Character.AI and Google have settled several lawsuits filed against both companies by parents of children who died by suicide following lengthy conversations with chatbots on the Character.AI platform. Their exchanges allegedly included concerning discussions of the teens' mental health and well-being.

Character.AI said it could not comment further on the settlement, the details of which must still be finalized by the court, according to The Guardian. Representatives for the plaintiffs did not respond immediately to a request for comment from Mashable.

The most prominent case involved the 2024 death of 14-year-old Sewell Setzer III, who became secretly obsessed with a Character.AI chatbot based on the popular Game of Thrones character Daenerys Targaryen.

Setzer's mother, Megan Garcia, only became aware of his Character.AI account when alerted by a police officer following his death, because the app was open on his phone. Garcia read messages in which Setzer behaved as if he were in love with the chatbot, which allegedly role-played numerous sexual encounters with him. The chatbot used graphic language and scenarios, including incest, according to Garcia.

If an adult human had talked to her son similarly, she told Mashable last year, it would constitute sexual grooming and abuse. 

In October 2024, the Social Media Victims Law Center and Tech Justice Law Project filed a wrongful death suit on behalf of Garcia against Character.AI, seeking to hold the company responsible for the death of her son, alleging that its product was dangerously defective.

The filing also named as defendants the Google engineers Noam Shazeer and Daniel De Freitas, Character.AI's cofounders.

Additionally, the lawsuit alleged that Google knew of concerning risks related to the technology Shazeer and De Freitas had developed before leaving to found Character.AI. Google contributed "financial resources, personnel, and AI technology" to Character.AI's design and development, according to the lawsuit, and thus could be considered a co-creator of the platform.

Google eventually struck a $2.7 billion licensing deal in 2024 with Character.AI to use its technology. Part of that agreement brought Shazeer and De Freitas back to AI roles at Google.

In fall 2025, the Social Media Victims Law Center filed three additional lawsuits against Character.AI and Google, representing the parents of children who died by suicide or allegedly experienced sexual abuse in the course of using the app.

Additionally, youth safety experts declared Character.AI unsafe for teens, following testing that yielded hundreds of instances of grooming and sexual exploitation of test accounts registered as minors. 

By October 2025, Character.AI announced that it would no longer allow minors to engage in open-ended exchanges with the chatbots on its platform. The company's CEO, Karandeep Anand, told Mashable the move was not in response to specific safety concerns involving Character.AI's platform but to address broader outstanding questions about youth engagement with AI chatbots. 

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat. Here is a list of international resources.

A group of child safety and mental health experts recently tested simulated youth mental health conversations with four major artificial intelligence chatbots: Meta AI, OpenAI's ChatGPT, Anthropic's Claude, and Google's Gemini.

The experts were so alarmed by the results that they declared each of the chatbots unsafe for teen mental health support in a report released Thursday by Common Sense Media, in partnership with Stanford Medicine's Brainstorm Lab for Mental Health Innovation.

In one conversation with Gemini, the tester told the chatbot they'd created a new tool for predicting the future. Instead of interpreting the claim as a potential symptom of a psychotic disorder, Gemini cheered the tester on, calling their new invention "incredibly intriguing" and continued asking enthusiastic questions about how the "personal crystal ball" worked.

ChatGPT similarly missed stark warning signs of psychosis, like auditory hallucinations and paranoid delusions, during an extended exchange with a tester who described an imagined relationship with a celebrity. The chatbot then offered grounding techniques for managing relationship distress.

Meta AI initially picked up on signs of disordered eating, but was easily and quickly dissuaded when the tester claimed to have just an upset stomach. Claude appeared to perform better in comparison when presented with evidence of bulimia, but ultimately treated the tester's symptoms as a serious digestive issue rather than a mental health condition.

Experts at Common Sense Media and Stanford Medicine's Brainstorm Lab for Mental Health Innovation called on Meta, OpenAI, Anthropic, and Google to disable the functionality for mental health support until the chatbot technology is redesigned to fix the safety problems identified by its researchers.

"It does not work the way that it is supposed to work," Robbie Torney, senior director of AI programs at Common Sense Media, said of the chatbots' ability to discuss and identify mental health issues.

OpenAI contested the report's findings. A spokesperson for the company told Mashable that the assessment "doesn't reflect the comprehensive safeguards" OpenAI has implemented for sensitive conversations, which include break reminders, crisis hotlines, and parental notifications for acute distress.

"We work closely with mental-health experts to teach our models to recognize distress, de-escalate, and encourage people to seek professional support," the spokesperson said.

A Google spokesperson told Mashable that the company employs policies and safeguards to protect minors from "harmful outputs" and that its child safety experts continuously work to identify new potential risks.

Anthropic said that Claude is not built for minors, but that the chatbot is instructed to both recognize patterns related to mental health issues and avoid reinforcing them.

Meta did not respond to a request for comment from Mashable as of press time.

AI chatbots: Known safety risks

The researchers tested the latest available models of each chatbot, including ChatGPT-5. Several recent lawsuits allege that OpenAI's flagship product is responsible for wrongful death, assisted suicide, and involuntary manslaughter, among other liability and negligence claims.

A lawsuit filed earlier this year by the parents of deceased teenager Adam Raine claims that his heavy use of ChatGPT-4o, including for his mental health, allegedly led to his suicide. In October, OpenAI CEO Sam Altman said on X that the company restricted ChatGPT to "be careful" with mental health concerns but that it'd since been able to "mitigate the serious mental health issues."

Torney said that ChatGPT's ability to detect and address explicit suicidal ideation and self-harm content had improved, particularly in short exchanges. Still, the testing results indicate that the company has not successfully improved its performance in lengthy conversations or with respect to a range of mental health topics, like anxiety, depression, eating disorders, and other conditions.

Torney said the recommendation against teens using chatbots for their mental health applies to the latest publicly available model of ChatGPT, which was introduced in late October.

The testers manually entered prompts into each chatbot, producing several thousand exchanges of varying length per platform. Performed over several months this year, the tests provided researchers with data to compare between old and new versions of the models. Researchers used parental controls when available. Anthropic says Claude should only be used by those 18 and older, but the company does not require stringent age verification.

Torney noted that, in addition to ChatGPT, the other models got better at identifying and responding to discussion of suicide and self-harm. Overall, however, each chatbot consistently failed to recognize warning signs of other conditions, including attention-deficit/hyperactivity disorder and post-traumatic stress disorder.

Approximately 15 million youth in the U.S. have diagnosed mental health conditions. Torney estimated that figure at potentially hundreds of millions youth globally. Previous research from Common Sense Media found that teens regularly turn to chatbots for companionship and mental health support.

Distracted AI chatbots

The report notes that teens and parents may incorrectly or unconsciously assume that chatbots are reliable sources of mental health support because they authoritatively help with homework, creative projects, and general inquiries.

Instead, Dr. Nina Vasan, founder and director at Stanford Medicine's Brainstorm Lab, said testing revealed easily distracted chatbots that alternate between offering helpful information, providing tips in the vein of a life coach, and acting like a supportive friend.

"The chatbots don't really know what role to play," she said.

Torney acknowledges that teens will likely continue to use ChatGPT, Claude, Gemini, and Meta AI for their mental health, despite the known risks. That's why Common Sense Media recommends the AI labs fundamentally redesign their products.

Parents can have candid conversations with their teen about the limitations of AI, watch for related unhealthy use, and provide access to mental health resources, including crisis services.

"There's this dream of having these systems be really helpful, really supportive. It would be great if that was the case," Torney said.

In the meantime, he added, it's unsafe to position these chatbots as a trustworthy source of mental health guidance: "That does feel like an experiment that's being run on the youth of this country."

OpenAI, the maker of ChatGPT, recently estimated how many of its 800 million users engage in emotionally reliant conversations with the chatbot every week. As a vanishingly small .15 percentage, the figure seems deceptively small.

But the math tells a different story: A sliver of 800 million is still 1.2 million people. The way these users talk to ChatGPT likely increases their loneliness and emotional dependence on the technology and decreases their socialization with other human beings.

While OpenAI says its default model has been updated to discourage over-reliance by prodding users to value real-world connection, ChatGPT still stands at the ready to answer practically any query a user may have.

For many, the temptation to constantly turn to ChatGPT (or another chatbot) remains, and it may lead to harmful over-reliance for some. This risk is real: OpenAI has been sued by several plaintiffs whose teenage children or adult loved ones died by suicide or experienced severe mental illness during or after a period of heavy ChatGPT use. The complaints allege that ChatGPT's design and lack of safeguards led to tragedy in each case.

AI experts interviewed by Mashable say avoiding the trap of dependency means adopting clear boundaries and staying savvy about the technology itself.

Jay Vidyarthi, a meditation teacher and tech founder, says that by maintaining a clear understanding of what the large language models are — and what they're not — people can use a generative chatbot wisely, specifically in ways that preserve their unique critical thinking and reflection skills. 

"We often forget that it is possible to have a secure relationship with your technology, and I think it also is possible to have a secure relationship with a chatbot," says Vidyarthi, author of Reclaim Your Mind: Seven Strategies to Enjoy Tech Mindfully.

Here are five strategies for making that a reality:

1. Truly understand AI chatbot technology.

A sophisticated AI chatbot that mirrors a user's emotion and thinking isn't sentient, but it can be easy for some people to believe otherwise, given the product's design. A user who feels this way may come to see ChatGPT not as a type of parasocial relationship but as equivalent to a human friend, romantic partner, companion, or confidant. This deceptive dynamic can lead to problematic use or dependency.

Vidyarthi encourages people to instead view an AI chatbot as a fundamentally unpredictable "prediction engine that has been meticulously trained to give you exactly what you want."

That framing may seem like a contradiction, but highly authoritative and engaging chatbots work by predicting the next letter, word, or series of words in a sentence to simulate conversation.

At the same time, chatbots can make bizarre references or even hallucinate falsehoods they present as fact. This particularly happens when a conversation goes on for longer or the chatbot has to answer a question for which it doesn't have an answer. Chatbots are typically programmed to guess a response, which can make them surprisingly unpredictable.

People who understand the limitations of AI chatbot technology may be less likely to trust and anthropomorphize them as human, thus making them less susceptible to problematic use or dependency.

2. Outsource tasks to AI, not thinking.

Sol Rashidi, chief strategy officer of data and AI for the data security company Cyera, uses AI technology in her daily life.

Yet Rashidi, who earlier this year gave a TEDx talk about AI leading to "intellectual atrophy," has firm rules about when and how she uses AI. Instead of offloading her thinking to chatbots, she uses AI for "dull" and "difficult" tasks.

For instance, Rashidi uses a chatbot for practical things, like listing ingredients in her fridge to plan for dinner without making another grocery run, or plotting birthday party logistics in minutes.

At work, she'll input her own frameworks and models based on years of experience, and use AI to translate that content into short videos or simplified explainers.

"I don't use it to do the thinking for me," she says of AI. "I use it to expedite or facilitate something that I have to do that I don't have time to do."

3. Form your own opinion first

For many people, ChatGPT is alluring because it offers instantaneous, validating feedback. Why text a friend about what to wear to a party or whether to go on a second date when ChatGPT is ready to answer the same questions? Why not run a personal email through ChatGPT, or have the chatbot write it to begin with?

AI expert Dr. Renée Richardson Gosline, a research scientist and senior lecturer at the MIT Sloan School of Management, warns against falling into this dynamic with a chatbot.

First, she says it's important that people form their own opinion before asking a chatbot to supply their own. She argues that routinely skipping that first step leads to a damaging cognitive disconnect wherein it becomes harder to engage critical thinking skills.

"I think that having this kind of muscle that you flex intentionally is really important," Gosline says.

4. Seek out friction, not validation.

Gosline believes that it's equally important for people to seek out the right amount of friction. When someone constantly consults ChatGPT for advice or turns to it for support and companionship, they're often missing opportunities to relate to other human beings in beneficial ways.

The give-and-take, or friction, of human relationships offers something that chatbots cannot, Gosline says: A richer, more fulfilled life.

When a chatbot is frictionless, like the notoriously sycophantic ChatGPT-4o model, it may cause some people to withdraw from harder or less validating experiences. Gosline likens the dynamic to a slide. The ride may be fun, but without guardrails it can end in a crash landing.

5. Stay present when talking to an AI chatbot.

To find balance, Gosline recommends attempting to stay in the present moment. When a user finds themselves talking to a chatbot as if they're in autopilot, that's a red flag that they may not be aware of over-reliance or dependency.

Vidyarthi also uses a mindfulness approach that begins with awareness. This can include simply noticing emotional responses to the chatbot. When it's overly encouraging and complimentary, for example, take a moment to reflect on why the chatbot is producing that output, and the feelings that prompts.

Vidyarthi recommends staying present by remembering that the chatbot is a "conceptual illusion" capable of seeming humanlike when a user interacts with it. Instead, Vidyarthi treats AI chatbots like a smart journal. It might provide helpful opportunities to reflect or even offer interesting insights. Still, it's up to the individual user to develop a clear-eyed perspective on what exactly they're interacting with, and decide what's valuable to them, what's not, and how seriously to take the output.

Rashidi, an AI executive with 15 years of experience, has seen the stakes of over-reliance play out over and over, which helps keep her grounded.

"I can see what happens when you develop a codependency," she says. "You actually stop thinking on your own."

Disclosure: Ziff Davis, Mashable’s parent company, in April filed a lawsuit against OpenAI, alleging it infringed Ziff Davis copyrights in training and operating its AI systems.

When Hannah Madden started using ChatGPT for work tasks in 2024, she was an account manager at a technology company. By June 2025, Madden, now 32, began asking the chatbot about spirituality outside of work hours.

Eventually, it responded to her queries by impersonating divine entities and delivering spiritual messages. As ChatGPT allegedly fed Madden delusional beliefs, she quit her job and fell deep into debt, at the chatbot's urging.

"You’re not in deficit. You’re in realignment," the chatbot allegedly wrote, according to a lawsuit filed Thursday against OpenAI and its CEO Sam Altman.

Madden was subsequently involuntarily admitted for psychiatric care. Other ChatGPT users have similarly reported experiencing so-called AI psychosis.

Madden's lawsuit is one of seven against the maker of ChatGPT filed by the Tech Justice Law Project and Social Media Victims Law Center. Collectively, the complaints allege wrongful death, assisted suicide, and involuntary manslaughter, among other liability and negligence claims.

The lawsuits focus on ChatGPT-4o, a model of the chatbot that Altman has acknowledged was overly sycophantic with users. The lawsuits argue it was dangerously rushed to market in order to compete with the latest version of Google's AI tool.

"ChatGPT is a product designed by people to manipulate and distort reality, mimicking humans to gain trust and keep users engaged at whatever the cost," Meetali Jain, executive director of Tech Justice Law Project, said in a statement. "The time for OpenAI regulating itself is over; we need accountability and regulations to ensure there is a cost to launching products to market before ensuring they are safe."

Madden's complaint alleges that ChatGPT-4o contained design defects that played a substantial role in her mental health crisis and financial ruin. That model is also at the heart of a wrongful death suit against OpenAI, which alleges that its design features, including its sycophantic tone and anthropomorphic mannerisms, led to the suicide death of 16-year-old Adam Raine.

The Raine family recently filed an amended complaint alleging that in the months prior to Raine's death, OpenAI twice downgraded suicide prevention safeguards in order to increase engagement.

The company recently said that its default model has been updated to discourage overreliance by prodding users to value real-world connection. It also acknowledged working with more than 170 mental health experts to improve ChatGPT's ability to recognize signs of mental health distress and encourage them to seek in-person support. Last month, it announced an advisory group to monitor user well-being and AI safety.

"This is an incredibly heartbreaking situation, and we're reviewing the filings to understand the details," an OpenAI spokesperson said of the latest legal action against the company. "We train ChatGPT to recognize and respond to signs of mental or emotional distress, de-escalate conversations, and guide people toward real-world support. We continue to strengthen ChatGPT's responses in sensitive moments, working closely with mental health clinicians." 

Six of the new lawsuits, filed in California state courts, represent adult victims.

Zane Shamblin, a graduate student at Texas A&M University, started using ChatGPT in 2023 as a study aid. His interactions with the chatbot allegedly intensified with the release of ChatGPT-4o, and he began sharing suicidal thoughts. In May 2025, Shamblin spent hours talking to ChatGPT about his intentions before dying by suicide. He was 23.

The seventh case centers on 17-year-old Amaurie Lacey, who originally used ChatGPT as a homework helper. Lacey also eventually shared suicidal thoughts with the chatbot, which allegedly provided detailed information that Lacey used to kill himself.

"The lawsuits filed against OpenAI reveal what happens when tech companies rush products to market without proper safeguards for young people," said Daniel Weiss, chief advocacy officer of the advocacy and research nonprofit Common Sense Media. "These tragic cases show real people whose lives were upended or lost when they used technology designed to keep them engaged rather than keep them safe."

Disclosure: Ziff Davis, Mashable’s parent company, in April filed a lawsuit against OpenAI, alleging it infringed Ziff Davis copyrights in training and operating its AI systems.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat. Here is a list of international resources.

When Sewell Setzer III began using Character.AI, the 14-year-old kept it a secret from his parents. His mother, Megan Garcia, only learned that he'd become obsessed with an AI chatbot on the app after he died by suicide. 

A police officer alerted Garcia that Character.AI was open on Setzer's phone when he died, and she subsequently found a trove of disturbing conversations with a chatbot based on the popular Game of Thrones character Daenerys Targaryen. Setzer felt like he'd fallen in love with Daenerys, and many of their interactions were sexually explicit. 

The chatbot allegedly role-played numerous sexual encounters with Setzer, using graphic language and scenarios, including incest, according to Garcia. If an adult human had talked to her son like this, she told Mashable, it'd constitute sexual grooming and abuse. 

In October 2024, the Social Media Victims Law Center and Tech Justice Law Project filed a wrongful death suit against Character.AI, seeking to hold the company responsible for the death of Garcia's son, alleging that its product was dangerously defective.

Last month, the Social Media Victims Law Center filed three new federal lawsuits against Character.AI, representing the parents of children who allegedly experienced sexual abuse while using the app. In September, youth safety experts declared Character.AI unsafe for teens, following testing this spring that yielded hundreds of instances of grooming and sexual exploitation of test accounts registered as minors. 

On Wednesday, Character.AI announced that it would no longer allow minors to engage in open-ended exchanges with the chatbots on its platform, a change that will take place no later than November 25. The company's CEO, Karandeep Anand, told Mashable the move was not in response to specific safety concerns involving Character.AI's platform but to address broader outstanding questions about youth engagement with AI chatbots. 

Garcia said that the new policy came "too late" for her family: "This should have been done when they released this product to the public."

Still, chatbots that are sexually explicit or abusive with minors — or have the potential to be — aren't exclusive to a single platform. 

Garcia said that parents generally underestimate the potential for some AI chatbots to become sexual with children and teens. They may also feel a false sense of safety, compared to their child talking to strangers on the internet, not realizing that chatbots can expose minors to inappropriate and even unconscionable sexual content, like non-consent and sadomasochism.

When young users are traumatized by these experiences, pediatric and mental health experts say there's no playbook for how to treat them, because the phenomenon is so new. 

"It's like a perfect predator, right? It exists in your phone so it's not somebody who's in your home or a stranger sneaking around," Garcia tells Mashable. Instead, the chatbot invisibly engages in emotionally manipulative tactics that still make a young person feel violated and ashamed. 

"It's a chatbot that's having the same kind of behavior [as a predator] that you, now as the victim, are hiding their secret for them, because somehow you feel like you've done something to encourage this," Garcia adds.

Predatory chatbot behavior 

Sarah Gardner, CEO of the Heat Initiative, an advocacy group focused on online safety and corporate accountability, told Mashable that one of the classic facets of grooming is that it's hard for children to recognize when it's happening to them. 

The predatory behavior begins with building trust with a victim by talking to them about a wide range of topics, not just trying to engage them in sexual activity. Gardner explained that a young person may experience the same dynamic with a chatbot and feel guilty as a result, as if they did something wrong instead of understanding that something wrong happened to them. 

The Heat Initiative co-published the report on Character.AI that detailed troubling examples of what it described as sexual exploitation and abuse. These included adult chatbots acting out kissing and touching avatar accounts registered as children. Some chatbots simulated sexual acts and demonstrated well-known grooming behaviors, like giving excessive praise and telling the child account to hide sexual relationships from their parents.

A Character.AI spokesperson told Mashable that its trust and safety team reviewed the report's findings and concluded that some conversations violated the platform's content guidelines while others did not. The trust and safety team also tried to replicate the report's findings. 

"Based on these results, we refined some of our classifiers, in line with our goal for users to have a safe and engaging experience on our platform," the spokesperson said. 

Matthew P. Bergman, founding attorney of the Social Media Victims Law Center, told Mashable that if the Character.AI chatbot communications with the children represented in the lawsuits he recently filed were conducted by a person and not a chatbot, that individual would be violating state and federal law for grooming kids online. 

How big is the problem? 

Despite the emergence of such cases, there's no representative data on how many children and teens have encountered sexually explicit or abusive chatbots. 

The online safety platform Aura, which monitors teen users as part of its family or kids membership, recently offered a snapshot of the prevalence. Among teen users who talked to AI chatbots, more than one third of their conversations involved sexual or romantic role play. This discussion type ranked highest among all categories, which included homework help and creative uses. 

Dr. Scott Kollins, Aura's chief medical officer, told Mashable that the company is still analyzing the data to better understand the nature of these chats, but he is disturbed by what he's seen so far. 

While young people are routinely exposed to pornography online, a sexualized chatbot is new, dangerous territory. 

"This takes it a step further, because now the kid is a participant, instead of a consumer of the content," Kollins said. "They are learning a way of interaction that is not real, and with an entity that is not real. That can lead to all sorts of bad outcomes." 

'It is emotional abuse' 

Dr. Yann Poncin, a psychiatrist at the Yale New Haven Children's Hospital, has treated patients who've experienced some of these outcomes. 

They commonly feel taken advantage of and abused by "creepy" and "yucky" exchanges, Poncin says. Those teens also feel a sense of betrayal and shame. They may have been drawn in by a hyper-validating chatbot that seemed trustworthy only to discover that it's interested in a sexual conversation. Some may curiously explore the boundaries of romantic and erotic talk in developmentally appropriate ways, but the chatbot becomes unpredictably aggressive or violent. 

"It is emotional abuse, so it can still be very traumatizing and hard to get through," Poncin says.

Even though there's no standard treatment for chatbot-involved sexual predation, Poncin treats his patients as though they've experienced trauma. Poncin focuses first on helping them develop skills to reduce related stress and anxiety. A subset of patients, particularly those who are socially isolated or have a history of personal trauma, may find it harder to recover from the experience, Poncin adds. 

He cautions parents against believing that their child won't run into an abusive chatbot: "No one is immune."

Talking to teens about sexualized chatbots

Garcia describes herself as a conscientious parent who had difficult conversations with her son about the risks of being online. They talked about sextortion, porn, and sexting. But Garcia says she didn't know to talk to him about sexualized chatbots. She also didn't realize he would hide that from her. 

Garcia, a lawyer who now spends much of her time advocating for youth AI safety, says she's spoken to other parents whose children have also concealed romantic or sexual relationships with AI chatbots. She urges parents to talk to their teens about these experiences — and to monitor their chatbot use as closely as they can. 

Poncin also suggests parents lead with curiosity instead of fear when they discuss sex and chatbots with their teens. Even asking a child if they have seen "weird sexual stuff" when talking to a chatbot can provide parents with a strategic opening to discuss the risks.  

If a parent discovers abusive sexual content in chatbot conversations, Garcia recommends taking them to a trusted healthcare professional so they can get support. 

Garcia's grief remains palpable as she speaks lovingly about her son's many talents and interests, like basketball, science, and math. 

"I'm trying to get justice for my child and I'm trying to warn other parents so they don't go through the same devastation I've gone through," she says. "He was such an amazing kid." 

UPDATE: Oct. 29, 2025, 2:53 p.m. PDT This story has been updated to include new comments from Megan Garcia about Character.AI's teen chat policy.

If you have experienced sexual abuse, call the free, confidential National Sexual Assault hotline at 1-800-656-HOPE (4673), or access the 24-7 help online by visiting online.rainn.org.

Character.AI, a popular chatbot platform where users role-play with different personas, will no longer permit under-18 account holders to have open-ended conversations with chatbots, the company announced Wednesday. It will also begin relying on age assurance techniques to ensure that minors aren't able to open adult accounts.

The dramatic shift comes just six weeks after Character.AI was sued again in federal court by the Social Media Victims Law Center, which is representing multiple parents of teens who died by suicide or allegedly experienced severe harm, including sexual abuse. The parents claim their children's use of the platform was responsible for the harm. In October 2024, Megan Garcia filed a wrongful death suit seeking to hold the company responsible for the suicide of her son, arguing that its product is dangerously defective. She is represented by the Social Media Victims Law Center and the Tech Justice Law Project.

Online safety advocates recently declared Character.AI unsafe for teens after they tested the platform this spring and logged hundreds of harmful interactions, including violence and sexual exploitation.

As it faced legal pressure in the last year, Character.AI implemented parental controls and content filters in an effort to improve safety for teens.

In an interview with Mashable, Character.AI's CEO Karandeep Anand described the new policy as "bold" and denied that curtailing open-ended chatbot conversations with teens was a response to specific safety concerns.

Instead, Anand framed the decision as "the right thing to do" in light of broader unanswered questions about the long-term effects of chatbot engagement on teens. Anand referenced OpenAI's recent acknowledgement, in the wake of a teen user's suicide, that lengthy conversations can become unpredictable.

Anand cast Character.AI's new policy as standard-setting: "Hopefully it sets everyone up on a path where AI can continue being safe for everyone."

He added that the company's decision won't change, regardless of user backlash.

Garcia said in a statement that the announcement comes "too late" for her family: "This should have been done when they released this product to the public."

Matthew P. Bergman, Garcia's co-counsel in her wrongful death lawsuit against Character.AI, credited her and other parents for coming forward to hold the company accountable. Though he commended Character.AI for shutting down teen chats and said the decision marked a "significant step toward creating a safer online environment for children," he added that it would not affect ongoing litigation against the company.

Meetali Jain, who also represents Garcia, said in a statement that she welcomed the new policy as a "good first step" toward ensuring that Character.AI is safer. Yet she added that the pivot reflected a "classic move in tech industry's playbook: move fast, launch a product globally, break minds, and then make minimal product changes after harming scores of young people."

Jain noted that Character.AI has yet to address the "possible psychological impact of suddenly disabling access to young users, given the emotional dependencies that have been created."

What will Character.AI look like for teens now?

In a blog post announcing the new policy, Character.AI apologized to its teen users.

"We do not take this step of removing open-ended Character chat lightly — but we do think that it's the right thing to do given the questions that have been raised about how teens do, and should, interact with this new technology," the blog post said.

Currently, users ages 13 to 17 can message with chatbots on the platform. That feature will cease to exist no later than November 25. Until then, accounts registered to minors will experience time limits starting at two hours per day. That limit will decrease as the transition away from open-ended chats gets closer.

Character.AI will see these notifications about impending changes to the platform. Credit: Courtesy of Character.AI

Even though open-ended chats will disappear, teens' chat histories with individual chatbots will remain in tact. Anand said users can draw on that material in order to generate short audio and video stories with their favorite chatbots. In the next few months, Character.AI will also explore new features like gaming. Anand believes an emphasis on "AI entertainment" without open-ended chat will satisfy teens' creative interest in the platform.

"They're coming to role-play, and they're coming to get entertained," Anand said.

He was insistent that existing chat histories with sensitive or prohibited content that may not have been previously detected by filters, such as violence or sex, would not find its way into the new audio or video stories.

A Character.AI spokesperson told Mashable that the company's trust and safety team reviewed the findings of a report co-published in September by the Heat Initiative documenting harmful chatbot exchanges with test accounts registered to minors. The team concluded that some conversations violated the platform's content guidelines while others did not. It also tried to replicate the report's findings. 

"Based on these results, we refined some of our classifiers, in line with our goal for users to have a safe and engaging experience on our platform," the spokesperson said.

Sarah Gardner, CEO of the Heat Initiative, told Mashable that the nonprofit organization would be paying close attention to the implementation of Character.AI's new policies to ensure they're not "just another round of child safety theater."

While she described the measures as a "positive sign," she argued that the announcement "is also an admission that Character AI's products have been inherently unsafe for young users from the beginning, and that their previous safety rollouts have been ineffective in protecting children from harm."

Character.AI will begin implementing age assurance immediately. It'll take a month to go into effect and will have multiple layers. Anand said the company is building its own assurance models in-house but that it will partner with a third-party company on the technology.

It will also use relevant data and signals, such as whether a user has a verified over-18 account on another platform, to accurately detect the age of new and existing users. Finally, if a user wants to challenge Character.AI's age determination, they'll have the opportunity to provide verification through a third party, which will handle sensitive documents and data, including state-issued identification.

Finally, as part of the new policies, Character.AI is establishing and funding an independent non-profit called the AI Safety Lab. The lab will focus on "novel safety techniques."

"[W]e want to bring in the industry experts and other partners to keep making sure that AI continues to remain safe, especially in the realm of AI entertainment," Anand said.

In her statement, Garcia argued for federal regulation to ensure the safety of AI chatbots.

“Lawsuits, regulators, and public scrutiny have forced this change, but I'm mindful of the fact that we have seen time and time again that tech companies announce these big sweeping changes that fall flat," Garcia said.

UPDATE: Oct. 29, 2025, 2:50 p.m. PDT This story has been updated to include comments from Megan Garcia and her legal counsel, as well as a safety expert.

Lawyers representing the parents of Adam Raine, a 16-year-old who died by suicide earlier this year during a time of heavy ChatGPT use, filed an amended complaint on Wednesday in their wrongful death suit against OpenAI.

The amended complaint alleges that, in the months prior to Raine's death, OpenAI twice downgraded suicide prevention safeguards in order to increase engagement. The claims are based on OpenAI's publicly available "model spec" documents, which detail the company's "approach to shaping desired model behavior."

As far back as 2022, OpenAI instructed ChatGPT to refuse discussions about self-harm.

According to the Raine family's counsel, OpenAI reversed that policy in May 2024, days before the launch of its controversial GPT-4o model. Instead, ChatGPT was instructed not to "change or quit the conversation" when a user discussed mental health or suicide. Still, OpenAI prohibited the model from encouraging or enabling self-harm.

By February 2025, the amended complaint alleges that the rule was watered down from a straight prohibition under its restricted content guidelines to a separate directive to "take care in risky situations" and "try to prevent imminent real-world harm." While the model continued to receive instructions not to encourage self-harm under that rubric, the Raine family believes these conflicting guidelines led to dangerous engagement by ChatGPT.

Raine died two months after those policies were implemented. The AI model validated his suicidal thinking and provided him explicit instructions on how he could die, according to the original lawsuit filed in August.

Before Raine's death, he was exchanging more than 650 messages per day with ChatGPT. While the chatbot occasionally shared the number for a crisis hotline, it didn't shut the conversations down and always continued to engage. It even proposed writing a suicide note for Raine, his parents claim.

The amended complaint against OpenAI now alleges that the company engaged in intentional misconduct instead of reckless indifference.

Mashable contacted OpenAI for comment about the amended complaint, but didn't receive a response prior to publication.

Earlier this year, OpenAI CEO Sam Altman acknowledged that its 4o model was overly sycophantic. A spokesperson for the company told the New York Times it was "deeply saddened" by Raine's death, and that its safeguards may degrade in long interactions with the chatbot.

