8 HAPPINESS TIPS FROM AROUND THE WORLD

Happiness and mental health go hand and hand. The following countries and places have cultural practices for happiness baked into their daily life. May learning about these global happiness traditions inspire you to adopt some happiness-boosting activities in your own life!

1. Denmark

Denmark consistently ranks among the top two or three happiest nations around the globe, according to the annual World Happiness Report. There’s no doubt that the concept of Danish hygge (pronounced “hoo-ga”) adds to the mental wellness and happiness of its people.

Hygge translates to something akin to “cozy contentment” in English. Hygge is the feeling that comes from snuggling up inside when it is dark and cold outside. The word is derived from the 16th-century Norwegian root hugga, which means “to console or comfort.” It’s also the root of our modern word hug.

Hyggelig evenings involve cooking with others, gathering around a table for a hearty meal, then clearing the table of dishes and breaking out board games. Thus, hygge is amplified by gathering casually with family and friends.

Create greater happiness with hygge:

Add a little hygge into your own life at any time of year. Light candles around your home. Candlelight can also bring a simple celebratory quality to sharing a meal.

If it is cold outside, take pleasure in creating warm, inventive beverages to sip and relax to.  Put digital devices away and enjoy curling up with a good book and a soft blanket.

Gather with friends around your dining table for a meal that all contribute to. Linger afterwards and talk.

2. Turkey

Turkish people have an expression called keyif (pronounced kay-eef), which translates to “pleasure” or “joy” in English. It is about taking a moment away from busyness to experience pleasure or savor a moment of life.

For example, Turks may practice keyif by sitting on a park bench to watch the sunset while enjoying gypsy musicians busking on a street corner or feeding birds a little bit of bread. Keyif is not just a pause but also enjoying a moment to do nothing at all.

Create greater happiness with keyif:

Try playing a game of backgammon with a friend or partner in the middle of the day just for the fun of it.

If you work from home, depending upon your interests, take a moment to play a musical instrument, knit for 10-15 minutes, or add a few jigsaw puzzle pieces to a jigsaw you have going. You can also have a cup of tea and enjoy a quiet moment to look out the window.

It’s good for the brain to get out of your chair and focus on something else pleasurable before going back to work.

You can enjoy keyif socially too! Join some friends at an outdoor cafe and people watch.

3. Nigeria

Nigerians follow an ancient philosophy known as ubuntu (pronounced oo-BOON-too). It is derived the Zulu phrase, “Umuntu ngumuntu ngabantu,” which loosely translates to “a person is a person through other people.” In other words, community is the building block of a society.

Archbishop Tutu of South Africa is credited with introducing the concept of ubuntu to the West. In an Amnesty International report, archbishop Tutu explains ubuntu “is the essence of being human. It speaks of the fact that my humanity is caught up and is inextricably bound up in yours. I am human because I belong.”

Ubuntu is a reminder that no one is an island and every single thing we do, good or bad, has an effect on our families, our friends, and the community around us.

Create greater happiness with ubuntu:

Get involved with community service. Find a “Community Serve Day” sponsored by a local church or charity. Do a beach cleanup, make gift bags to show appreciation for first responders, clean up a baseball field, or paint a single mom’s house.

Seek out ways to celebrate the positive things that happen in your friends and loved ones’ lives that may go unnoticed. Live by this African proverb: “If you want to go fast, go alone. If you want to go far, go together.”

4. The Netherlands

The Netherlands (also known as Holland) have a happiness concept called gezelligheid (pronounced guh-ZELL-eek-hite), which refers to a sense of well-being that encompasses comfort, ease, and togetherness. In different contexts, gezelligheid can refer to a social or relaxed situation but it also conveys conviviality, fun, and coziness. 

The Dutch believe the word gezelligheid (the noun form) and gezellig (an adjective) are not translatable because they are more about a feeling that happens in ordinary moments in life. An evening, a place, or a person can all be gezellig. In these contexts, it usually means something like quaint, lovely, cozy and time spent with loved ones or friends after a long absence or in general fellowship.

Gezelligheid is considered the Dutch secret to happiness by some. Gezelligheid is about creating a sense of belonging, a space where we can truly relax, be ourselves, and connect with those around us.

Create greater happiness with gezelligheid:

Consider taking a fun outing with friends and/or loved ones such as a boat ride or an enlivening walk. Put away your phones! Enjoy conversation. Relax.

The Dutch also have a phrase called: “gezelligheid kent gee tijd,” which means, “coziness knows no time.” So, there’s a lingering quality to this form of happiness. Don’t keep a tight schedule, instead leave ample time to enjoy your activities so you don’t have to rush and can savor the experience.

5. Indonesia

Javanese people live by the principles of guyub (pronounced guy-oob), which has been called Indonesia’s secret to happier, healthier communities. Similar to the general meaning of ubuntu, guyub embraces the brotherly or sisterly bond shared between everyone in the community.

