Limusinaspallares

Some things are not debatable. Rain falls from the sky. Elevators go up and down. Orange traffic cones are orange. But because we interpret the world through our experiences, a lot isn’t so definitive.

The boss might say, “Good job,” and we wonder why they didn’t say, “Great job.” We see someone looking in our direction and they seem angry, so we believe that they’re mad at us, and no other explanation makes sense.

What’s happening is that we’re distorting our experience, jumping to conclusions, mind reading, and going to the worst-case scenario. When we do this, we shrink our successes and maximize our “failures,” and because it can be an automatic process, it’s hard to tell when it’s happening. “You don’t know you’re wearing magnifying glasses,” says Dr. Luana Marques, associate professor of psychology at Harvard Medical School.

So what can you do to see things more clearly and with a more balanced perspective? It takes practice and a willingness to tolerate discomfort, but as with addressing any problem, it starts with awareness.

What’s happening when we magnify failures and jump to negative conclusions?

We like to process information quickly, and we use filters to help do that. If we believe, “I’m no good,” all words and behaviors that support that contention just make everything easier.

“The brain doesn’t want to spend energy trying to fight that,” Marques says. And the brain responds depending on the distortion. If something causes anxiety, say from a curious look or comment, the limbic system is activated and we’re in fight-or-flight mode, hyper-focused on the threat, not thinking creatively or considering alternative, less threatening options.

But sometimes, there’s no threat in play. We’re just thinking, probably overthinking, when we question our abilities and minimize our accomplishments.

So what can you do about it?

Label the type of thinking distortion

It helps to define our distortions, the common ones being:

• Catastrophizing: Taking a small incident and going to the worst-case scenario.
• Black-and-white thinking: Seeing only all-or-nothing possibilities.
• Jumping to conclusions: Assuming what will happen rather than waiting to see what will actually happen.
• Mind reading: Assuming what someone is thinking without much evidence.

When you label it, you can better understand and recognize what your go-to distortion is, because “we tend to do one more than another,” Marques says.

After that, it helps to take your emotional temperature by asking: Am I stressed? Am I sweating? Is my heart pounding or my breathing shallow? It brings you more into the moment and it allows you to think about what you were doing that brought on the response, such as, “I was trying to guess the outcome.” It’s another way to pinpoint the distortion you tend to favor, she says.

Challenge the distortion

Whichever distortion it is, you want to examine your assumption by looking for other evidence. If you question your boss’s reaction to you, ask yourself: What does my boss really say? What does this person say about other people? Have I received raises and promotions? Am I given good projects?

An easy trap with distortions is that they’re plausible. A person who is mad at me would give me a look. A person who hated me wouldn’t text me back. Maybe so, but think of five other possible explanations, Marques says. This exercise engages the prefrontal cortex, which takes you out of the fight-or-flight mode and expands your thinking. You’re then problem-solving and not solely keyed on one option.

You also want to ask an essential question: is this thinking helpful? You might realize that all your thinking/wondering/worrying does is make you anxious. Gaining that presence might be enough to get you off the path of distorted thinking. “Asking and answering the question about your thinking pauses the brain, and you potentially see the world differently,” she says.

Being balanced and kind to ourselves

As you examine and attempt to control your distortions, be mindful of how you treat yourself. Self-criticism is a really easy trap to fall into, but try talking to yourself as you would a friend. Better yet, imagine you’re speaking to a child. Your language would be considerate, supportive, and you wouldn’t use words such as “stupid” or “dumb.” This approach also shifts you into the detached, third person. “You get out of your head,” Marques says. “We’re cleaning our magnifying glasses a little bit.”

Lastly, realize that you’re not looking to switch your attitude from “I’m unworthy” to “I’m super-great.” That’s just trading one extreme for another. All you want is to counterbalance your distortion, then let it go. Countering thinking distortions is a lot like meditation, where you practice acknowledging your thoughts without getting hooked onto them.  “You don’t have to magnify or minimize.” Marques says.

Boutique or specialty fitness studios offer all sorts of ways to exercise, such as strength training, indoor cycling, and kickboxing. Other popular options, like yoga and Pilates, are less likely to leave you sweaty and breathless, emphasizing flexibility and measured movement. Now a new trend has emerged: studios that focus solely on stretching. What are these studios offering, and will you benefit from this focus?

What are stretch studios offering?

These studios, which include StretchLab, StretchMed, LYMBYR, and others, provide assisted stretching sessions, either one-on-one or in small groups. The promised benefits range from reasonable goals of increasing flexibility and range of motion to more questionable assertions, such as preventing injuries and eliminating chronic pain.

"If you participate in certain sports that require flexibility, like dance or gymnastics, stretching may be important to maintain range of motion," says Dr. Adam Tenforde, associate professor of physical medicine and rehabilitation at Harvard Medical School, and sports medicine physician at Spaulding Rehabilitation and Mass General Brigham.

But if your focus is on improving your overall health, the evidence to support stretching is sorely lacking — especially compared with the wealth of evidence supporting the benefits of regular, moderate physical activity.