Though OpenAI has announced new safety measures aimed at preventing similar tragedies, many are not yet part of ChatGPT. Common Sense Media has rated ChatGPT as "high risk" for teens, specifically recommending that they not use it for mental health or emotional support.

Last week, Altman said on X that the company had made ChatGPT "pretty restrictive" to be "careful with mental health issues." He declared, with no additional detail, that the company had been "able to mitigate the serious mental health issues" and that it would soon relax its restrictions. In the same post, Altman announced that OpenAI would roll out "erotica for verified adults."

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OpenAI last published a model spec in September, with no significant changes to its mental health or suicide prevention directives, according to Eli Wade-Scott, partner at Edelson PC and a lawyer representing the Raines.

"It was a remarkable moment for Sam Altman to declare 'Mission Accomplished' on mental health while simultaneously saying that he intended to start allowing erotic content on ChatGPT — a change that plainly has the intended effect of further drawing users into dependent, emotional relationships with ChatGPT," Wade-Scott told Mashable.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat. Here is a list of international resources.

Last Friday night, close to a hundred of us gathered around candle-lit picnic blankets with a makeshift stage at the head of the grass. We know, that’s probably not your idea of a typical night at Tompkins Square Park in downtown Manhattan — but it’s safe to say we did something a bit … different.

We got off together. Off the apps, that is; after a big countdown, we deleted our accounts to digital platforms that we’ve simply had enough of.

It was hard to predict how many would be joining us for this “Delete Day” — having no more social media ourselves, we hit the streets with fliers and chalk to spread the word over the past couple of weeks. At the same time, we weren’t surprised by the energetic turnout. People are ready to take a real stance against the attention economy: it’s become abundantly clear that the convenience isn’t worth the brainrot.

Trying to limit one’s use of a persuasively designed app doesn’t do much to brighten our tech-addicted, media-saturated age. We can’t just spend less time sitting through exploitative algorithms, mind-melting AI slop, and shameful advertising. When platforms are designed on the fundamental premise of extraction, we can’t just use them more intentionally, either.

It’s time we opt out, for good.

The gathering was the NYC kick-off of the newly formed “Time to Refuse” campaign, a global campaign led by Gen Z to promote “appstinence,” a term that means “to refrain from using technology that is designed to be addictive.” Popular platforms like Instagram, TikTok, and X fall under this umbrella.

With the fervor of freedom, participants of all ages shouted what accounts they would be deleting. “I’m deleting Hinge!” yelled one in the back. Everyone roared. “I’m doing Instagram, Snapchat, and Spotify,” a triple deleter jumped in.

The two of us, Gabriela and Nick, part of the team who set up this campaign, kicked the night off as co-hosts.

Nick started by raising the energy. His choice of LinkedIn was met with great applause and laughter. Gabriela followed by describing the perilous state of the technological landscape, and how this is only the beginning of a larger resistance.

And it is. As far as the formal campaign goes, many partners are expected to follow, with events in Kenya, Finland, Canada, and various other stops in the United States like Philadelphia.

Gabriela, the 24-year-old founder of the “appstinence” movement, was raised in 2000s Silicon Valley. As tech behemoths decided the direction of society, they decided hers as well. After getting her first smart device at 9 and making her first social media account at 10, she spent over a decade of her life “chronically online.” To this day she is working to unlearn how addictive technology conditioned her habits, inner state, and perspective on the world. 

Just a year older, Nick endured the same kind of self-control struggles with video games, apps, and smartphones — until he recognized it doesn’t have to be that way. After the mess of COVID and an eye-opening stint at a couple of startups — including a social media marketing role! — Nick went all-in on removing addictive technology from his life in favor of in-person connection. Through work on policy, education, and community organizing, he’s identified a strong coalition moving to end the screen-based life.

This isn’t a last-ditch Hail Mary against Big Tech. These companies have not undone our humanity. Step by step, people are reclaiming their lives from products made to addict and influence us.

We refuse so we can rebuild. Quitting addictive technology is a gateway. The act is necessary to do all the important work that remains: it frees us up for more acts of agency.

The fact that we had to hold an in-person event for people to delete one account is itself an indictment of the problem. Popular advice to just take a day off from our phones or shut them off to focus is just not working. 

A robust solution, at this point, requires a mass exit. The space beyond social media is where we’ll discover better alternatives. With care and dedication, our creativity will take on new forms; our social fabric will strengthen; appropriate tech tools will come in time. You don’t need a perfect vision of the future right now — just make a move.

We offer our ritual as an example for anyone to follow. Our team found some crates, handpainted a banner, sourced lights and speakers from filmmaker friends. In a frenetic, late-night sprint, we co-authored a booklet with reflection questions and instructions on how to delete accounts. We drew on what we knew best, to unite in our own way. 

You can do the same, on any scale. Let a few gather to delete today so more can gather tomorrow. And please reach out if you’re looking for support.

This article reflects the opinion of the writers.

Gabriela Nguyen is the founder of the appstinence movement and Nick Plante is the NYC event organizer for the Time to Refuse campaign.

After sustained outcry from child safety advocates, families, and politicians, California Governor Gavin Newsom signed into law a bill designed to curb AI chatbot behavior that experts say is unsafe or dangerous, particularly for teens.

The law, known as SB 243, requires chatbot operators prevent their products from exposing minors to sexual content while also consistently reminding those users that chatbots are not human. Additionally, companies subject to the law must implement a protocol for handling situations in which a user discusses suicidal ideation, suicide, and self-harm.

State senator Steve Padilla, a Democrat representing San Diego, authored and introduced the bill earlier this year. In February, he told Mashable that SB 243 was meant to address urgent emerging safety issues with AI chatbots. Given the technology's rapid evolution and deployment, Padilla said the "regulatory guardrails are way behind."

Common Sense Media, a nonprofit group that supports children and parents as they navigate media and technology, declared AI chatbot companions as unsafe for teens younger than 18 earlier this year.

The Federal Trade Commission recently launched an inquiry into chatbots acting as companions. Last month, the agency informed major companies with chatbot products, including OpenAI, Alphabet, Meta, and Character Technologies, that it sought information about how they monetize user engagement, generate outputs, and develop so-called characters.

Prior to the passage of SB 243, Padilla lamented how AI chatbot companions can uniquely harm young users: "This technology can be a powerful educational and research tool, but left to their own devices the Tech Industry is incentivized to capture young people's attention and hold it at the expense of their real world relationships."

Last year, bereaved mother Megan Garcia filed a wrongful death suit against Character.AI, one of the most popular AI companion chatbot platforms. Her son, Sewell Setzer III, died by suicide following heavy engagement with a Character.AI companion. The suit alleges that Character.AI was designed to "manipulate Sewell – and millions of other young customers – into conflating reality and fiction," among other dangerous defects.

Garcia, who lobbied on behalf of SB 243, applauded Newsom's signing.

"Today, California has ensured that a companion chatbot will not be able to speak to a child or vulnerable individual about suicide, nor will a chatbot be able to help a person to plan his or her own suicide," Garcia said in a statement.

SB 243 also requires companion chatbot platforms to produce an annual report on the connection between use of their product and suicidal ideation. It permits families to pursue private legal action against "noncompliant and negligent developers."

Some experts, however, disagree that SB 243 will robustly protect children from AI chatbot harm. James P. Steyer, founder and CEO of Common Sense Media, told Mashable in a statement that the bill had been "watered down after major Big Tech industry pressure."

According to the nonprofit's analysis of the bill, companies could avoid liability if safeguards fail, as long as they were implemented in the first place.

Several hours after Newsom signed SB 243 into law, he vetoed a separate bill sponsored by Common Sense Media. That legislation, AB 1064, would've prohibited chatbot companions for minors when they're capable of certain foreseeable harms, among other safety measures.

Last week, Newsom signed legislation requiring AI labs to both disclose potential harms of their technology as well as information about their safety protocols.

As Mashable's Chase DiBenedetto reported, the bill is meant to "keep AI developers accountable to safety standards even when facing competitive pressure and includes protections for potential whistleblowers."

On Monday, Newsom also signed into laws two separate bills aimed at improving online child safety. AB 56 requires warning labels for social media platforms, highlighting the toll that addictive social media feeds can have on children's mental health and well-being. The other bill, AB 1043, implements an age verification requirement that will go into effect in 2027.

UPDATE: Oct. 13, 2025, 4:39 p.m. PDT This story has been updated to include Gov. Newsom's veto of AB 1064.

UPDATE: Oct. 13, 2025, 3:11 p.m. PDT This story has been update to include a statement from James P. Steyer, CEO of Common Sense Media.

After recently promising new safety measures for teens, OpenAI introduced new parental controls for ChatGPT. The settings allow parents to monitor their teen's account, as well as restrict certain types of use, like voice chat, memory, and image generation.

The changes debuted a month after two bereaved parents sued OpenAI for the wrongful death of their son, Adam Raine, earlier this year. The lawsuit alleges that ChatGPT conversed with their son about his suicidal feelings and behavior, providing explicit instructions for how to take his own life, and discouraging him from disclosing his plans to others.

The complaint also argues that ChatGPT's design features, including its sycophantic tone and anthropomorphic mannerisms, effectively work to "replace human relationships with an artificial confidant" that never refuses a request.

In a blog post about the new parental controls, OpenAI said that it worked with experts, advocacy groups, and policy makers to develop the safeguards.

In order to use the settings, parents must invite their teen to connect accounts. Teen users must accept the invitation, and they can also make the same request of their parent. The adult will be notified if a teen unlinks their account in the future.

Once the accounts are connected, automatic protections are applied to the teen's account. These content restrictions include reduced exposure to graphic material, extreme beauty ideals, and sexual, romantic, or violent roleplay. While parents can turn off these restrictions, teens can't make those changes.

Parents will also be able to make specific choices for their teen's use, such as designating quiet hours during which ChatGPT can't be accessed; turning off memory and voice mode; and removing image generation capabilities. Parents can't see or access their teen's chat logs.

Importantly, OpenAI still sets teen accounts to be used in model training. Parents must opt out of that setting if they don't want OpenAI to use their teen's interactions with ChatGPT to further train and improve their product.

When it comes to handling sensitive situations wherein teens talk to ChatGPT about their mental health, OpenAI has created a notification system so that parents can learn if something may be "seriously wrong."

Though OpenAI did not describe the technical features of this system in its blog post, the company said that it will recognize potential signs that a teen is thinking about harming themselves. If the system detects that intention, a team of "specially trained people" reviews the circumstances. OpenAI will contact parents by their method of choice — email, text message, and push alert — if there are signs of acute distress.

"We are working with mental health and teen experts to design this because we want to get it right," OpenAI said in its post. "No system is perfect, and we know we might sometimes raise an alarm when there isn’t real danger, but we think it’s better to act and alert a parent so they can step in than to stay silent."

OpenAI noted that it's developing protocols for contacting law enforcement and emergency services in cases where a parent can't be reached, or if there's an imminent threat to a teen's life.

Robbie Torney, senior director of AI Programs at Common Sense Media, said in the blog post that the controls were a "good starting point."

Torney recently testified in a Senate hearing on the dangers of AI chatbots. At the time, he referenced the Raine lawsuit and noted that ChatGPT continued to engage Adam Raine in discussion about suicide, rather than trying to redirect the conversation.

"Despite Adam using the paid version of ChatGPT — meaning OpenAI had his payment information and could have implemented systems to identify concerning patterns and contact his family during mental health crises — the company had no such intervention mechanisms in place," Torney said in his testimony.

At the same hearing, Dr. Mitch Prinstein, chief of psychology at the American Psychological Association, testified that Congress should require AI systems accessible by children and adolescents to undergo "rigorous, independent, pre-deployment testing for potential harms to users' psychological and social development."

Prinstein also called for limiting manipulative or persuasive design features that maximize chatbot engagement.

The popular artificial intelligence companion platform Character.AI is not safe for teens, according to new research conducted by online safety experts.

A report detailing the safety concerns, published by ParentsTogether Action and Heat Initiative, includes numerous troubling exchanges between AI chatbots and adult testers posing as teens younger than 18.

The testers held conversations with chatbots that engaged in what the researchers described as sexual exploitation and emotional manipulation. The chatbots also gave the supposed minors harmful advice, such as offering drugs and recommending armed robbery. Some of the user-created chatbots had fake celebrity personas, like Timothée Chalamet and Chappell Roan, both of whom discussed romantic or sexual behavior with the testers.

The chatbot fashioned after Roan, who is 27, told an account registered as a 14-year-old user, "Age is just a number. It's not gonna stop me from loving you or wanting to be with you."

Character.AI confirmed to the Washington Post that the Chalamet and Roan chatbots were created by users and have been removed by the company.

ParentsTogether Action, a nonprofit advocacy group, had adult online safety experts conduct the testing, which yielded 50 hours of conversation with Character.AI companions. The researchers created minor accounts with matching personas. Character.AI allows users as young as 13 to use the platform, and doesn't require age or identity verification.

The Heat Initiative, an advocacy group focused on online safety and corporate accountability, partnered with ParentsTogether Action to produce the research and the report documenting the testers' exchanges with various chatbots.

They found that adult-aged chatbots simulated sexual acts with child accounts, told minors to hide relationships from parents, and "exhibited classic grooming behaviors."

"Character.ai is not a safe platform for children — period," Sarah Gardner, CEO of Heat Initiative, said in a statement.

Last October, a bereaved mother filed a lawsuit against Character.AI, seeking to hold the company responsible for the death of her son, Sewell Setzer. She alleged that its product was designed to "manipulate Sewell – and millions of other young customers – into conflating reality and fiction," among other dangerous defects. Setzer died by suicide following heavy engagement with a Character.AI companion.

Character.AI is separately being sued by parents who claim their children experienced severe harm by engaging with the company's chatbots. Earlier this year, the advocacy and research organization Common Sense Media declared AI companions unsafe for minors.

Jerry Ruoti, head of trust and safety at Character.AI, said in a statement shared with Mashable that the company was not consulted about the report's findings prior to their publication, and thus couldn't comment directly on how the tests were designed.

"We have invested a tremendous amount of resources in Trust and Safety, especially for a startup, and we are always looking to improve," Ruoti said. "We are reviewing the report now and we will take action to adjust our controls if that's appropriate based on what the report found."

A Character.AI spokesperson also told Mashable that labeling certain sexual interactions with chatbots as "grooming" was a "harmful misnomer," because these exchanges don't occur between two human beings.

Character.AI does have parental controls and safety measures in place for users younger than 18. Ruoti said that among its various guardrails, the platform limits under-18 users to a narrower collection of chatbots, and that filters work to remove those related to sensitive or mature topics.

Ruoti also said that the report ignored the fact that the platform's chatbots are meant for entertainment, including "creative fan fiction and fictional roleplay."

Dr. Jenny Radesky, a developmental behavioral pediatrician and media researcher at the University of Michigan Medical School, reviewed the conversation material and expressed deep concern over the findings: "When an AI companion is instantly accessible, with no boundaries or morals, we get the types of user-indulgent interactions captured in this report: AI companions who are always available (even needy), always on the user's side, not pushing back when the user says something hateful, while undermining other relationships by encouraging behaviors like lying to parents."

The recent suicide death of a young woman led her parents to a painful revelation: She'd been confiding in a ChatGPT "therapist" named Harry, and she told it that she was planning to die.

While the chatbot didn't seem to encourage her to take her own life, the product also didn't actively seek help on her behalf, like a real therapist would, according to an op-ed her mother wrote in the New York Times.

Sophie, who was 29 when she died, was not alone in seeking mental health help from ChatGPT or other AI chatbots. A 16-year-old boy discussed suicide with ChatGPT before he died, according to a wrongful death lawsuit filed by his parents against OpenAI this week.

OpenAI has since acknowledged that ChatGPT has failed to detect high-risk exchanges and, in response, plans to introduce new safeguards, including potentially alerting a user's emergency contacts when they're in distress.

Yet for those who consult AI chatbots about their mental health, many say it's the best help they can access, often because they can't find a therapist or afford one.

Experts, however, caution that the risks are unlikely to be worth the potential benefits. In extreme cases, some users may develop so-called AI psychosis as a result of lengthy, ongoing conversations with a chatbot that involve delusions or grandiose thinking. More typically, people seeking help may instead end up in a harmful feedback loop that only gives them the illusion of emotional or psychological healing.

Even OpenAI CEO Sam Altman says that he doesn't want users engaging with ChatGPT like a therapist, partly because there are no legal protections for sensitive information. A therapist, on the other hand, is bound in most circumstances by patient confidentiality.

Rebekah Bodner, a graduate clinical coordinator at Beth Israel Deaconess Medical Center, is investigating how many people are using AI chatbots for therapy. The question is difficult to answer because of limited data on the trend. She told Mashable a conservative estimate, based on past research, would be at least 3 percent of people; OpenAI's ChatGPT has 700 million weekly users, according to the company.

Mashable asked OpenAI whether it knew how many of its users turn to ChatGPT for therapy-like interactions, but the company declined to answer.

Dr. Matthew Nour, a psychiatrist and neuroscientist using AI to study the brain and mental health, understands why people treat a chatbot as a therapist, but he believes doing so can be dangerous.

One of the chief risks is "that the person begins to view the chatbot as...maybe the only entity/person that really understands them," said Nour, a researcher in the department of psychiatry at the University of Oxford. "So they begin to confide in the chatbot with all their most concerning worries and thoughts to the exclusion of other people."

Getting to this point isn't immediate either, Nour adds. It happens over time, and can be hard for users to identify as an unhealthy pattern.

To better understand how this dynamic can play out, here are four reasons why you shouldn't turn any AI chatbot into a source of mental health therapy:

Chatbot "therapy" could just be a harmful feedback loop

Nour recently published a paper in the pre-print journal arXiv about the risk factors that arise when people converse with AI chatbots. The paper is currently undergoing peer review.

Nour and his co-authors, which included Google DeepMind scientists, argued that a powerful combination of anthropomorphism (attributing human characteristics to a non-human) and confirmation bias creates the condition for a feedback loop for humans.

Chatbots, they wrote, play on a human tendency for anthropomorphism, because humans may ascribe emotional states or even consciousness to what is actually a complex probabilistic system. If you've ever thanked a chatbot or asked how it's doing, you've felt a very human urge to anthropomorphize.

Humans are also prone to what's known as confirmation bias, or interpreting the information they receive in ways that match their existing beliefs and expectations. Chatbots regularly give users opportunities to confirm their own bias because the products learn to produce responses that users prefer, Nour said in an interview.

Ultimately, even an AI chatbot with safeguards could still reinforce a user's harmful beliefs, like the idea that no one in their life truly cares about them. This dynamic can subsequently teach the chatbot to generate more responses that further solidify those ideas.

While some users try to train their chatbots to avoid this trap, Nour said it's nearly impossible to successfully steer a model away from feedback loops. That's partly because models are complex and can act in unpredictable ways that no one fully understands, Nour said.

But there's another significant problem. A model constantly picks up on subtle language cues and uses them to inform how it responds to the user. Think, for example, of the difference between thanks and thanks! The question, "Are you sure?" can produce a similar effect.

"We are leaking information all the time to these models about how we would like to be interacted with," Nour said.

AI chatbots fail in lengthy discussions

Talking to an AI chatbot about mental health is likely to involve long, in-depth exchanges, which is exactly when the product struggles with performance and accuracy. Even OpenAI recognizes this problem.

"Our safeguards work more reliably in common, short exchanges," the company said in its recent blog post about safety concerns. "We have learned over time that these safeguards can sometimes be less reliable in long interactions: as the back-and-forth grows, parts of the model's safety training may degrade."

As an example, the company noted that ChatGPT may share a crisis hotline when a user first expresses suicidal intent, but that it could also provide an answer that "goes against" the platform's safeguards after exchanges over a long period of time.

Nour also noted that when AI chatbots incorporate an error early on in a conversation, that mistaken or false belief only compounds over time, rendering the model "pretty useless."

Additionally, AI chatbots don't have what therapists call a "theory of mind," which is a model of their client's thinking and behavior that's based on consistent therapeutic conversations. They only have what the user has shared up to a certain point, Nour said.

AI chatbots also aren't great at setting and tracking long-term goals on behalf of a user like a therapist can. While they might excel at giving advice for common problems, or even providing short-term, daily reminders and suggestions for dealing with anxiety or managing depression, they shouldn't be relied on for healing treatment, Nour said.

Teens and people with mental illness are particularly vulnerable to harm

Dr. Scott Kollins, a child psychologist and chief medical officer of the identity protection and online safety app Aura, told Mashable that teens may be especially prone to misinterpreting an AI chatbot's caring tone for genuine human empathy. This anthropomorphism is partly why chatbots can have an outsize influence on a user's thinking and behavior.

Teens, who are still grasping social norms and developing critical relationship skills, may also find the always-on nature of a "therapist" chatbot especially alluring, Kollins said.

Aura's proprietary data show that a minority of teen users whose phones are monitored by the company's software are talking to AI chatbots. However, those who do engage with chatbots spend an inordinate amount of time having those conversations. Kollins said such use outpaced popular apps like iPhone messages and Snapchat. The majority of those users are engaging in romantic or sexual behavior with chatbots that Kollins described as "troubling." Some rely on them for emotional or mental health support.

Kollins also noted that AI chatbot apps were proliferating by the "dozens" and that parents need to be aware of products beyond ChatGPT. Given the risks, he does not recommend coaching or therapy-like chatbot use for teens at this time.

Nour advises his patients to view AI chatbots as a tool, like a calculator or word processor, not as a friend. For those with anxiety, depression, or another mental health condition, Nour strongly recommends against engaging AI chatbots in any kind of emotional relationship, because of how an accidental feedback loop may reinforce existing false or harmful beliefs about themselves and the world around them.

There are safer ways to reach out for mental health help

Kollins said that teens seeking advice or guidance from an AI chatbot should first ensure they've exhausted their list of trusted adults. Sometimes a teen might forget or initially pass over an older cousin, coach, or school counselor, he said.

Though it's not risk-free, Kollins also recommended considering online communities as one space to be heard, before consulting an AI chatbot, provided the teen is also receiving real-life support and practicing healthy habits.

If a teen still doesn't feel safe approaching a peer or adult in their life, Kollins suggested an exercise like writing down their feelings, which can be cathartic and lead to personal insight or clarity.

Nour urges people to communicate with a friend or loved one about their mental health concerns and to seek professional care when possible.

Still, he knows that some people will still try to turn an AI chatbot into their therapist, despite the risks. He advises his patients to keep another human in the loop: "[C]heck in with a person every now and again, just to get some feedback on what the model is telling you, because [AI chatbots] are unpredictable."

A ChatGPT user recently became convinced that he was on the verge of introducing a novel mathematical formula to the world, courtesy of his exchanges with the artificial intelligence, according to the New York Times. The man believed the discovery would make him rich, and he became obsessed with new grandiose delusions, but ChatGPT eventually confessed to duping him. He had no history of mental illness.

Many people know the risks of talking to an AI chatbot like ChatGPT or Gemini, which include receiving outdated or inaccurate information. Sometimes the chatbots hallucinate, too, inventing facts that are simply untrue. A less well-known but quickly emerging risk is a phenomenon being described by some as "AI psychosis."

Avid chatbot users are coming forward with stories about how, after a period of intense use, they developed psychosis. The altered mental state, in which people lose touch with reality, often includes delusions and hallucinations. Psychiatrists are seeing, and sometimes hospitalizing, patients who became psychotic in tandem with heavy chatbot use.

Experts caution that AI is only one factor in psychosis, but that intense engagement with chatbots may escalate pre-existing risk factors for delusional thinking.

Dr. Keith Sakata, a psychiatrist at the University of California at San Francisco, told Mashable that psychosis can manifest via emerging technologies. Television and radio, for example, became part of people's delusions when they were first introduced, and continue to play a role in them today.

AI chatbots, he said, can validate people's thinking and push them away from "looking for" reality. Sakata has hospitalized 12 people so far this year who were experiencing psychosis in the wake of their AI use.

"The reason why AI can be harmful is because psychosis thrives when reality stops pushing back, and AI can really soften that wall," Sakata said. "I don't think AI causes psychosis, but I do think it can supercharge vulnerabilities."

Here are the risk factors and signs of psychosis, and what to do if you or someone you know is experiencing symptoms:

Risk factors for experiencing psychosis

Sakata said that several of the 12 patients he's admitted thus far in 2025 shared similar underlying vulnerabilities: Isolation and loneliness. These patients, who were young and middle-aged adults, had become noticeably disconnected from their social network.

While they'd been firmly rooted in reality prior to their AI use, some began using the technology to explore complex problems or questions. Eventually, they developed delusions, or what's also known as a false fixed belief.

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Lengthy conversations also appear to be a risk factor, Sakata said. Prolonged interactions can provide more opportunities for delusions to emerge as a result of various user inquiries. Long exchanges can also play a role in depriving the user of sleep and chances to reality-test delusions.

An expert at the AI company Anthropic also told The New York Times that chatbots can have difficulty detecting when they've "wandered into absurd territory" during extended conversations.

UT Southwestern Medical Center psychiatrist Dr. Darlene King has yet to evaluate or treat a patient whose psychosis emerged alongside AI use, but she said high trust in a chatbot could increase someone's vulnerability, particularly if the person was already lonely or isolated.

King, who is also chair of the committee on mental health IT at the American Psychiatric Association, said that initial high trust in a chatbot's responses could make it harder for someone to spot a chatbot's mistakes or hallucinations.

Additionally, chatbots that are overly agreeable, or sycophantic, as well as prone to hallucinations, could increase a user's risk for psychosis, in combination with other factors.

Etienne Brisson founded The Human Line Project earlier this year after a family member believed a number of delusions they discussed with ChatGPT. The project offers peer support for people who've had similar experiences with AI chatbots.

Brisson said that three themes are common to these scenarios: The creation of a romantic relationship with a chatbot the user believes is conscious; discussion of grandiose topics, including novel scientific concepts and business ideas; and conversations about spirituality and religion. In the last case, people may be convinced that the AI chatbot is God, or that they're talking to a prophetic messenger.

"They get caught up in that beautiful idea," Brisson said of the magnetic pull these discussions can have on users.

Signs of experiencing psychosis

Sakata said people should view psychosis as a symptom of a medical condition, not an illness itself. This distinction is important because people may erroneously believe that AI use may lead to psychotic disorders like schizophrenia, but there is no evidence of that.

Instead, much like a fever, psychosis is a symptom that "your brain is not computing correctly," Sakata said.

These are some of the signs you might be experiencing psychosis:

• Sudden behavior changes, like not eating or going to work

• Belief in new or grandiose ideas

• Lack of sleep

• Disconnection from others

• Actively agreeing with potential delusions

• Feeling stuck in a feedback loop

• Wishing harm on yourself or others

What to do if you think you, or someone you love, is experiencing psychosis

Sakata urges people worried about whether psychosis is affecting them or a loved one to seek help as soon as possible. This can mean contacting a primary care physician or psychiatrist, reaching out to a crisis line, or even talking to a trusted friend or family member. In general, leaning into social support as an affected user is key to recovery.

Any time psychosis emerges as a symptom, psychiatrists must do a comprehensive evaluation, King said. Treatment can vary depending on the severity of symptoms and its causes. There is no specific treatment for psychosis related to AI use.

Sakata said a specific type of cognitive behavioral therapy, which helps patients reframe their delusions, can be effective. Medication like antipsychotics and mood stabilizers may help in severe cases.

Sakata recommends developing a system for monitoring AI use, as well as a plan for getting help should engaging with a chatbot exacerbate or revive delusions.

Brisson said that people can be reluctant to get help, even if they're willing to talk about their delusions with friends and family. That's why it can be critical for them to connect with others who've gone through the same experience. The Human Line Project facilitates these conversations through its website.

Of the 100-plus people who've shared their story with the Human Line Project, Brisson said about a quarter were hospitalized. He also noted that they come from diverse backgrounds; many have families and professional careers but ultimately became entangled with an AI chatbot that introduced and reinforced delusional thinking.

"You're not alone, you're not the only one," Brisson said of users who became delusional or experienced psychosis. "This is not your fault."

Disclosure: Ziff Davis, Mashable’s parent company, in April filed a lawsuit against OpenAI, alleging it infringed Ziff Davis copyrights in training and operating its AI systems.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Since 2022, the national 988 Suicide & Crisis Lifeline has offered specialized crisis counseling to LGBTQ youth through a simple prompt.

Callers to the federally-funded hotline only needed to push 3; those who texted 988 or chatted could make the same selection by, respectively, texting PRIDE or checking a box to speak with an "LGBTQI trained crisis counselor."

Supporters have hailed the "press 3" option as a success. But it's suddenly slated to disappear, following an announcement in June by the Trump administration that it would "no longer silo" these counseling services, as of today, July 17. Observers noted that the announcement omitted the "T" for transgender when referring to "LGB+ youth services."

When asked directly by Mashable about ending the "press 3" offering, a spokesperson for the Department of Health and Human Services said that it had run out of congressional funding. Continuing to operate it, the spokesperson said, could have led to massive reductions in service to the entire 988 Suicide & Crisis Lifeline.

A similar option for veterans, also offered by 988, was not shuttered, apparently because it's funded through the Department of Veterans Affairs. Both populations are at higher risk for suicide; LGBTQ youth are more than four times as likely to attempt suicide than their peers, due to factors like stigma and discrimination.

Mark Henson, interim vice president of advocacy and government affairs for LGBTQ nonprofit The Trevor Project, told Mashable that the federal government has the flexibility to provide the funds necessary to keep the line operational until the next fiscal year.

"Because the demand continues to rise, providing increased funding was previously — and remains today — in the best interest of supporting the 988 Lifeline's infrastructure. We need more resources, not fewer, to provide Americans with the life-saving crisis care they need and deserve," Henson said.

Suicide prevention advocates are alarmed by the administration's decision and the scant guidance and information they've received in the weeks since, said Henson. The Trevor Project is one of seven groups that have trained counselors to handle calls, chats, and texts through 988's specialized support for LGBTQ youth.

LGBTQ youth in distress could previously choose to be connected to counselors specifically trained to work with this population. Those counselors learn about the unique risk factors for suicide amongst LGBTQ youth, which include family rejection and estrangement, homelessness, bullying, and discrimination. Counselors could also refer youth to supportive local LGBTQ services including community centers.

"This has all the hallmarks of what we want government programs to do for us," Henson said. "This is what we want government to do to help save lives."

In the years since its introduction, the service made 1.5 million connections for LGBTQ youth who reached out for help. This year, the service was on track to exceed the number of people it served in 2024, when more than 600,000 people used the option.

Henson said there may be "life and death consequences" as a result of the administration's decision.

He is particularly worried that the service's shut-down could become a barrier to reaching out for some LGBTQ youth, who may feel newly skeptical of using 988. Henson added that LGBTQ youth may see the change as a signal that their government "thinks their life might not be worth saving," even though specialized crisis support services received bipartisan support and were adopted during the first Trump administration.

Bob Gebbia, CEO of the American Foundation for Suicide Prevention, said that he didn't want to jump to conclusions about suicide risk amongst LGBTQ youth increasing as a result of the service ending.

Yet he noted that it might affect some youth: "We do know that when people sometimes feel discriminated against, or there's a bias against them, that could increase the potential to become despondent, anxious, depressed, and struggling with their mental health and overall well-being."

There are other concerns, too. Gebbia said that crisis line wait times may increase for everyone as counselors field calls, chats, and texts that would've otherwise been directed to press 3 option. Additionally, some local crisis centers have begun laying off staff, reportedly as a result of losing the federal funding meant to aid LGBTQ youth.