Joy is shared and pain is consoled by the community. Guyub is how the community cultivates a strong sense of belonging, compassion, and sincere support for one another. It is the idea that you’re glad for another’s good fortune and trust that your own existence matters to other people.

Create greater happiness with guyub:

Practice guyub simply by improving your listening skills with others. Speak less and listen more. Really listen.  You’ll learn more about the people around you.

Extend a kind or encouraging word or act to others when the opportunity presents itself. One compliment can go a long way in improving someone’s day. When was the last time you complimented your partner at home for making a meal? Offer a helping hand to your neighbor. Express kindness in your interactions throughout your community.

6. Philippines

The hard-to-pronounce Filipino compound noun pakikipagkapwa-tao (pronounced pah-kee-kip-ahg-kap-wa-tao) places great value on community happiness, harmony, and unity.

The Filipino mindset is one of getting along with others rather than standing out alone. The entire community benefits if progress is achieved—no one is left behind, and this increases happiness for all.

The ethos of pakikisama, which means “getting along with others,” is deeply embedded in the Filipino psyche and value system. That’s why multigenerational households or having family homes near each other is common among Filipinos. Church plays a vital role in the Philippines as a place for communal bonding as well.

Create greater happiness with pakikipagkapwa-tao:

Participate in a food drive. Sponsor a child in a poverty-stricken country with organizations that give a hand up, not a handout, such as World Vision or Compassion International. Explore how you can help international humanitarian efforts such as Doctors Without Borders.

7. Japan

Japan has a relatively new tradition known as shinrin-yoku, loosely translated as “forest-bath” or “taking in the forest atmosphere.” The idea took root in the ’80s to counter city-life burnout.

It inspired the Japanese people to reconnect with their many forests. The simple practice entails taking slow walks in the woods to convene with nature through the five senses.

It’s a bit like Norway’s friluftsliv, but forest-bathing has become a practical way to reduce urban stress and boost mood among the Japanese—and its benefits are confirmed by research.

Create greater happiness with shinrin-yoku:

Make your next getaway an area where you can forest-bathe. When you do, engage four of the five senses: sight, smell, hearing, and touch.

Look up at the canopy and observe how the light comes through the trees. Listen for the breeze and the chirping of birds. Smell the richness of loam and soil. If you can’t get to a forest, you can also simply go to the park and engage your senses on a quiet stroll.

8. Hawaii

Hawaii was found to be the “Happiest State in America” in 2024 by personal finance website WalletHub. Its analysis compared states across metrics, including the depression rate, productivity, income growth, and the unemployment rate.

Of course, Hawaii’s beaches, swaying palm trees, warm trade winds, and majestic mountains may have something to do with all that happiness, but its culture factors into well-being too. 

The Hawaiian people have continued to practice traditions handed down from their ancestors who inhabited the islands long before Westerners. The tradition of ho’oponopono (pronounced hoe-pono-pono) comes from the Hawaiian words ho’o (to make) and pono (right or correct). Saying pono twice makes it “doubly right,” and it applies to oneself and others.

Ho’oponopono is defined as “mental cleansing: family conferences in which relationships are set right through prayer, discussion, confession, repentance, and mutual restitution and forgiveness,” according to the Hawaiian dictionary. Ancient islanders believed that errors, guilt, or anger caused physical illness. Their cure was forgiveness.

Create greater happiness ho’oponopono:

Do you need to ask someone for forgiveness or is there someone you need to forgive?   If so, make use of the ho’oponopono-inspired prayer of forgiveness, which is based on four key phrases: 

“I love you.”

“I’m sorry.”

“Please forgive me.”

“Thank you.”

Write the prayer down on a piece of paper and put it somewhere you can see it every day.

Another way to embrace ho’oponopono is by having a family meeting known as a pule ‘ohana. That’s when the family gathers to review the day, discussing what went well.

HOW TO CELEBRATE INTERNATIONAL HAPPINESS DAY

One way to honor this day of happiness would be to simply practice one of these eight happiness rituals on March 20. Of course, you can continue the good feelings by incorporating the remaining rituals that speak to you, one at a time, into your life gradually.

In this blog, you’ll learn the symptoms to look out for—and how to seek help.

WHAT IS EMOTIONAL LABILITY?

What does emotional lability mean? The Encyclopedia of Personality and Individual Differences defines it as “a distinct emotional process characterized by frequent, excessively rapid, and intense changes in emotions resulting in an inability to maintain a consistent emotional state over time.” Alternate terms include:

• Affective instability
• Affective lability
• Emotional impulsivity
• Emotional instability
• Emotional variability
• Mood instability
• Mood lability

Emotional lability differs from typical mood changes because the moods are rapid, intense, and severe. While both may result from an outside stimulus (a “trigger”), typical mood changes are generally less extreme in nature.