"Contrary to popular belief, there’s no consistent evidence that stretching helps prevent injuries," says Dr. Tenforde. And if you have an existing injury, such as a muscle or joint sprain, aggressively stretching that tissue could actually make the injury worse, he adds.

The "stretch therapists" and "flexologists" at stretching studios may have certain certifications and training, but they’re probably not qualified to recognize and address health-related causes for pain or stiffness. If you have a previous or current musculoskeletal injury, you’re much better off going to a physical therapist who has the expertise and training to treat you correctly.

Feeling tight and stiff?

If you’re free from injuries but just feel tight and stiff, try a yoga class, which can provide added benefits like improving your balance and helping you relax and de-stress. Or consider tai chi, a gentle, meditative form of exercise that can help lower blood pressure and enhance balance. Another option is to get a massage.

If you decide to try assisted stretching offered at a studio, listen to your body, and make sure you communicate how you’re feeling with the therapist working on you, Dr. Tenforde advises.

But you’ll probably do more for your overall health by spending that time taking a brisk walk or some other type of exercise instead, he says. Most Americans don’t meet the federal recommended guidelines for physical activity, which call for 150 minutes per week of moderate-intensity exercise and muscle-strengthening activities twice weekly. "As doctors, we’re dealing more with diseases related to inactivity, not diseases of inflexibility, says Dr. Tenforde.

Want to do your stretching at home?

Three easy morning exercises — an A-B-C routine of arm sweeps, back bend, and chair pose — can help ease morning stiffness. This also works well during the day if you spend too much time sitting.

Stretching at home could save you money and time. These tips can help you get the most out of at-home morning stretches or other flexibility routines.

• Warm up muscles first. Much like taffy, muscles stretch more easily when warm.
• Feel no pain. Stretch only to the point of mild tension, never to the point of pain.
• Pay attention to posture and good form. Posture counts whether you’re sitting, standing, or moving. Photos of stretches tell only part of the story, so read instructions carefully to get form right.
• Focus on the muscle being stretched. One side of your body often is tighter than the other. Work on balancing this over time.
• Breathe. Breathe comfortably while stretching rather than holding your breath.
• Practice often. You’ll make the best flexibility gains if you stretch frequently — daily, or on as many days of the week as possible. At the very least, try to do stretches two or three times a week.

"No!"

It might have been endearing as your child’s first word, but dread often kicks in when that word starts to follow parental requests. Experiencing resistance to small or big asks? Stuck in arguments that seem to go in circles and leave you exasperated with unmet requests? The good news is that this pattern can be disrupted. First, you’ll need to identify reasons behind the opposition. Then you can apply relevant strategies to see more helpful behaviors instead.

Below are some examples of opposition drivers and tips to address them.

Difficulty with transitions

If you find that your child resists a request right after engaging in an activity, it might be that your child first needs time to transition. This can be a common experience when parents make requests while children are playing video games or another stimulating activity. One way to manage this is to give your child a five- or 10-minute heads-up (whichever they might need) that you will be asking for the game to stop. This gives your child time to find a place to pause if playing a video game and to transition.

Some families find it helpful to talk with their children before playtime begins to learn what game or activities will be taking place, and how much advance notice might be helpful before the activity would need to stop. This invites collaboration and shows that you respect that not all moments are ideal for stopping a game.

Independent streak

Children almost never are in control, and resistance can show up when that wears on them. Try to fold in elements of choice and control throughout the day for children (that are within a framework you determine) to create more of a balance with your requests. Perhaps you let a young child know that they will need to wear long sleeves and pants because of the weather, but they can pick which top and pair of pants to wear that day. Another idea is to invite your child to pick a side dish for a future dinner from a premade list of a few options.

It also helps to create opportunities for your child to practice being independent. This fosters mastery and offers experiences of feeling in control. This could look like your child preparing any parts of meals that are age-appropriate (for example, a three-year-old could pour cereal into a bowl; a five-year-old could measure ingredients for baking). The kitchen counter may be extra sticky as your child learns new skills. With time, your child will be more adept, and your counters will be cleaner.

Hunger and tiredness

We need both food and sleep to recharge our batteries. When we run low on either or both, it’s extra difficult to be our best selves. If you find that your child is crankier than usual, reflect on when your child last ate and how your child slept the night before (or napped if your child is of napping age). If it’s been a while since your child has eaten and/or your child did not sleep as much as usual, your child may need to recharge before being more receptive to requests. Have your child grab a healthy snack or meal if needed. If sleep is the issue, validate to yourself that this is frustrating that there is no quick fix. Acknowledge privately they are not their usual self at this moment and may be more receptive tomorrow.

Resistance also may crop up when children are coming down with a viral illness, so keep an eye out for any symptoms that may emerge.

Mental health challenges

Everyone has off days, but a persistent pattern of resistance to requests and distress following them may suggest that a child is experiencing mental health difficulties. For example, if a child appears oppositional every morning before school, it could be that they experience anxiety about going to school and are trying to avoid the distress they experience when there. In this case, it is important to ignore the "no" bait and focus on the emotion behind the refusal. Validate or acknowledge how your child is feeling to open the door to learn more. For example, you could say, "You seem really worried about going to school. What about school has been so tough lately?"