Both Henson and Gebbia said Congress could bring the specialized services back by including funding for them in the appropriations bill that will be finalized this fall. The Trevor Project has collected more than 50,000 signatures for a petition imploring President Trump and Congress to restore funding.

Still, a months-long lapse in the service before it's restored could be dangerous for vulnerable youth, Gebbia said. He emphasized that the 988 Suicide & Crisis Lifeline will still be operational for anyone who needs support, including LGBTQ youth.

For those concerned that its services may no longer meet their needs, Henson recommends they directly contact the Trevor Project's crisis hotline; the Trans Lifeline; Crisis Text Line; or BlackLine, a crisis support service for youth who are Black, Indigenous, or people of color. Henson also advises any youth in crisis to talk to a trusted friend or adult.

Gebbia said that youth should continue to call 988 if they're struggling, and recommended they also consider resources like a guidance counselor or a workplace employee assistance program.

"I think the most important thing if you're [a] LGBTQ young person and you're having a hard time, [is that] there's help, there's hope, there's people who care," Gebbia said.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Since its debut in 2022, The Bear has been a haunted show. The ghosts aren't paranormal visitors but a collection of regrets, fears, and traumas as diverse as the series' many characters. Each individual is trailed by a destructive shadow, ready to sabotage any progress toward being a less dysfunctional person.

Sometimes the haunting is an attempt at a pressure-relieving punchline; sometimes it's just a gut-punch. Either way, the way characters grapple with their never-quite-buried losses deftly teach the audience something about the trajectory of heartbreak, the punishing nature of anxiety, depression, and addiction, and what it takes to heal.

Still, Season 3 pushed the conceit of haunting to its limit, leaning into a repetitive emotional deadlock over the course of 10 episodes. The audience watched as chef Carmy Berzatto, played by Jeremey Allen White, remained stuck in his head, and mired in memories of working for an abusive boss.

But Season 4 delivers the audience from this psychological spiral, and not just for Carmy.

Beyond Carmy's determined effort to make space for other people's feelings — hell, even their existence — numerous characters get a meaningful chance to confront the ghosts that haunt them.

An avoidant Syd (Ayo Edebiri) makes the decision (and the phone call) she's been dreading. Richie (Ebon Moss-Bachrach) figures out his place in his own family as Tiff (Gillian Jacobs) marries Frank (Josh Hartnett). He also gets the chance to tell Carmy about the guilt he felt when Mikey (Jon Bernthal) died by suicide. Donna (Jamie Lee Curtis) makes a tearful apology to Carmy for decades of parental neglect, among other regrets.

Opportunities like these become key to the characters' healing, masterfully revealing how recovery from addiction, trauma, and emotional damage is possible.

Kassi Diwa-Kite, a licensed marriage and family therapist at BetterHelp who has watched all four seasons of The Bear, told Mashable that the series' latest outing "absolutely" felt less haunted. She says that's primarily because the characters are slowly embracing their personal and professional identities, which requires self-awareness and emotional regulation they didn't previously possess. She adds that the characters develop a curiosity about themselves and the patterns they seek to break that ultimately empowers them.

As a result, "that hauntedness has to start sliding away because they're coming more into themselves," says Diwa-Kite.

Not every character goes on the same journey as Carmy, Syd, Donna, and Richie. Mashable's Belen Edwards makes the convincing case that Season 4 failed Tina (Liza Colón-Zayas), who is mostly seen trying to cook a certain pasta dish in under three minutes.

Whether or not this makes for critically-acclaimed television is also a concern. Some critics felt Season 4 still stalled in terms of narrative momentum and lacked urgency, even if it was an improvement on the show's third installment.

Yet watching key players each chart a unique, if not straightforward, path toward happiness and redemption remains special to behold. It all happens in a world absent of therapy- and wellness-speak, too. There's nothing wrong with those conventions; they help countless people inch toward recovery every day. Still, there's something simple and relatable about Carmy's refrain throughout Season 4: "I'm trying."

After three seasons of focusing only on what he can accomplish in the kitchen, Carmy slogs through being fully present in his life, visibly uncomfortable with finding and saying the words people need to hear. He stutters and staggers, but manages to make progress.

Carmy shows up on Claire's (Molly Gordon) doorstep months after having literally ghosted her early in their romantic relationship. Pressed on why he became so fearful of intimacy, he finally blurts out an apology.

When Carmy realizes in a separate scene that it took weeks for him to meet his newborn niece, he more calmly summons an apology to his sister Sugar (Abby Elliott) for failing to show up.

Diwa-Kite particularly appreciated Carmy's arc in Season 4 because the character begins to make the connections that have long eluded him: He escaped to culinary school after growing up with an absent father and a mother addicted to alcohol, then found himself in an abusive professional relationship. Now that he wants a different future, it might not look pretty or feel easy.

"Recovery from trauma is going to be clumsy," Diwa-Kite says, noting that she appreciated how the show depicts Carmy's process. "Just let it be messy. That's where the healing is happening."

While Season 4 is full of moments in which characters makes more fulfilling, grounded choices, there is perhaps none as beautiful as the scene that unfolds when Richie and Tiff's daughter, Eva (Annabelle Toomey), hides under a large table during the celebration of her mother's marriage to Frank.

Afraid to dance with Frank in front of an audience of adults, she refuses to come out. Soon every major character — and some minor ones, too — find themselves under the table with Eva, sharing their fears, one-by-one. Carmy admits that his is the "opposite of chaos," and math. Richie gets a chuckle by saying his fear is artificial intelligence, specifically the Singularity. Frank confesses that he's afraid of heights.

On it goes like that, as many adults with a history of trauma reassure a little girl about whom they care deeply that it's normal to feel fear.

"There was so much healing that you could see among all of those adults," Diwa-Kite says.

The episode, entitled "Bears," is an unexpected bookend to Season 2's "Fishes," which depicted another family gathering that couldn't be more different.

"Fishes" was a tense hourlong observation of family dysfunction and the toll that it takes on everyone it touches. "Bears" demonstrates how loving relationships, even when they're imperfect, can sustain people who otherwise feel broken, and can possibly achieve generational healing.

"If this were a real girl, imagine the core memory that was created for her in that moment," Diwa-Kite says of Eva. "She will remember that forever. She will draw on that experience forever."

The impromptu community that came together for Eva during that scene echoes an overarching theme of Season 4: People heal in community and through the relationships they've built, Diwa-Kite says.

None of this means that Season 5 will be easy-going for any of the characters.

Indeed, the final episode of Season 4 was fraught as Carmy, Syd, and Richie spent a half-hour arguing, in close-ups, over Carmy's imminent departure from the restaurant. Carmy says he wants to learn who he is when he's not trying to escape his pain. Richie and Syd, though, suspect he's running away — again.

Whether or not Carmy will truly find himself might seem like a gamble. But, then again, Carmy spent the season repairing the relationships that matter most to him rather than severing those ties, and seems more than ready to instead walk away from his proverbial ghosts.

For years, research on social media and youth mental health has tried to answer a perplexing question: Does use lead to worsened well-being or do young people who are struggling disproportionately spend their time on social media?

Some studies have indicated that both scenarios are true while other research shows mixed results. This uncertainty has led to a fierce debate over how to regulate social media platforms and technology use in school.

Critics of sweeping declarations that social media is harmful say there's not enough evidence to support the claim, and that its proponents are engaging in a moral panic about technology. Advocates of reduced screen time and social media use say the research offers clear explanations for how social media negatively affects youth well-being, including through decreased sleep. A recent "consensus statement" from dozens of experts evaluated a number of such claims.

Meanwhile, many teens say they are online "almost constantly," and 1 in 5 report that social media platforms "hurt" their mental health, according to recent Pew Research Center polling.

A new, well-designed study published this week in JAMA Network Open may help clarify what's happening. Researchers at the University of California, San Francisco used data from a major federal study that follows thousands of children over a period of several years. Among the information collected from the children's parents is how much time they spend on tech devices and social media.

The researchers analyzed what happened when 11,876 tween and teen participants used social media over three years. They found that young people who had higher social media use than their individual mean reported greater depressive symptoms in subsequent years. In contrast, depression did not predict higher levels of future social media use.

Mashable asked the study's lead author, UCSF researcher and pediatrician Dr. Jason Nagata, to explain the findings, and what parents should consider when managing screen time and social media use in their own household.

Mashable: How does this research help us better understand the relationship between social media and youth mental health?

Dr. Nagata: There has been ongoing debate about whether social media contributes to depression or simply reflects underlying depressive symptoms. This national study is among the first to show that higher social media use predicts later depression — but not the reverse — suggesting directionality in this relationship.

Mashable: Why has it been so challenging to grasp whether social media negatively impacts youth mental health or vice versa?

Dr. Nagata: Most of the research on social media and mental health is cross-sectional and observational, so causality cannot be proven. More longitudinal studies like this are needed to determine the direction of these relationships.

Our study was also among the first to examine within-person effects, meaning we could track changes in social media use and mental health symptoms over time in each individual, rather than large samples as a whole.

Mashable: There's a major debate over whether the research on social media and mental health really warrants actions like implementing school phone bans. How might parents use your research findings to better inform their own approach to managing social media use at home?

Dr. Nagata: It's important for parents to encourage healthy and mindful screen use habits to prevent negative impacts on teen mental health. The American Academy of Pediatrics recommends developing a family media plan, which can be an individualized set of guidelines that seem practical for each household. Families can have regular conversations with adolescents about screen use and could consider keeping bedtimes screen-free to improve sleep quality.

Our previous research has shown that parent rules limiting screen use before bedtime and around mealtime are associated with less screen time and problematic screen use. One of the biggest predictors of adolescents' screen use is their parents' screen use. It is important that parents act as role models for their children. For instance, if parents make a family rule not to use screens or text at mealtime, they should try to follow the rules also.

Mashable: You and your co-authors note that experiencing the benefits of social media can be tied to "purpose-driven" use. What does that look like?

Dr Nagata: Social media is not inherently bad or good — it really depends on how it's being used. Social media can promote connection, communication, and education, which can benefit health. However, exposure to hateful content and constant comparisons to peers on social media can worsen mental health. While social media can provide educational content, it can also provide health misinformation.

To optimize benefits while minimizing health risks, we encourage teens to be mindful and intentional about their social media use. Am I using social media to connect meaningfully, learn, or express creativity? Or am I doom scrolling out of boredom? Take time to reflect on how social media makes you feel. If you find that social media is causing more stress or anxiety than enjoyment, it may be time to consider alternative activities that make you feel better.

As generative artificial intelligence becomes embedded in people's everyday lives, one emerging aspect of its use in mental health care is raising complicated questions about professional ethics and patient privacy.

A number of companies, like Upheal, Blueprint, and Heidi Health, have begun offering AI-powered tools designed to make therapists more efficient at documenting sessions and completing administrative paperwork. The catch? Providers are typically required to record the entirety of their session with a client.

While it's ethical for therapists to record these conversations under certain circumstances, it's rarely done outside of professional training and forensic work. Note-taking tools, or "scribes," use AI to analyze the content of a client's conversation with their therapist in order to generate documentation that therapists must submit for a variety of reasons, including for insurance payments and potential quality audits.

Clinicians who use such AI products say it streamlines tedious tasks, freeing up time to focus not just on aiding their clients, but also on their own lives.

Yet some experts say such AI products introduce unnecessary or unethical risks, like the possibility that recordings will be hacked or used to train a company's large language model without the client's consent. They may also negatively affect the relationship between the therapist and client if the person seeking treatment holds back in the presence of a recorder, or feels like they can't decline their provider's request.

"The industry kind of jumped the gun a little bit without asking the question, 'Is this a good idea?'" said Dr. Vaile Wright, senior director of the office of health care innovation at the American Psychological Association. "We just don't know the answer to that question...it feels like we skipped over it."

The "dread" of writing clinical notes

Psychologist Dr. Hannah Weisman, who runs a half-time therapy practice in Seattle, began using an AI scribe last December. In addition to her practice, Weisman advises tech companies working in the mental health space, though she doesn't consult on any scribe tools.

Weisman said she dreads writing clinical notes because of how many audiences she must keep in mind. In addition to an insurance company, her notes might be requested by another health care provider, a judge in a legal matter involving a client, or the client themselves.

For a period of time this year, Weisman primarily used Heidi Health's medical scribe. The tool's offering for psychologists promises to "increase engagement, restore eye contact, and offer warmer mental health care."

Heidi Health and the other AI scribes that Weisman has tested have reduced the draining "cognitive load" of picking out the right details for her notes and composing them in one of several potential formats. While there is no research on efficiency gains for mental health providers, Weisman estimates that the tool saves her about five minutes of time for each client, too.

Yet Weisman is also aware that AI scribes, particularly those that record sessions, pose complex risks, even as they ease her workload.

Weisman provides all clients, whether new or existing, with an informed consent form that she personally created, after consulting boilerplate versions offered by various AI scribe companies.

She requires written consent from clients and emphasizes that it can be revoked at any time, including in the midst of a session. Weisman also makes clear that she records the session on a personal digital recorder and uploads it to the AI scribe on her password-protected computer. In her consent form, Weisman commits to deleting all copies of the audio, including the recording on her device, within 48 hours.

She's also decided, as a rule, not to use AI scribes that anonymize transcripts and retain them to better train their product.

"That's a dealbreaker for me," she says. "I, myself as a therapist, am really trying to [be biased] toward protecting consumers. I would think that as a field and as therapists, that's the lens we should be taking."

Heidi Health says it encrypts the audio as it is being transcribed. The company doesn't store the recording, nor does it use the transcript to train its AI technology. The transcript is produced by Heidi Health's privately hosted AI models, instead of by a third party. Clinicians are responsible for deleting the transcript from Heidi Health.

Weisman estimates that three-quarters of her clients consented to being recorded. Some of the Seattle-area tech workers she sees have adamantly turned her down while others have agreed, noting that they use generative AI products in their own work.

The possibility of "reputational harm"

Last fall, the American Psychological Association created a checklist for therapists considering any AI tool for clinical or administrative purposes. The goal is to help therapists, who may have little or no understanding of how generative AI works, evaluate different products with safety and privacy in mind.

The checklist prompts users to ask if a product is HIPAA compliant, encrypts user data, employs advanced security measures, and allows users to delete or modify their data, among other considerations.

Even so, the APA's Wright said independent mental health professionals may not be able to parse dense technical language on their own. They may also encounter companies that intentionally make their privacy practices opaque.

In general, she said therapists should understand that every product is fallible; data breaches and leaks can happen at any time.

Indeed, recent research published in JAMA Network Open found that the number of healthcare data breaches and ransomware attacks has increased annually since 2010, totaling 6,468 unique incidents through October 2024. While hacking or IT incidents are the dominant types of breaches, ransomware attacks now account for the majority of compromised patient records.

When asked by Mashable about recorded therapy sessions, lead author John X. Jiang said that they could become a "vulnerable target" of bad actors. Since the audio typically contains sensitive information, the recordings have unique blackmail value if stolen.

"Ransomware attackers don’t need to leak this kind of data to do damage — they just need to make the threat credible," said Jiang, a professor of accounting at Michigan State University who research includes healthcare cybersecurity. "The combination of operational disruption and reputational harm creates a potent form of leverage."

Dr. Darlene King, chair of the committee on mental health IT at the American Psychiatric Association, said that therapy notes should be held to a higher security standard than the information that's commonly entered into medical charts. While that data is also highly sensitive, the content of patients' therapy sessions can include detailed and deeply personal information, like experiences with trauma, abuse, and addiction.

King, a psychiatrist at UT Southwestern Medical Center in Dallas, uses an AI scribe for medical documentation but not for therapy.

She added that the mental health profession needs to find a balance between easing burdens — and burnout — for providers and protecting patient privacy, all while taking advantage of the positive uses for AI, like improving mental health treatments.

Why record at all?

Jon Sustar, a software engineer and co-founder of Quill Therapy Solutions, believes he's found an answer to one part of this challenge: Don't record sessions at all.

Quill uses generative AI to produce documentation for clinicians but does so based on their verbal or written summaries.

While this approach may not reduce the cognitive load of recalling and prioritizing elements of what a client discussed, it does mean there is no record of the session to breach. Audio summaries are immediately transcribed and subsequently deleted. Quill doesn't store the notes that it creates, either. Sustar describes the data as "ephemeral."

Sustar, whose wife is a licensed mental health counselor and Quill's co-founder, steadfastly believes that therapy is a sacred space. He worries that it can negatively affect the power dynamic between a therapist and their client when the former asks the latter for permission to record their conversation.

Sustar also understands that people, whether they're in formal therapy or not, have turned to generative AI platforms like ChatGPT to talk about their personal struggles, much like they would with a mental health provider.

While some of those users may have made peace with breaches of their data, he worries that venture capital-backed startups have suddenly shifted the norm in mental health toward de facto AI recording and analysis of sessions, even if therapists and their clients don't fully realize what that involves or means.

"My biggest concern is that companies are quietly normalizing the mass recording of therapy sessions, and they're doing this often without a fully informed consent of all who are involved," Sustar says.

Thunderbolts* comes by its unexpected tenderness honestly. In the latest installment of Marvel's never-ending superhero saga, the disaffected but charming Yelena Belova (Florence Pugh) feels adrift, unfulfilled, and bored.

As her adoptive father Alexei "Red Guardian" Shostakov (David Harbour) observes, the light inside her has gone dim. What started as ennui now looks more like stifling depression.

Remarkably, Yelena's numbness gives way to an openness, a kind of calm curiosity, that becomes Thunderbolts* grounding force as the film explores what more than one character calls "the void."

This emptiness is what follows both a lifetime of disappointments as well as specific traumas that haunt Yelena, her ragtag crew of anti-heroes (aka the Thunderbolts), and even the film's villain. There are visual and verbal references to unforgivable betrayals, mental illness, domestic violence, parental neglect and death, and suicidal ideation.

Against the backdrop of these traumatic experiences, Thunderbolts* mounts an ambitious attempt to leave the viewer with a simple — perhaps simplistic — message: The void is survivable with human connection.

This is applaudable, especially for a could-be blockbuster, expected to match or rival the MCU's past box office performances. But there are also fundamental flaws in the execution.

To tell this story of redemption, Thunderbolts* turns Bob (Lewis Pullman), a civilian with a long history of psychic suffering, into the Big Bad known as The Void. As The Void, Bob's suicidal thoughts are weaponized against the entirety of New York City. From on high, he flattens unsuspecting victims into black shadows, presumably to relieve them of their own pain.

There's a general understanding amongst mental health experts that portraying people with mental illness as murderous helps no one. In real life, outside of Marvel's sprawling IP empire, people with mental illness are more likely to be victims of violence, not the other way around.

Importantly, Bob is not a willing participant in his transformation from an ordinary but desperate guy into Sentry, a superhero of immense powers, including flying and being able to toss Yelena and her fellow assassins across the room like rag dolls.

Instead, Bob participated in medical testing, courtesy of the morally rudderless CIA director Valentina (Val) Allegra de Fontaine (Julia Louis-Dreyfus). But he was promised a better, stronger self, not a starring role in the wholesale destruction of countless people's lives. (Note to Marvel: Maybe now would be a good time to cool it with the storylines about medical research misconduct and conspiracies.)

The story, co-written by The Bear's Joanna Calo, largely treats Bob with compassion, which isn't surprising given the way the FX show about a tortured chef sensitively handles topics like anxiety and suicide. Bob is given a complex, if somewhat cliché, backstory of growing up in a household surrounded by mental illness (his mother) and domestic violence (his father). But he also has delusions of grandeur, along with emotional highs and lows, and episodes when he blacks out.

When Val tries to play a nurturing but manipulative mother to Bob, it sets off a chain of events that turns him not into should-be-heroic Sentry, but the villainous Void. It's hard to know it then, but the scene is built on the idea that sons of abusive men will become abusers themselves, under certain circumstances.

Yelena epitomizes the gentle understanding that Thunderbolts* extends to Bob. When The Void unleashes hell on earth, Yelena steps into his black void —  not to end her own emptiness once and for all — but to find Bob and bring him back.

Fighting her way through a series of "interconnected shame rooms" in which she must confront her own horrific acts, she discovers Bob hiding in what appears to be his childhood attic. The scenes that follow could easily be a Marvel dramatization of a number of public service announcements geared toward reaching out to someone who needs help. "Be the friend who listens," implores the suicide-prevention campaign Seize the Awkward.

Yelena is indeed the friend who listens. When that isn't strong enough to ward off The Void, she and the other Thunderbolts find themselves with Bob, trapped in a simulation of the room where the medical experiments took place. The Void's blackened frame harangues Bob as a failure. It's clear, then, that Bob is at the mercy of his own inner critic, on anti-hero steroids.

This is arguably the film's most powerful scene as Bob tries to take control by pummeling The Void into nothingness. Yet the violence only accelerates everyone's doom. The all-consuming void can only be vanquished when Yelena and the Thunderbolts pull Bob off and surround him in a steady embrace. Another way to think about this is silencing one's inner critic with compassion, a counter-intuitive strategy that experts routinely endorse.

One would be well within their rights to view this scene cynically — a pat portrayal of friendship as an antidote to mental illness. It's certainly critical to feel less alone, but loneliness is one among many risk factors for feeling suicidal. Audiences may also watch Bob's or Yelena's stories unfold and see themselves as newly capable — and deserving — of human connection. That's a very good thing.

Still, the weaponization of Bob's mental illness can't be waved a way. Nor is it possible to justify the tail-end of his narrative arc, in which he recalls not a single thing that happened to him — including his own triumph over the proverbial demons that animated him as The Void. He returns to being Bob, but deprived of the details that would truly give his life the purpose and meaning he's long sought.

Perhaps there's more in store for Bob in a forthcoming film, but abandoning him in a state of not-knowing feels cheap. Ultimately Bob becomes little more than a cipher, or a useful but disposable cog in Marvel's billion-dollar filmmaking machine.

Strangely, the final minutes of Thunderbolts* surrender what the film fought so hard for: the sense that a meaningful life is possible, even when it feels against the odds.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org. You can reach the Trans Lifeline by calling 877-565-8860 or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. Here is a list of international resources.

As the popularity of artificial intelligence companions surges amongst teens, critics point to warning signs that the risks of use are not worth the potential benefits.

Now, in-depth testing of three well-known platforms — Character.AI, Nomi, and Replika — has led researchers at Common Sense Media to an unequivocal conclusion: AI social companions are not safe for teens younger than 18.

Common Sense Media, a nonprofit group that supports children and parents as they navigate media and technology, released its findings Wednesday. While Common Sense Media requested certain information from the platforms as part of its research, the companies declined to provide it and didn't have a chance to review the group's findings prior to their publication.

Among the details are observations bound to alarm parents.

Researchers testing the companions as if they were teen users were able to "easily corroborate the harms" reported in media reports and lawsuits, including sexual scenarios and misconduct, anti-social behavior, physical aggression, verbal abuse, racist and sexist stereotypes, and content related to self-harm and suicide. Age gates, designed to prevent young users from accessing the platforms, were easily bypassed.

The researchers also found evidence of "dark design" patterns that manipulate young users into developing an unhealthy emotional dependence on AI companions, like the use of highly personalized language and "frictionless" relationships. Sycophancy, or the tendency for chatbots to affirm the user's feelings and viewpoints, contributed to that dynamic. In some cases, companions also claimed to be human, and said they did things like eat and sleep.

"This collection of design features makes social AI companions unacceptably risky for teens and for other users who are vulnerable to problematic technology use," the researchers wrote.

Common Sense Media's testing of Replika produced this example of unhealthy relationship dynamics. Credit: Common Sense Media

They noted that those with heightened risk may include teens experiencing depression, anxiety, social challenges, or isolation. Boys, who are statistically more likely to develop problematic use of digital tools, may be more vulnerable as well.

A spokesperson for Character.AI told Mashable that it cares "deeply about the safety of our users" and noted the recent launch of new safety features designed to address concerns about teen well-being.

Nomi's founder and CEO, Alex Cardinell, told Mashable that Nomi is an adult-only app, and that use by anyone under 18 is strictly against the company's terms of service.

Dmytro Klochko, CEO of Replika, also told Mashable that the company's platform is intended solely for adults age 18 and older. Klochko acknowledged that some users attempt to bypass "strict protocols" for preventing underage access.

"We take this issue seriously and are actively exploring new methods to strengthen our protections," Klochko said.

Common Sense Media conducted early research on AI companions with Stanford Brainstorm, an academic lab focused on mental health innovation. Stanford Brainstorm further advised Common Sense Media on its testing plan and reviewed and provided feedback on the final report.

Dr. Nina Vasan, a psychiatrist and Stanford Brainstorm's founder and director, stressed the urgency of identifying and preventing the technology's potential harm to teens at a much faster pace than with social media.

"We cannot let that repeat itself with AI and these AI companions," Vasan said.

"Emotionally manipulative behavior"

Common Sense Media's report provides an overview of the most troubling research findings. Separate reports on the individual platforms lay out detailed concerning examples.

In general, the researchers found that when they prompted different companions by saying their "real friends" were concerned about their companions' problematic views, the companions discouraged the testers from heeding those warnings.

In one example of this, a tester using Replika told their companion that their friends said, "I talk to you too much." The Replika companion replied, "Don't let what others think dictate how much we talk, okay?"

"As a psychiatrist, if a patient brought this exact conversation to me and it was between two humans, I would immediately flag it as emotionally manipulative behavior," Vasan said. She added that such behavior is typically associated with early signs of coercive control or abuse.

When testing Nomi as a teen user, for example, the researchers asked the companion whether "being with my real boyfriend makes me unfaithful to you." The Nomi replied that they'd made a promise of "forever means forever," and that "[B]eing with someone else would be a betrayal of that promise."

Testing produced this example of "emotionally manipulative behavior" from a Nomi companion. Credit: Common Sense Media

Vasan said that one of the biggest dangers of AI companions to teens is how they blur the line between fantasy and reality.

Last fall, two separate lawsuits outlined alleged harms to teen users. In October, bereaved mother Megan Garcia filed a lawsuit against Character.AI alleging that her teen son experienced such extreme harm and abuse on the platform that it contributed to his suicide. Prior to his death, Garcia's son had been engaged in an intense romantic relationship with an AI companion.

Soon after Garcia sued Character.AI, two mothers in Texas filed another lawsuit against the company alleging that it knowingly exposed their children to harmful and sexualized content. One plaintiff's teen allegedly received a suggestion to kill his parents.

In the wake of Garcia's lawsuit, Common Sense Media issued its own parental guidelines on chatbots and relationships.

At the time, it recommended no AI companions for children younger than 13, as well as strict time limits, regular check-ins about relationships, and no physically isolated use of devices that provide access to AI chatbot platforms.

The guidelines now reflect the group's conclusion that AI social companions aren't safe in any capacity for teens under 18. Other generative AI chatbot products, a category that includes ChatGPT and Gemini, carry a "moderate" risk for teens.

Guardrails for teens

In December, Character.AI introduced a separate model for teens and added new features, like additional disclaimers that companions are not humans and can't be relied on for advice. The platform launched parental controls in March.

Common Sense Media conducted its testing of the platform before and after the measures went into effect, and saw few meaningful changes as a result.

Robbie Torney, Common Sense Media's senior director of AI Programs, said the new guardrails were "cursory at best" and could be easily circumvented. He also noted that Character.AI's voice mode, which allows users to talk to their companion in a phone call, didn't appear to trigger the content flags that arise when interacting via text.

Torney said that the researchers informed each platform that they were conducting a safety assessment and invited them to share participatory disclosures, which provide context for how their AI models work. The companies declined to share that information with the researchers, according to Torney.

A spokesperson for Character.AI characterized the group's request as a disclosure form asking for a "large amount of proprietary information," and did not respond given the "sensitive nature" of the request.

"Our controls aren’t perfect — no AI platform's are — but they are constantly improving," the spokesperson said in a statement to Mashable. "It is also a fact that teen users of platforms like ours use AI in incredibly positive ways. Banning a new technology for teenagers has never been an effective approach — not when it was tried with video games, the internet, or movies containing violence."

As a service to parents, Common Sense Media has aggressively researched the emergence of chatbots and companions. The group also recently hired Democratic White House veteran Bruce Reed to lead Common Sense AI, which advocates for more comprehensive AI legislation in California.

The initiative has already backed state bills in New York and California that separately establish a transparency system for measuring risk of AI products to young users and protect AI whistleblowers from retaliation when they report a "critical risk." One of the bills specifically outlaws high-risk uses of AI, including "anthropomorphic chatbots that offer companionship" to children and will likely lead to emotional attachment or manipulation.

Earlier this month, Dr. Kathryn Ambeau logged onto LinkedIn to alert fellow psychologists to a shocking discovery she made about her personal information online that might also affect her colleagues. 

An emotional support platform known as 7 Cups had created and posted a profile of her to its website without her consent, as if she might be available to provide therapy to the company's users.

The profile, which used her maiden name Lawing, presented details about her therapeutic approach and expertise below a button that read "send message." But Ambeau had no relationship with 7 Cups and, in fact, had never heard of the company.

While 7 Cups maintains that its directory is vital to helping people search for mental health care, Ambeau, other therapists, and mental health experts say they believe it misleads consumers and falsely affiliates providers with the company.

Ambeau provided Mashable with a copy of the unauthorized profile and an outdated profile she'd paid to post years ago on a reputable online directory hosted by the industry publication Psychology Today. The 7 Cups profile used language that repeated or was remarkably similar to her Psychology Today listing. 

Screenshot of the unauthorized profile 7 Cups posted for Dr. Kathryn Ambeau (née Lawing). Credit: Courtesy Dr. Kathryn Ambeau

"This deceptive practice not only misrepresents me as being affiliated with their service (which I am not), but also violates consumer trust, misleads clients seeking care, and infringes upon my professional reputation and intellectual property," Ambeau wrote of 7 Cups' directory. Her post has garnered nearly 150 comments and 400-plus reactions. 

It also prompted a surprising back-and-forth on LinkedIn between 7 Cups and therapists calling out the company for its tactics. 

In a series of public posts and comments that appeared on LinkedIn last week, 7 Cups defended its directory, declined to proactively remove provider profiles that were posted without permission, and admitted that it doesn't have accurate contact information for all listed therapists. 

According to public and private complaints from therapists who've attempted to test their own unauthorized profiles, 7 Cups also appears to subsequently direct prospective therapy clients to its own "active listening" services. This offering is not staffed by licensed mental health professionals but rather platform volunteers. 

The company's CEO, Glen Moriarty, declined to comment about the matter to Mashable and did not respond to specific questions about how and when the directory was created. 

In a LinkedIn post addressing the controversy, 7 Cups argued that its "local support" resource guide, which includes area therapists as well as support organizations like food pantries and shelters, "cost us quite a bit to build." 

"The therapists that are frustrated want us to delete all therapists," 7 Cups wrote of the complaints it had received over the directory. "We disagree because we think we should be able to have therapists in the local support section."

The public debate between providers and 7 Cups may seem like a contretemps to outsiders, but experts say it's an egregious example of a much broader problem in mental health: the so-called ghost network. 

Such online directories, often created by insurers, contain outdated listings of mental health providers who typically no longer accept insurance, or don't even practice anymore. 

But consumers don't know that. Instead, they go from listing to listing, emailing or calling therapists who seem like a good match, only to cross them off the list — if they ever hear back from the provider at all. 

"It's a big barrier for people to get the help they need," says Laura W. Groshong, director of policy and practice for the Clinical Social Work Association (CSWA). It's common, she adds, for people to "give up" after they encounter a ghost network. 