In 2013, an article in the journal Psychological Medicine noted that affective instability remained poorly defined and thus attempted to define clearer parameters. The study outlined four general categories to help measure affective instability: oscillation, intensity, ability to regulate, and the change in mood triggered by environment.

Ultimately, the authors suggested that emotional lability be defined as “rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioral consequences.”

SIGNS AND SYMPTOMS OF EMOTIONAL LABILITY

Emotional lability may be confused with emotional dysregulation, a common feature of attention-deficit hyperactivity disorder (ADHD). According to The American Professional Society of ADHD and Related Disorders (APSARD), the term “affective lability” is typically used for those with mood disorders, while “emotional dysregulation” is often attached to ADHD.

Some common behaviors associated with emotional lability include:

• Uncontrollable crying or laughter
• Anger outbursts or temper tantrums
• Rapid shifts between moods
• Overreactions to events
• Irritability
• Inappropriate emotions (such as laughing at a sad event)

When moving through rapid emotional shifts, an individual may suddenly move from crying to laughter without any apparent cause. During the episode, each emotion is also exaggerated in intensity and severity.

CAUSES AND CONDITIONS ASSOCIATED WITH EMOTIONAL LABILITY

In 2015, an article in the British Journal of Psychiatry examined the significance, definition, and measurement of mood instability. It noted that mood instability is a common experience, affecting nearly 14% of the population. The issue is seen more frequently in women than men.

The authors stated that peak prevalence occurs in those ages 16-24, then gradually declines with age, affecting only 7% of those ages 65-74.

But they added that mood instability affects 40-60% of those with depression, anxiety disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). It is also a prevalent feature of bipolar disorder and ADHD and can result from trauma that contributes to borderline personality disorder, hallucinations, paranoia, and psychotic disorders.

Emotional lability increases risk of suicidal ideation, alcohol misuse, and other issues that reduce quality of life. In addition, mood instability can lead to poorer long-term outcomes in those with conditions like bipolar disorder.

According to the American Stroke Association (ASA), neurological conditions, such as stroke, amyotrophic lateral sclerosis (ALS), Parkinson’s, TBI, multiple sclerosis, and dementia, can also contribute to emotional lability.

These neurological conditions create what’s called the pseudobulbar affect (PBA), also called reflex crying and involuntary emotional expression disorder.

PBA occurs because parts of the brain that control emotions are compromised. The ASA points to a “neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression” as a reason for these intense mood swings.

Finally, certain medications—such as amphetamines prescribed for ADHD—have been associated with risk of emotional lability, according to a 2018 meta-analysis published in Journal of Affective Disorders.

THE ROLE OF THE BRAIN IN EMOTIONAL REGULATION

Since brain function affects mood stability, mood swings and brain health are closely linked. Key regions of the brain contribute to these symptoms. For example, the limbic system, as the brain’s emotional center, plays a vital role in mood regulation.

Part of the limbic system, the brain’s thalamus is important in processing emotions. It acts as a relay station for sensory and motor information, carrying external stimuli from the outside world to the brain. The thalamus has been linked to numerous issues, from chronic pain and PTSD to clinical depression and low moods.

The temporal lobes are also involved in emotional stability. Dysfunction in these areas may lead to symptoms like angry outbursts, aggression, or emotional ups and downs.

The involvement of multiple brain regions, as well as numerous conditions that may contribute to emotional lability, makes brain imaging particularly useful to pinpoint its underlying root causes.

Because SPECT scans paint a picture of activity and blood flow in the brain, they are invaluable—alongside a comprehensive evaluation—to successfully diagnose and effectively treat the condition(s) in question.

DIAGNOSING AND TREATING EMOTIONAL LABILITY

Emotional lability can significantly impact many aspects of daily life, including relationships. It creates challenges in both personal and professional settings, taking a toll on loved ones and leading to outcomes like poor performance at work or school. Therefore, obtaining the correct diagnosis, treatment, and lifestyle recommendations is crucial.

Fortunately, various therapies and lifestyle tips can help individuals who are experiencing severe mood swings. Try these emotional lability treatment strategies to promote greater mood stability:

• Incorporate brain-boosting nutrients like omega-3 fatty acids, which help support the limbic system (and therefore emotional well-being)
• Avoid sugary foods
• Listen to calming music
• Try dancing or other forms of rhythmic movement
• Practice mindfulness-based cognitive therapy, hypnosis, meditation, and/or neurofeedback, which help support emotional regulation
• Boost serotonin with exercise, diet, and a 5-HTP nutritional supplement
• Reduce screen time
• Increase cerebral blood flow with deep breathing, yoga, and cardiovascular exercise

Meanwhile, the caregivers and family members of those who experience emotional lability should educate themselves on this topic to better offer support to their loved ones.

Understanding that it’s an issue of brain health helps prevent them from taking these extreme mood swings personally or viewing them as a moral failing.