Use a similar approach for symptoms of depression, such as withdrawing from and refusing to engage in activities: validate your child’s feelings and invite your child to share more to help you understand their experiences. Discovering what is driving the resistance can allow you to develop a collaborative plan to support your child’s needs and get extra help if needed. Cognitive behavioral therapy is an evidence-based treatment for children experiencing anxiety and/or depression. Your pediatrician can be a helpful resource for mental health treatment referrals. The Anxiety & Depression Association of America also provides treatment resources.

Sometimes, oppositional behavior is pervasive. It can include a frequent loss of temper, irritability, difficulty following the rules, defiance of authority figures, spitefulness, and more. If these behaviors occur at home and also show up in other settings, such as at school, a child may be experiencing symptoms of oppositional defiant disorder. Parent training programs such as parent management training, along with problem-solving skills training, are evidence-based treatments, and pediatricians also may be able to provide relevant referrals.

Your patience understandably can wear thin if you find yourself facing repeated resistance. That experience, though, does not have to continue. You can help shift these patterns once you discover what is driving the "no."

That recurring sound that you hear but nobody else does? It’s not all in your head. Well, not exactly.

You may be one of the estimated 50 million-plus people who suffer from tinnitus. The mysterious condition causes a sound in the head with no external source. For many it’s a high-pitched ringing, while for others it’s whistling, whooshing, buzzing, chirping, hissing, humming, roaring, or even shrieking.

The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating. One approach to managing this condition is different forms of sound therapy intended to help people tune out the internal soundtrack of tinnitus.

What causes tinnitus?

There are many possible causes of tinnitus. Long-term exposure to loud noises is often blamed. But other sources include middle ear problems like an infection, a tumor or cyst pinching nerves in the ear, or something as simple as earwax buildup. Tinnitus also can be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Even old-fashioned aging can lead to tinnitus, which is common in people older than age 55. As people get older, the auditory nerve connecting the ear to the brain starts to fray, diminishing normal sounds.

“Neurons (nerve cells) in areas of the brain that process sound make up for this loss of input by increasing their sensitivity,” says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear. “The sensitivity knobs are turned up so high that neurons begin to respond to the activity of other nearby neurons. This creates the perception of a sound that does not exist in the physical environment. It’s a classic example of a feedback loop, similar to the squeal of a microphone when it is too close to a speaker.”

At times, everyone experiences the perception of a phantom sound. If it only lasts for a few seconds or minutes, it’s nothing to worry about. However, if it pulsates in sync with your heart rate, it’s definitely something to get checked out by a physician, says Polley. If it’s a relatively continuous sound, you should see an audiologist or otolaryngologist (ears, nose, throat specialist).

Can sound therapy help tune out tinnitus?

There is no cure for tinnitus, but it can become less noticeable over time. Still, there are ways to ease symptoms and help tune out the noise and minimize its impact. Treatments are a trial-and-error approach, as they work for some people but not others.

One often-suggested strategy is sound therapy. It uses external noise to alter your perception of or reaction to tinnitus. Research suggests sound therapy can effectively suppress tinnitus in some people. Two common types of sound therapy are masking and habituation.

• Masking. This exposes a person to background noise, like white noise, nature sounds, or ambient sounds, to mask tinnitus noise or distract attention away from it. Listening to sound machines or music through headphones or other devices can offer temporary breaks from the perception of tinnitus. Household items like electric fans, radios, and TVs also can help. Many people with tinnitus also have some degree of hearing loss. Hearing aids can be used to mask tinnitus by turning up the volume on outside noises. This works especially well when hearing loss and tinnitus occur within the same frequency range, according to the American Tinnitus Association.
• Habituation. Also known as tinnitus retraining therapy, this process trains your brain to become more accustomed to tinnitus. Here, you listen to noise similar to your tinnitus sound for long periods. Eventually your brain ignores the tone, along with the tinnitus sound. It’s similar to how you eventually don’t think about how glasses feel on your nose. The therapy is done with guidance from a specialist and the time frame varies per person, usually anywhere from 12 to 24 months.

Additional approaches may help with tinnitus

Depending on your diagnosis, your doctor also may recommend addressing issues that could contribute to your tinnitus.

• Musculoskeletal factors. Jaw clenching, tooth grinding, prior injury, or muscle tension in the neck can sometimes make tinnitus more noticeable. If tight muscles are part of the problem, massage therapy may help relieve it.
• Underlying health conditions. You may be able to reduce the impact of tinnitus by treating conditions like depression, anxiety, and insomnia.
• Negative thinking. Adopting cognitive behavioral therapy and hypnosis to redirect negative thoughts and emotions linked to tinnitus may also help ease symptoms.
• Medication. Tinnitus can be a side effect of many medications, especially when taken at higher doses, like aspirin and other nonsteroidal anti-inflammatory drugs and certain antidepressants. The problem often goes away when the drug is reduced or discontinued.

Have family or friends in assisted living facilities? Finding the right gift can be complicated. Health issues may rule out some gifts: cross off sweets or chocolates for those who need to keep blood sugar under control. There isn’t much space for extra belongings in the apartment or room. In some cases, your giftee’s physical or mental capabilities (or both) are declining.

