Clinical Guide to Exposure Therapy. Springer International Publishing; 2022:1-31. doi:10.1007/978-3-031-04927-9_1

  9. Murray H, El-Leithy S. Behavioural experiments in cognitive therapy for posttraumatic stress disorder: Why, when, and howVerhaltenstherapie. 2021;31(1):50-60. doi:10.1159/000511921

Additional Reading

By Lisa Fritscher

Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics.


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How Does Zoloft Work? Understanding Sertraline’s Effects


Key Takeaways

  • Zoloft works by stopping serotonin from being reabsorbed in the brain, which can help improve mood.
  • It might take about four to six weeks to see noticeable improvements in mood and symptoms when taking Zoloft.

Zoloft is a medication sometimes prescribed to treat depression, anxiety, and other conditions. It works by preventing the reuptake of serotonin, a neurotransmitter that affects mood. By preventing reuptake, Zoloft can increase the amount of serotonin available in the brain.

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI). Although it is most commonly used to treat depression, it is also used to treat obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). Zoloft is sometimes prescribed for social anxiety disorder and other phobias.

This article discusses how Zoloft works and possible side effects you might experience. It also covers important precautions to be aware of before taking this medication.

How Does Zoloft Work?

SSRIs are known as second-generation antidepressants since they are newer than monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). 

Zoloft, like other SSRIs, works by blocking the reabsorption of serotonin into neurons in the brain.

Serotonin is a chemical neurotransmitter that transmits electrical impulses from one neuron to the next. Normally, serotonin is quickly reabsorbed, but Zoloft and other antidepressants in this class let the serotonin remain in the synaptic gap between neurons for longer.

This allows the chemical to send additional messages to the receiving neuron, which is thought to boost mood.

How Can You Tell if Zoloft Works?

After you first start taking Zoloft, you may experience some daytime sleepiness. However, some people have the opposite effect and experience increased energy and sleeping problems. 

Your doctor may recommend changing when you take your medication depending on the effect you experience. They may suggest taking it at night before bed if it makes you feel fatigued. If you feel energized, taking it in the morning is better so it is less likely to interfere with your sleep.

Zoloft takes time to work, so you may wonder how to tell if your medication is helping. After a few weeks, you may feel less depressed or anxious. You may have more energy and motivation. Sleep improvements and a better appetite are changes you may see during your first month or so of taking your medication.

After six to eight weeks, you may see a more noticeable impact on the symptoms of your condition. You may have an easier time managing your normal everyday activities and better able to enjoy life.

It is important to remember that these changes tend to be gradual. They may happen slowly, sometimes making it more difficult to notice the improvements you are experiencing.

How Much Zoloft Do You Need to Take?

Zoloft is available in a variety of strengths and is only sold by prescription. Both liquid and tablet forms of the medication are available.

Your dosage will depend on what you are being treated for. Standard dosages for different mood disorders are:

  • Major depressive disorder: 50 to 200 mg daily
  • Obsessive-compulsive disorder: 50 to 200 mg daily
  • Post-traumatic stress disorder: 50 to 200 mg daily
  • Pre-menstrual dysphoric disorder: 50 to 100 mg daily during the luteal phase
  • Social anxiety disorder: 50 to 200 mg daily

Zoloft tablets are available in 25 mg, 50 mg, and 100 mg doses. Your doctor may start you at a lower dose and gradually increase the amount you take to achieve the desired effects.

You may or may not quickly begin to feel the effects. Talk to your doctor if you have any concerns.

How Long Does it Take for Zoloft to Work?

Zoloft does not begin working immediately. It takes time for the medication to reach a steady state in your body and gradually increase the serotonin in your brain. Like all medications in its class, Zoloft does not perform optimally until you have taken it consistently for several weeks.

In many cases, you may begin to notice a change in your symptoms after about two weeks and greater improvement after about four to six weeks.

The first changes you might notice include improvements in appetite, sleep, and energy levels. However, if you do not see any noticeable improvement after several weeks, talk to your doctor.

Zoloft Drug Interactions

Avoid the liquid formulation of Zoloft if you are on Antabuse (disulfiram) because it contains alcohol. Wait at least 14 days after your last dose of any MAOI before beginning sertraline treatment.

Zoloft interacts with a wide range of natural remedies. Ask your doctor before taking tryptophan, St. John’s wort, or any other herbal or natural formulation.

In addition, Zoloft interacts with numerous prescription and over-the-counter medications, including NSAID pain relievers, diuretics, stomach medicines, blood thinners, and treatments for certain mental illnesses.

Zoloft can also interact with other medications and substances that increase serotonin levels, including other antidepressants. If serotonin levels become too high, you may experience serotonin syndrome. Serotonin syndrome can be life-threatening and lead to symptoms such as anxiety, confusion, fever, high blood pressure, irregular heartbeat, and seizures.

Provide your doctor with a full list of all over-the-counter, prescription, and natural products you use, and do not add anything new without your doctor’s approval. Avoid alcohol and illegal drugs while using sertraline.

Precautions Before You Take Zoloft

Since 2005, all SSRIs have carried “black box” warnings from the FDA regarding a higher risk for suicidal ideation and behavior in children. The FDA expanded its warning in 2007 to include young adults under the age of 25.

Although many young people successfully take these common medications, informed consent is important. Discuss the benefits and risks with your child’s doctor before making a decision.

Your risks from Zoloft may be higher if you have certain medical conditions, including diabetes, low blood sodium levels, seizures, and liver disease. Give your doctor a full medical history of all current and previous illnesses.

Also, let your doctor know if you have a history of drug abuse. If you are currently breastfeeding or pregnant, or if you plan to become pregnant, discuss the risks and benefits of treatment with your physician.

Side Effects When Taking Zoloft

Like all medicines, Zoloft carries a risk for side effects. Common side effects such as headache, sleep difficulties, dry mouth, sweating, and loss of appetite are typically mild and may subside in a few days or weeks.

Let your doctor know right away if you experience more severe side effects such as chest pain, skin rash, vomiting, anxiety, diarrhea, aggression, or confusion.

What Happens if You Stop Taking Zoloft?

All SSRIs, including Zoloft, carry a risk for a collection of withdrawal symptoms known as SSRI discontinuation syndrome. Common sertraline withdrawal symptoms include odd electrical sensations known as “brain jolts” or “brain zaps,” dizziness, and headaches.

Although the syndrome is not generally considered dangerous, the symptoms can be distressing. Don’t lower your dose or suddenly stop taking Zoloft without your doctor’s approval.

If you stop taking Zoloft, it is also possible that you may experience a return of symptoms. If you begin experiencing depression, anxiety, or other mental health concerns. They may recommend resuming your medication, switching to a different type of antidepressant, or treating your condition with psychotherapy.


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