WHEN TO SEEK PROFESSIONAL HELP FOR EMOTIONAL LABILITY

While moderate shifts in mood are normal, emotional lability raises certain red flags that indicate the need for intervention. When mood swings are especially severe and/or rapid, out of proportion to situations, and interfering with daily life tasks and relationships, it’s time to seek help.

If you suspect you or a loved one are experiencing emotional lability, it’s important to receive a comprehensive evaluation, including brain SPECT imaging if possible, to pinpoint the underlying causes. Starting on the road to recovery with a targeted brain-body treatment plan will help regulate moods to make life more stable, manageable, and enjoyable.

UNDERSTANDING TRAUMA AND ITS IMPACT ON THE BRAIN

Trauma takes various forms. An example of physical trauma, for example, is a concussion, a type of traumatic brain injury (TBI). TBI describes an injury to the head that disrupts healthy brain functioning. Those who have experienced head trauma, including a mild traumatic brain injury, or mTBI, can experience long-term cognitive, psychological, or behavioral issues.

Emotional trauma, on the other hand, occurs in response to distressing events. In many cases, the trauma is processed and does not create long-lasting effects. But in vulnerable populations, or as a result of ongoing trauma, post-traumatic stress disorder (PTSD) may occur. PTSD leads to persistent symptoms that can interfere with daily life and impact mental health.

Those with a high number of adverse childhood experiences (ACEs) comprise one population that is more vulnerable to emotional trauma. Children who have faced multiple hardships—such as abuse, neglect, or household issues like mental illness, suicidal behavior, and/or incarceration—can face lasting consequences in their later years.

The symptoms of trauma can be emotional, cognitive, and physical. Trauma affects multiple regions of the brain, including the amygdala, prefrontal cortex, and hippocampus.

Emotional trauma symptoms include anxiety, depression, PTSD, trouble sleeping, and hypervigilance, among other possible side effects. Meanwhile, TBIs can also raise the risk of depression, anxiety, and PTSD, as well as ADD/ADHD, psychosis, dementia, and suicide.

SPECT BRAIN IMAGING AND TRAUMA

The brain imaging diagnostic tool called SPECT (single photon emission computed tomography) can help accurately identify any underlying brain issues that may be contributing to mental health symptoms. Therefore, SPECT scans help determine how trauma is affecting the brain. Other types of brain imaging, such as MRIs, can reveal the brain’s anatomy but do not indicate how well it functions.

And because SPECT is a functional brain imaging tool that evaluates brain activity and blood flow patterns, it helps differentiate between TBI and PTSD, which can have many of the same symptoms. In fact, one study found that brain SPECT imaging was able to differentiate a PTSD group from a TBI group with 89% accuracy.

Can trauma change brain function? SPECT scans indicate that it can. Amen Clinics clinicians have found a diamond pattern in the brain of those with emotional trauma. This pattern reflects increased activity in the anterior cingulate gyrus, basal ganglia/amygdala, and thalamus. Similarly, those with PTSD show overactivity in the deep limbic area, basal ganglia, and anterior cingulate gyrus.

Because SPECT shows which areas of the brain are working too hard, not working hard enough, and working well, this type of brain scan is especially important to help guide treatment strategies. A 2012 study found that adding SPECT scans to a standard mental health evaluation changed psychiatrists’ recommended diagnosis and/or treatment eight times out of 10. 

This study also highlighted how SPECT can reveal previously undetected trauma. More than one in five cases showed an undiagnosed brain injury, while another one in five cases indicated unexpected toxicity. In 60% of cases, consulting SPECT scans led to a change in the medications or supplements recommended by medical experts.

A BRAIN-BASED APPROACH TO HEALING TRAUMA

In instances of trauma, the entire body is affected. Facing an acute stressor activates the sympathetic nervous system, creating a chain reaction that leads to the stress response known as fight or flight. As a result, the hormones cortisol and adrenaline flow through the body.

Frequent or long-term stressors can lead to this stress response getting stuck in place. Chronic stress may then create a variety of physical, psychological, cognitive, and behavioral symptoms. It can even weaken the body’s immune response.

In other words, chronic trauma dysregulates the brain-body connection. That’s one reason why it’s so important to address both the brain and body when healing trauma. Amen Clinics advocates a “whole body” approach to recovery, looking at the entire person to treat problems at the root causes—rather than prescribing a medication designed to merely mask symptoms in the short term.

Evaluating the entire person is important when dealing with trauma, which can contribute to or aggravate multiple mental health conditions, including:

• PTSD and complex PTSD
• Depression
• Anxiety
• Addictions and other trauma-related coping mechanisms

A brain-based approach to healing trauma also allows for personalized treatment plans. Because each person is unique, and each mental health condition is never a single or straightforward issue, a helpful treatment for one individual may be ineffective or even harmful to another.