"Any gift you give will probably be appreciated," says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center. "But it helps if it’s something the person can really use and will enjoy. Tailor it to their particular ailments, needs, and interests." Below is a roundup that can help you select a great gift for the holidays — or any other occasion.

Gifts for social engagement

"Many people feel lonely and isolated in assisted living facilities. Keeping loved ones socially connected combats that, and also helps ward off chronic disease and cognitive decline," Salamon notes. Gifts that may fit the bill include:

• A simple phone. The easier a phone is to operate, the more likely your loved one will be able to use it. That could be a landline phone with large, easy-to-read numbers ($25 and up), a flip phone ($35 and up), or a smartphone with few buttons and apps ($50 and up). Remember that cell phones come with monthly service costs; prices depend on the carrier.
• A smart speaker. If phone use is too hard for your loved one, consider a smart speaker ($20 and up) that can be programmed to dial important numbers (like yours). Commands can be said aloud at any time to make a call. Check if your loved has internet service, which is needed for smart speaker use.
• A photo book. A loose-leaf photo album (less than $20) or easily created photo book ($10 and more) with recent photos of family and friends may be a warm reminder of connections, or can be a gift to share with others in the assisted living facility. That social interaction is important for health. Plus, it will make the person feel good to see all of those photos of people who love them.

Gifts to aid independence

Health problems can make simple activities challenging. These gifts can give your loved one a little independence.

• Adaptive tools. Your loved one may be able to take back some control of dressing with a long-handled shoehorn, a button hook, or a zipper pull (less than $10 each).
• A magnifying glass. Especially handy for those with impaired vision (and who hasn’t misplaced reading glasses?), having a magnifying glass ($5 and up) is handy for reading or seeing small objects. For a nice upgrade, make it a lighted magnifying glass ($15).
• Handwriting aids. Hand arthritis or neurodegenerative conditions (such as Parkinson’s disease) make writing difficult. Ergonomically-shaped adaptive pens ($10 and up) can help your loved one jot down information or thoughts.

Gifts for sharper thinking skills

"Challenging your brain or learning new information promotes new brain cell connections, which help protect and maintain cognition," Dr. Salamon says. Give your loved one something that will make the process easy and fun, such as the following:

• A daily trivia calendar. (About $15)
• Large-print nonfiction or fiction books. ($5 and up). Audio selections are enjoyable, too.
• Large-print books of brain games and puzzles. ($5 and up)
• A print subscription to a health publication, such as the Harvard Health Letter ($24).

Gifts to ease health issues

A well-chosen gift can bring comfort and help ease health issues. Try addressing someone’s aches and pains with gifts such as:

• A microwavable heat wrap ($15 and up).
• A handheld massager ($5 and up).

Or you could address circulatory problems that make people feel cold or increase the risk for blood clots in the legs. Ideas include:

• A soft fleece blanket ($10 and up).
• Warm slippers with slip-resistant soles ($20 and up).
• Brightly patterned compression stockings with fun designs ($15 and up). Be sure to check the size so they aren’t too small for your loved one.

Gifts to track health

Even though assisted living facility staffers monitor residents’ health, your loved one may find it useful to have one of the following gifts:

• A blood pressure monitor ($30 and up). Look for one with a cuff that goes around the upper arm; inflates automatically; has a lighted background with large numbers; and is certified by the Association for the Advancement of Medical Instrumentation, the British Hypertension Society, or the European Society of Hypertension.
• A digital "stick" thermometer ($10 and up). The right one will be large and easy to hold, with a lighted background and large numbers.

Not quite right?

Keep thinking. A nice, warm fleece sweater ($20 and up)? Extra reading glasses to place in favorite nooks ($15 and up)? If none of these ideas is right, consider giving a healthy treat. A great choice right now is fresh citrus (send a box for $30 and up). "Avoid grapefruit, which can interfere with certain medications," Dr. Salamon advises, "but oranges or tangerines are sweet and rich in vitamin C, which supports a healthy immune system. And that’s a great gift."

All of us know that motivation is a key ingredient to accomplishing goals in our personal and professional lives. But if you wait for motivation to strike like a sudden lightning storm, you’re a lot less likely to take a single step toward any goal. Even if you have a much-desired goal in mind, it’s all too easy to deplete motivation through feeling overwhelmed, procrastination, or impatience. The steps below can help you increase your motivation to accomplish the goals that matter to you.

The meaning of your goal

Before setting a goal, it is critical to clearly identify meaning — that is, why is successfully reaching this goal important to you? What will this achievement mean to you? For example, telling yourself “I want to lose 10 pounds so I have more energy to play with my grandchildren” conveys far more meaning than “I want to lose weight.” Or maybe your goal is to paint a room a different color because you feel that color will bring more joy into your life. That’s very different than setting a goal of “paint room.”

If you set a goal and find yourself procrastinating or not achieving it, revisit the meaning of the goal you have set. Is this a goal that continues to matter to you? If so, consider the meaning behind the procrastination or the difficulties that you are experiencing.