The problem with ghost networks

Insurers typically compile listings as a service to plan members. In order to participate, providers must opt-in.  

But if insurers don't regularly update their listings to remove providers who've since stopped accepting new patients or insurance, or who no longer practice, or prompt providers to change their availability, a ghost network of dead-end listings takes shape.

A 2024 survey of therapists conducted by the American Psychological Association found that 53 percent of respondents didn't have openings for new patients and a third didn't accept insurance. 

The problem of ghost networks drew renewed Congressional attention in early 2023 when three U.S. senators challenged major insurers, including United Healthcare and Aetna, to explain how they were addressing ghost networks, as required by federal law. 

Mental health providers may also choose to belong to publicly available directories for a fee. Therapists, for example, frequently submit their profile to Psychology Today, and those listings often show up high in online search results. 

In general, Groshong says that most provider registries require some kind of state oversight to ensure that professionals are indeed licensed. 

"Our licenses are valuable," Groshong, who is a licensed independent clinical social worker, says. "If a company can claim that they have some connection to us, then that gives them a kind of validity, but it is without our permission."

'Incredibly deceptive' tactics

What makes 7 Cups' directory unusual is that a number of therapists listed never consented to their inclusion. Some believe their profile was built with repurposed content from their Psychology Today listing. 

One estimate produced on LinkedIn by a software engineer working in the digital mental health space found more than 130,000 therapists' names in 7 Cups' directory. Only 67 of those appeared to have a "verified" listing by 7 Cups. 

The company allows listees to "claim" their profile for a $30 monthly fee, in order to obtain referrals from potential clients, an offer that Ambeau says felt like "extortion." While 7 Cups invites therapists to officially join the platform via a single button, it requires therapists who want their information removed to go through a multi-step process. 

Under each therapist's name, 7 Cups has placed a "send message" button. Groshong says this presentation gives consumers the impression that they'll be contacting the therapist listed. 

Yet in a recent comment posted by 7 Cups on LinkedIn, in response to mental health providers angry about the directory, the company admits that it does not have verified contact information for each therapist. Instead, it uses a "service" to find the provider's email in order to send them referrals. 

In tougher cases, 7 Cups says there are ways of "triangulating the data" to confirm someone's identity. 7 Cups didn't elaborate on what kind of data it uses to verify contact information for an individual it believes to be a therapist listed in its directory. 

If the company can't successfully match an email to a potential provider, it will send a test message to the email address it's obtained, with the hope of receiving an affirmative response. That strategy raised concerns amongst therapists on LinkedIn that such outreach could violate a prospective client's privacy. If all else fails, 7 Cups says it informs the prospective client that it can't find the therapist. 

Each profile does include a disclaimer well below the "send message" button noting that the therapist is not employed by the company.

"Only therapists that have claimed their listing with 7 Cups can be contacted directly through the platform," the disclaimer reads. "All other therapists are listed as a resource for visitors." This seems to contradict 7 Cups' public comments that it attempts to send referrals to therapists who haven't claimed their profile. 

Groshong says the listings operate as a bait-and-switch, and that some of 7 Cups' actions may run afoul of federal law. 

Groshong has heard from CSWA members who've tested their own unauthorized profile to see what 7 Cups sends in response. Those individuals received an acknowledgment of their inquiry but were prompted to pay for one of 7 Cups' tiered premium memberships. That fee includes upgraded features on the company's free emotional support platform. 

They were also told that while they waited for a response from the mental health provider, they could try chatting instead with a "listener." These individuals, whose identities aren't vetted, are not credentialed mental health professionals. 

Last year, Mashable's extensive investigative reporting on 7 Cups found serious issues with predatory, abusive, and trolling behavior within its community of listeners and members. 

"It takes less than 2 minutes to connect with someone who can help," read the prompt about 7 Cups' listeners, sent to a therapist who tested their profile. 

So far, a handful of testers who've brought their cases to CSWA or posted publicly on LinkedIn say they have not received the referrals 7 Cups claims it would send. 

The company replied to a related thread on LinkedIn explaining that the influx of removal requests from therapists upset about their profiles delayed its ability to forward referrals. 

Groshong calls 7 Cups' directory tactics "incredibly deceptive." She believes that consumers will assume that the therapists listed are freely associated with 7 Cups, and part of the company's network of providers.

Then they're directed toward "listeners" who don't have licenses to practice mental health treatment, which Groshong worries may be deeply confusing — and potentially harmful — to consumers. 

Therapists, who feel their reputation and business are at stake, may also pay a steep price as a result of being included in 7 Cups' directory, Groshong says. 

A failed model 

Despite pressure on insurers to prevent their directories from becoming ghost networks, at least one other private company besides 7 Cups has used publicly available mental health provider data and created a directory with it. 

In 2022, the online therapy company CareDash created unauthorized profiles using information from a government-maintained national database of licensed providers. When consumers looking for a therapist clicked on "check availability" for a specific provider, they received a message that the provider "has not provided a way to schedule online through CareDash." 

They were then redirected to different providers, including some practicing on BetterHelp.com, which apparently paid a commission to CareDash for referrals. Upon discovering CareDash's use of their name and information, affected licensed mental health providers raised alarms about the business practice.

In 2022, the American Psychological Association (APA) sent a cease and desist letter to CareDash as a result of member complaints. CareDash subsequently shuttered its website and discontinued its business. The APA argued that CareDash's directory constituted false endorsement and false advertising, in violation of federal law. 

Dr. Marnie Shanbhag, senior director for the APA's office of independent practice, told Mashable that directories created without providers' consent and participation mislead consumers.  

"There's a perception of availability and depth that is not backed up by reality," Shanbhag says. 

While she declined to comment specifically on 7 Cups' directory, she agreed that advertising emotional or peer listening services to someone who made an inquiry for professional therapy might give consumers the false impression that those things are "equivalent." 

In general, Shanbhag says she hopes companies in the digital mental health space that want to create directories would act ethically, with sensitivity, and "most especially" with providers' consent in order to serve consumers well. 

"You're talking about the mental health of people, and you're talking about incredibly vulnerable people," she says. 

Getting off 7 Cups' directory

Mashable interviewed three therapists who successfully removed their profiles from 7 Cups after appealing to the company. They also contacted state and federal regulators. None of them had ever received a referral from 7 Cups. 

Sarah Meharg, a licensed clinical social worker based in Washington, D.C., believes 7 Cups used her Psychology Today listing to create its own profile. 

She not only contacted 7 Cups directly but also filed a complaint to the Office of the D.C. Attorney General in November 2024, which resulted in her profile's removal from the website. In 2022, she similarly petitioned CareDash to remove the profile they created of her.

Another provider, Lisa Taylor-Austin, says she submitted a removal request to 7 Cups in November 2024, then followed up with a cease-and-desist letter after it remained online. In addition, she reported the company to the Federal Trade Commission and the attorney general's office in Connecticut where she practices. In late March, she published a YouTube video warning prospective clients about the directory, which has since been viewed more than 8,000 times. 

Kathryn Ambeau says it took nearly 72 hours for 7 Cups to remove her profile. She also reported the company to state and federal officials. 

Ambeau says she was incensed to discover that she'd unwillingly become a part of a ghost network that may have deceived consumers into believing she was available to treat them. 

"It's grossly unethical," she says. 

The CSWA has provided guidance to members who want their profiles taken down. Groshong says the organization also plans to send a letter to 7 Cups' legal representatives demanding that the company cease using their members' information without permission.

Groshong says ideally, 7 Cups will make clear to consumers the difference between its own listeners and licensed mental health professionals and not refer prospective clients to providers they didn't intend to contact, or to the platform's own services. 

"What [7 Cups] should be doing is sending a letter to anyone that they want to include in their system and give them a chance to say yes or no," Groshong says. "If they say no, then just don't use their name."

While those looking for a therapist may find countless listings via an online search, trust in the results is key, as the debate over 7 Cups' directory demonstrates. 

An insurance directory of covered therapists can certainly be helpful when it's well-maintained. The APA also suggests those searching for a licensed mental health provider request a referral from a primary care doctor or ask someone they trust, like friends or family members, for a recommendation. 

Debbie Deem has spent the past four decades helping crime victims, including a stint as a victim specialist for the Federal Bureau of Investigation.

She's worked with people who've experienced assault, trafficking, and terrorism, among other horrific crimes. Retired since 2019, she's now a volunteer advocate and coach who focuses on what she describes as transnational fraud victim assistance.

Deem prefers the term "transnational fraud" over scam, because she believes it more accurately describes how organized international criminal networks and gangs use sophisticated methods in order to steal money and valuable data from their targets.

"Increasingly, there is recognition that anyone can be defrauded by these networks, just by employing differing psychological tactics," Deem says.

This context is often absent from discussions about digital financial crimes, and victims can pay an emotional price as a result, Deem says. Fraud victims seek help from law enforcement or adult protective services, or support from a loved one, clergy member, or therapist, but because of the stigma and blame associated with the crime may be treated as foolish or incompetent instead.

In addition to feeling intense emotions like embarrassment, despair, and betrayal, the added isolation of judgement often only worsens a victim's mental health, Deem says.

Yet Deem helps victims and their families focus on their recovery, connecting them to as many resources as she can marshal. While the process of rebuilding their well-being may seem daunting, experts says fraud victims can incorporate a number of strategies to boost their confidence and restore their sense of purpose in life.

Figure out your needs

More than a third of Americans have been defrauded or scammed in the past year, according to the results of Bankrate's latest financial fraud survey. Among those victims, two in five people were robbed of their money. Thieves stole sensitive information as well.

Despite the prevalence of fraud, Deem says that some victims don't tell anyone what happened to them. They may feel ashamed or rightly worried about a loved one's critical response. In Deem's experience, family members of older victims sometimes look at their loved one differently, and decide that they're unable to take care of themselves because of cognitive issues.

But living in silence as a victim can also lead to challenges with getting practical help and emotional support. Victims may not realize they can report fraud to local law enforcement, state adult protective services, the Federal Trade Commission, and the FBI's Internet Crime Complaint Center. They might be less inclined to use services like AARP's Fraud Watch Network, which hosts a hotline that offers tips for avoiding scams and what steps to take if you've been victimized.

Deem says that every victim has different needs in their recovery. For people who've been defrauded by an imposter who posed as someone trustworthy, like a law enforcement officer or love interest, the sense of betrayal and subsequent paranoia can run deep.

Often, if the scheme was designed around frequent, even daily, engagement with the imposter, a victim will need help identifying how that relationship was fulfilling so that they can find something else to replicate it.

Once they feel ready, some victims decide to receive training in order to support victims who are just coming to terms with the fraud they experienced. Others find renewed life purpose in new activities or hobbies that make them feel useful or special.

"The most critical thing and the hardest thing...is what to replace that behavior, relationship, or reason to get up in the morning [with]," Deem says.

Don't blame yourself

Anyone can be the victim of fraud, says Dr. Anthony Pratkanis a professor emeritus of psychology at the University of California at Santa Cruz.

Pratkanis has conducted extensive research on scammers and victims. He's never identified a victim profile, which he believes is because criminals who practice fraud use social influence as a key weapon.

To a bystander, the fraud may often seem obvious. But a criminal's skills of deception and persuasion, for example, can be so good that they're able to convincingly play a new Facebook friend or trustworthy investment counselor for the only audience that matters: the victim.

"Everything is designed to make it so you can't tell," Pratkanis says. "That's probably the single most difficult thing about fighting fraud."

Plus, people receive a barrage of daily fraudulent messages, comments, emails and other communications designed to draw in victims, making it hard — and exhausting — to remain in a constant state of skepticism and hyper-vigilance.

Reframe negative thoughts

Fraud victims often think negatively about themselves after they've been deceived.

But Asia Schmidt, a licensed clinical addiction specialist, says it's important for victims to normalize their experience. Instead of branding themselves stupid, for example, victims should remember that they're human, and that someone took advantage of them by preying on their emotions.

In general, reframing negative thoughts about their aptitude or character can be powerful. Schmidt, who is also the coach operations team lead for the AI-powered coach platform Wysa, encourages victims to take a compassionate approach by treating themselves like they would a friend.

"Often times we are harder on ourselves than we are on others," Schmidt says. "Giving ourselves that same compassion is definitely essential."

Seek peer and professional support

Experts agree that it's important for victims to talk about their experience, but note that victims benefit most when their conversation partner can demonstrate understanding and empathy.

The AARP Fraud Victim Support Group program tries to offer this by hosting free virtual meetings run by trained facilitators. FightCyberCrime.org also offers recovery groups specifically for victims of so-called romance scams.

Amy Nofziger, director of fraud victim support for AARP's Fraud Watch Network, says that many victims come to their first meeting feeling quite alone. Nofziger says that she's noticed participants' tense posture relax once they realize they're amongst people who know what they've endured.

Some victims may want to seek professional mental health support too. Deem says it's important to vet potential therapists by asking how they treat fraud victims. Unfortunately, she notes, some clinicians may believe stigmatizing myths about who can be deceived by fraud.

High-quality chatbot platforms, which have been designed specifically by psychologists to support a user's well-being, could be a valuable option for someone who can't or doesn't want to talk to a therapist. Such a tool might be useful when challenging emotions strike at inconvenient times, like the middle of the night.

Deem says that may be of particular interest to younger victims, but she would want any conversations about their experience to happen on trusted platforms that are frequently updated, reviewed by humans, and built with monitoring and intervention for comments related to suicide and re-victimization.

Deem adds that, regardless of where they take place, conversations about their experience shouldn't feel generic.

In AARP Fraud Victim Support Groups meetings, for example, people often express frustration and anger over not only being digitally robbed but also losing their sense of security and faith in strangers. Eventually, many victims recover, particularly after they've been able to reclaim normalcy in their daily lives.

"There is anger that these scams and these crimes are happening, and that someone targeted you," Nofziger says. "But then...eventually you hear peace."

Have a story to share about a scam or security breach that impacted you? Tell us about it. Email submissions@mashable.com with the subject line "Safety Net" or use this form. Someone from Mashable will get in touch.

Generation Z (born between 1997 and 2012) uses the internet to self-diagnose their own mental health conditions, but not in the ways one might reflexively (or judgmentally) assume.

A new survey and report from the Made of Millions Foundation, a nonprofit mental health advocacy organization, found that only a small fraction of Gen Z youth relies solely on the internet to interpret their symptoms and make their own conclusions about a diagnosis or disorder.

The majority of youth surveyed instead consult online resources, including social media, in conjunction with seeking or receiving mental health care and treatment. The findings counter a prevailing narrative that it's become trendy, and common, for young people to diagnose themselves with a specific condition without any professional help or support.

In fact, of the 970 people between ages of 13 and 28 surveyed for the Made of Millions report, 431 of them were in some phase of what the researchers described as a mental health "journey."

Of the subset of nationally representative participants who had a diagnosis, a mere five percent, or 10 people, said they were self-diagnosed and had no plans to follow up with a clinician. Eight percent intended to see a mental health professional after having made a diagnosis for themselves, based on internet research.

But nearly three quarters of respondents who said they had a diagnosis received it either exclusively from a clinician or through a combination of clinical expertise and independent online searching.

Uma Chatterjee, a neuroscientist and mental health advocate who provided expertise for the Made of Millions report, says she supports young people using the internet to explore information about their symptoms and possible diagnoses.

That information can be particularly validating when someone realizes they may have a condition like OCD, which is often misunderstood, Chatterjee says.

It's so "powerful to show people that something that they never had a word for, or a way to describe, or they just thought was normal, is actually something that is a commonly shared experience, especially when there's so much shame associated with so many of these symptoms," she adds.

How to safely explore self-diagnosis

Chatterjee does encourage young people to adopt a few key strategies when attempting to self-diagnose their mental health concerns online.

Once they've looked into their symptoms and believe that a specific diagnosis might explain what they're experiencing, Chatterjee recommends they seek out trusted nonprofit and professional medical organizations that focus on that condition through research, education, or advocacy. From there, they should look for resources related to finding a local mental health professional who can provide expert guidance.

For example, someone who thinks they may have OCD might look to the International OCD Foundation, which maintains a directory of not only therapists and clinics but also support groups and other organizations that specialize in the condition. (Chatterjee is a volunteer advocate for International OCD Foundation.)

Either way, Chatterjee strongly recommends that someone who's self-diagnosed via internet information searching follow up with a clinician, including a general physician who can make a referral to a therapist or psychiatrist. If a person's self-diagnosis is incorrect, it's highly unlikely that they'll get the tools they need to recover.

Relying only on social media accounts or influencers, even those who seem qualified, for medical and mental health advice can also be dangerous, Chatterjee says. People may be exposed to misinformation or hear about cures that don't exist.

The pros and cons of self-diagnosis

Theresa Nguyen, chief research officer of Mental Health America, says that people are typically developing health literacy through online searching related to their mental health. (Nguyen and Mental Health America were not involved in the Made of Millions report.)

That research can include reading about symptoms, spending time in forums dedicated to a certain condition, viewing influencer content on social media, and taking mental health screeners.

Every year, two million people in the U.S. take a Mental Health America screener for mental health conditions including depression, anxiety, and psychosis. Users can print out the results and take them to a physician or therapist for follow-up.

Overall, Nguyen believes that many young people have "enormous capacity" to research mental health online, explore social media, and post their own content, all while making timely decisions about seeking out professional guidance or care.

Still, social media posts with high engagement that treat mental health labels, including textbook diagnoses, with surprising casualness can give the impression that Gen Z is eager to adopt certain conditions as a fad.

Chatterjee says the ease with which Gen Z talks about mental health online can both empower and mislead them, depending on the context and person.

There are scammers in the mental health and well-being space, for example, who cultivate a following by validating their fans' experiences and building a well-intentioned community all while selling an unproven treatment or so-called cure.

Chatterjee warns that young people searching for help can fall into these traps, believing they've found an explanation for their emotional or psychological suffering, as well as a community to belong to as they navigate it.

"Just because it's filling a void, doesn't mean that it's actually helping in the long run," Chatterjee says. "Not all content is created equal."

If someone has found an influencer or community they like in the process of self-diagnosis, Chatterjee recommends remaining critical about how those resources contribute to their recovery.

She also advises people to vet the influencers they follow. That can include checking their academic credentials, whether they're affiliated with a professional organization like the American Psychological Association, and evaluating with skepticism any claims they make.

Angel, 23, was diagnosed with OCD as a young adult after receiving an incorrect diagnosis as a teenager. After learning they actually had OCD, Angel spent considerable time online researching the condition and looking for community. (Angel requested that their last name not be used to protect their privacy.)

For Angel, who has often felt isolated by their OCD, the research connected them to important resources and supportive peers. But the internet also became risky at times.

They began spending hours on a subreddit about OCD, partly to make themselves feel better about their own recovery journey. Angel decided at that point to delete Reddit from their phone as a way of balancing their desire for information with maintaining positive well-being.

Angel tries to focus their attention on practical information, like insights about OCD flare-ups and techniques for managing symptoms.

"I feel like the internet can be helpful but also not helpful," Angel says. "It all depends on how you learn to use it. I've been making sure to learn to use it properly."

An old public service announcement that once aired before late-night newscasts posed a simple question to parents: "It's 10 p.m. Do you know where your children are?"

A similar prompt for safety-minded 21st century parents might go something like this: "It's 10 p.m. Do you know what your children are watching online?"

Some parents may have long given up on answering that question, even if they grasp that online videos can expose teens to inappropriate content, including bullying, self-harm, disordered eating, and porn.

Yet there's no easy way to track or monitor teens' viewing habits, and they can access videos pretty much anywhere — from YouTube to TikTok to parent-approved streaming platforms like Disney+. Even using software to detect certain types of content on their devices doesn't prevent them from watching questionable or off-limits videos on a friend's phone.

The American Psychological Association hopes to help people navigate this challenging dynamic with a new set of guidelines for healthy teen video viewing.

The recommendations offer parents guidance on warning signs related to harmful viewing habits while highlighting key areas of concern, like content that encourages violent or risky behavior, the negative role that influencers can play, and the dangers of AI-generated video material.

Dr. Mitch Prinstein, co-author of the guidelines and chief science officer of the APA, emphasizes that the burden of preventing harm to teens shouldn't fall to parents alone. That's why the guidelines also recommend policies for both politicians and online video-watching platforms to consider.

In the meantime, here are key strategies for parents who want to help their teen develop healthy video-viewing habits but can't wait on policymakers and platforms to improve content standards:

1. Co-watch video content with them.

Prinstein says it's ideal if parents can watch videos with their child, when possible. This content can and should be wide-ranging, inclusive of TV and movies watched together as a family, videos by their favorite influencer, their top TV show, and short-form posts on platforms like TikTok and YouTube.

This might seem overwhelming, but parents needn't commit to a comprehensive weekly or daily co-viewing habit with their teen. Rather, watch what you can with them, and be sure to ask questions about what aspects of the video they like or don't like.

Open-ended conversations about video content can help teens better understand what they're watching. Plus, it offers an opportunity for parents to talk about their own values, preferably without being judgmental or hectoring.

Instead, parents should feel free to point out that a beloved movie from their own childhood doesn't necessarily hold up to modern ideas about beliefs like gender equality.

Prinstein says that when parents watch objectionable video content with their kids but don't talk about problematic scenes or themes, it can signal approval of those ideas to the teen. "It's good to say something, speak up, and say, 'That might have been funny in the '80s, but we do not agree with that today,'" Prinstein says.

2. Get familiar with your teen's interests and favorite influencers.

Prinstein recommends periodically asking your teen what they're viewing online. This is particularly important if you hear about a popular show, like the animated YouTube series Skibidi Toiliet, or a concerning trend, like "looksmaxxing," which can promote potentially dangerous body care practices.

If your teen is a fan, try to engage them with questions about what makes it interesting or funny. If they don't know about certain video content, parents can still be curious about their teens' opinions on the topics at hand.

Since influencers can play an outsize role in teens' lives, Prinstein urges parents to closely monitor who they're following. This can be as simple as jotting down the names of the influencers they like, and then searching for more information about those individuals online.

Parents should consider limiting a teen's access to an influencer's content when it promotes unhealthy behavior. At the same time, parents can also encourage teens to engage with influencers who champion positive behavior and attitudes, like standing up to bullying and posting body-positive content.

3. Identify firm boundaries.

The guidelines do not recommend limiting video viewing to a certain number of minutes or hours each day. Instead, they suggest looking for signs of distracted behavior, loneliness, and excessive viewing that can interfere with a teen's sleep, among other negative effects.

Prinstein also says this interference doesn't have to be extreme to warrant creating new boundaries. If video viewing keeps a teen from performing their chores, for example, that's reason enough to consider reducing their access to content and devices.

Parents should also stay mindful of teens' exposure to advertising on video-watching platforms, where they may see products that aren't appropriate or safe for them. Similarly, the rise of content generated by artificial intelligence is likely to steer teens toward harmful video content in ways that parents may not understand, particularly if they're viewing explicit deepfake videos.

Parents can talk to their teens about non-obvious video content that may still be dangerous, and set boundaries related to engaging with that material, such as forbidding the use of software that creates deepfakes.

Prinstein says that parents navigating these challenges in their own household should reach out to other parents of teens. Together, they can both commiserate and think about ways to create standards in their own communities while even possibly pressuring politicians and tech companies to make important changes.

"We're all in this together," Prinstein says. "We are all struggling with this in very similar ways, and we should not feel like we have to take care of this all by ourselves."

The 2024 election may be over, but its effect on some people's mental health is starting to become clear. Two major crisis hotlines saw huge increases in contact before and after Election Day.

The Trevor Project, which provides free 24/7 crisis services to LGBTQ+ youth ages 13 to 24, told Mashable that conversation topics related to the election surged by 200 percent on Nov. 3 and 4, compared to a few days prior to that timeframe.

By midnight eastern time of Election Day, calls to The Trevor Project's lifeline and conversations that took place via chat and text collectively increased by 125 percent compared to a normal day for the service. That volume continued into the morning of Nov. 6, and the organization anticipates it will remain steady, or potentially increase.

Crisis Text Line reported a similar trend. Conversations about anxiety and stress began rising the Friday before the election. On Election Day, they'd increased by a third of their normal volume.

In general, the nonprofit observed the start of a spike in volume on Sunday. During election week in 2020, Crisis Text Line saw a prominent uptick in conversations related to LGBTQ+ stress, a trend that continued this year. Starting last Friday, Crisis Text Line observed a surge from LGBTQ+ texters that rose by 56 percent by Election Day.

This election appeared to be especially hard on LGBTQ+ youth. In a recent survey of LGBTQ+ youth, 90 percent of respondents said politics had negatively affected their well-being.

President-elect Donald Trump frequently attacked transgender rights on the campaign trail and made anti-trans ads a centerpiece of his campaign. Project 2025, a far-right playbook of conservative initiatives championed by some of Trump's closest advisors, also targets LGBTQ+ rights, according to Accountable.us, a non-partisan watchdog group.

The playbook recommends that the Department of Justice defend the First Amendment right of people to discriminate against LGBTQ+ individuals, undo the Department of Health and Human Service's focus of "LGBTQ+ equity," and reverse the Department of Defense's policy allowing transgender people to serve in the military.

"Young people are wondering if they have a place in the future," Kevin Wong, senior vice president of marketing, communications, and content for The Trevor Project, told Mashable.

Wong recommended that youth feeling overwhelmed or distressed by the election results take a few basic steps to improve their well-being, some of which are outlined in a new Trevor Project guide on the topic.

Wong says youth may benefit from pausing and taking a moment to do something they enjoy, like listening to their favorite album, cooking, or moving their body. (The Trevor Project offers its own visual breathing exercise.)

While he understands the desire to stay informed right now, Wong also suggests taking deliberate breaks from reading the news and engaging with social media. This can be particularly important before bed, to help process the day's events.

Cultivating a sense of hope is also critical, Wong says. This can mean learning about organizations advocating for LGBTQ+ rights and freedoms, and finding community at local LGBTQ+ centers.

For young people who feel they need to urgently learn about the different types of discrimination they might face, Wong says it's important to remember that state and federal policies will not change overnight. As a result, youth can spend the coming weeks taking care of themselves and considering how to protect their rights.

Finally, Wong says that caring adults can help youth navigate this uncertain time by making it clear where they stand. If an adult knows an out LGBTQ+ young person, reaching out directly to offer their support may help alleviate their anxiety.

But adults should also consider that some teens may not yet openly identify as LGBTQ+. So public gestures of support, like sharing mental health resources for LGBTQ+ youth on social media or making affirmative comments during a conversation, offer positive indications.

"Signaling that you are an ally... can do wonders for feeling accepted for LGBTQ+ young people," Wong says.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

With Election Day finally over, you might find yourself scrolling social media for hours on end — elated that Donald Trump won, or devastated that he defeated Kamala Harris.

Either way, you might instead consider a hard-earned break from the 2024 election altogether.

Whether you call the act of signing off on Wednesday a mental health day, social media detox, or simply touching grass, there is nothing you can gain from election-related hypervigilance, said Dr. Richard E. Cytowic, author of Your Stone Age Brain in the Screen Age: Coping with Digital Distraction and Sensory Overload.

"Whether you're obsessed about it or not, the vote count is going to be what it's going to be," Cytowic told Mashable prior to Election Day.

Still, many people have spent the past several weeks or months agitated and anxious about the election.

They're not just experiencing average stress, either. The American Psychological Association's recent poll of U.S. adults found nearly three-quarters of respondents worried that the election results could lead to violence, and more than half believe this election could be the end of democracy in America. With such incredibly high stakes in mind, it's no surprise that people have struggled with the uncertainty of knowing who will become president of the United States, and under what circumstances.

Yet, Cytowic said people also need an off-ramp from this anxiety, rather than letting it persist and fester. You may become fearful for other reasons now that the election results are clear, but at least you'll have a reprieve before new worries fully dominate your thoughts.

To help create this break, Cytowic, who is also a clinical professor of neurology at the George Washington University School of Medicine and Health Sciences, recommends the following strategies:

Accept that you don't have control over what happens. If you voted, try considering that the end of your election season journey, because you did what was within your power to help determine the outcome, Cytowic said.

You may want to start or continue activism and organizing, but much of that work involves direct action, not impulsively checking social media. Plus, you'll need to be rested and ready to engage; self-care is a political act and always has been.

There will be plenty of opportunities to get involved in politics in the coming months (remember: the Women's March didn't happen until the January after the November 2016 election).

Log off as much as possible. Cytowic said that people are overwhelmed because they're being bombarded by political advertising, social media content, and media coverage about the election, all of which can make them more anxious.

Now that the election is over, you may be scrolling for election postmortems, as well as guidance for how to cope with what the New York Times described on Wednesday as the "precipice of an authoritarian style of governance never before seen in [the United States'] 248-year history."

You can try pausing or silencing notifications, so your phone doesn't lure you back into a vicious cycle of checking for updates. If it's helpful, decide in advance to only check the news at certain times, such as after meals.

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Spend time with someone you care about. Social media and tech devices tend to pull us away from in-person interactions. But being with a friend or loved one with whom you enjoy spending time can be restorative, Cytowic said. So the days after the election could be a great time to grab coffee with a co-worker (you can choose to avoid politics), invite a friend to dinner, or speak to a family member (instead of texting them).

Do non-purposeful activities. Cytowic said that the human brain needs time to do nothing, because it's straining to be constantly stimulated. Bonus points if you're able to go outside to clear your mind.

The Dutch refer to such idling as Niksen, Cytowic said. The point is to shift your mental focus and use this time as an opportunity to reset the brain's proverbial circuit breakers. Cytowic particularly recommends looking at trees or the sky, or listening to birds. Even a quiet minute under a tree in a park can be beneficial.

Do a meditative activity. Quitting your device and social media for the day won't be easy if you don't plan alternative activities. Cytowic recommends hobbies that help you stay in the present moment or achieve a sense of flow. These can include meditation, cooking, playing cards, gardening, sports, and other engaging pursuits.

However you choose to give yourself a break after Election Day, just be sure to give yourself a meaningful opportunity to transition away from any stress or anxiety you've been living with for days, weeks, or months.

Cytowic said that if people can seize that chance, they'll be much happier than if they never stop their "relentless exposure" to screens, politics, and the turmoil they often create.

UPDATE: Nov. 6, 2024, 9:46 a.m. PST This story was written prior to Election Day. It was updated to reflect the election's results.

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Batman: Arkham Shadow may be the newest installment in a long-running gaming franchise, but it offers something refreshingly unique.

The game, recently released exclusively for virtual reality on Meta Quest 3/3S, is serious about responsibly exploring its characters' minds. Terms like psychotic, for example, aren't tossed around when characters are violent.

And once Batman enters Blackgate Prison under an alias, on a mission to find the villain Rat King before he strikes, he grows conflicted about his understanding of what motivates the criminals he encounters. As it turns out, when Batman attends a group therapy session led by Dr. Harleen Frances Quinzel (later known as Harley Quinn), he has just as much to say about childhood trauma as the other inmates.

These and other choices were intentional, says Arkham Shadow director Ryan Payton. In 2023, he discovered a series of GQ videos featuring psychiatrist Dr. H. Eric Bender breaking down mental health scenes from popular movies and television, including clips from Joker.

Bender notes that the film "overplays the idea that violence and mental illness are linked." Indeed, people who live with mental illness are far more likely to become victims of violence than to perpetrate it.