Others may experience mental health issues that do not respond to traditional treatments like antidepressants. Using brain imaging to identify trauma-related dysfunction helps create personalized treatment plans that target the exact areas of the brain in need of help.

The individual can then take the proper steps to rebuild their brain health—because brain health is mental health. Since there are many natural ways to heal trauma in the brain, medications are never considered the first or only strategy for recovery. Tactics like dietary changes, exercise, meditation, and supplements can make a major impact without any damaging side effects.

THERAPEUTIC INTERVENTIONS FOR TRAUMA

Many victims of trauma will experience mental health improvements through lifestyle interventions. But there are numerous additional evidence-based therapies available to tackle PTSD brain recovery and other trauma-related symptoms or conditions. These include:

• Eye movement desensitization and reprocessing (EMDR). This interactive psychotherapeutic technique uses bilateral hemispheric brain stimulation. During a session, the individual processes traumatic memories in a healthy way and is able to reduce or eliminate the strong emotions they evoke.
• Cognitive behavioral therapy (CBT). In this form of psychotherapy, clients learn to identify and then replace their negative or harmful patterns of thinking and behaving. Patients learn more helpful ways of thinking and acting, as well as better coping skills to handle challenging situations in the future.
• Neurofeedback. This treatment helps people retrain their brain. Those with stress, anxiety, and behavioral issues can learn healthier forms of self-control, emotional self-regulation, responses, and behavior. Thanks to its neuroplasticity, the brain learns a more efficient way of functioning and, with practice, reinforces new pathways for better mental health.
• Hyperbaric oxygen therapy (HBOT). This innovative, noninvasive treatment involves breathing 100% pure oxygen in a pressurized chamber. The client’s lungs take in up to three times more oxygen than usual, which is transported by the bloodstream to damaged tissues. This process facilitates improvements in mental health conditions, TBIs, and cognitive or memory problems.
• Mindfulness and meditation. A study at Harvard showed that eight weeks of mindfulness-based training not only led to enhanced psychological well-being and reduced mental health symptoms. Participants also demonstrated “changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”

In addition, numerous lifestyle choices will support trauma healing. For example, adopting a brain-healthy diet fuels the entire body with proper nutrition. We know that the Standard American Diet (SAD) deteriorates brain function. But consuming vegetables, fruits, lean proteins, and healthy fats (including omega-3s, which improve brain blood flow) contributes to better mental health.

Sleep is another key factor in the process of recovering from emotional trauma. Unfortunately, there is an association between exposure to traumatic events and reduced sleep quality. As one study notes, sleep problems often accompany PTSD and “may interfere with recovery from elevated post-traumatic stress levels.”

Finally, physical activity helps the brain recover from trauma—both physical and emotional. Exercise has been shown to reduce symptoms of anxiety and depression as well as feelings of stress and anger. Studies have noted numerous positive brain changes, increased neuroplasticity, and better moods as a result of exercise. It also releases feel-good endorphins and promotes better sleep.

TRAUMA AND RELATIONSHIPS

Implementing brain-based trauma treatment using the above tactics is not only important for the individual suffering from the effects of emotional trauma. We know that childhood trauma impacts adult relationships in a multitude of ways. Therefore, many lives can be affected by just one person’s unaddressed trauma.

For example, the brain changes associated with trauma can lead to:

• Trouble forming secure attachments in relationships
• Issues with trust and interpersonal communication
• Behavioral issues
• Poor emotional regulation
• Problems with learning
• Difficulties in social interactions
• Aggression
• Risky behaviors

These issues may then contribute to larger effects over a lifetime, such as chronic physical health conditions, unemployment, and poor performance at school and work. Ultimately, those who do not receive help are unable to fulfill their true potential

And, as the effects of trauma are being treated, rebuilding relationships is instrumental for healing. Healthy relationships have been called the single most important factor in long-term health and longevity.

Connecting with others—support groups, therapists, mental health organizations, family, and friends—can transform both physical and mental health outcomes. Conversely, a lack of quality relationships can be detrimental to health over the long term.

SUCCESS STORIES IN USING A BRAIN-BASED APPROACH

Clearly, trauma and mental health (which is inextricably linked with brain health) go hand in hand. That means using a brain-based approach is the most effective way to treat trauma, as seen in numerous success stories at Amen Clinics.

Seeing before-and-after SPECT scans of these clients verifies the progress they’re making—and highlights when and what different interventions may be needed. By examining issues like trauma as brain health issues, individuals shed stigma and shame. Meanwhile, their loved ones can better understand their behavior and avoid moral judgments.

10 SIGNS OF MENTAL HEALTH TREATMENT FAILURE

1. Your symptoms aren’t improving.

One of the clearest signs that your mental health treatment isn’t working is the lack of improvement in your symptoms. Whether you’re managing clinical depression, anxiety disorders, post-traumatic stress disorder (PTSD), or another condition, effective treatment should lead to measurable progress over time.