Operationalize your goal

Write out a detailed plan to achieve the goal. Use the SMART acronym to guide this plan:

• Specific (What exactly do you want to accomplish?)
• Measurable (How will you know when you have succeeded?)
• Achievable (Is the goal you have set possible?)
• Realistic (Does setting this goal make sense for you right now?)
• Time-bound (What is the specific time frame to accomplish this goal?)

For example, a goal of “exercise more” is too vague, and will not set you up for success. Instead, set a goal of walking 50 steps in the next hour, or taking a 15-minute walk Wednesday morning. This goal is specific, measurable, achievable, realistic, and time-bound.

Set up a to-do list — and tick it off

Once you identify a specific goal, make a to-do list to accomplish it.

• What resources do you need?
• What are the steps you’ll take toward your goal? Break down tasks into manageable mini-tasks and write each one down.
• Set deadlines for each task. Make a schedule to accomplish these tasks, being sure to include regular breaks and realistic time frames.
• Cross off each mini-task as you complete it. Step by step, you’ll see you’re making progress toward your goals.

If you are having difficulty breaking down your goal into smaller tasks, just begin working toward it. For example, if you set a goal of increasing the number of steps you walk each day, but have difficulty identifying the ideal number of steps as a goal, just start walking. You can figure out that ideal number later.

Include others

Invite a team to help you with your goal. You could join a running club, or ask family and friends to check on your progress in achieving tasks related to your overall goal. Perhaps friends can send email or text message reminders to keep you accountable. Finally, surround yourself by other people who are actively working on their own goals. Their efforts may inspire you, too.

Visualize success

Create an image of yourself achieving this goal. This image could be in your mind, or perhaps you could draw a picture of yourself achieving your goal. Imagine what achieving this goal will mean for you. How will you experience the success? How will it feel for you? Remember these positive emotions as you are completing the tasks on your to-do list to help fuel motivation.

Avoid distractions

Try to choose a space that is organized, free of clutter, and with minimal distractions. Focus on one task at a time, not multitasking. Close email and place your phone on silent. Avoid social media sites that make goals seem very easy to attain.

Track progress and time spent

Decide how often you’ll track progress toward your overall goal through your to-do list. Are you meeting the timeline you initially established? If not, identify stumbling blocks. Revisit the importance and meaning of this goal and how you initially set up your SMART model. If necessary, reconsider challenging aspects of your goal and make changes in your plan.

Think creatively about how to expand available time to work on your goal. Can you make certain tasks more routine in your life? Can you link unenjoyable tasks with more pleasurable activities? For example, if you dread your goal of taking 100 additional steps each day, could you listen to music or a podcast that you enjoy while you are taking these steps?

Embrace empathy

Be kind to yourself when tracking progress toward achieving your goal. Practice self-compassion on occasions when you fall short. Build small rewards into the process, and consider how to celebrate all your accomplishments.

All parents want their children to be successful in life — and by successful, we mean not just having a good job and a good income, but also being happy. And all parents wonder how they can make that happen.

According to Harvard’s Center on the Developing Child, it’s less about grades and extracurricular activities, and more about a core set of skills that help people navigate life’s inevitable challenges. These skills all fall under what we call executive function skills, which we use for self-regulation. Most people who are successful and happy in life have strong executive function skills.

What are five important core skills?

• Planning: being able to make and carry out concrete goals and plans
• Focus: the ability to concentrate on what’s important at a given time
• Self-control: controlling how we respond to not just our emotions but stressful situations
• Awareness: not just noticing the people and situations around us, but also understanding how we fit in
• Flexibility: the ability to adapt to changing situations.

While these are skills that children (and adults) can and do learn throughout their lifetimes, there are two time periods that are particularly important: early childhood (ages 3 to 5) and adolescence/early adulthood (ages 13 to 26). During these windows of opportunity, learning and using these skills can help set children up for success. In this post, we’ll talk about that second window of adolescence.

The best way to learn any skill is by actually doing it. Here are some suggestions for parents wondering how to help and when to step back.

Planning

When children are little, it’s natural for parents and caregivers to do the planning for them. But as children grow into teens, they need to learn to do it for themselves.

• Avoid micromanaging your teen’s life. Instead, set some ground rules — simple ones like: homework needs to get done, they need seven to eight hours of sleep, and regular exercise is important. You may have some other ground rules, like attending family meals or religious services. Then let your teen figure out how to get it done. Step in only if ground rules are clearly being broken consistently.
• When teens have long-term projects, such as a research project or college applications, sit and talk with them about how they want to get it done. Let them come up with ideas before you do!
• Involve your teens in planning family activities or vacations, home renovations, or other projects. Let them make some of the decisions (even if you don’t always agree).

Focus

The explosion of device use has caused all sorts of problems with focus in people of all ages. There is an instant gratification to screens that makes it hard to put them aside and focus on less stimulating tasks — so now, more than ever, it’s important to

• talk about how social media and the Internet can interfere with daily life (and homework), and help them come up with strategies to manage the distraction.
• have screen-free meals and family time.
• encourage hands-on activities that don’t involve screens, like cooking, baking, building things, sewing, crocheting, drawing, painting, or gardening.