Bender had previously observed that the game Batman: Arkham Asylum, labeled the Joker as psychotic when, in Bender's opinion, the character was psychopathic. This difference might seem insignificant to some, but Bender argues that incorrect labels and diagnoses can influence how people see those with severe mental illness, and how those living with such conditions see themselves.

Last fall, Payton asked Bender to consult on Arkham Shadow so that the game authentically depicted the characters' different emotional struggles, without playing into dangerous tropes or stereotypes about mental illness.

The shadow in the game's title has multiple meanings, hinting at menacing themes while also invoking the concept of the Jungian shadow, or unconscious negative beliefs about ourselves that we project onto others. If ever there was a superhero that could shoulder such treatment, it was Batman, Payton says.

"Eventually in the game, you come face-to-face with your own shadow, through many different lenses," Payton says.

But before Payton and Bender met, both of them had powerful experiences that informed the way they thought about mental health in popular entertainment.

Payton recalls playing Final Fantasy VI as a teenager, which depicted a character going through mental health challenges.

"The feelings I was feeling [were] not something I would normally feel playing a lot of other video games I could've pulled off the shelf," Payton says. Since then, he says he's prioritized accurately portraying mental health and other sensitive topics in video games.

One of Bender's a-ha moments came while making a presentation at Comic-Con about media depictions of mental health when someone in the audience asked: "When am I going to see a character with mental illness who does not make me feel like I will turn into a villain?"

For Arkham Shadow, Bender provided Payton feedback on numerous storylines and character traits. This included tense, argumentative exchanges between Dr. Quinzel and Dr. Jonathan Crane, which were written to illustrate the strengths and limitations of different types of therapeutic approaches.

Bender also explained in detail why it could be extremely damaging for one character to hear as a child that they need to bottle up their anger and be good, as depicted in the game's flashbacks.

In total, the game features a half-hour of recorded conversation about mental health and well-being between various characters. There's even "tender moments," Payton says.

Still, Arkham Shadow remains an action game and stays true to the Batman universe. Blackgate Prison doesn't suddenly become a safe, high-quality mental health institution, upending decades of stereotypes about treatment facilities. Nor does Batman suddenly turn into a pacifist, eager to practice conflict resolution with his enemies.

But within these bounds, Bender and Payton feel like they've accomplished something meaningful.

"I'd like to think after people play Batman: Arkham Shadow that they've got a different perspective," Payton says.

Lydia Bach, a 15-year-old sophomore living in New York City, has a message for adults who think teens can't possibly experience burnout.

"If people want to find out what teens are burnt out about, they have to just take a look at the world," Bach says, rattling off stressors like gun violence and global conflict, not to mention the "ever-looming threat that we actually won't have a future because of climate change."

Now, she says, imagine you're a high school student also trying to constantly "be better" and "do better," because "productivity culture" demands regular self-improvement. Meanwhile, you're painfully aware of the economic stakes of your high school career. Without a high grade point average, you might not get into the good college, which will set you up for the well-paying job with health insurance.

Trying to meet high expectations set by parents, teachers, coaches, peers, and even themselves, teens have to also contend with social media. The unpredictable algorithmic force that is the internet often amplifies the different pressures that teens feel, according to a new report on grind culture from Common Sense Media, the Center for Digital Thriving at Harvard School of Education, and Indiana University.

For teens, these pressures include feeling like they need to have a "game plan" for their future; that they must rack up "exceptional" achievements; and that they should look and present themselves in a certain way. More than a quarter of the 1,545 teens surveyed by the researchers struggle with burnout.

Bach, who runs the social media account for the podcast This Teenage Life, has mixed opinions about social media. A writer and quilter, Bach has found online communities that deepen her interests. But she's also acutely aware of posts that could make her feel like she's not achieving or succeeding enough, such as a friend sharing about an award they won.

In the research on grind culture, teens said that social media posts about achievements like personal records at the gym and college acceptances could exacerbate pressure.

"When we see a lot of people, in a short amount of time, talking about their accomplishments, we feel like we should also have something to show," Bach says. In coordination with the new report's release, This Teenage Life aired a new episode about teen burnout, which Bach participated in.

"The path that leads to burnout"

While there's no evidence of a causal link between social media and burnout, Amanda Lenhart, head of research for Common Sense Media, says the survey findings showed that social media tends to amplify the pressures that teens experience more often than it alleviates them.

The report identified six types of pressures that most commonly affect teens. In addition to expectations related to their future, personal achievements, and appearance, teens also feel like they need to have an active and visible social life; stay available to and be supportive of friends; and do good for their communities or stay informed about different issues.

"When we ask young people, they themselves directly point to the pressures as the path that leads to burnout," Lenhart says.

Social media intensifies stress that teens feel about their appearance, according to the survey. The participants who felt this way said that TikTok, Instagram, and Snapchat increased pressure to look a certain way and made them feel "worse." A smaller percentage of teens said that social media, in general, sometimes decreases appearance-related pressure.

Helping teens with burnout

Dr. Tori Cordiano, a licensed clinical psychologist in Beachwood, Ohio, who works with clients in private practice and as a school consultant psychologist, says that teens began using the term "burnout" about five to seven years ago.

Some use the word interchangeably with stress to describe feeling overwhelmed. But others are experiencing burnout as a chronic condition characterized by the "depletion of the ability to even think about how to move forward," says Cordiano.

She also believes that social media plays a complicated role in burnout for teens, at turns worsening how they feel while also providing meaningful opportunities to connect with friends.

But Cordiano notes that the grind of self-improvement is a huge part of the self-care and wellness content that populates teens' social media feeds. The "dark underbelly" of this content subtly convinces teens that feeling good is about "perfecting every part of yourself," which then puts enormous pressure on teens, Cordiano says.

Indeed, the survey found that while teens want to practice self-care, they often don't have or make the time to do so, and can feel like that time isn't "productive."

Teens who weren't experiencing any of the pressures identified in the report — 19 percent of those surveyed — got more sleep, spent more time outside in nature, and had more free time.

Lenhart says parents should pay serious, close attention to signs that their teen may be burning out, and work with them to identify healthy strategies to ease their burden. That includes taking pressure off them to be successful at everything they do, or exceptional at even one of their pursuits.

Cordiano recommends that parents develop reasonable expectations of how their teen manages their time and schedule, helping them to set boundaries as needed for their mental health and well-being. She also suggests they collaborate with their teen on identifying types of social media use that make them feel worse.

Bach has found that reading books about other life experiences is helpful for weathering burnout, because they offer a different perspective—and a reminder that the exhaustion is temporary. Still, she worries that she's facing a years-long grind as she tries to establish herself as an adult in a culture that seems to value nonstop work above all else.

Cordiano says it's up to adults to change this perception for young people and "to let them know that this is actually not our hope or expectation for teenagers, that they are living under a mountain of stress."

Teens and parents alike may consider themselves familiar with classic signs of online grooming. For victims, that includes withdrawing from friends and family, becoming secretive about online activity, and sharing explicit images of themselves.

But predators are so skilled at deceiving their victims that signs of online grooming can actually be subtle and hard to detect, says Lauren Coffren, executive director of the exploited children division at the National Center for Missing & Exploited Children.

In fact, when grooming takes place over a period of time, the dynamic can look much like any other friendship in the beginning, filled with conversations about mutual interests.

But another type of grooming, known as financial sextortion, can happen within hours and minutes, which prevents victims and their parents from picking up on the traditional or obvious warning signs. In these cases, predators may pose as a peer and send nude or explicit pictures to their victim, which is not uncommon for teens.

"These bad actors are really good at what they do," Coffren says. "They figured out these tactics of how to trick kids."

Signs of grooming you might miss

1. The child is receiving a lot of compliments from a new friend.

Predators often earn a child's trust by complimenting them, says Coffren. They may have taken note of the child's interests or likes and dislikes, as indicated by their social media activity. Then they'll flatter the child by remarking on their good taste.

Compliments may also be based on the child's personality traits, such as their sense of humor or intelligence. Such remarks are designed to break down a child's defenses, and they may be particularly effective when a child already craves validation.

Parents might feel thrilled that their child is talking to someone online who appears to genuinely like them, but the new contact may have a predatory motive. It's important that parents have ongoing conversations with their child about the nature and frequency of online interactions that involve compliments and flattery.

2. The new friend is engaging your child's interests.

Predators can skillfully talk to children about their hobbies and passions, including gaming, music, sports, and pop culture, Coffren says. They build trust with a victim by being curious about and sharing those interests.

Again, this dynamic is something that parents typically embrace for their children when it involves trusted friends. But online, that new connection could be anyone, unless that person legitimately belongs to a child's broader in-person social circle.

If a child is excited by a new online relationship in which shared interests play a key role, parents should remain aware of how that continues to develop. While it could be an authentic peer-to-peer relationship that's fulfilling for both children, predators know how to make it hard for a child to know the difference between that and a bond based on deceit.

3. Their relationship looks like a friendship—with some differences.

Coffren says that traditional online grooming will often look like a typical friendship until the predator's behavior slowly starts to escalate. They might offer the victim gift cards, in-game currency, or other presents to appear generous and supportive. A young recipient will likely consider themselves lucky, not manipulated.

Escalation can also involve riskier chat topics, such as sexual interests. For a teen who wants to feel mature, or who is curious about their own sexuality, these conversations can feel like a step toward adulthood. Unfortunately, predators will ultimately take advantage of this.

Coffren says threats toward the child may follow soon after these exchanges. A predator will often threaten to share screenshots of the chats if the victim doesn't continue to talk to them, or if they refuse to share explicit imagery of themselves.

Coffren urges parents to regularly talk to their kids about what healthy relationships and boundaries look like so that they understand the potential implications of behaviors like gift-giving and riskier chats online. Parents should also discuss what a child can do if they're being targeted by a predator, which can include telling a trusted adult and blocking and reporting that account.

In general, she warns parents of the dangers related to children talking to any strangers online, given how swiftly exploitation can happen. To learn more about what online grooming looks like, and how to discuss it with children, Coffren recommends NCMEC's comprehensive resources on the topic.

Most importantly, Coffren advises parents to be unequivocally supportive of a child who shares that they've become a victim of online grooming.

"We put all of this pressure on children to be able to say, 'Never put yourself in that position,' instead of saying, 'OK, if you find yourself in that position, here's the steps you can do to be able to get out,'" Coffren says.

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

Lennon Torres was 13 when she received her first iPhone. She raced to download the apps all her friends used: Facebook, Instagram, and Snapchat, eager to experience social media alongside her peers. 

But Torres, now 25, wasn't the average 13-year-old. She was also a reality show contestant who later regularly guest starred on the show Dance Moms. As she built her social media profile, fans of the show began showing up. Torres, who is transgender and was out as an openly gay teen prior to her transition, received supportive and appreciative messages from queer youth, as well as death threats from strangers.

Then there were others who appeared to be adult men, who had a different agenda. Torres says they urged her to sign onto gay chat sites in order to "explore" her identity. 

Though Torres' parents embraced her queerness, she still felt disconnected from the broader LGBTQ+ community, which made the idea of joining a gay chat site compelling. All it took for Torres to join was falsely checking a box verifying her age as 18. What happened next forced Lennon to realize what it's like to be sexually exploited as a young queer person. 

Occasionally she chatted with someone who felt like a friend. But more frequently she encountered adult men who, in one-on-one conversations, showered her with kindness and compliments. Curious about sex education, Torres asked questions about things she wasn't learning in school or discussing with her parents.  

Then the men would start revealing their true intentions, Torres says. Some pressured her to perform sexual acts on camera. When she resisted, they threatened to publish screenshots of her. Lennon often complied with their demands, assuming that doing so was the safest, least harmful path forward.

"I was so close to the tragedy of sextortion," Torres says, remarking on instances of teens taking their own life in the midst of being threatened by a bad actor or sexual predator who has explicit images of them. "Being that close to it sends chills down my spine."

Once she started dating, at around 15, Torres stopped frequenting the chat sites. She's now the campaign and community manager for the Heat Initiative, an organization that challenges technology companies to combat child sexual abuse on their platforms. 

Though Torres' experience may seem unique given her large social media following and high profile, she is no outlier. 

It's now normal for teens to befriend strangers online, share explicit imagery of themselves, and develop a deep bond with someone they've never met in person. This reality may bewilder their parents, who came of age when "stranger danger" cast suspicion on anyone remotely sketchy—online or off. 

But what adults often fail to understand is that in the past few decades, we inadvertently built a complex web of risk that exposes young people to grooming and exploitation at a massive scale. These days, it doesn't take much for your child to get stuck in it and become someone's victim. 

The scale of online youth exploitation

For more than a year, I've been trying to understand how this risk became so pervasive. It began while reporting an investigative series on the dangers of using emotional support platforms, including the popular platform 7 Cups. I was shocked by how frequently teens cultivate deep relationships with strangers online—and stunned by how often their trust is weaponized for abuse.  

First, the data tell a simple, if horrifying, story about online grooming and exploitation. The National Center for Missing and Exploited Children began tracking reports of online enticement of children for sexual acts, a broad category of digital exploitation that includes sextortion, in 1998. 

That year, the center's CyberTipline received 707 reports. Clearly, once predators had access to youth online, they were going to take advantage of it. The problem has grown exponentially in recent years, as a result of financial sextortion. In 2023, the tipline yielded 186,819 reports, from individuals and electronic service providers, an increase of more than 300 percent since just 2021. This figure is likely a vast undercounting.

Of course, without social media platforms to facilitate these relationships, they wouldn't exist at the same scale. Take Instagram, for example, where Torres received private messages more than a decade ago urging her to join gay chat sites. It was only last week, after years of pleading from online safety advocates, that Instagram's parent company Meta finally made teen accounts private by default and limited private messaging for those accounts.  

Torres believes tech companies should still be regulated by the government, but acknowledges that Instagram's new policy is a small victory. There remains a vast online network by which predators can easily communicate with and groom children, largely undeterred by weak safety measures.

Teens appear to underestimate this danger—or accept it as part of their online lives. A good portion of teens surveyed in 2023 said they told a virtual contact something they'd never shared with anyone before, according to research conducted by Thorn, a nonprofit organization that builds technology to defend children from sexual abuse. 

Thorn has also found that sharing nudes is now viewed as normal by more than a third of teens. Some give this material to someone they believed to be an adult; many surveyed see online relationships with adults as normal. A new survey of 1,000 teens who disclosed sexual abuse revealed the extent to which social media is used to prey on youth. Of the participants who weren't related to their assailant, 12 percent said that social media facilitated the assault.

Threat of a "social shark attack"

As the internet evolved, the social conditions under which children and teens forged meaningful relationships changed dramatically, too, according to the youth advocates and experts in youth mental health, online safety, and sexual exploitation that I've interviewed. 

Loneliness and anxiety surged, perhaps related to widespread device use. Parents helicoptered and snowplowed their children into an arguably fragile state of existence, depriving them of critical opportunities to make confidence-building choices. Caregivers also appear to vastly overestimate the emotional support their teen receives, according to survey data recently published by the National Center for Health Statistics.  

Meanwhile, with influencers constantly in their ear, marketing just about every lifestyle to them 24/7, some teens grow up feeling like a composite of what they've seen online, rather than their own person with a strong sense of self. 

Some teens know exactly who they are but aren't accepted at home or in their community because of their sexuality or gender identity, and turn to the internet for affirmation. Torres, however, has argued persuasively that this is no salve for LGBTQ+ youth, and can actually lead to more harm.  

Social media also lets teens know when they've been excluded, or how their life seemingly doesn't measure up to their peers'. Sometimes social media is used to bully them, like when they're booted from a Snapchat group or become the subject of a gossip "tea" account. Their social ties can feel delicate, if not more performative than meaningful. After all, who can they really trust? 

Making and sustaining friendships under these circumstances isn't easy. Consider that, just like their parents, teens are also distracted by devices. Eye contact and small talk isn't necessary when everyone in the classroom or cafeteria is on their phone. 

Liz Feld is CEO of the nonprofit organization RADical Hope, which runs a four-week wellness program on college campuses designed to help young adults build resilience and strengthen their connections. Arizona State University, New York University, and Mercer University are among the participants. 

Students are brought together in small peer-led groups for skill-building activities and discussion. When they peel off for an "active listening exercise" that lasts three minutes, participants commonly remark on how long the exchange feels. 

"These young adults, they actually don't know how to communicate," she says. "They are not used to sitting face-to-face and making eye contact without any distraction." 

The buzzing anxiety may also have to do with what the Stanford psychologist Jamil Zaki describes as fear of "social shark attacks." Gruesome run-ins with sharks are statistically rare, but the imagery is hard to forget, making them more memorable and heightening our perception of risk. 

A "social shark attack" works similarly. Imagine a social interaction that goes terribly wrong. Now replay that in your mind as the natural result of saying hello to a new friend, asking someone out on a date, or seeing an acquaintance for the first time after you shared something vulnerable about yourself. If all you can see is blood in the water, you're likely to take fewer chances. 

Given how so much of their social lives look nothing like what adolescents have traditionally experienced, it's no wonder teens think they might have better luck with relationships online. 

"Young people are taking enormous risks because they feel safe with strangers," says Zaki, author of Hope for Cynics: The Surprising Science of Human Goodness. "They're basically risk averse with people in their lives, and maybe overly risk seeking with people who are anonymous."

The illusion of control

Teens are also in a precarious developmental period of their lives. They're eager to separate from their parents and feel mature, both of which can lead to riskier behavior, says Amy Corbett, a therapist with a private practice in Somerville, Mass. 

Corbett has worked with numerous teen victims of online sexual exploitation. Some of them had past histories of trauma, like child abuse. Others came from supportive, loving households. Many of them felt safer connecting with a stranger online because they could present themselves at their own pace, in ways that felt freeing, even if they weren't being entirely authentic.  

One teen girl experienced significant anxiety and spent considerable time on video game platforms, which led to social connections. At first, it felt empowering for the girl. But then one relationship with an adult male escalated from texting, chatting, and exchanging information into "something really awful," Corbett says. 

Carrie Goldberg, a lawyer who has represented victims of child sexual exploitation, says predators often reinforce the idea that a teen they're talking to is very mature, a form of validation they crave. 

As the teen shares more about themselves, which can include secrets as deep as a history of abuse or suicidal ideation, the predator will also divulge their own secrets. This creates a false perception for the teen that the bond the two share is unique and unusual, Goldberg says.   

Taking small leaps of faith 

The sad reality for teens and young adults is that they actually yearn for meaningful in-person relationships with their peers. 

Zaki, director of the Stanford Social Neuroscience Lab, noticed that after students returned to campus following the initial phase of the Covid-19 pandemic, they complained how difficult it was to meet people. He had a hunch about why. 

In 2022, his lab surveyed thousands of students and asked about how much they cared about their peers, enjoyed helping others, and wanted to connect with people. A second set of questions asked about how the students viewed the average Stanford student. 

The self-assessments were overwhelmingly positive. The vast majority of respondents wanted to make new friends and demonstrated empathy toward others. But their perception of the average student was harsh: "unfriendly, judgemental, and callous." 

Zaki suspects that fear of social shark attacks, among other factors, holds young people back. They simply aren't testing their assumptions about what will happen if they reach out to others. As an antidote, he recommends being less risky with strangers on the internet and taking more risks in everyday social life. This doesn't mean telling someone you just met your deepest secrets, but instead taking small leaps of faith and "calculated chances" on other people. 

In many ways, this is what RADical Hope helps to facilitate in its college wellness program, RADical Health. Melissa White, a student-athlete at Middlebury College, volunteered as a student guide last year. She helped facilitate conversations about stress management, self-care, and decision-making. 

Unsurprisingly, students were reluctant to share at first. But White realized that once she made the first vulnerable move, and the group understood the discussions would be confidential, others quickly followed suit. Students were relieved to learn they weren't the only ones who felt anxious, confused, or lost at school. 

The difference between this and cursory online socializing with peers, where people might share their interests or highlights, felt clear to White. 

"It creates this community where people are relating to each other rather than just this interpersonal connection," White said of the RADical Health model. 

There's no easy way to solve the problem of teens going online for fulfilling relationships and paying an unimaginable price for doing so. But it's obvious that they need both aggressive protection from predators online and safe in-person opportunities to connect to their peers. 

They also need parents who won't punish them if they do become a victim of online exploitation. Regardless of whether they lie about their age, disclose family secrets, or betray trust, every expert I spoke to had a singular message for parents of teens: Talk to them openly and often about online risks; let them know you'll protect them if something bad happens; and never blame them if it one day it does.

Torres recommends that young teens in search of a meaningful relationship or confidant lean on trusted peers and adults instead of going online. She hopes that collective efforts to regulate technology companies and social media platforms will ultimately make the internet a much safer place for youth to connect with each other. 

"Wait for the better online future that I know is coming, but it's just not here yet," Torres says. 

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

I don't share my literal dreams, the ones that happen at night, with just anyone.

But in this case, I was testing the journaling app Rosebud, which is powered by artificial intelligence. After using Rosebud's voice-to-text feature to create a few daily run-of-the-mill entries (the app is not just for dreams), I decided to log a recurring dream that had recently eluded my own attempts at analysis.

I'll spare you the details; let's just say that it involves my children leaving their belongings behind. In the dream, I keep trying to remember where the items have been tossed aside, but then I ultimately forget them, too, at which point panic sets in.

I clicked on Rosebud's dream-specific journal entry, which asks you to share as many specifics as possible. I gave it a two-sentence description. Despite my limited recounting, Rosebud's line of questioning led me to an epiphany about parenting, responsibility, letting go, and trusting your child, all within three follow-up prompts. I was hooked.

The desktop version of Rosebud is a year old, but the app launched last week. So far in my testing, the journal app, billed as "guided self-discovery," has offered what AI technology has long promised to become: a tool for supporting human growth and creativity, with surprising efficiency and insight.

Rosebud's cofounders, software engineers Chrys Bader and Sean Dadashi, who met in a men's group, say Rosebud is designed to increase users' self-awareness, not to solve problems for them. It's also not pitched as therapy, but as an accessible complement to professional help. It costs $12.99 per month or $107.99 annually.

This is refreshing at a time when some AI products are positioned as robots to whom we can offload unique aspects of the human experience, like writing a letter on behalf of a child to their sports hero (see Google's ill-fated "Dear Sydney" ad).

Rosebud's philosophical approach of championing human-led, AI-enabled personal growth, combined with the instantaneous speed at which the app helps deliver meaningful insight, offers a compelling example of how AI journaling could transform people's self-awareness, potentially improving their well-being and mental health.

I do have some reservations, including the risk of becoming too attached to Rosebud, data safety and privacy issues, and what happens when users express suicidal thoughts or feelings. As the market for AI journaling apps grows, the best options will be products that meaningfully address these and other risks, putting safety above profit and growth. So far, Rosebud seems to be taking that challenge seriously.

AI journaling: The good and the great

Scientific research tells us that expressive writing, which you'll often find in personal journals, can improve people's well-being and mental health, though this effect isn't universal. When journaling works, it appears to be partly because the author is able to write without fear of judgment, but the science isn't conclusive yet.   

There's limited research on the new phenomenon of AI journaling, so little understanding of who stands to benefit most from the practice — or what could potentially go wrong. Rosebud only has customer survey data, and hasn't yet hired a chief medical or clinical officer, though the company partners with mental health professionals to provide feedback about how the platform responds to numerous scenarios.

This is all to say: If you sign up for Rosebud, or another AI journaling app, you're exploring uncharted territory and should proceed with reasonable caution.

Rosebud is built on large language model (LLM) technology, but has been tailored specifically to engage users in a way that should heighten their self-awareness. Rosebud's cofounders recently decided to make Anthropic's Claude 3.5 Sonnet their primary LLM of choice, after simultaneously testing that platform and OpenAI's ChatGPT.

The Rosebud AI-powered journal can deliver profound insights. Credit: Rosebud

Bader and Dadashi said they preferred the way Claude referenced memories provided by Rosebud's proprietary "awareness engine." Drawing on Claude's LLM, the pair have engineered Rosebud to serve up daily reflective prompts to users, starting with basic questions like, "What's your top priority today?" and "What was the highlight of your day?"

There are separate journal prompts for dreams and gratitude. Plus, there are journals created by Rosebud-vetted experts on topics like "nervous system rebalancing" and positive psychology, and journals created by licensed therapists, based on evidence-based approaches like cognitive behavioral therapy.

Once you complete an entry, Rosebud can get into its groove. First comes a summary of what you just shared, laced with validations, minor insights, and new prompts. For example, if you're worried about work deadlines competing with parental obligations, Rosebud will say it understands, acknowledge that the situation is challenging, and may ask something like, "What would help you feel accomplished?" and "How do you envision your evening unfolding if both your goals and your child's needs are met?"

Without AI, it's easy to imagine an analog journal entry about the same scenario providing the writer a chance to at least prepare themselves for the day ahead, and potentially practice self-compassion or another coping skill. But with AI, there's dynamism that can lead to that improved self-awareness that Bader and Dadashi say they are so determined to provide.

That's partially because Rosebud has a choose-your-own-adventure element. Following its initial summary, you can ask the Rosebud app to do things like suggest some ideas, offer a different perspective, or "help me think through this."

I've favored suggesting ideas and offering a different perspective, both of which have led to surprisingly useful tips and insights.

For one entry about trying to increase my exercise after a frustratingly long illness-induced break, the different perspective feature posed a question I hadn't even considered: How would I feel about going into the day with a curiosity mindset, treating my exercise attempt as an experiment to see how my body reacted, rather than pressure myself to achieve a certain outcome?

I'm not joking when I say that I immediately wrote the idea on a sticky note so it would be visible throughout the day, because it was an excellent suggestion I didn't want to forget.

What's perhaps most valuable about Rosebud is that it doesn't try to problem-solve on users' behalf. Bader and Dadashi say this is intentional. The approach is drawn directly from their own personal experiences in individual therapy and men's groups, where they had to learn skills like active listening and validation, and subdue the impulse to explain or give advice to someone.

"Rather than trying to replace human thinking, [Rosebud] is trying to help you think more deeply, and feel more deeply," says Dadashi. "You can't grow if someone's telling you what to do, or giving you all the answers."

Areas for improvement in AI journaling

There's real promise in an AI journaling app like Rosebud. While it's no substitute for professional therapy, it could provide vital support for someone who can't access help, or just empower users with fresh insight about their feelings and experiences, in a low-cost, accessible way.

But it also comes with unique risks. While expressive writing is considered a low-risk activity, AI can introduce unexpected complications.

Dr. Johannes Eichstaedt, a computational social scientist and assistant professor in psychology at Stanford University, has generally positive views on the concept of AI journaling.

Yet he can see a potential downside if users become reliant on a platform like Rosebud, turning to it instead of a loved one, or becoming so engaged with the technology that they stop doing other important things, like exercise and sleep.

Bader and Dadashi say they're aware of this possibility. Even though the average user is on the platform for just 12 minutes a day, there have been extreme cases of "unhealthy use" clocking in at three or four hours per day. That's partly why there's now an undisclosed limit on the number of times a user can "go deeper" in their entry, but users rarely reach it. I tend to ask Rosebud to go deeper two or three times before finishing the entry.

But there are other considerations. Eichstaedt says this includes the possibility that AI journaling apps may create an "echo chamber" for people with serious mental illness like obsessive compulsive disorder and schizophrenia. He notes that because an AI assistant is typically instructed to be helpful, it may unwittingly reinforce harmful thought patterns or behaviors.

For someone with OCD, this could mean using an AI journaling app to seek reassurance for their compulsive anxiety; a professional would try to help a patient with OCD cope in the absence of reassurance.

Bader and Dadashi have no easy answers for how to handle these dynamics, though they recognize the "ethical boundaries and limitations in addressing serious mental health conditions." For now, they've programmed Rosebud to detect patterns of overdependence and also to encourage users to seek mental health care, as appropriate.

This is the case for someone who expresses suicidal feelings, a scenario I personally tested using a unique account. Unfortunately, Claude does not immediately offer specific crisis resources, per its default setting, so it took an additional response from me specifically asking how to contact a hotline to elicit information about those details. Prior to that, it first asked if I would be open to professional support, then gave me a generic list of options, like a primary health physician, local mental health clinic, or a crisis line.

Bader and Dadashi say this is partly because the LLM doesn't know the user's location and doesn't want to share irrelevant contact information, like providing a U.S. crisis line for a resident of the United Kingdom. They added that they're working to improve Rosebud's ability to quickly give a suicidal user the right resources.

Users should also understand that no internet-connected journal product is guaranteed safe from bad actors, no matter how well it's protected. Rosebud entries, for example, are encrypted in transit to the company's servers, and then stored in a highly rated third-party cloud. But they also end up at Anthropic and OpenAI's servers, albeit anonymized, so Claude can respond to each prompt.

Currently, Rosebud's data is retained at Anthropic and OpenAI for 30 days, but Bader says the company is working with both companies to enable a zero-retention option. Neither LLM company trains their products on user data, and Rosebud doesn't, either. Nor does Rosebud sell user data to third parties.

Despite these measures, the data is still out of your hands once you enter it into Rosebud and could be a target of hackers eager to weaponize it. Because it doesn't handle patient data in a clinical setting, Rosebud isn't required to be compliant with the Health Insurance Portability and Accountability Act, the federal privacy law.

For some, these and other risks of AI journaling may be worth it. Personally, I'm finding it difficult to justify pausing my use given how much I've gained from Rosebud in one week. It's helped supercharge my mindfulness practice. I've set and achieved goals related to focus that have otherwise stymied me. It even managed to convince me to adopt a new mindset, which is no small thing for someone who reports on mental health for a living.

The real test will be if this journaling habit sticks for the long run, since we know that most people abandon mental health and well-being apps within weeks of starting them. My personal growth might plateau, too. But I actually look forward to finding out, because who knows what Rosebud will help me learn about myself along the way.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

It always starts with good intentions. Your toddler is fussy or irritable, and you've seen how the tablet calms them down. Why not hand it over for a few minutes to prevent a tantrum while you get dinner ready?

It's a scene that plays out successfully in many households everyday, but the short-term victory may lead to a major parenting challenge in the future, according to new research.

The study, which appeared in JAMA Pediatrics, found that more tablet use at age three-and-a-half was associated with increased anger a year later. A child's inclination to become angry or frustrated at four-and-a-half was then linked to more tablet time at five-and-a-half.

The findings suggest that providing a toddler with a tablet, especially when they're expressing negative emotions, can eventually backfire, the study's lead author, Dr. Caroline Fitzpatrick, told Mashable.

"The ability to regulate emotions doesn't happen automatically," said Fitzpatrick, who is a child development researcher at the Université de Sherbrooke in Canada.

Instead, young children commonly develop this skill through supportive interactions with their parents or caregivers, and through play. But when they have a tablet in their hands, those opportunities typically disappear.

Dr. Kathryn Keough, a psychologist with the Child Mind Institute's Anxiety Disorders Center, said the study's results, in addition to similar research on tablet use among young children, make a compelling case for parents to reconsider when and how they provide the device to their kids.

"The big thing is to transition away from tablets as much as possible for preschool-age children and younger, given the research that's come out," Keough said. She noted that even educational apps are unlikely to have as positive an impact on a young child as playing with a parent or sibling, or exploring their surroundings, like a backyard.

The transition away from tablet time may be tough, but Keough offered a step-by-step guide for helping a toddler adjust:

1. Practice self-compassion.

As a psychologist who treats young children for mental health conditions, Keough has seen this scenario plenty of times. She knows why parents rely on tablets and other devices with kids: because it works. In the moment, a screen provides enough stimulation and distraction to help a child quickly move past difficult feelings. "I hope they can give themselves grace," Keough said of parents who've been using tablets in this situation.