According to statistics from the National Library of Medicine, up to 50% of people with depression do not respond to their initial treatment plan. If you feel like you’re running in place, it’s time to discuss alternative options with your provider.

2. You feel worse over time.

It’s not uncommon to experience emotional discomfort when diving into tough topics during therapy, but constantly feeling worse without relief could signal a deeper problem. A 2023 study found that treatment-resistant mental health issues often worsen without appropriate adjustments.

So, if your symptoms are intensifying, it’s crucial to reevaluate your approach with your mental health professional.

3. You lack a sense of connection with your therapist.

Clear and comfortable communication provides therapeutic rapport that plays a significant role in a successful mental health treatment plan. If you don’t feel heard, understood, or respected by your therapist, it can hinder your progress.

Research from Frontiers in Psychiatry Journal shows that a strong therapist-client alliance can be a powerful predictor of therapeutic success, impacting nearly 8% of success in therapy. If this connection is missing, consider seeking a different provider to ensure you’re giving yourself the best chance for treatment.

4. Your treatment plan feels generic.

A cookie-cutter approach to mental health treatment often fails to address the specific needs of an individual. For example, stimulant medication for ADHD may be highly effective for one person, but could make another person’s symptoms worse.

Personalized treatment plans often allow space for better outcomes. If your current plan doesn’t feel tailored to you, discuss customized options with your provider.

5. Side effects from medication outweigh benefits.

While medication can be a lifeline for many, the wrong prescription or dosage can lead to side effects that worsen your quality of life. According to a 2023 report by the JAMA Network Research Journal, about 25% of people experience adverse effects from antidepressants that cause them to discontinue treatment within the first month and 68% within three months.

If you have questions or feel your medication isn’t improving your mental health and creating additional challenges, it’s essential to work with your doctor to find a better solution.

6. You’re not learning new coping strategies.

Effective mental health treatment should equip you with tools and strategies to manage stress, triggers, and symptoms. If you’re not gaining actionable coping skills, you might not be receiving the full benefit of therapy.

You can feel more empowered to support your own brain health alongside your choice of therapy by incorporating practical strategies that have been proven to work like:

• Practicing gratitude journaling to shift focus toward positive daily experiences
• Having a creative outlet like painting, music, or crafting to better express yourself emotionally
• Spending time in nature to reduce stress, improve mood, and get your body moving
• Practicing mindfulness meditation to increase self-awareness which calms the mind and restores control over your emotional health
• Using aromatherapy with calming scents like lavender or eucalyptus to promote relaxation

If your sessions lack this focus, it’s worth discussing with your therapist and your doctor.

7. You’re avoiding therapy sessions or assignments.

If you find yourself dreading therapy sessions or avoiding assigned homework, it could be a sign that your current approach isn’t resonating with you. A 2019 article by the American Psychological Association found that client engagement is a critical predictor of success and continued attendance in mental health treatment.

If your treatment feels like a chore, consider exploring alternative therapies that align better with your needs.

8. Your goals are unclear or unmet.

A clear roadmap is vital for effective mental health treatment. Goal setting has been shown to help young people with anxiety or depression by improving communication, building trust, and making their care feel more manageable.

If you haven’t set specific goals with your provider or feel like you’re not making progress toward them, it’s a red flag. Measurable progress is a key indicator of treatment success. If your sessions feel aimless, request a structured plan with clear milestones.

9. You’re only addressing surface-level issues.

Some therapy models focus on immediate symptom relief without digging into the underlying causes. While short-term relief is important, ignoring the root cause can lead to recurring problems and disengagement when things don’t work out.

Comprehensive mental health treatment should address both immediate symptoms and long-term factors like trauma or lifestyle. If your sessions lack depth, it may be time to switch approaches.

10. You’re relying solely on one form of treatment.

Mental health treatment often works best when it’s multifaceted. For instance, combining therapy with lifestyle changes, medication, or brain-healthy habits can amplify results.

Decades of research and clinical practice at Amen Clinics underscores the value of integrating brain health practices like proper nutrition, exercise, and mindfulness into treatment plans. If your current approach feels one-dimensional, consider supplementing it with additional strategies.

WHAT TO DO IF YOUR MENTAL HEALTH TREATMENT ISN’T WORKING

If any of the above signs resonate with you, it’s time to act. Here’s how you can advocate for better mental health therapy outcomes starting now:

1. Communicate openly with your provider: Share your concerns in detail and ask for adjustments to your treatment plan.
2. Seek a second opinion: Consulting another mental health professional can offer fresh insight and alternative approaches to find new ways to heal your brain.
3. Build brain-healthy habits: Learn about how your brain and body work together to help or hinder your progress. Take steps to tailor your lifestyle to support brain function and mental clarity, including a nutrient-rich diet, regular exercise, and mindfulness practices.
4. Consider innovative therapies: If traditional talk therapy isn’t working, explore options like EMDR therapy, neurofeedback, or group coaching.
5. Explore personalized care: The brain SPECT imaging and integrative approaches at Amen Clinics help address root causes of mental health issues, so you can get a targeted treatment plan for your individual needs. 