Self-control

This is one where being mindful of your own reactions to situations is important. How do you react to anger and frustration? Is road rage a problem for you? Remember that our children always pay more attention to what we do than what we say. To help your teen learn self-control, you can:

• Talk about feelings, and about strategies for managing strong feelings — like taking a deep breath, stepping away from the situation, screaming into a pillow, etc.
• Debrief after upsets, once everyone has calmed down. What might your teen have done differently? What could they do next time?
• Talk about how their behavior affects others, and why it’s important to be mindful of that (a practice that also teaches awareness).

Awareness

Teens can be very aware — but mostly of their own world. Help them learn to see beyond that.

• Talk about current events and stories in the news. In particular, talk about how these affect people, and how different people might see them differently.
• Go places with your teen — even just a walk in the woods or a visit to a nearby town can give them opportunities to look around them and see things they might otherwise miss.
• Join community service activities as a family; show teens how they can make a difference.
• Have rituals of checking in as a family, like at dinner. Give everyone a chance to talk about their day.

Flexibility

Life throws curve balls all the time, and teens need to be able to adjust.

• Don’t be too rigid about your teen’s schedule. Help them prioritize, and see which things can be missed or postponed when something happens, good or bad.
• Encourage some spontaneity. This, too, is about learning to prioritize and not getting too stuck in routines.
• Be a role model. Be spontaneous yourself — and don’t get too upset when plans change. Make new plans.

Any time you let your teen do something, there is a reasonable chance that they will fail. Resist the urge to jump in right away. While it’s important to have your child’s back (now and for the rest of their life), sometimes teens need to fail in order to learn. Give them a chance to figure it out themselves before you offer help. They may just surprise you.

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How well are you protecting yourself against heart disease, the nation’s leading cause of death? A check of five important numbers can give you a good idea.

“For my patients, I typically look at their blood pressure, blood sugar, LDL cholesterol and triglycerides values, and their waist circumference,” says Harvard Heart Letter editor-in-chief Dr. Deepak L. Bhatt, who directs interventional cardiovascular programs at Harvard-affiliated Brigham and Women’s Hospital. Those values provide a picture of a person’s overall health and, more specifically, what factors they may need to address to lower their chance of a heart attack or stroke, he says.

Below are the ideal values for each measurement, along with why they’re important and targeted advice for improving them. Universal suggestions for improving all five measurements appear at the very end.

How do your heart health numbers stack up?

While the ideal values are good goals for most people, your doctor may recommend different targets based on your age or other health conditions.

Blood pressure

Less than 120/80 mm Hg

Blood pressure readings tell you the force of blood pushing against your arteries when your heart contracts (systolic blood pressure, the first number) and relaxes (diastolic blood pressure, the second number). Your blood pressure reflects how hard your heart is working (when you’re resting or exercising, for example) and the condition of your blood vessels. Narrowed, inflexible arteries cause blood pressure to rise.

Why it matters to heart health: High blood pressure accelerates damage to blood vessels, encouraging a buildup of fatty plaque (atherosclerosis). This sets the stage for a heart attack. High blood pressure forces the heart’s main pumping chamber to enlarge, which can lead to heart failure. Finally, high blood pressure raises the risk of strokes due to a blocked or burst blood vessel in the brain.

What helps: A diet rich in potassium (found in many vegetables, fruits, and beans) and low in sodium (found in excess in many processed and restaurant foods); minimizing alcohol.

LDL cholesterol

Less than 100 mg/dL

A cholesterol test (or lipid profile) shows many numbers. Doctors are usually most concerned about low-density lipoprotein (LDL) cholesterol, particles that makes up about two-thirds of the cholesterol in the blood.

Why it matters to heart health: Excess LDL particles lodge inside artery walls. Once there, they are engulfed by white blood cells, forming fat-laden foam cells that make up atherosclerosis.

What helps: Limiting saturated fat (found in meat, dairy, and eggs) and replacing those lost calories with unsaturated fat (found in nuts, seeds, and vegetable oils).

Triglycerides

Less than 150 mg/dL

Perhaps less well-known than cholesterol, triglycerides are the most common form of fat in the bloodstream. Derived from food, these molecules provide energy for your body. But excess calories, alcohol, and sugar the body can’t use are turned into triglycerides and stored in fat cells.

Why it matters to heart health: Like high LDL cholesterol, elevated triglyceride values have been linked to a higher risk of heart attack and stroke.

What helps: Limiting foods that are high in unhealthy fats, sugar, or both; eating foods rich in omega-3 fatty acids (such as fish); avoiding alcohol.

Blood sugar

Less than 100 mg/dL

High blood sugar defines the diagnosis of diabetes. Type 2 diabetes is most common. It occurs when the body develops insulin resistance (insulin enables cells to take in sugar) and does not produce enough insulin to overcome the resistance.

Why it matters to heart health: High blood sugar levels damage blood vessel walls and cause sugar (glucose) to attach to LDL. This makes LDL more likely to oxidize — another factor that promotes atherosclerosis. Excess sugar in the blood also makes cell fragments called platelets stickier so they’re more likely to form clots, which can trigger a heart attack or stroke.