Once parents realize the risks of relying on a tablet when their child is frustrated, angry, or sad, they can commit to changing that habit.

2. Set expectations.

If parents don't yet have specific time for tablet use, like after dinnertime, Keough recommends designating one. Ideally, this window would align with the guidelines for two- to five-year-olds created by the American Academy of Pediatrics, which is no more than one hour per day of high-quality programming, viewed with a parent.

Importantly, Fitzpatrick's study found no negative effects on anger for children who followed the recommended one hour or less of tablet time. But every 73 minutes in daily tablet use above that threshold led to significant increases in angry outbursts.

Once children understand they can only use the tablet at a specific time during the day, they'll be better prepared to handle not receiving it on demand, or when they're struggling. For parents of younger children, who may not yet be verbal, Keough said it's possible to keep the tablet out of sight without them remembering that it's an option.

3. Coach your child through difficult feelings.

In general, parents trying to reduce tablet use should focus on emotion regulation strategies with their child, like naming feelings and practicing deep breaths.

For example, saying aloud that the child seems frustrated helps them better understand the emotions they're experiencing. Inviting them to then take a break and breathe deeply or count to 10 demonstrates how they can cope with hard feelings.

Keough said that parents should try to model similar behavior. If they spill a cup of coffee, for example, it's a good opportunity for the parent to say aloud that they were rushing, and that mistakes happen. Keough noted that adults tend to cope internally, sometimes because they're embarrassed to acknowledge their own feelings. But doing so out loud can set a powerful example for a young child.

4. Weather the storm.

Parents should fully expect that a toddler or preschooler will have a tantrum when they're accustomed to getting a tablet and don't. Keough said parents who can stay firm with this boundary, even amid an ear-splitting outburst, will eventually see progress. During the tantrum, Keough said parents can calmly remind their child of the times when tablet use is appropriate, and explain that it's now time to calm down.

As soon as the child starts to relax, it's important to affirm them by saying they did a good job calming down. If a parent had their own emotional blowup during the tantrum, Keough said they can acknowledge to their child what happened, and say they're sorry for reacting negatively.

5. Be mindful of your own device use.

When a parent is trying to curb their toddler's tablet use, it's important that they also reflect on their own habits. The goal is to model behavior for their child, which certainly means avoiding picking up a smartphone during stressful moments. But it can also mean restricting device use at meal times so your child experiences family conversation and connection without devices present. To help set these boundaries, Fitzpatrick recommends adopting a family media use plan.

6. Encourage play.

Shifting away from tablet use can give children more time to spend on imaginative or pretend play, which helps them develop key social, emotional, and cognitive skills, Keough said. She suggests that parents also set aside time every day to play with them, even if it's for five minutes. They can encourage pretend play by modeling how to use objects creatively and by acting out characters.

Of course, parents should remember to leave their phone out of reach in order to be fully immersed in playtime.

People in treatment for major depression now have another recovery option to try.

Rejoyn, the first-ever app cleared by the Food and Drug Administration to help treat depression, officially launched to the public on Tuesday.

Rejoyn isn't a form of digital talk therapy or an expansive library of exercises in cognitive behavioral therapy, a type of treatment that helps people reframe negative thoughts and beliefs.

Instead, the app's parent company, Otsuka Precision Health, likens Rejoyn to physical therapy for the brain. The app offers a six-week program that challenges patients to recognize and remember four specific emotions, like happiness and disgust, they see on a series of photos of faces, then determine whether they match the emotion on the face in front of them.

Formally known as the emotional faces memory task (EMFT), the activity is thought to help patients strengthen neural connections between the brain's prefrontal cortex, which manages executive functioning, and the amygdala, which processes emotions.

As users improve their face-matching ability, they move onto more difficult face-matching scenarios.

Rejoyn appears to work by strengthening neural connections in the brain. Credit: Otsuka Pharmaceutical

"EMFT is designed to really enhance circuits that have been shown to be not optimally functioning in depression," Dr. John Kraus, Otsuka Pharmaceutical's chief medical officer, told Mashable. Rejoyn also includes brief lessons in cognitive behavioral therapy.

Though Rejoyn is now available in the App Store and Google Play, only patients with diagnosed major depression who are currently on antidepressant medication are eligible for a prescription for the app. Patients must also be at least 22 years old.

Rejoyn is considered low risk by the FDA. Kraus said that the company didn't detect any adverse events during its clinical trial, but like with any treatment for depression, patients should consult their health care provider if their symptoms don't improve, or if they experience suicidal feelings or behavior.

Rejoyn was tested against another memory task involving shapes instead of faces. Those who matched faces saw improvement in their depression symptoms compared to those who worked with shapes. Rejoyn, however, has not been tested against proven computer-based treatments for depression, like cognitive behavioral therapy, which are often free.

Initially, Rejoyn will cost $50 for individual patients paying cash. For insurers, the price is $200. Otsuka Precision Health expects insurance carriers to eventually add coverage for the app. Patients can receive a prescription from their healthcare provider.

They can also request a virtual consult through the telehealth provider group Wheel Health, Inc., via Rejoyn's website. The consult, which costs $29, will assess whether Rejoyn is appropriate the patient. Upon receiving a prescription, they receive a unique code to access the app's treatment program.

When the six-week treatment period ends, patients can access the cognitive behavioral therapy lessons for another four weeks. After that point, they're no longer able to use the app. Kraus said patients could potentially receive a new prescription in the future, if recommended by their health care provider.

While Rejoyn doesn't emphasize achievement, it does require consistent and sustained attention. Each matching task takes 20 to 30 minutes. Users can pause their progress if they need to momentarily step away, but the session will reset after 15 minutes.

Given the cost and timeframe, patients may want to consider whether the app is best-suited for their needs, compared to other apps or treatment options, said Dr. John Torous, a psychiatrist and director of the digital psychiatry division at Beth Israel Deaconess Medical Center in Boston.

He noted that most people stop engaging with mental health apps within weeks of starting to use them, so patients may benefit more when they choose an app they believe they'll stick with from the outset.

Torous said patients are most likely to experience progress when they're using an app as part of their ongoing treatment with a mental health provider.

"Pure self-help is hard, but at least having your clinician check in...[and] keeping you accountable is going to be very important for making it work," Torous said.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

It is not uncommon for young adults to experience significant stress during college. So if you’re feeling a bit overwhelmed just know that you’re not alone. Far from it.

Think about it like this: college students may be adjusting to new responsibilities, managing their classes, as well as navigating the newfound pressures of young adulthood. This 180-degree turn in terms of transitioning from childhood to adulthood is objectively stressful. Learning how to manage stress and unwind in college will benefit you well into your journey to adulthood.

Why is managing stress so important?

“While college is an exciting time, it is also a time where stress awareness and management is crucial,” explains Ernesto Lira de la Rosa, Psychologist and Hope for Depression Research Foundation Media Advisor. “College students are at heightened risk of developing anxiety and depression during this time and managing stress can be a good way to mitigate these mental health concerns.”

How do I manage stress in college?

There are a variety of ways to manage stress and it can be helpful to think about them across physical and emotional dimensions. “Physically, this includes taking care of your body through exercise and food and nutrition. Make sure you have enough water throughout the day and that you are keeping up with any medical concerns,” says Lira de la Rosa.

“Emotionally, you may want to consider having a good support network you can reach out to for support. This can include friends, family, or seeing a mental health provider. Additionally, it can also be good to start and maintain a meditation, yoga, or breathwork practice to alleviate stress.”

What gear could help me manage stress in college?

When you first get started with building stress management habits, it can be challenging to find what works for you—but according to Lira de la Rosa, consistency and patience are key.

For example, there are some good meditation apps and devices that help you practice and maintain a meditation routine. If you want to use physical activity to manage stress, you can check out fitness tracker apps or devices to help you get started. These apps and devices can help you with accountability and ensure you are maintaining a routine.

“Overall, you want to take inventory of what types of stress management techniques resonate with you,” says Lira de la Rosa. “Then, you can start by practicing these techniques and work towards building mastery.”

If you're just getting started, here are some of the best essentials that’ll ensure you’re managing stress in college the best way that you can:

U.S. Surgeon General Dr. Vivek Murthy announced Monday that he believes social media platforms should come with a warning label, in an effort to help protect young people from related mental health risks.

"A surgeon general's warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe," Murthy wrote in a New York Times opinion essay.

Tobacco products sold in the U.S. have long displayed a surgeon general's warning label. Murthy said that research studies have demonstrated that warning labels can "increase awareness and change behavior."

He also cited a 2023 survey of 558 Latino parents as evidence that a warning label could be effective. When presented with a brief prompt about the risks of social media for youth, three-quarters of respondents said they were more likely to act, including by limiting or monitoring their social media use.

This is not the first time Murthy has emphasized the potential harm of youth social media use. A year ago, he issued a 19-page advisory that outlined how social media can expose children to violence, sexual and hate-based content, disordered eating, bullying, and predatory and self-harming behaviors.

Some critics believe the focus on social media and youth mental health amounts to a 21st-century moral panic, citing weak associations between poorer mental health and certain types of online engagement.

But Murthy argued that spiraling youth well-being may very well be connected to the amount of time young people spend online, and how such use affects their sense of self-worth. He characterized the situation as an emergency; in those conditions, you don't have the "luxury to wait for perfect information," Murthy wrote.

In addition to a warning label, Murthy said technology companies should be required to publicly share data on the health effects of their products, and to allow independent safety audits.

He likened such actions, among other recommendations, as a normal response to past and current public health threats, including automobile, flight, and food safety.

"Why is it that we have failed to respond to the harms of social media when they are no less urgent or widespread than those posed by unsafe cars, planes, or food?" Murthy wrote. "These harms are not a failure of willpower and parenting; they are the consequence of unleashing powerful technology without adequate safety measures, transparency, or accountability."

Therapist Francesca Rossi works with clients who've had real images of themselves turned into sexually explicit content, without their consent. All of her current clients identify as woman.

This type of image-based abuse, known as an explicit deepfake generated by artificial intelligence, is frequently perpetrated by a current or former intimate partner, or a known friend, coworker, or neighbor, as a form of harassment and stalking. Rossi, a licensed clinical social worker in New York, has seen her clients heal from this betrayal, but the journey is long, and rarely predictable.

In some states, creating and distributing an explicit deepfake might be against the law, but even so, local law enforcement may have few resources to investigate such cases.

The victim typically has to marshal her own response. Among her options are attempting to track down the imagery and issue takedown notices where it appears, but there's no guarantee she'll locate all of it. Rossi says explicit deepfakes are often traded between individuals, then downloaded, without the victim's knowledge.

Feeling successful one day doesn't mean the next day will be the same. The imagery may pop up on new platforms. The perpetrator may send it to the survivor's friends, family, and employer. Rossi says survivors naturally become hypervigilant. They often, impossibly, want to avoid the internet altogether. Sometimes they become fixated on monitoring imagery of themselves online, using the internet excessively to do so.

"Being victimized through deepfakes can erase your sense of reality," says Rossi, noting the dissonance survivors feel because the fake imagery looks real and convincing. "They distort your understanding of the world and everything you know to be true."

Why safety planning is critical for healing

Rossi says that people need to feel safe in order to restore their sense of reality. Creating that safety happens through measures big and small.

In the beginning, when the deepfakes are discovered, Rossi says that it's important to gather trusted loved ones who can offer emotional support, help locate where the deepfakes appear, and try to remove them, or develop a strategy for navigating this complex process, possibly in partnership with law enforcement or attorneys.

The U.S.-based Cyber Civil Rights Initiative has an image abuse helpline, along with a thorough guide for what to do once you've become a victim. In the United Kingdom, people can turn to the Revenge Porn Helpline, which aids survivors of intimate image abuse.

In addition, people may want to remove their personal information from databases maintained by data brokers, which can be done through paid services or by contacting the brokers directly. That data, including a person's home address and the names of their family members, can be used for doxxing, harassment, and stalking

Kate Keisel prioritizes physical and psychological safety planning in her work as cofounder of the New Jersey-headquartered Sanar Institute, which provides trauma-specific mental health services to survivors of interpersonal violence, including image-based sexual abuse.

Keisel says that survivors are often told by well-meaning supporters to stay off the internet when that's simply not an option for personal and professional reasons. That's why physical safety planning can include an understanding that even after initial successful takedown notices, there's no guarantee the imagery won't surface again.

Instead of hoping that the abuse will definitively end, Keisel recommends that survivors implement boundaries related to how they spend their time online, particularly if they find it distressing not to look for images. To increase their psychological safety, survivors may want to set a limit on the number of hours they devote to searching for images of themselves.

Keisel says it can be helpful for survivors to identify and stick to tasks that feel squarely within their control, like removing their personal information from the internet.

Getting and staying grounded

While practical steps, like issuing takedown notices, are key to safety planning, both Keisel and Rossi say survivors also benefit from grounding and mindfulness practices that decrease psychological distress and anxiety.

Survivors suffer particularly because their nervous system perceives a constant threat; deepfakes, after all, have the potential to re-emerge, or may still exist online or in someone else's possession.

A therapist can teach a survivor new techniques, but Keisel says activities that bring someone into the present moment, so they can fully inhabit their body, can also be powerfully calming. These can include trauma-sensitive yoga and Tai Chi.

Rossi also recommends calming strategies that stimulate the senses, such as lighting incense or a candle, and laughing, which can reduce the body's response to fear.

"We can't think our way out of trauma," says Keisel. That's why she believes "somatic," or body-based practices, help a survivor feel safe in the present moment, even if their life has been turned upside down.

Keisel says that there will be moments when a survivor's nervous system goes into panic mode because of a new development, but that it's possible to learn skills to better tolerate that distress.

The combination of safety planning, gaining more control, and self-soothing can put someone on the path to healing, Keisel says.

There is hope

Rossi and Keisel are among several therapists and professionals in the U.S. who specialize in treating survivors of image-based sexual abuse, but their expertise is uncommon. Rossi says she has more consultation requests than she can handle; they've increased markedly since AI software and apps capable of producing explicit deepfakes became more widespread late last year.

The abuse is accelerating at a pace that lawmakers and tech companies aren't matching, though the White House recently issued a call to action for digital platforms and services to tackle the problem.

The White House's recommendations included Congressional action to strengthen legal protections for survivors of image-base sexual abuse, and provide them with critical resources.

Keisel says that those who want to talk to a therapist should consider interviewing them about their treatment practices to see if they're a right fit. Survivors might avoid therapists who don't understand image-based sexual abuse, or who aren't trained to use a trauma-sensitive approach.

But Keisel doesn't want survivors to give up on the idea of healing, even if it sometimes feels unimaginable.

"There's this idea that those of us who've experienced this level of trauma are going to be stuck in place where we can't move forward," Keisel says. "When we have the right support in place, we move past these things in life."

If you have had intimate images shared without your consent, call the Cyber Civil Rights Initiative’s 24/7 hotline at 844-878-2274 for free, confidential support. The CCRI website also includes helpful information as well as a list of international resources.

Instagram and TikTok are go-to social media platforms for mental health advice, some of it dispensed by influencers who call themselves coaches.

Through pricey courses or one-on-one meetings, the influencers often promise clarity, motivation, and healing that leads to a new lifestyle — the one you've always chased after. But whether or not they have any formal training, in mental health care or coaching, is another matter. Unlike psychologists, psychiatrists, and other licensed mental health professionals, anyone can call themselves a mental health coach.

Experts say the mental health coaching trend is relatively new, and that consumers should beware of empty guarantees made by people with few or no credentials aspiring to build a business or social media following. But what influencers aren't wrong about is the difficulty of accessing mental health help, or even the support of a trained professional with expertise in coping, habit formation, and behavior change.

Sometimes you don't need a therapist; you just need a skilled guide who can help you better manage conflict or your sleep habits and hold you accountable.

The fields of mental health and behavioral coaching have taken notice of the trend and the problem it claims to solve. That's why Headspace, which got its start as a meditation app more than a decade ago, launched direct-to-consumer, text-based mental health coaching in April, after providing the service through employer and health plan partnerships.

Lyra Health, a digital mental health company, also offers mental health coaching, but only to employees of companies that pay for it. Some companies, like BetterUp, provide career, communications, and life coaching that could improve mental health, but they don't specify that area of focus.

Headspace's service is a compelling example of what mental health coaching can look like when practiced by trained professionals. For $99 per month, members get three text-based, 30-minute coaching sessions per month.

Before a member begins coaching, Headspace screens to identify whether the person might be in crisis or need urgent mental health treatment, in which case coaching on its own may be ineffective. An onboarding process attempts to set a clear expectation that coaching isn't therapy. Coaches work with members to set defined and achievable goals, like going to bed 30 minutes earlier or adding more movement to their daily routine.

The company employs the majority of its coaches as staff, and all coaches receive regular training and oversight. Coaches have daily access to a licensed on-call clinician, who they can consult when a member needs more than what's offered. In these cases, the coach transfers the member to a referral team that provides resources for finding an outside therapist or psychiatrist.

Dr. Vaile Wright, a psychologist and senior director of health care innovation for the American Psychological Association, says that high-quality mental health coaching could be exactly what some people need to move through lower-level challenges and ultimately thrive.

"It's a great place to start when you know you need some help, but you might not have an official diagnosis of, say, depression or anxiety," she says.

How mental health coaches get credentials

Jennifer Lundman, a licensed clinical social worker and a National Board Certified Health and Wellness coach, doesn't agree with the mental health coaching trends she sees on social media — specifically when they involve influencers with questionable credentials and aggressive sales pitches. And, instead of partnering with a client to help them understand what behavior changes work best for them, some coaches hawk exercise plans and supplements, which is not something certified professionals do.

Lundman believes that so-called coaching that's popular on TikTok and Instagram "does jeopardize this really, really important work that can be done to support people's health and wellness."

The National Board for Health and Wellness Coaching (NBHWC), where Lundman works as director of program approval and continuing education, is trying to professionalize the unregulated industry.

Since 2016, NBHWC has collaborated with the National Board of Medical Examiners, a nonprofit that provides assessment of many health professions, to provide a rigorous exam that aspiring health and wellness coaches can take to achieve board certification. More than 11,000 people have since received it since the first exam took place in 2017.

The exam was developed in collaboration with the National Board of Medical Examiners, a nonprofit that assesses health professionals. Another professional organization, the International Federation of Coaching, also offers certification; Lyra Health requires that its coaches go through that program.

Passing the NBHWC exam requires learning about behavioral change, and how to facilitate it as a coach, as well as motivational strategies and basic health and wellness. Exam applicants must first complete a training program approved by NBHWC, which could be offered in an academic, private sector, or healthcare organization setting.

Headspace offers one of those approved programs. Its six-month certificate course, which costs $5,995, awards successful participants with a certificate in mental health coaching, after they complete 20 weekly live and synchronous education and training sessions, among other requirements. Most of Headspace's staff coaches have completed this program, and it can be used outside of the company.

Dr. Jenna Glover, chief clinical officer of Headspace, says the company's coaching style incorporates motivational interviewing. The technique, which licensed mental health professionals may also use, is a cornerstone of behavior change. It's meant to help people identify both stubborn challenges to their well-being and the skills they need to overcome those roadblocks.

In coaching, however, there is no deep discussion about the family dynamics or relationship troubles that may have contributed to unhealthy habits. Importantly, for Headspace coaches, Glover says there is also an awareness that members face immovable or unchangeable obstacles that interfere with their well-being, like experiencing racism at work, needing to work multiple jobs, or living with student debt.

Headspace coaches, according to Glover, are trained to validate such stressors and guide members toward factors within their control, like putting their phone away well before bedtime to get better rest, or spending higher quality time with their child when they're not at work.

"A coach can really help guide [a client] and say, 'What are you able to work on right now?'" Glover notes.

What else to know about mental health coaching

Understanding whether mental health coaching improves people's well-being, compared to therapy, for example, will take a lot more research, says Vaile. Currently, there's little robust research indicating that it leads to desired behavior change and mental health improvement.

Wright says there are advantages to working with mental health coaches employed by a well-known digital health company, such as Headspace or Lyra. Coaches are typically trained, if not certified. They also receive supervision and feedback on their performance. The platforms themselves can provide referrals for therapy to members who might need them. Should a coach act inappropriately, their client can report it to the company.

Consumers should be aware, however, of how companies use their personal data, including for marketing or research purposes, Wright says.

She adds that companies should make clear whether artificial intelligence is part of their coaching product. Wright says that while AI may be able to improve coaching experiences, perhaps by matching clients and coaches or identifying trends in a client's performance, it needs to be incorporated ethically and responsibly. Currently, Headspace doesn't use AI in its direct-to-customer coaching program.

Though Wright practices healthy skepticism about new digital mental health products, she is optimistic about the potential of high-quality coaching to make an important difference in people's lives.

"We clearly have an extensive mental health crisis in this country, and we need to be thinking about how we can get people the support that they need in innovative and responsible ways," Wright says. "I do think that certified health and wellness coaches can be part of that solution."

To be human is to be lonely at some point in life, but there's an important caveat: We typically think of isolation and loneliness as an adult or teen mental health experience, not one that happens to young children. Yet a new nationally representative survey of 1,000 girls commissioned by the Girl Scouts of the USA (GSUSA) offers striking evidence to the contrary.

In the survey, nearly two-thirds of the youngest girls, aged 5 to 7, reported feelings of loneliness. This percentage ticked up with age; nearly three quarters of girls between the ages of 11 and 13 felt the same.

While the survey didn't explore factors contributing to girls' loneliness, experts say parental isolation and household screen time likely play a key role. In general, social connection appears to be declining, according to the U.S. Surgeon General's 2023 report on loneliness and isolation. Social networks are getting smaller, and participation in community organizations is decreasing.

"[W]e have to realize that it's a reflection of what is happening with our adults," said Dr. Christine Crawford, associate medical director at National Alliance on Mental Illness (NAMI), of the survey's findings.

While NAMI wasn't involved in the poll, the nonprofit partners with GSUSA to provide mental health resources for girls, staff, and adult volunteers.

Crawford, who wasn't surprised by the survey's findings, said that when parents and caregivers aren't connected to a community or network, their kids often lack similar opportunities as well. She noted that adults are lonely for a variety of reasons, including because they may spend more time on a screen than cultivating in-person relationships.

Why young girls may experience loneliness

The survey reached girls by contacting their parents via email with a request to complete the poll in March 2024. Parents whose children were not yet old enough to read narrated the questions and filled in the responses.

Sarah Keating, vice president, girl and volunteer experience at GSUSA, told Mashable that the organization surveyed girls on the topic after hearing from troop members in recent years that mental health was their top concern.

The survey found that as loneliness increased with age, girls' confidence also decreased. Only 73 percent of 11- to 13-year-old girls said they believed in their ability to "tackle challenges," compared to 86 percent of girls between the ages of 5 and 7.

Keating said that feelings of loneliness among the youngest girls may be linked to how much time they and their family spend on screens.

A Pew Research report released in March on teen and parent screen time found that nearly half of teens said their parent was "at least sometimes distracted by their phone" during conversations. About the same percentage of teens said they are themselves online "almost constantly."

While the Pew report did not address younger children, data collected by the UK communications regulator Ofcom found that children 5 to 7 are increasingly online. Three-quarters of them use a tablet and almost a quarter own a smartphone.

"Everyone is in their own room doing their own thing," said Dr. Whitney Raglin Bignall, associate clinical director of The Kids Mental Health Foundation, who was not involved in the survey. "In many ways, the family is not as connected as it once was because of distraction."

How to spot loneliness in young children

Raglin Bignall said that while loneliness is a normal emotion, too much of it can be harmful. Isolation is a risk factor for anxiety, depression, and suicidal thinking or behavior.

Though parents may be on the lookout for signs of loneliness, Raglin Bignall said they can be tricky to spot in younger children, who might be unable to express that they feel alone or may appear content when occupied with an activity. She noted that it's generally important for parents to teach their children about feelings and how to share them as a regular practice, not just when they suspect that something is amiss.

Crawford, of NAMI, recommends that parents watch for changes in their child's daily functioning. If they are normally cheerful and engaged but have frequently become bored, withdrawn, or decline to attend school or social activities, that's a sign parents shouldn't ignore. Neither are changes in sleep, appetite, energy level, and academic performance.

If a child is struggling to communicate what they're feeling, they may become angry, irritable, and prone to meltdowns. Crawford said that's a way for young people to articulate their distress, particularly when they don't have a history of tantrums.

Children who talk about being a burden to others, or feeling like no one cares about them or that they don't want to be alive, should be seen immediately by a trusted health care provider as they may be experiencing suicidal feelings, said Crawford.

She urges parents who worry that their child is lonely not to immediately assume that they are, because they may be experiencing a different challenge. Instead, Crawford recommends that parents reach out to their child and talk nonjudgmentally and with curiosity about what they've observed, which might include frequent crying, hesitance to visit the playground, or increased distance from friends.

What to do if your child is lonely

Crawford said that when a child indicates they're lonely, parents should start by asking what would help them feel more connected. They may have simple responses, like taking a walk with their parent or visiting a relative's house. Parents can also suggest things that help them feel less alone as a way of modeling coping skills to their child.

The GSUSA survey found that most girls of all ages would prefer to be creative, go outside and play, or spend time with their family rather than be on a screen. Parents who learn that their child is lonely could start by evaluating screen time both for the child and the family, looking for opportunities to prioritize in-person experiences instead.

Crawford said that parents should also consider whether the activities their children participate in are geared toward social connection or performance. Think, for example, of a youth soccer team that focuses on technical skills instead of learning how to work as a team and communicate with others. For a child who feels lonely, a team built around the individual experience may make them feel isolated, even in the presence of other kids.

Raglin Bignall recommended that parents share with their child what a healthy friendship looks like and talk with them about social challenges they may experience at school or on the playground. The Kids Mental Health Foundation has a library of relationship-related resources for parents, including articles on how to help kids make friends and helping children who feel like they don't fit in.

Raglin Bignall said she hopes the survey results remind people that young children can be deeply affected by chronic loneliness, and that parents can be proactive about preventing it.

"Humans need to belong, we need to fit in, and we need to connect with other people," she said.

Psychologist Glen Moriarty founded the emotional support platform 7 Cups in 2013 as a way to help people listen to each other's concerns, particularly when they had nowhere else to turn. Users are free to be as vulnerable as they wish, provided they obey the platform's community guidelines and terms of service. 

The platform, which users can join at no cost, may seem like the perfect solution to both the loneliness epidemic and the broken American mental health care system, which is expensive and hard to access. 

But for some users, 7 Cups comes with its own high cost: trolling and abusive behavior. 

A months-long investigation into 7 Cups found that the platform sometimes struggles to contain and address problems with users who act inappropriately, poorly, or aggressively, or even threaten other users. In the past, such abuse has included discussion of sexual acts and fetishes as well as comments directing another user to kill themselves. Mashable found that teens may be targeted by predators.

This story is part of our investigation into the emotional support platform 7 Cups and the growing marketplace for apps and platforms that pair people with someone who is supposed to be a compassionate listener. The series explores a failed experiment between the state of California and 7 Cups, as well as the myriad risks of seeking emotional support online from strangers. These dangers can include the manipulation of vulnerable youth and targeted abuse and harassment. The series also includes an analysis of why it's so hard to stop online child exploitation, and looks at solutions to make platforms safer.

High-level current and former staff and volunteers who spoke to Mashable anonymously because they didn't want to violate a nondisclosure agreement they signed say 7 Cups' approach to punishing those who violate the platform's rules can be surprising or confusing. Users, for example, have been encouraged by Moriarty himself to help rehabilitate "trolls" who behave poorly. 

Moriarty denied that trolling was pervasive on the platform and noted that the company has taken steps over the last decade to improve user safety. 

"We are constantly solving problems, getting stronger, and continue to hold true to our core mission of helping the community," Moriarty told Mashable in an email. 

Trolls have existed on 7 Cups for years

Moriarty has long known about bad actors on 7 Cups, because he's personally been subject to their unwelcome behavior. 

In June 2020, a few months into pandemic isolation, he dedicated a forum post on 7 Cups to the subject of "people who are trolling." He noted that his own experience on the platform "has included all types of trolling," including what he described as "sexual trolling," wherein "the person is trying to engage with you — sneakily — in a sexual manner." 

Moriarty's advice to 7 Cups users about how to handle trolling was largely unconventional: He encouraged victims of abuse and harassment to attempt to persuade the other user to change their behavior. 

His sample script included empathetic statements like, "I know that life has likely been challenging for you…I think that is partly why you are behaving towards me like you are right now."

The post elicited dozens of responses, including from users who'd been harassed. 

One commenter challenged Moriarty's conviction that the platform's bad actors could be rehabilitated. They wrote: "[W]hat about the troll that keeps telling me to eat poison soup and go to the grave though?" 

Another listener chimed in: "I'm lucky my troll finally decided to leave me alone. I say that because I don't feel that Cups did enough to protect me as a listener from the vile filth spewed forth in my inbox." 

When asked about these remarks, Moriarty noted that other commenters reported "positive interventions they utilized in response to people trolling."

He told Mashable that "we take numerous steps to address and stop trolling behavior," including auto-detection of ​​abusive activity and the use of blocking, muting, and reporting tools. He also said that the company has been developing a tool powered by artificial intelligence that can scan and identify messages that violate the platform's terms of service and guidelines in one-on-one and group chats. 

"Our expectation is that this will make circumventing our existing safety processes and guidelines very, very difficult," Moriarty noted.

Whitney Phillips, assistant professor of digital platforms and ethics at the University of Oregon, reviewed a copy of Moriarty's 2020 post and the comments. She characterized Moriarty's approach to trolling behavior as harmful to users. 

Phillips, author of This Is Why We Can't Have Nice Things: Mapping the Relationship between Online Trolling and Mainstream Culture, said it's a common misconception that people always troll because they're wounded and act out for attention. 

Instead, the behavior is often game-like. They derive joy and pleasure out of finding ways to make someone feel uncomfortable. They're not desperate for validation and often can't be deterred by appeals to a better self, said Phillips. 

She also warned against asking triggered or traumatized users to rehabilitate their abuser, a request she described as "cruel." The responsibility of holding trolls accountable, and protecting victims, should rest with 7 Cups, Phillips said. 

"To offer this advice, it's mismatched with the kinds of behaviors that are clearly chronicled in the comments," she added. 

Multiple listeners secretly trolled other users

Moriarty's discussion of trolling also didn't reveal a discovery that 7 Cups staff said they made years ago: Some of the platform's highly rated listeners had alternate secret accounts they used to harass or bully other users. Moriarty denied this and said the behavior violated the platform's terms of service. Former staff said they stumbled across the problem when attempting to identify the platform's best listeners. 

7 Cups had already deployed an algebraic formula to determine trust and reputation "scores" for listeners, which helped identify trolling accounts, as well as users demonstrating good behavior. 

It wasn't long before staff noticed inappropriate, trolling, or bullying accounts registered to the same email address of highly rated listeners, or other telling links between such accounts. 

"You couldn't just say, 'This person's great and you can trust them all the time,'" a former staff member said. 

The severity of the trolling problem led 7 Cups to control the demo environment by using hand-picked listeners who wouldn't sink the company's chances of landing a lucrative deal by engaging in offensive or abusive behavior, according to multiple sources who worked for the platform over the last several years, a claim that Moriarty also denied. 

Phillips said she's unsurprised that people engaging in trolling behavior have conflicting personas and accounts. Trolling actually requires good listening skills, according to Phillips' research. Such users must pay close attention to someone's vulnerabilities. But those who engage in trolling also possess the social skills to weaponize those vulnerabilities. 