Identifying when your mental health treatment isn’t working can feel discouraging, but think of it as an opportunity for growth and positive change. By recognizing the signs and taking proactive steps, you can find a treatment plan that truly supports your overall wellness. Mental health is a journey, not a destination—and the right support can make all the difference.  

WHAT IS LONG COVID?

Long COVID – also known as post-COVID condition – is a syndrome that occurs in individuals with a history of likely or confirmed SARS CoV-2 infection, usually about three months from the onset of COVID-19. 

Long COVID comes with an array of symptoms that last for at least two months and cannot be explained by an alternative diagnosis to be considered long COVID. The most common symptoms may include any of the following:

• Fatigue
• Malaise
• Brain fog
• Memory issues
• Heart palpitations
• Blood clots
• Persistent cough
• Chest pain
• Loss of lung function
• Muscle pain and joint aches
• Headache
• Hair loss
• Loss of smell
• Altered taste
• Sexual dysfunction
• Sleep disturbances
• Gastrointestinal issues
• Anxiety
• Depression

These symptoms often have an impact on everyday functioning. Symptoms may appear for the first time following initial recovery from an acute COVID-19 episode, or they can persist from the time of the initial illness. Additionally, they may vary or relapse over time.

One of the most recent scientific surveys of nearly 30,000 participants revealed that about 8% of U.S. adults reported having ever had long COVID. Just under 4% of U.S. adults reported currently having the condition or currently having activity-limiting long COVID.

Of course, the SARS CoV-2 infection is the original initiator of long COVID, but more research is needed to fully understand what transpires at the cellular and molecular levels that brings about long COVID health complications and symptomology.

WHAT DRIVES LONG COVID?

Scientists see long COVID more as an umbrella term because it appears there are likely multiple mechanisms that lead to its development and these conditions are not mutually exclusive—and may even coexist.

According to 2023 research, the leading theories about what drives long COVID include damage/alteration to the immune system, the persistence of residual COVID viral components that lead to chronic inflammation, endothelial (lining of blood vessels) dysfunction or activation, reactivation of pre-existing chronic infections, microflora imbalances in the gut, and unrepaired tissue damage.

Here’s a closer look at a few of them.

1. Viral Persistence

Viral persistence is characterized by ongoing shedding of SARS-CoV-2 after the acute infection has run its course. These persistent infections from long COVID shedding may fly under the radar, but their subclinical viral presence is thought to continuously aggravate the immune system – which, in turn, may trigger chronic inflammation.

Indeed, persistent COVID viral RNA was found in the feces of a group of individuals months after clearing the initial infection, according to one study reported by researchers at the Yale School of Medicine. These individuals also reported experiencing residual GI symptoms months after being diagnosed with COVID.

If long COVID develops due to subclinical levels of the virus persisting in the body, that would make the condition similar to other infection-associated chronic conditions (also called post-acute infection syndrome) such as CFS, Lyme disease, EBV, or herpes zoster (shingles) that develop after the acute infection has passed.

2. COVID and Dormant Infections

Because COVID can cause immune system dysfunction, scientists sought to explore an important question: Can COVID reactivate infections? After all, a compromised long COVID immune response could leave an opportunity for previously dormant viral or bacterial infections to re-emerge—especially the IACC’s just mentioned.

There’s a likely connection between COVID and immune system reactivation, evidence suggests. EBV, which causes mononucleosis and other illnesses, appears to be reactivated in some long COVID patients. Indeed, research shows that an increase of EBV antibody levels are present in some individuals with continuing long COVID symptoms.

Additionally, research has found many overlaps between long COVID symptomatology with clinical presentation of chronic fatigue syndrome. Twenty-five out of 29 known chronic fatigue symptoms were noted in one COVID study. However, it is still not exactly clear how COVID impacts chronic illnesses.

3. Autoimmunity

SARS-CoV-2 infection may trigger autoimmune disease. Some patients with long COVID have elevated levels of autoantibodies (malfunctioning immune cells), which are thought to play a role in autoimmune disorders such as rheumatoid arthritis, lupus, or Sjögren’s syndrome, Yale Medicine reports.

Antibodies help to protect against foreign invaders, such as bacteria and viruses. However, autoantibodies can attack the body’s own cells, leading to inflammation and tissue injury.

In some patients with long COVID, antinuclear autoantibodies have been observed up to one year after acute infection. They can target parts of cell nuclei, which may promote inflammation and damage organ systems.

For instance, in the inner lining of blood vessels (the endothelium), these antinuclear autoantibodies can create a hyper-inflammatory state or alterations to blood cells that can lead to inappropriate clotting.