What helps: Avoiding sugary beverages and foods high in sugar; eating whole, unprocessed grains instead of foods made with refined grains (white flour, white rice).

Waist circumference

Whichever number is lower:

Less than half your height in inches

OR

Women: Less than 35 inches

Men: Less than 40 inches

Measure your waist around your bare abdomen just above your navel (belly button). A big belly — what doctors call abdominal or visceral obesity — usually means fat surrounding internal organs.

Why it matters to heart health: Visceral fat secretes hormones and other factors that encourage inflammation, which triggers the release of white blood cells involved in atherosclerosis.

What helps: Consuming fewer calories, especially those from highly processed foods full of sugar, salt, and unhealthy types of fat.

Universal advice to improve all five measures of heart health

If one or more of your numbers is above ideal levels, you’re far from alone. Most Americans are overweight or obese and have bigger-than-healthy bellies. Excess weight and waist circumference affect blood pressure, LDL cholesterol, triglycerides, and blood sugar. Eating a healthy, plant-based diet can help. Regular exercise also helps: aim for at least 30 minutes of moderate-intensity exercise like brisk walking most days. Other lifestyle habits that can lower your heart disease risk include getting seven to eight hours of sleep nightly and managing your stress level.

A student suddenly develops leg pain and paralysis; soon hundreds of schoolmates have similar symptoms. Nuns begin biting each other, and soon the same thing is happening at other nearby convents. Three schoolgirls begin laughing uncontrollably, sometimes going on for days. When nearly 100 classmates develop the same problem, the school is forced to close down.

Yet in each case, no medical explanation was ever found. Eventually, these came to be considered examples of mass sociogenic illness, which many of us know by different names: mass hysteria, epidemic hysteria, or mass psychogenic illness. Over the years, many possible sources for these illnesses have emerged — and today TikTok and other social media sites may be providing fertile ground.

What is sociogenic illness?

The hallmark of these conditions is that multiple people within a social group develop similar, medically inexplicable, and often bizarre symptoms. In some cases, those affected believe they have been exposed to something dangerous, such as a toxin or contagion, although thorough investigation finds none.

The suffering caused by these illnesses is quite real and profound —even in the absence of a clear cause and presence of normal test results. And no, a person with sociogenic illness is not "just looking for attention" or "doing it on purpose."

Labeling people as hypochondriacs or "crazy," or illness as "hysteria," isn’t helpful. Hysteria and hysterical — drawn from hystera, the Greek word for womb — are loaded terms, often used to diminish women as psychologically unstable or prone through biology to uncontrollable outbursts of emotion or fear. And while some researchers suggest these illnesses more commonly affect women, most of the published literature on this condition is decades old and based on a limited number of cases.

Common features of mass sociogenic illness

Past outbreaks include illnesses in which people suddenly fainted; developed nausea, headaches, or shortness of breath; or had convulsive movements, involuntary vocalizations, or paralysis. Usually, these outbreaks occurred among people in close proximity, such as at a school or workplace. Rarely, cases appear to have been spread by shows on television. Now, social media is a possible new source.

Certain features are typical:

• experiencing symptoms that have no clear medical explanation despite extensive investigation
• symptoms that are temporary, benign, and unusual for those affected
• rapid onset of symptoms and rapid recovery
• those affected are connected by membership and interaction within a social group or by physical proximity.

Generally, treatment includes:

• ruling out medical explanations for symptoms
• shutting down a facility where it occurred
• removing people from the site of supposed exposure (online or not)
• separating affected individuals from one another.

Reassurance regarding the lack of danger, and demonstrating that the outbreak stops once individuals are no longer in close contact with each other, generally reduces anxiety and fosters recovery.

Tics and TikTok: a new driver of sociogenic illness?

The first known examples of social media-induced sociogenic illness were recognized in the last year or two, a time coinciding with the pandemic. Neurologists began seeing increasing numbers of patients, especially teenage girls, with unusual, involuntary movements and vocalizations reminiscent of Tourette syndrome. After ruling out other explanations, the tics in these teenagers seemed related to many hours spent watching TikTok videos of people who report having Tourette syndrome and other movement disorders. Posted by social media influencers, these videos have billions of page views on TikTok; similar videos are available on YouTube and other sites.

What helped? Medications, counselling, and stress management, according to some reports. Avoiding social media posts about movement disorders and reassurance regarding the nature of the illness also are key.

Geographic boundaries may have become less relevant; now, the influences driving these illnesses may include social media, not just physical proximity.

Dancing plagues, mad gassers, and June bugs

Sociogenic illnesses are nothing new. If you had lived in the Middle Ages, you might recall the "dancing plague." Across Europe, scores of afflicted individuals reportedly began to involuntarily and deliriously dance until exhaustion. And let’s not forget the writing tremor epidemic of 1892, the Mad Gasser of Mattoon during the mid-1940s, and the June bug epidemic of 1962.

The anxieties and concerns of the times play a role. Before the 1900s, spiritual or religious overtones were common. When concerns were raised about tainted foods and environmental toxins in the early 1900s, unusual odors or foods sparked a rash of palpitations, hyperventilation, dizziness, or other anxiety symptoms. More recently, some residents of the West Bank who thought nearby bombings released chemical weapons reported dizziness and fainting, although no evidence of chemical weapons was found.