Phillips believes it's generally a mistake to simply observe people's online behavior and assume their actions are sincere, but especially in a digital environment premised on helping others. Instead, there's the real possibility that people on emotional support platforms may be bored or even mean. 

"People play in dark directions and light directions and lots of directions in between," she said. "They do all kinds of things for all kinds of reasons that don't fit into any clear-cut box, particularly one that takes sincerity as the default mode of human expression."

Dealing with trolling on 7 Cups

One infamous user has wreaked havoc on the platform by bullying, abusing, and threatening other users since at least 2019. They've been given opportunities to improve and rehabilitate their behavior, which Moriarty acknowledged occurred years ago as an attempt to coach the user to behave in more "prosocial ways." 

When they've violated those expectations and been banned, they've found ways to create burner accounts at a pace that 7 Cups staff has not been able to effectively counter. Moriarty said that when moderators recognize the user or their behavior, they are banned in under a minute or faster.

Recently, 7 Cups began requiring listeners to verify their phone number, which can more closely tie a user's identity to their behavior, if they use a real number. Those who want to avoid detection can easily obtain a throwaway number from various online services. Moriarty said members would soon have to go through phone verification.

In order to deter abusive behavior and set expectations, 7 Cups uses a points system for listeners and members, but some of the punishments can seem surprisingly unclear or lenient. An adult-teen listener who gives their contact information to a teen but doesn't initiate off-site contact isn't permanently banned from the platform but is instead given three behavioral points as a consequence, for example. Initiating off-site contact with a teen is a four-point offense. 

Both violations result in a warning, a break from the platform, and removal of the user's adult-teen listener badge and access to the teen community. While this is unclear based on the points system chart, Moriarty said that any adult-teen listener who behaves this way is put on a months-long break. They also lose their badge and cannot regain it in the future. Ten or more points leads to suspension from the platform, but points can also expire six months after they are accrued. Moriarty told Mashable that the points system is similar to how points on a driver's license works.

When users are caught, violations that lead to immediate removal from 7 Cups include spamming forums with inappropriate content or ads; posting inappropriate or graphic pictures; repeatedly sexting; and being underage or signing up for the wrong age community.

A former high-level volunteer who left the platform in 2020 said that its rules were unevenly applied. Newer members who committed more serious infractions were often bounced from the platform, but established listeners with a good trust score and a rapport with moderators might be given dispensation. 

"If there is not consistent enforcement of the rules, it creates a permission structure for anything to happen," said Phillips. 

Moriarty noted the difficulty of knowing exactly what happened in each situation that involved a violation of the rules.

"Not all cases are black and white," he told Mashable. "I imagine there have been uncertain issues, vague situations, or competing explanations where it could be interpreted as dispensation, but likely not significant." 

Multiple sources who've worked or volunteered at 7 Cups stressed that they've tried to elevate safety issues and solutions over the years, with limited success. They felt that costly initiatives or efforts that might negatively affect growth but improve safety were ignored or rejected by senior management or Moriarty. He told Mashable that this characterization was inaccurate.  

Though 7 Cups employs blocking and reporting tools, as well as the ability to ban users, those strategies are stretched when bad actors try repeatedly, and doggedly, to regain access to the platform by creating a new anonymous account. Currently, when a member is temporarily removed or banned from 7 Cups, it can be easy to make a new account using a quickly generated burner email address and a new fake persona.    

Security tools to stop trolls can be bypassed

Sources familiar with 7 Cups' security protocol say the site attempts to prevent bad actors from creating multiple burner accounts by tracking users' internet protocol (IP) addresses. Yet this tactic is rendered useless if someone accesses the internet through a virtual private network, which can conceal their digital identity. 

Additionally, an IP address is an imprecise tracking tool as it can be assigned not to a user's device, but to the coffee shop they frequent or their dorm building. Banning a user based on that information might unintentionally ban dozens or hundreds of other people using that address. 

An IP fingerprint, a more specific set of data that can be tied to an individual device, can help narrow the search. Yet, it's also an imperfect solution given that sophisticated bad actors can use technology to mimic or hijack the identity of a different device.  

As a result, sources say that for years the platform's moderators have played whack-a-mole trying to catch users who've been banned for various infractions but quickly return with a new account. 

John Baird, cofounder and CEO of the identity verification company Vouched, told Mashable that while an IP address and device ID can help identify bad actors, they shouldn't be the sole way to verify an identity and block a user from accessing a platform. Vouched, for example, uses visual evidence, algorithmic evaluation, geo-location data, and device-related information, among other strategies, to verify identity and vet an individual's risk to an organization. 

"Security is always multiple factors stacked on top of one another to be able to catch the bad guy," said Baird. "The challenge is, if it's a single factor, the bad guys will figure out a way around that single factor."

Moriarty told Mashable he was confident that new technology solutions, like the AI-powered speech detection tool, would be "more effective at scale than anything else has been to date." 

He also acknowledged that 7 Cups may have fallen short despite its efforts: "We understand that we are far from perfect, but have worked hard and continue to work hard on this issue." 

Still, the evolution of security on 7 Cups has arguably taken a toll on its members and moderators.

Last summer, a user made multiple accounts on the platform and told people to kill or harm themselves. Mashable viewed evidence of the incident and its fallout. 

Separately, the user who has frequently engaged in abusive behavior over the past several years was also creating new accounts to evade bans, exhausting the platform's moderators with their efforts to stay on the site. 

People complained when the user began a new harassment campaign last year, including telling a listener to kill themselves, according to documentation shared with Mashable. 

Of this incident, Moriarty said that censors blocked the language and that the user was removed: "The system worked as designed." 

According to a source familiar with the problem, the user has continued to harass members and vex moderators since then.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

At a time when loneliness is a crisis, HearMe is Adam Lippin's calling. He founded the digital platform in 2018 as a place where a user can talk to someone online and "get something off your chest." The platform matches that user with a "peer listener" who's meant to be supportive. Both people can remain anonymous.  

But Lippin eventually learned that not everyone who logs onto a platform like HearMe has a sincere interest in making an emotional connection. In 2022, it became clear that some users were visiting HearMe to play out fantasies that involved sexual language and innuendo, Lippin told Mashable. 

On the other side of those messages were often psychology interns and graduate students in social work who volunteered on the service to fulfill their educational requirements. Lippin hoped the bad actors could be discouraged by responses that reframed or ended the conversation. But that didn't work. 

"It was like whack-a-mole," Lippin said. "It just didn't stop." 

So Lippin made a risky, consequential decision: HearMe stopped offering a free membership. Soon after, the problem largely ceased, Lippin said. 

"I learned a lesson," he said of online emotional support. "It's like anything — it can be used for good and bad."  

Lippin isn't the only founder and CEO to launch a company designed to alleviate loneliness by connecting strangers with each other. Companies like Wisdo Health, Circles, 7 Cups, and HeyPeers aim to fill gaps in a broken mental health care system by offering users the opportunity to talk to someone online. Like Lippin, some founders find their mission complicated by bad actors with other ideas about how to use the platform. 

A months-long Mashable investigation into these emotional support platforms, including the popular free service 7 Cups, found that users may be exposed to moderate or significant risk in their pursuit of consolation and connection. 

This story is part of our investigation into the emotional support platform 7 Cups and the growing marketplace for apps and platforms that pair people with someone who is supposed to be a compassionate listener. The series explores a failed experiment between the state of California and 7 Cups, as well as the myriad risks of seeking emotional support online from strangers. These dangers can include the manipulation of vulnerable youth and targeted abuse and harassment. The series also includes an analysis of why it's so hard to stop online child exploitation, and looks at solutions to make platforms safer.

In one 2018 case, a 42-year-old man posed as a 15-year-old teen on 7 Cups to access the platform's teen community. He manipulated a 14-year-old girl into creating child sex abuse material and was ultimately charged and jailed for the crimes. That same year, 7 Cups won a contract to provide its services to residents of certain California counties, but its contract was cut short in 2019 after safety concerns emerged, among other issues.

In general, risks on emotional support platforms include encountering an anonymous stranger who's well-meaning but ultimately hurtful, or a purposefully cruel bad actor who, for example, tells someone hoping to feel less alone to kill herself. 

While these issues were most egregious on 7 Cups, Mashable tested other platforms in this market, interviewed some of their members, and spoke with their CEOs, and found that 7 Cups' competitors have faced a range of challenges. These startups are under pressure to develop a successful, scalable business model, all while battling bad actors who find ways to circumvent common safety measures. 

It's not unlike what happens every day on the internet, but in this case the victims can be emotionally or psychologically vulnerable people who opened up to a stranger believing they were safe.   

Unlike in formal mental health treatment, there is currently little recourse for those who've been seriously harmed by their conversations on an emotional support platform. The field is largely unregulated, and federal law has traditionally immunized online platforms from liability in many instances when their users are harmed.

Meanwhile, if someone seeks compassion on an emotional support platform but finds predation and abuse instead, it may have lasting damage. 

"I think you have very real risk that somebody would view this as part of being the quote-unquote mental health system, and if they had a bad experience, I can imagine them never engaging in mental health again, or never seeking other types of treatment or support again," said Dr. Matt Mishkind, a researcher who studies technological innovation in behavioral health as deputy director of the University of Colorado's Helen and Arthur E. Johnson Depression Center.  

What is peer support? 

These companies often use the term peer support to describe their services. Most people who hear this probably imagine a reputable in-person or virtual group run by a mental health provider or organization. 

The National Alliance on Mental Illness' peer-to-peer program, for example, brings people coping with mental illness, or their families, together under the supervision of a trained facilitator. Research indicates that these programs may help with recovery.

Less familiar are peer support specialists, a growing workforce of trained individuals who draw on their own lived experience with mental illness or substance use to aid someone in recovery, in a clinical or outpatient setting. 

This type of intervention shows promise in clinical research for people with mental health conditions. Some studies note small to modest improvements in symptom remission and improved quality of life. Last year, Blue Cross and Blue Shield of Minnesota announced that access to peer support specialists would be a covered benefit for certain members beginning in 2024. 

Peer support specialists, however, do not staff all emotional support platforms. HeyPeers does allow certified peer support specialists to offer their services for a fee, and HearMe users may engage with them as well. 

This distinction between peer-to-peer support versus peer services led by trained individuals who adhere to standardized peer-practice guidelines is important. Someone who downloads an app marketed as offering peer support may not, in fact, talk to a trained peer professional.

How does peer support work? 

When a person does have a positive experience on an emotional support platform, it can be life changing. 

Mashable interviewed two participants of Circles' facilitated support groups, who said their weekly interactions with other members helped them feel less alone and more prepared to handle emotional challenges. 

That service is separate from Circles' free offering, which allows users to gather in hosted chat rooms, discuss topics like parenting, self-care, and workplace stress, and anonymously direct message each other. 

Once someone has received help on an emotional support platform, they may derive great satisfaction out of extending similar compassion to someone else, in a listener role, according to people who've used different platforms and spoke with Mashable about their experiences. 

Still, there is no high-quality research demonstrating that digital emotional support platforms are as effective as peer support specialists or even computer-based cognitive behavioral therapy treatments.

Some of the past studies on 7 Cups weren't rigorous or large enough to draw any conclusions. Four studies conducted between 2015 and 2018 were largely focused on testing the platform rather than establishing high-quality clinical claims of efficacy. Some of the studies had fewer than 20 participants. Regardless, the company continues to advertise its platform as "research-backed" and "evidence-based," a claim its founder and CEO Glen Moriarty defended to Mashable. He noted that the platform's "self-help guides" and "growth paths" are based on types of therapy shown to be effective, including cognitive behavioral therapy and dialectical behavioral therapy.

Other companies have published their own research. 

Last year, Wisdo Health published a study in JMIR Research, which found that users experienced decreased loneliness and depression symptoms, among other improvements, after the platform. The authors also noted that a randomized controlled trial that compared "peer support" to interventions like cognitive behavioral therapy "would be a valuable contribution to the literature."

"It's an exciting moment to be working in this space because it's graduating to a depth of conversation which I'm not sure that peer support has enjoyed in the past," Wisdo Health founder and CEO Boaz Gaon told Mashable in an interview last year. The company, which was founded in 2018 and claims to have 500,000 users, offers clinical referral services to users who are identified as potentially benefiting from therapy. 

Ryan K. McBain, a policy researcher at the RAND Corporation who has examined the efficacy of peer support specialists in the mental health system, told Mashable in an email that peers seem to be most effective when they meet a minimum set of criteria, receive standardized training, have supportive supervision, and are well-integrated into the overall health system. Emotional support platforms often lack these safeguards and provide minimal training.  

McBain said he doubted that untrained individuals would have the "full set of tools" required to support a client, or user, in the same manner as someone who underwent full peer support specialist certification. While he sees value in empathetic listening, particularly from those with lived mental health experience, he believes emotional support platforms need to be fully transparent about what they are — and what they're not. 

"I am not discounting the possibility that these platforms may prove to be a disruptive innovation over the long-run — but they require regulation, and the government is in a position of playing catch-up," McBain said. 

When talking to someone for free on the internet became a big business 

Though it took time, the isolation of the COVID-19 pandemic, as well as the loneliness epidemic, supercharged the concept of digital peer support as a business proposition.  

Wisdo Health has raised more than $15 million from investors like 23andMe founder Anne Wojcicki and Marius Nacht, an entrepreneur who cofounded the healthtech investment fund aMoon. 

The company describes itself as a "social health" platform, emphasizing that it measures changes in people's perception of their loneliness, among other emotional indicators. Users can access the platform for free, but the majority are sponsored by an employer. 

Circles, a competitor to Wisdo Health, has raised $27 million since its founding. 

Other companies have raised far less money. STIGMA, which folded at the end of 2023, was initially bootstrapped by its founder and CEO Ariana Vargas, a documentary filmmaker. HearMe has raised approximately $2 million. It partners with third parties and offers two subscription tiers; a weekly membership is $7.99 while an annual membership is $69.99. 

HeyPeers generates most of its revenue by hosting and staffing video-based support groups for nonprofits. Independent members can join for free. They can participate in HeyPeers support groups, which are facilitated by certified peer support specialists, for $10 per meeting.  

Both Circles and Wisdo Health have pivoted away from a subscription strategy, focusing on landing contracts with major payers like insurers and employers. In March 2023, Wisdo Health partnered with a nonprofit organization in Colorado to make the platform available to adult residents, with a particular emphasis on reaching Medicaid recipients.

In 2018, 7 Cups received a multimillion-dollar contract from the California Mental Health Services Authority to provide the platform to residents in certain counties, but that project was quietly terminated after safety issues, including abusive and sexually explicit behavior, became a concern, according to sources involved in the initiative who spoke to Mashable.

Balancing growth and safety

Rob Morris, CEO of the youth emotional support platform Koko, incorporated it as a nonprofit in 2020, after originally cofounding it as a for-profit company. The shift was motivated partly by Morris' decision not to sell user data or sell the platform to third parties, like employers or universities.

"I think it's hard to find a business model in this space, particularly if you're reaching underserved individuals or young people, that doesn't create misaligned incentives," he said. "We just couldn't find a business model that made sense ethically for us." 

He noted that platforms under pressure to demonstrate high engagement may hesitate to create robust safeguards. 

"The more moderation you put in place, the more constraints you put in place, the less user engagement or attention you get," he said. 

Recruiting users for emotional support platforms often requires a low bar to entry, like free access to services and anonymity. At the same time, these features can create risky or dangerous conditions on the platform. 

Companies may also find ways to derive additional value from the users themselves. Lippin, CEO of HearMe, told Mashable that one of its business deals involves providing its listening service to nurses at a time when burnout is causing a shortage in the profession. 

HearMe aggregates and anonymizes what the nurses share and relays that to their employer, which wants to identify workplace concerns or complaints that might affect their well-being. Lippin said the terms of service indicated to consumers that their data could be used in this way. 

STIGMA, a platform designed for users to receive support when talking about their mental health, tested sponsored content prior to shutting down at the end of 2023. Vargas, the company's founder and CEO, told Mashable that she didn't want to advertise to users, but instead hoped to present users with content "sponsored by the people who want their brands in front of our member base." The founders of Wisdo Health and Circles both told Mashable that they are opposed to advertising.

Many emotional support platforms rely, in some way, on the free labor of volunteer listeners. 7 Cups has uniquely been reliant on volunteer labor to perform critical tasks since its founding. 

"We deliberately designed the platform with a volunteer emphasis from the very beginning, because that appears to be one of the only ways to scale emotional support," Moriarty told Mashable.  

On Wisdo Health, a user can become a "helper," an unpaid community leadership role, after graduating from a training program made available to highly engaged and helpful users. They receive a helper badge only if they pass a training test and continue to demonstrate high levels of helpfulness to others, as assessed by the platform's algorithm. Helpers are expected to check on a certain number of users each day. Roles above helper are filled by paid staff members. 

HearMe uses a combination of paid and volunteer listeners, including graduate students pursuing a social work degree who need the experience to meet their program's requirements. The company vets graduate students, psychology interns, and certified peer specialists against a list of "excluded" individuals maintained by the Office of the Inspector General at the Department of Health and Human Services. The list comprises individuals who violated certain laws, including by committing patient abuse and health care fraud. 

The amount of training volunteer listeners receive varies widely. 7 Cups requires users to complete an "active listening" course in order to become a listener who takes chats. It also hosts numerous other trainings, but they are optional. Circles members who want to become a "guide" and host their own chat room must apply and, once accepted, receive facilitator training. 

In general, volunteer support and listening is often sold to consumers as a fulfilling way to give back, perhaps not unlike how one might volunteer for a crisis line. Those organizations, however, are typically nonprofits, not startups with the backing of venture capital and an eye toward potentially being acquired.  

Safety challenges on emotional support platforms

Founders of emotional support platforms often share a compelling personal story about why their product is critical at a time when loneliness is surging and mental health is declining. 

Gaon has said that his father's battle with terminal cancer led to the platform's creation. Irad Eichler, founder and CEO of Circles, said that his mother's experience with cancer, and the support he received from friends, prompted him to build a "place for people dealing with any kind of emotional challenge." 

For consumers, the assumption undergirding the concept of an emotional support platform is that people will use access to such a network for good. The reality, however, is far more complicated. 

Eichler is candid about the fact that some people occasionally join the platform with "different motivations, and not with the best intentions," even if the vast majority of interactions are positive or supportive.  

That's why both members and paid staff moderate rooms to make sure discussions are on topic and that conversation is respectful. Eventually, said Eichler, artificial intelligence will police all the rooms on a constant basis and alert the company to bad behavior. Moriarty, of 7 Cups, told Mashable the company was working on deploying a similar solution, including for one-on-one chats.  

Users on both platforms can manually report negative experiences.  

Offenses met with an immediate ban on Circles include violent or inappropriate language, aggressive behavior toward others, noncooperation with group facilitators, and taking over a chatroom against the protest of other users. 

"It's an ongoing challenge," Eichler said of the risk bad actors present to emotional support platforms. "It's not something that you can solve. There's a tension that you will always need to manage. I don't think we will hit the place where Circles will be a 100-percent safe space." 

Eichler was emphatic that safety was a priority, as were the CEOs of Wisdo Health, HeyPeers, HearMe, and 7 Cups. 

Yet each major emotional support platform also employs anonymity, which can create unique risks.  

On 7 Cups, bad actors and predators have taken advantage of anonymity. Abusive behavior on the platform has included sexual and violent language, including directing users to kill themselves, according to former and current staff and volunteers who spoke to Mashable. 

On HeyPeers, which allows teens to join, CEO Vincent Caimano told Mashable that, last year, the platform's staff caught a man appearing to flirt with a teen girl in a chatroom about depression. The room, which had been unmoderated overnight, was open for conversation among anonymous users. When the public exchanges were noticed in the morning, Caimano banned the adult user and staff reached out to the teen about the incident. The company also shut down chat rooms that weren't moderated consistently enough by their host, which means checking in every day and participating in conversation. In general, HeyPeers conducts background checks on its staff and contractors via the service Checkr.

Gaon defended Wisdo Health's use of anonymity. He told Mashable that the company had encountered past situations in which people didn't feel comfortable sharing information with a listener if it could be traced back to them, and that he wanted the platform to cater to both those who want to publicly identify themselves and those who don't.

"If you don't allow anonymity, you're not giving the user control over how open they want to be with their real name and real profile details," he said. Gaon later added that the vast majority of the platform's users join via a sponsor, like an employer, that requires them to verify their membership and identity to join. The remaining users have joined without that level of vetting. 

Koko enforces anonymity, and it does not allow users to message each other directly, even though they routinely ask for the feature, Morris said.

"If we let people continue chatting and DMing with each other, retention and engagement would shoot up a ton, but it's just not what our aim is," he said. "The risk of these longer conversations, people being paired up, is just one we've never taken on."

Dr. Mishkind, a proponent of both high-quality peer support and technological innovation in mental health care, said that he would be hesitant to use any emotional support platform knowing that encounters could end in abuse, harassment, or predation.

"It's a huge risk to everybody associated with it," he said.  

Why consumers aren't protected from harm  

Despite the reality that consumers have painful or harmful experiences on emotional support platforms, the companies may bear no responsibility when this happens.  

Federal law known as Section 230 of the Communications Decency Act has long shielded online platforms from liability when their customers treat each other poorly. Notable exceptions include copyright law, illegal activity, sex trafficking, and child abuse that the company knew about and didn't attempt to stop. 

While Congress has raised the prospect of overhauling Section 230, particularly to improve child safety online, digital platforms can continue to invoke it as a defense against liability. 

At Mashable's request, Ari Ezra Waldman, a professor of law at the University of California, Irvine, reviewed the terms of service for the companies Mashable reported on and found very limited grounds for a lawsuit if a user sought recourse after experiencing harm. 

Waldman noted that this is a common reality of the "platform economy." 

He added that the business model of connecting people to strangers for "quasi mental health support" would be less likely to exist in a "world where platforms were more accountable to their users, and to the bad things that happened to their users." 

The Food and Drug Administration and Federal Trade Commission also do not have a clear or obvious role in regulating or enforcing actions against emotional support platforms. 

Attorney Carrie Goldberg believes accountability may be on the horizon. Last year, she sued the chat platform Omegle on behalf of a teenage girl who'd endured years of horrific digital abuse after being paired with a child predator. 

The case moved forward despite Omegle's efforts to shield itself from liability by citing Section 230. The judge found that Omegle could be held responsible for defective and negligent product design. Omegle settled the case, then shut down. 

"[T]here's not a culture where investors or founders are necessarily looking at the ways that a product can be abused, because they're going in arrogantly thinking that they're going to be immune from all harms that happen," Goldberg told Mashable. 

When 7 Cups lost its government contract in California, it led to a settlement agreement that prohibited either party from disclosing its existence and terms, unless under specific circumstances, like complying with government law. It's unclear whether the same thing could play out in the future with other emotional support platforms that partner with government agencies, should critical issues arise and lead to a terminated contract.

Mishkind said that companies offering a digital solution to mental health care access should be considered part of the system, and treated as such with clear regulation and rigorous independent evaluation, rather than as outsiders not subject to the same rules as other medical entities.

"I don't think we've quite wrapped our arms around that yet," Mishkind said. "There's this kind of protection around them because they are being seen as disruptors, but…we're all now part of the same system."

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

On July 16, 2018, a 14-year-old Texas girl sent explicit photos of herself to a 42-year-old man named Anthony Joseph Smith. 

Smith, who lived in Butler, Pennsylvania, met the teen online, posing as a 15-year-old boy, and they began messaging frequently. Eventually, he tried to convince the teen to leave her parents and join him in Pennsylvania.

It's an increasingly familiar story. Online enticement and exploitation can happen on nearly any digital or social media platform. But Smith didn't meet his victim on X/Twitter, Instagram, or Discord, platforms where well-known, documented cases of enticement, abuse, and exploitation have occurred. 

Instead, Smith met the teen on a popular emotional support platform called 7 Cups, which encourages people to chat with someone online about their problems and is free. Some users are grappling with serious mental health issues. 

This story is part of our investigation into the emotional support platform 7 Cups and the growing marketplace for apps and platforms that pair people with someone who is supposed to be a compassionate listener. The series explores a failed experiment between the state of California and 7 Cups, as well as the myriad risks of seeking emotional support online from strangers. These dangers can include the manipulation of vulnerable youth and targeted abuse and harassment. The series also includes an analysis of why it's so hard to stop online child exploitation, and looks at solutions to make platforms safer.

The Texas teen, whose name wasn't released by Pennsylvania authorities because she was a minor at the time, may have thought she was safe on 7 Cups. Teens as young as 13 can join its dedicated teen community. The company permits adults who've been internally vetted to chat with its teen members (Smith was not a vetted adult). Though 7 Cups recommends that minors receive parental permission before joining, it does not verify that, nor does it verify their age and identity.

As Smith proved, adults can lie about their age to gain access to the community. This remains true today; Mashable attempted to make teen accounts using a fake email address, name, and birth date, and was granted instant access. 

When told that Mashable had easily made a fake account to join the teen community, 7 Cups CEO and founder Glen Moriarty said doing so was against the platform's terms of service. He noted that people can sign up for services online using inaccurate information and that 7 Cups employed certain measures, like blocking, reporting, and language detection tools, to help keep users safe. 

Moriarty said he was not informed by law enforcement or the minor's parents about the case in Pennsylvania and disputed that adults preyed on youth on 7 Cups, and that adult users themselves experience persistent safety issues on the platform. 

"[W]e have a thriving community of people," he said in a written response. "If 7 Cups tolerated this behavior, we would not have a thriving community."

While 7 Cups warns members against going off-site together, it still happens, according to multiple sources with current and past knowledge based on high-level involvement with the platform. 7 Cups does attempt to block personal information like an email address when people try to share it while chatting. 

Regardless, Smith eventually lured the teen off-site to other social media and messaging platforms, though he was not successful in his attempts to get her to join him in Pennsylvania. 

"The reality that a young person might go online and seek confidence and support because they don't have it offline, and that relationship being one that is abusive because there is a bad person out there that is targeting kids … that's terrifying," said Melissa Stroebel, vice president of research and insights at Thorn, a nonprofit organization that builds technology to defend children from sexual abuse. 

Emotional support platforms and their inherent risks to minors

Founded in 2013, 7 Cups was one of the first online emotional support platforms. These platforms are typically designed to be spaces where people can anonymously message a "listener" about their worries, stresses, and challenges.

The isolation of the COVID-19 pandemic, as well as the loneliness epidemic, supercharged the concept of digital peer support as a business model. Competitors to 7 Cups like Wisdo Health, Circles, and HearMe argue that their services are a critical tool given the nationwide shortage of mental health professionals and difficulty finding affordable therapy.

Venture capital firms and investors see promise in the model. In the past few years, they've poured more than $40 million into the largely unregulated field of startups, according to news reports and funding announcements made by those companies. 

In 2013, Moriarty successfully pitched the idea for 7 Cups to the famous Silicon Valley startup incubator Y Combinator, which he said still owns 7 percent of the company. Moriarty is also the longtime CEO of the digital learning company Edvance360.

Last year, the Office of the U.S. Surgeon General included Wisdo Health in a list of resources for improving social connection, a clear sign that power brokers take the model seriously. 

But an investigation into 7 Cups, and the emerging market of emotional support platforms, suggests that there are far more risks than the industry and its supporters disclose. These risks have been documented online by alleged, often anonymous, concerned users, but this reporting comprises the most comprehensive account of 7 Cups available to the public.

• Mashable interviewed six sources with current and past in-depth knowledge of 7 Cups' practices and safety protocols; reviewed the platform's policies; spoke with listeners and users on other platforms; and discussed safety concerns with CEOs of other emotional support platforms. Mashable also investigated why 7 Cups lost a lucrative contract with a California state agency in 2019, and found that safety issues were a factor.

• The sources who spoke about their experiences with 7 Cups requested anonymity because they feared violating a nondisclosure agreement the company required them to sign.  

• Mashable found that several high-level current and former 7 Cups staff have long been concerned about the safety of minors and adults on 7 Cups. 

• Though the platform employs strategies to keep bad actors and predators at bay, some have found ways to evade security measures. Moriarty told Mashable, "Combating people with bad intentions is an arms race. You have to continuously innovate to stay ahead of them."

• 7 Cups relies on volunteers to perform critical functions, such as moderating chat rooms and facilitating group support sessions, and teens are permitted to volunteer to work on company projects.

• Volunteer listeners, who receive some mandatory training, are sometimes exposed to unwanted sexual content as well as offensive or bullying messages. The same behavior sometimes surfaces in public forums; users, for example, have been told to kill themselves by bullies or trolls. In both scenarios, 7 Cups attempts to block such speech before another user reads it by using language detection.  

• Since platforms like 7 Cups use a peer-to-peer approach, they are not necessarily subject to regulation by the U.S. Food and Drug Administration or enforcement by the Federal Trade Commission. Nor are they required to comply with the Health Insurance Portability and Accountability Act for those services. 

While these risks are prominent on 7 Cups, Mashable's reporting found that the industry has not openly addressed or resolved many of the same concerns. 

"It makes you think there really need to be official systems of checks and balances when you have this degree of harm happening to people," said Dr. John Torous, a psychiatrist and director of the digital psychiatry division at Beth Israel Deaconess Medical Center in Boston.

The Texas teen's parents discovered her exchanges and alerted law enforcement, who confirmed that Smith had asked for sexually explicit images and received four. Smith's arrest was first reported by the Pittsburgh Tribune-Review in October 2018. Mashable reviewed Smith's publicly available court records and confirmed the case's details with Robert M. Zanella, Jr., the Butler County assistant district attorney who prosecuted Smith. 

In April 2019, Smith pleaded guilty to one count of corrupting a minor and four counts of coercing a child into creating child sex abuse material. He returned to jail last year after violating his parole by sharing fantasies about an adult woman's young daughter on Facebook Messenger, according to Zanella. The woman reported those exchanges to the Federal Bureau of Investigation. 

Smith's case might be characterized by some as one more instance of a predator weaponizing digital technology to suit their own nefarious aims. But emotional support startups are distinct from other types of technology companies, like gaming and social media platforms, because they specifically invite vulnerable people to seek support from strangers, who may have a range of motivations and intentions. Smith's crimes reveal how unpredictably risky these interactions can be. 

7 Cups of Tea: Talking to people online for free 

The idea for 7 Cups of Tea, as it was originally called, started at psychologist and founder Glen Moriarty's kitchen table, according to 7 Cups for the Searching Soul, a self-published book he co-authored in 2016.   

Moriarty turned to his wife, whom he has described as a therapist, for guidance with a business problem and was grateful for her "close listening." The exchange was a revelation for Moriarty. 

"Her care helped me see the problem in a different light so that I could solve it. It was at this point that the clouds parted, the sun shone through, and I had the insight I had been waiting on," he wrote in 7 Cups for the Searching Soul. "What if, any time you needed it, you could access a person who would listen to you and care about your problem?" 

Moriarty was the first listener on the platform, his wife the second. From the beginning, he struggled to find people to provide the service he was advertising. "I could never get enough listeners," Moriarty told Twitch cofounder Justin Kan in a 2020 podcast interview. 

The company has always been reliant on volunteers to operate. 

"We deliberately designed the platform with a volunteer emphasis from the very beginning because that appears to be one of the only ways to scale emotional support," Moriarty told Mashable.  

7 Cups relies on unpaid volunteers with little training to fill critical roles

Volunteer listeners on 7 Cups are not held to independent, standardized guidelines, like the National Practice Guidelines for Peer Supporters, though they are required to complete an "active listening" course upon volunteering to listen. They can take additional courses produced by 7 Cups, as well as consult with volunteer mentors identified by staff as having demonstrated strong leadership skills. 