4. Inflammation

Inflammation, or recruiting white blood cells and the release of cytokines that initiate tissue swelling and injury, may also underlie some types of long COVID. The acute phase of COVID infection alters tissue function and unleashes a chronic inflammatory state in cells, specifically cells in the brain that are longer-lived. Inflammation is one of the major chronic illness triggers after COVID.

All of the theories noted above may possibly contribute to the sustained inflammation seen in long COVID cases.

WHAT IS LYME DISEASE?

Lyme disease is a bacterial infection that develops after a person is bit by a tick carrying the infection-causing bacterium, Borrelia burgdorferi. In rare cases, Lyme can develop from another tick-carrying bacterium called Borrelia mayonii.

While cases of Lyme have been reported in all 50 sates in the U.S., the vast majority of Lyme disease is found in the Northeast, mid-Atlantic, and upper-Midwest.

LYME DISEASE SYMPTOMS 

When Lyme disease infection first occurs, the most common symptom is an erythema migrans rash. It appears like a red circle with a bullseye on the skin. Research has found about 70-80% of cases have this rash, which appears at the site of the tick bite.

Over time, other symptoms of Lyme disease may appear. However, some people may not notice any symptoms initially. The CDC notes that any of the following early symptoms of Lyme disease typically appear three to 30 days after the tick bite:

• EM rash
• Headache
• Fatigue
• Fever
• Chills
• Muscle and joint aches
• Swollen lymph nodes

Days or even months after the tick bit, these later symptoms may appear:

• EM rashes that appear on other areas of the body
• Severe headaches and neck stiffness
• Arthritis (particularly in large joints like the knees)
• Pain that comes and goes in the tendons, joints, muscles, and bones
• Facial paralysis or severe weakness of facial muscles
• Heart palpitations or an irregular heartbeat
• Bouts of dizziness or shortness of breath
• Shooting pain, tingling, or numbness in the feet and or hands
• Nerve pain
• Brain and spinal cord inflammation
• Sometimes if an individual receives treatment right away, before the condition develops, they may not experience these later symptoms of Lyme disease.

Lyme disease may also trigger symptoms related to mental health conditions, such as:

• Brain fog
• Anxiety
• Depression
• OCD
• Memory loss

And similar to long COVID, some Lyme patients continue to have ongoing symptoms, which can be severe and debilitating. The CDC calls this phenomenon post-treatment Lyme disease syndrome (PTLD), also known as chronic Lyme disease.

Many researchers and clinicians believe that the persistence of bacteria is the cause of these lingering symptoms. The antigen that triggers the inflammatory responses in chronic Lyme symptoms is found on the outer layer of the bacterial cell wall.

Pieces of these bacterial cell walls can linger in the body—undetected in the neurons or spinal cord, even post infection. This may contribute to the prolonged inflammation that leads to chronic illness.

According to a recent 2024 study in the Journal of Infectious Diseases, prevalence of PTLD varies from 0% to 48%, depending on how chronic Lyme disease is measured and defined. Some advocacy groups settle on a prevalence rate of 30%.

LONG COVID AND LYME DISEASE

COVID symptoms and Lyme disease share similar symptoms, but that’s not all. In a 2022 study, researchers found that chronic Lyme and COVID-19 are linked as having a history of Lyme disease correlated to increased risk of severe COVID-19.

In fact, long COVID and Lyme disease have so many overlapping similar features, research has been conducted to find biomarkers that differentiate between the two conditions.

Unfortunately, without clear biomarkers, the lack of differences between them impedes scientific research, according to some experts. A potential participant in a trial might be sick from long COVID, Lyme, or another infection-associated chronic condition.

At Amen Clinics, brain SPECT imaging and lab work play important roles in helping determine the underlying root cause of symptoms.

At this point, there are currently no FDA-approved treatments for chronic Lyme, or full-scale clinical therapy trials, which is very common among chronic conditions. But there’s hope that with the prevalence of long COVID, new research will reveal therapies that may help treat all of these similar chronic conditions, such as COVID, Lyme, EBV, CFS, and the herpes zoster.

MANAGING POST-COVID LYME SYMPTOMS

Until an effective treatment is found, post-COVID Lyme symptoms can be managed through lifestyle changes. (Of course, an acute Lyme infection requires antibiotics.) Here’s what you can do for chronic Lyme and long COVID symptoms:

• Support from a qualified mental health professional, good sleep hygiene, consuming a brain healthy diet and avoiding alcohol, excess sugar, and refined carbohydrates can all help to support a healthy mood and keep inflammation levels down.
• Additionally, practicing deep breathing or mindfulness practice like yoga, tai chi, or meditation can help keep anxiety levels down, and inflammatory cortisol levels in check.
• Acupuncture, gentle massage, heat, stretching and toning exercises, and water therapy are all good for managing pain.