Closer to home, reports are swirling that Havana syndrome may represent another example of mass sociogenic illness, although no firm conclusions can yet be made. Initially described among members of the US State Department in 2016 in Havana, Cuba, individuals who experienced this suddenly developed headache, fatigue, nausea, anxiety, and memory loss.

These symptoms have been reported by hundreds of people in different parts of the world. Many are foreign service workers attached to US diplomatic missions. Soon after the first case reports, suspicion arose that a new weaponized energy source was causing the illness, such as microwaves fired from some distance. Cuba, Russia, or other adversaries have been blamed for this. Thus far, the true nature and cause of this condition is uncertain.

Nocebo, not placebo

One theory suggests that sociogenic illness is a form of the nocebo effect. A placebo — like a sugar pill or another inactive treatment — may help people feel better due to expectation of benefit. The nocebo effect describes the potential that people could have a negative experience based purely on the expectation that it would occur.

Think of it this way: you may be more likely to experience a headache from a medication if you’ve been warned of this possible side effect, compared with another person warned about a different side effect. Similarly, let’s say you see people fainting. If you believe this is caused by a substance they — and you! — were exposed to, you may faint, too, even if there’s no actual exposure to a substance that could cause fainting.

The bottom line

We don’t know why some develop sociogenic illness while others don’t. Plenty of people have lots of stress. Millions of people were stuck inside during the pandemic and turned to social media for more hours each day than they’d like to admit. Many people are prone to the power of suggestion. Yet, sociogenic illness remains relatively rare. Despite existing for hundreds of years, much about this condition remains mysterious. An open mind is important. Some cases of sociogenic illness may be due to an environmental toxin or contagion that wasn’t detected at the time.

If you or a loved one spends a lot of time on social media and has developed an illness that defies explanation, talk to your healthcare providers about the possibility of social media-induced sociogenic illness. We may soon learn that it’s not so rare after all.

The COVID-19 pandemic has been hard on so many people in so many ways. For babies born during this pandemic, a study published in JAMA Pediatrics suggests that the damage has potential to be lifelong.

The first three years of life are crucial for brain development. And it’s not just the health of babies that matters, but the interactions between babies and their caregivers. Babies need to be touched, held, spoken to, smiled at, played with. As they receive and respond to those interactions, in a “serve and return” kind of way, neural connections are built in the brain. When babies don’t have those interactions, or enough of them, their brains don’t develop as they should — and can even be literally smaller.

When you are a stressed or depressed parent or caregiver, it can be hard to find the time, let alone the energy or interest, to talk to and play with your infant. There are multiple studies showing that maternal depression, poverty, and other family stressors can change the development of a child forever.

How was the study done?

In this study, part of an ongoing study of mothers and babies, researchers from Columbia University looked at the development of three groups of 6-month-old babies. Two of the groups were born during the COVID-19 pandemic; the mothers of one group had COVID-19, while the mothers of the other did not. The third group was a historical cohort (a group of babies who were born before the pandemic).

Mothers participating in the study used an Ages and Stages Questionnaire (ASQ-3) to record their babies’ development. The researchers noted no difference in the development of the two groups of babies born during the pandemic, suggesting that prenatal exposure to COVID-19 doesn’t affect development, which is great news. But the babies born during the pandemic scored lower in gross motor, fine motor, and social-emotional development than the babies born before the pandemic. Examples of developmental tasks for infants this age are rolling from back to tummy (gross motor), reaching for or grasping a toy with both hands (fine motor), and acting differently to strangers than to parents or familiar people (social-emotional development).

What does it suggest about infant development during the pandemic?

It’s just one study, and we need to do more research to better understand this, but the findings are not really surprising given what we know about infant development. The COVID-19 pandemic has caused a lot of stress — emotional, financial, and otherwise — for so many families. It has also markedly affected the number and kind of interactions we have with other people. Babies are on average interacting with fewer people (and seeing fewer faces because of masking) than they did before the pandemic.

Even though we need to do more research, this study should serve as an alarm bell for us as a society. The children of this pandemic may carry some scars forever if we don’t act now. We’ve been seeing the emotional and educational effects on children; we need to be aware of the developmental effects on babies, too. All of these could permanently change their lives.

What can we do to address these challenges?

We need to find ways to support families with young children, financially and emotionally. We need to be energetic and creative, and work every angle we can. While our government should play a role, communities and individuals can help too.

We need to refer families to and fund early intervention programs around the country that support the development of children from birth to 3 years of age. Because of the pandemic, many of these programs have moved to virtual visits, which can make them less effective. So we need to get creative here, too. We can’t just wait for the pandemic to be over.

And parents and caregivers of infants and toddlers need to know about this research — and ask for help. It’s understandable and natural for parents to think that babies are too small and unaware to be affected by the pandemic. But they are affected, in ways that could be long-lasting. Talk to your doctor about what you can do to help yourself, your family, and your baby’s future.

Follow me on Twitter @drClaire