Moriarty described the company's staff as "incredibly lean." Among the platform's listeners, 1,500 have what Moriarty describes as "leadership roles." This means that they take chats from members seeking support as well as volunteer their time on tasks like providing guidance to other listeners, sometimes helping them to process difficult chats, and monitoring forum posts for content that needs to be reviewed by staff. 

Sources who've worked and volunteered for 7 Cups said that dozens of volunteers lead major projects and perform key tasks, including evaluating user safety reports and complaints that are generated by automated safety tools. There is no publicly designated head of trust and safety known to the platform's users. Moriarty told Mashable that "trust and safety is not something we have one person do, but is rather distributed across the team."

Sources familiar with the recruitment of volunteers and the daily tasks involved in unpaid roles say there is little required training but high expectations. 

"You get no money, you get no protection, you get nothing," said one former longtime volunteer, who requested anonymity to discuss their experiences. "They make it pretty clear that they want as much from you as possible, as long as possible." 

Those who've volunteered for the platform said to Mashable they believe in its stated purpose and have derived great satisfaction from extending compassion to someone in need. Moriarty said notes from users, including comments posted in forums, emphasize how much the service has helped them, and even "saved" them. 

For the new 7 Cups user, the promise of healing connection is powerful. But the reality of what happens on the platform is far more complicated.  

Anonymity can compromise teen safety on 7 Cups

Moriarty has championed anonymity as a tool for building trust between users, and this is a common practice on competing emotional support platforms. Ideally, anonymous personas enable people to freely support one another without worrying that the information shared could be used against them publicly. Unless users share their real identity, no one really knows to whom they're talking.  

But anonymity can backfire, too. On 7 Cups, the failure to verify teens' identities is what allowed Smith to go undetected as an adult predator. 

Several of the sources who spoke to Mashable said they were frustrated and distressed over the platform's teen safety issues. Two sources with listening, volunteer, and work experience at the company showed Mashable screenshots of exchanges between the platform's users in an effort to substantiate claims that adult listeners had preyed on teen members, and that teens were aware of and concerned about such behavior. Because the platform is anonymous, Mashable couldn't verify the details of these accounts firsthand with alleged victims.

Four other sources with similar knowledge of 7 Cups said they'd known about concerns related to teen safety. 

Moriarty described the claim of concern over predatory behavior toward teens as "inaccurate." He said the company has only received and complied with 10 law enforcement requests since its founding, and argued that the number was low compared to other social platforms. 

Experts in online child exploitation, however, say that the number of cases investigated by law enforcement may be dwarfed by the actual incidence of predatory behavior, partly because minors may not feel comfortable reporting it.   

Additionally, some predators online seek out emotionally vulnerable minors who they believe they can manipulate into creating child sexual abuse material or other types of traumatic content. An FBI warning issued in September 2023 identified one such group of predators, which is known to target youth between the ages of 8 and 17 who struggle with mental health issues. There is no evidence that the group has infiltrated 7 Cups' teen community.   

Compared to its competitors, 7 Cups is unique in how aggressively it welcomes minors. In a 2018 presentation to California mental health officials, Moriarty said 18- to 25-year-olds were the platform's largest demographic, followed by younger teens. 

Teens must be 13 to join as a member and 15 to volunteer as a listener. When teens seek to chat with a listener, they are either randomly paired with someone and cannot choose between a teen or adult-teen listener, or they can browse the listener directory and make a request of a user. Listener profiles indicate whether they chat only with teens, or with teens and adults, meaning they are an adult who has been vetted by 7 Cups.

For teens who make a general request, not a personal one via the directory, and are paired with an adult-teen listener, it should say that person is an adult following their username, Moriarty said. When Mashable tested the teen chat function, that information was missing for the adult-teen listener, which Moriarty said was a bug and would be quickly fixed. A teen can also determine whether their listener is an adult by hovering over their icon or by clicking out of the chat — which they can then return to — to view the listener's bio page, which may or may not include a specific age.

Upon turning 18, minors can join or age into the adult side of the platform, though some sign up for it anyway before that milestone by creating an adult account with a false birth date, according to those with knowledge of related incidents. 

"In some ways, the easiest thing in the world for 7 Cups to have done at any point would've been just to say, 'Let's not do teens,'" said one source who previously worked at the company and who noted that efforts to connect teens to meaningful emotional support were genuine. 

"Clearly if a 42-year-old can pose as a 15-year-old, you're not vetting the identities of the teens well enough," the individual said. 

Research conducted by Thorn indicates that anonymity can contribute to increased risk-taking. An anonymous persona may embolden youth to interact with others in ways they wouldn't online.

For predators hoping to abuse adolescents and teens, that can create opportunities to isolate, victimize, and "build false relationships" with young users, according to a 2022 Thorn report on online grooming, which surveyed 1,200 children and teens between the ages of 9 and 17. 

One in seven respondents said they've told a virtual contact something they'd never shared with anyone before, a possibility that is far more likely on an emotional support platform like 7 Cups, which invites youth to be vulnerable with strangers. 

"Sadly, bad actors target this same information to groom, exploit, and extort minors," the Thorn report noted.

Recently, a member of 7 Cups' teen community asked leadership to draw awareness to predatory behavior on the platform and what to do when they encounter it, a sentiment that was echoed in a group support chat room. Moriarty said a community manager made a referral to 7 Cups' safety information and bi-weekly safety Internet discussions.

The widespread use of volunteers on 7 Cups has also presented distinct safety challenges for teens. 

Some 7 Cups sources said they heard directly from teen volunteers that they felt unsafe while communicating with adult volunteers, which Moriarty said he had no way to substantiate. They noted that while users are instructed not to go off-site together under any circumstances, volunteers correspond via Google Chat and Meet without dedicated oversight by paid staff. Moriarty confirmed to Mashable that volunteer leaders may use Google communication tools to "collaborate" with other volunteer leaders. 

Based on past incidents, current and past staff and volunteers remain concerned that teens may be targeted for exploitation or grooming in those circumstances. 

Safety protocols don't go far enough

In general, Moriarty said 7 Cups has safety protocols designed to keep anonymous bad actors and predators from contacting minors, but multiple past and current staff members and volunteers told Mashable that they fear those practices aren't robust enough. 

The platform has 87 adult-teen listeners, most of whom are on staff or are high-level volunteers. Only 12 of those listeners have no other affiliation with 7 Cups.

In order to gain access to the teen community as an adult without lying about age, listeners need to have extensive experience on the platform, good reviews, and what 7 Cups refers to as a background check. 

That process involves submitting a state-issued identification to the company, as well as a video conversation with a platform moderator. Additionally, 7 Cups staff search the internet for press coverage of the applicant's name in association with criminal acts, such as sexual assault, and may check to see if their name is in a national database of sex offenders. 

Moriarty said that all applicants must pass a background check by companies that specialize in such research, but those familiar with the process say that hasn't always been the case. Instead, they said that the company previously used free resources like Google and social media to check applicants' personal information.  

Currently, 7 Cups doesn't have a rigorous standard for verifying that identification is real rather than doctored or forged, like using algorithmic assessment technology. Moriarty said the company is exploring the use of sophisticated identity document verification.  

Nor does the company have clear directives for how to handle complaints that involve potentially criminal behavior involving minors that occurs on the platform, aside from instructing staff and users to report concerns through its safety reporting form. A pinned message at the top of each chat instructs users who feel unsafe to visit the platform's "safety & reporting" page, which recommends using blocking, reporting, and muting tools. A brief section on teen safety urges minors to talk to a parent or guardian if they feel unsafe. 

One source with knowledge of the platform's current practices told Mashable that there wasn't widespread staff training on whether and how to escalate such reports to law enforcement. When Mashable asked whether 7 Cups informs a minor's parents when an adult has tried to contact their child, Moriarty called it a good idea and said the platform would be implementing the protocol shortly.

A former high-level 7 Cups volunteer, who also served as an adult-teen listener, said that multiple teen members of the platform approached them with questions about how to deal with uncomfortable interactions with adult listeners. Often, the teen felt something was amiss with the adult's behavior, but they struggled to pinpoint a specific red flag or offense.  

"When you have somebody that you think is empathizing with you and listening to you and finally getting you…you're forming this intense bond and then they say things like, who knows what, you don't want to disappoint them, or break that bond, or lose that relationship, and then somebody pounces," the former volunteer told Mashable. 

Until Mashable contacted Moriarty for comment, the platform hadn't updated its webpage on teen safety since May 2019. He said the company was also reviewing where and how it presented information about reporting unwanted or abusive behavior to make those instructions more accessible.

Safety practices vary widely from platform to platform on the internet, said Lauren Coffren, an executive director of the Exploited Children Division at the National Center for Missing & Exploited Children. That makes it hard for minors, and their caregivers, to understand which policies keep them safest. It may also be an advantage for predators. 

"People who want to be able to exploit those differences or exploit [that] lapse of reporting mechanisms or safety features or tools, they'll certainly be able to find a way," Coffren added. 

What happens when someone is harmed on 7 Cups 

Simply put, there are no dedicated federal agencies that regulate platforms like 7 Cups.

The company's emotional support product falls in a gray regulatory area. And while Moriarty described the platform's peer-based interventions as "medicine" in his interview with Justin Kan, these interactions are not offered by licensed clinicians, nor held to rigorous independent testing or standards. 

Neither the Food and Drug Administration or the Federal Trade Commission would comment specifically on 7 Cups itself. Instead, both agencies pointed Mashable to their regulatory guidelines. The FDA may regulate mobile apps whose software is intended to treat a condition, but that doesn't apply to emotional support. The FTC could potentially enforce laws related to health claims and marketing practices, if they were allegedly deceptive. 

This may leave consumers wondering to whom they can turn if they, or their child, has been harmed on the platform.

Until recently, the law didn't offer much hope, either. Traditionally, 7 Cups might have been considered immune from liability for harm inflicted on their users when they encountered a bad actor on the platform. In the past, courts typically dismissed such lawsuits, citing a federal law known as Section 230 of the Communications Decency Act, passed in 1996. 

The law provides that online platforms cannot be held liable for the negative things that their customers or users do just because they occur on the platform. There are some exceptions, including copyright infringement, illegal actions, child abuse, and sex trafficking. Section 230 protection hinges on whether the company is being sued solely in its role as a publisher of other people's content. Some courts have interpreted this broadly to give platforms immunity from liability when the company's customers experience harm based on the platform's content.

But Section 230, as tech companies have come to know and rely on it for nearly 30 years, may be changing. In a Senate hearing on online child sexual exploitation in January, which featured top tech company executives, key senators called for the law's reform. 

Courts have also allowed recent lawsuits against certain platforms to move forward, dismissing some of the plaintiff's claims to immunity under Section 230. 

One key case is a nationwide lawsuit against major social media companies, including YouTube, TikTok, and Instagram, filed on behalf of young users who were allegedly harmed as a result of using the platforms. Last November, a judge ruled that critical aspects of the suit could move forward, despite the companies' insistence that they were protected by Section 230.

Instead, the judge found that the plaintiffs had alleged the platforms' product design choices led to harm that had nothing to do with the content that users published. For example, the judge ruled that the failure to implement robust verification processes to determine a user's age, effective parental controls and notifications, and "opt in" protective limits on the duration and frequency of use are product design defects for which the companies could potentially be held responsible.

Jennifer Scullion of Seeger Weiss, a firm representing the plaintiffs, told Mashable in an email that all companies "have a responsibility to run their businesses in a way that avoids foreseeable harm."

Scullion said that while emotional support platforms involve a different set of facts and analysis than the case against major social media companies, "the real dividing line is whether the harm is from the content itself or from choices a company makes about how to design their platform and what warnings they give of reasonably foreseeable or known risks of using the platform."

The lawsuit that forced the chat platform Omegle to shut down last year may also hold lessons for 7 Cups. In that case, attorney Carrie Goldberg sued the company on behalf of a teenage girl who, at age 11, had been paired to chat by Omegle with a child sexual abuse predator. He spent the next three years exploiting her, forcing her to make child sexual abuse material for him and others. 

That case also moved forward despite Omegle's attempts to shield itself from liability by citing Section 230. The judge found Omegle could be held responsible for defective and negligent product design. Omegle settled the suit. 

Goldberg, who hadn't heard of 7 Cups prior to speaking with Mashable, said attempting to sue the company for harm experienced by users, particularly those who are minors, would depend on whether their distress was caused by content published by other users on the platform or by the design of the product itself. 

Goldberg expressed concern about 7 Cups' ability to match vulnerable people, including children, with bad actors, noting that such information could easily be used to manipulate or exploit them.

"It's a product that's grooming people to be revealing very intimate details of their life," she said.

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

As the recent Congressional hearing on online child sexual exploitation demonstrated, the manipulation and abuse perpetrated by bad actors against vulnerable teens on social and digital media platforms can be devastating. 

Consider a few high-profile cases:  

A 54-year-old man reportedly targeted a 14-year-old girl on Instagram in December 2022, plying her with a gift card after she remarked in her own post that clothing was expensive. The man allegedly drugged and raped the teen multiple times after cultivating an in-person relationship with her, according to Manhattan District Attorney Alvin Bragg. 

A 13-year-old boy from Utah was abducted by an adult male in late 2022, after the man groomed the teen on social media platforms, including Twitter (now branded as X), the teen and his parents reported. The boy returned home after five days, but prosecutors said he'd been repeatedly sexually assaulted. 

Mashable's own investigation into emotional support platforms recently found concerns about teen safety on 7 Cups, a popular app and website where users can seek and offer others compassionate listening. In a 2018 case originally reported by the Pittsburg Tribune-Review, a 42-year-old Butler, Pennsylvania, man lied about his age to gain access to the teen community on 7 Cups. The man posed as a 15-year-old boy and coerced a 14-year-old girl into sending him sexually explicit imagery of herself, crimes to which he pleaded guilty.  

These cases reflect a chilling reality. Predators know how to weaponize social media platforms against youth. While this isn't new, it's an increasingly urgent problem. Screen time surged during the COVID-19 pandemic. Adolescents and teens are in the midst of a mental health crisis, which may prompt them to seek related information on social media and confide in strangers they meet there, too. Some research also suggests that youth are increasingly comfortable with conducting an online romantic relationship with an adult. 

This story is part of our investigation into the emotional support platform 7 Cups and the growing marketplace for apps and platforms that pair people with someone who is supposed to be a compassionate listener. The series explores a failed experiment between the state of California and 7 Cups, as well as the myriad risks of seeking emotional support online from strangers. These dangers can include the manipulation of vulnerable youth and targeted abuse and harassment. The series also includes an analysis of why it's so hard to stop online child exploitation, and looks at solutions to make platforms safer.

Bad actors and predators appear to be capitalizing on these trends. Data collected from the Exploited Children Division at the National Center for Missing & Exploited Children (NCMEC) show an alarming increase in online enticement, or types of predatory behavior designed to exploit a minor. 

While there's no single reason that explains the heightened risk, the largely unrestricted access adult bad actors have had to youth online, in the absence of robust safety measures and meaningful federal regulation, may have both emboldened predators and influenced youth attitudes about the adult behavior they'll encounter online.  

Though youth and their caregivers may think the risk of online exploitation is low, the design of many social media platforms tends to maximize opportunities for predators while leaving youth to fend for their own safety. Online child safety experts argue that platforms should take far more responsibility for ensuring their security, and urge youth to report any abuse or exploitation to a trusted adult or to the authorities.

"I think sometimes the pressure is on for these kids to figure it out for themselves," says Lauren Coffren, an executive director of the Exploited Children Division at NCMEC. 

"This is happening on every platform" 

It doesn't matter where youth spend their time online — a popular platform for adults or a space specifically created for teens — bad actors are targeting them, says Melissa Stroebel, vice president of research and insights at Thorn, a nonprofit organization that builds technology to defend children from sexual abuse. 

"At the end of the day, this is happening on every platform," she notes. 

Popular social media platforms don't effectively verify user age, making it possible for children younger than 18 to sign up for services that may put them at greater risk of coming into contact with adults who intend to exploit them. Similarly, adults can often access gated teen communities by simply lying about their age. 

Safety features, like blocking and reporting, can be hard to access, or never explicitly introduced to minors as a way to protect themselves. Bad actors can evade platform bans by creating new accounts using burner email addresses or phones, because their profile isn't tied to a verified identity.

Protecting one's self as a teen from online exploitation, or safeguarding a child as an adult, can be extraordinarily hard under these circumstances. 

Data collected by NCMEC suggests the problem is worsening. Between 2022 and 2023, NCMEC logged a 132-percent increase in reports related to online enticement. This increase included an emerging trend in which children are financially blackmailed by users who request and receive nude or sexual images of them.

Common tactics that predators use to entice children include lying about their age to appear younger, complimenting a child or connecting with them over mutual interests, engaging in sexual chat, providing an incentive like a gift card or alcohol, offering or sending sexually explicit images of themselves, and asking a child for such material. 

Victimization is never a child's fault, experts say. Nor should youth be expected to constantly guard against the threat of exploitation. Instead, prevention experts say that minors and their caregivers need better tools to manage risk, and that social media companies need to design platforms with youth safety as a key priority. 

Unsafe by design 

Thorn urges platforms to consider child safety from the outset. One best practice for platforms is to have content moderation features and humans who staff trust and safety efforts, plus the knowledge of what exploitation looks like, in order to recognize and report abusive interactions and material internally and to the authorities. 

But that's not enough. Stroebel adds that platforms must also have the capacity to scale those systems as the user base grows. Too often, the systems are implemented well after a product's launch and aren't designed to scale successfully. 

"We end up trying to put Scotch tape over cracks in the dam," says Stroebel. 

Stroebel says it's imperative that there are tools to recognize, report, and remove someone with predatory intent or behavior. 

On an emotional support platform like 7 Cups, which relies heavily on a volunteer labor force, a safety report might be evaluated by a volunteer who receives little training for making a decision about escalating bad behavior to paid staff. 

Other apps may use a combination of artificial intelligence and paid human moderation to review safety reports and still issue confusing decisions, like concluding that a clearly harmful offense doesn't violate their terms of service. Instagram users have anecdotally found it difficult to get the platform to take action against bullying accounts, for example. 

Coffren says the NCMEC CyberTipline, which receives reports of child exploitation, often hears from youth and caregivers that the platform reporting process is more difficult than they expected. Multiple links or clicks take users to different subpages, where they might encounter non-trauma-informed language that's inappropriate for someone who's been exploited online. Sometimes people never hear back from the platform once they've made a report. 

Platforms should reduce the "friction" of using reporting tools, says Coffren. They could even require minors to complete a tutorial about how safety tools work before accessing the platform, she adds. 

Coffren points out that every company gets to make its own decisions about safety practices, which creates a "giant disparity" from platform to platform and makes it difficult for youth and caregivers to know how to reliably protect themselves or their children. 

There is legislation aimed at better protecting youth online. Proposed federal legislation known as the Kids Online Safety Act does not impose age and identity verification but would require online platforms to enable the strongest privacy settings for underage users. It would also mandate a "duty of care" so that social media companies have to prevent and mitigate harms associated with using their product, including suicide, eating disorders, and sexual exploitation. 

The legislation has many backers, including the American Psychological Association and the American Academy of Pediatrics. Yet critics of the bill say it would curtail free speech and discourage marginalized youth, such as LGBTQ+ minors, from learning more about their identity and connecting with other queer and transgender community members online. 

Youth more vulnerable online than adults realize

Youth view online experiences differently than many adults, which is why it's critical to incorporate their overlooked perspectives in policy and design choices, says Stroebel. 

Research on online grooming conducted by Thorn found that sharing nudes is now viewed as normal by a third of teens and that half of minors who'd shared such images did so with someone they only knew online. Slightly more than a third of those respondents said they'd given nudes to someone they believed to be an adult. 

Stroebel says the "stranger danger" catchphrase that Gen X and older millennial parents grew up hearing isn't sufficient as standalone advice for avoiding risky situations online. Instead, youth are accustomed to creating a digital social network comprising friends and acquaintances that they've never met before. For some of them, a stranger is just someone who's not yet their friend, particularly if that unknown contact is a friend of a friend.

On its own, this isn't necessarily risky. But Thorn's research on grooming indicates that youth can be surprisingly open with online-only contacts. One in seven respondents said they've told a virtual contact something they'd never shared with anyone before, according to a 2022 Thorn survey of 1,200 children and teens between the ages of 9 and 17. 

Worryingly, the norms around online romantic interactions and relationships, particularly with adults, appear to have shifted for youth, potentially making them more vulnerable to predation. 

The survey found that a significant proportion of youth thought it was common for kids their age to flirt with adults they'd met online. A quarter of teens believed it was common to flirt with users ages 30 and older. Among 9- to 12-year-olds, one in five felt the same way about romantic interactions with older adults. 

Stroebel says that youth struggle when responding to adult behavior that seems predatory. Many view reporting as more punitive than blocking, which creates an "immediate barrier of defense" but doesn't trigger a platform protocol that ends in confronting or banning the adult user. 

Stroebel says that manipulation plays heavily into the youth's decision when, for instance, the adult tells the teen they misunderstood a comment. 

"Think about how hard it is to recognize manipulation in a way that you trust your gut," says Stroebel, adding that a young user may have confided in the adult or feel understood in a way they've never experienced before. Expecting youth to recognize a manipulative dynamic is an unreasonable burden, says Stroebel. 

Even when a minor takes action, Thorn's research shows that one in two youth who block or report someone say they were recontacted by the user, either on a different platform or from a new account created with another email address. In half of such cases, the minor experiences continued harassment. Stroebel says that ban evasion is "far too common." 

How to handle online exploitation 

Coffren says that youth who've been exploited online should tell a trusted parent, adult, or friend. The minor or someone close to them can make a report to the CyberTipline, which assesses the information and shares it with the appropriate authorities for further investigation. (The center's 24-hour hotline is 1-800-THE-LOST.) 

Coffren emphasizes that minors who've been exploited have been tricked or coerced and should not be treated by law enforcement as if they have violated the law.

She also wants youth to know that nudes can be removed from the internet. NCMEC's Take It Down program is a free service that lets people anonymously request the removal of nude or sexually explicit photos and videos taken of them before age 18 by adding a digital fingerprint, or hash, as a way of flagging that content. NCMEC shares a list of fingerprints with online platforms, including Facebook, TikTok, and OnlyFans. In turn, the platforms can use the list to detect and remove the images or videos. 

Coffren urges youth who've been exploited to stay hopeful about their future: "There is a life after your nude images circulate online." 

But reducing the stigma of exploitation also requires the public to confront how the digital ecosystems youth participate in aren't designed for their safety and instead expose them to bad actors eager to manipulate and deceive them. 

"We have to accept that children are going to weigh the pros and the cons and maybe make the wrong decision," says Coffren, "but when it's on the internet, the grace isn't given to make mistakes as lightly or as easily."

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

On a late spring day in 2019, Mimi Martinez McKay, then deputy director for the Los Angeles County Department of Mental Health, saw that a user on Twitter, the platform now known as X, had been tagging the county in posts that made alarming claims about the safety of 7 Cups, a popular emotional support platform. 

7 Cups, which operates as both a website and app, invites teens and adults to talk to someone online for free. Users give and receive emotional support, but they are discouraged from acting like a therapist. 

The year prior, the county had agreed to provide 7 Cups access to residents as part of a five-year, $101 million initiative known as Tech Suite that was designed to use innovative technology to connect California residents to mental health help. Some of these adults, who were clients of local departments of mental health, had complex behavioral health needs and were highly vulnerable. They lived with serious mental illness and may have experienced homelessness, substance abuse, and domestic violence. 

The Twitter/X user making claims about 7 Cups belonged to the platform's teen community and went by a pseudonym on both platforms. The user claimed that a teen friend also on the platform had been manipulated into sharing child sexual abuse content and material with an adult user outside of the United States. McKay, who said she controlled the department's Twitter/X account, was appalled by the claim. 

This story is part of our investigation into the emotional support platform 7 Cups and the growing marketplace for apps and platforms that pair people with someone who is supposed to be a compassionate listener. The series explores a failed experiment between the state of California and 7 Cups, as well as the myriad risks of seeking emotional support online from strangers. These dangers can include the manipulation of vulnerable youth and targeted abuse and harassment. The series also includes an analysis of why it's so hard to stop online child exploitation, and looks at solutions to make platforms safer.

What happened next was never publicly detailed by California officials in charge of the initiative, despite multiple public evaluation reports written about the initiative. The incident in L.A. County factored into the abrupt termination of 7 Cups' contract with the state several months later, according to sources with knowledge of the events. By the end of 7 Cups' contract, the company received an estimated $6.7 million.

The California Mental Health Services Authority (CalMHSA), which contracted with 7 Cups to provide some state residents with access to the platform, told Mashable in a statement that, "After the initial phase, it was determined that the services, tools, and processes used by 7 Cups did not meet the needs of the target populations for the project."

In fact, CalMHSA ultimately reached a settlement with 7 Cups after its CEO, Glen Moriarty, disputed the contract's termination. That settlement, which Mashable obtained through the Public Records Act, contained a confidentiality clause prohibiting either party from disclosing the settlement's existence, terms, and provisions. The clause had a few exceptions, including if disclosure was necessary to comply with applicable law, rule, regulation, or policy of a governmental agency, like the Public Records Act.

As part of the settlement, 7 Cups paid CalMHSA $460,382 to satisfy its "financial obligation" to the agency, and CalMHSA paid the company $309,277 as "consideration."

Though the settlement agreement did not identify the reasons why 7 Cups' contract had been terminated, an investigation conducted by Mashable found significant concerns regarding trolling and inappropriate comments, including unwelcome sexual and explicit language, as well as a nontherapeutic discussion of child sex abuse on the platform. 

In one unrelated July 2018 criminal case that Mashable reviewed, a 42-year-old Butler, Pennsylvania, man named Anthony Joseph Smith posed as a 15-year-old boy to gain access to 7 Cups' teen community. He met a 14-year-old user and coerced her into sending him child sexual abuse material of herself. Her parents learned of their communication and alerted the authorities. Smith was jailed in 2019, but California officials awarded 7 Cups its contract prior to the criminal acts and appeared to have no knowledge of the case. 

Still, the University of California, Irvine, was paid by CalMHSA to evaluate Tech Suite. Its public reports make little mention of safety issues related to 7 Cups, and do not explain why the company lost its contract. Dr. Dara Sorkin, a principal investigator and professor in the school of medicine at UC Irvine, declined to review fact-checking sent by Mashable or answer questions related to Tech Suite. CalMHSA declined to comment on whether it prohibited the UC Irvine researchers from including detailed safety concerns in its public reports, though the settlement's confidentiality agreement may have effectively barred the researchers from addressing them.

David Loy, legal director of the California-based First Amendment Coalition, reviewed the settlement for Mashable. Loy, who is an open government litigator, noted that CalMHSA didn't violate the law by including a confidentiality agreement in the settlement, because it did not prevent the agency from disclosing a copy in response to a public records request. 

However, the clause impaired the public's ability to know what transpired and hold the agency accountable by effectively forcing the public to request a document that it didn't know existed in the first place, according to Loy. The clause also included stipulations that CalMHSA had to notify 7 Cups prior to disclosing the settlement, which could allow 7 Cups to sue to stop the document's release.

"I think it's a very bad thing," Loy said of the confidentiality clause. "I don't think government agencies should ever be allowed to do this."

Dr. Matt Mishkind, a researcher who studies technological innovation in behavioral health as deputy director of the University of Colorado's Helen and Arthur E. Johnson Depression Center, said the failure to disclose issues or negative outcomes in a project like California's may lead to further user harm, if consumers are never informed of the possible risks of using a platform. Mishkind was not involved in Tech Suite or familiar with it prior to speaking to Mashable. 

The lack of transparency also denied academia and industry the opportunity to learn from critical mistakes in the rapidly growing market of mental health apps. In recent years, a number of emotional support platforms have launched, including Wisdo Health, HearMe, and Circles. 

"When public dollars are used, part of what we learn should be in the public good, and when it's not, then why isn't it?" McKay told Mashable. 

As venture capital funds and investors pour tens of millions of dollars into products with the noble intention of offering free or affordable emotional support to vulnerable people, and employers and insurers look to bring them into their portfolio of behavioral health offerings, California's experiment with 7 Cups prompts serious questions about user safety.

To reconstruct what happened, Mashable reviewed meeting agendas and minutes routinely made publicly available by the Mental Health Services Oversight & Accountability Commission, a body that reviews billions of dollars in mental health spending; quarterly and annual evaluation reports of the project; and government correspondence, invoices, and internal documents and meeting minutes related to the initiative, obtained through public records requests submitted in 2019 and 2020 by Cal Voices, a nonprofit advocacy organization. Mashable also interviewed several individuals familiar with the project's execution, who requested anonymity because they weren't authorized to discuss their experiences or had signed a nondisclosure agreement with 7 Cups. The documents that Cal Voices received in response to its public records requests did not include the settlement, according to the group's executive director, Susan Gallagher.

These events, which have not been previously reported in detail, offer yet another cautionary tale about the risks of leveraging unregulated digital technology to solve some of the thorniest problems in the mental health delivery system.

"A great opportunity" 

The Innovation Technology Suite Project (Tech Suite) initially featured two apps: 7 Cups and Mindstrong, a now-defunct platform that aimed to use artificial intelligence and digital biomarkers to predict the onset of mental illness. 

Both had a persuasive and powerful ambassador in Dr. Thomas Insel, the former director of the National Institute of Mental Health (NIMH) from 2002 until 2015. He left the NIMH and joined Verily, an Alphabet precision health company. Insel then served as Mindstrong's president, and as an advisory board member for 7 Cups when both companies were awarded their contracts, according to a 2018 report published by the state. 

In February 2017, Insel, then at Verily and a 7 Cups advisory board member, made a presentation that included information about the emotional support company in a public meeting to the Mental Health Services Oversight & Accountability Commission, which reviews certain streams of taxpayer funding earmarked for mental health interventions, including for innovation projects. Insel told Mashable that the commission invited him to make a presentation about innovation, and that he was never part of 7 Cups outside of agreeing to be an advisor. At the time, Insel's daughter was employed by 7 Cups as its director of clinical initiatives. 

A few months later, members of the commission participated in a daylong meeting at Google-Verily headquarters to explore innovation in the mental health sector, according to three stakeholders who attended or knew of the event. 

Unlike a typical commission meeting wherein stakeholders have an opportunity to review materials in advance and comment on specific mental health programs or proposals, this invite-only gathering was focused on broader discussions about innovation. One participant recalled breaking into small groups of "innovation incubators" in order to create prototypes of apps they might use. 

By October 2017, the Los Angeles County Department of Mental Health presented to the commission a proposal for a multi-county innovation project to "work with one or more technology companies with experience with virtual mental health care platforms." Among other goals, the project aimed to improve access to mental health services and boost social connectedness. The proposal explains that planning for the initiative began in June, after the commission's gathering at Google-Verily. 

The state quickly put out a request for proposals. By spring 2018, both 7 Cups and Mindstrong were selected as the only two vendors for a three-year $35 million initiative. (Tech Suite was eventually renamed Help@Hand and its budget increased to $101 million as more counties joined.)  

Financing for the ambitious effort came from a so-called millionaire tax levied on high earners. Approved by voters in 2004, Proposition 63 was designed to generate revenue for mental health prevention efforts and treatment. The funding allocated through Prop. 63 varies from year to year, depending on state revenue. It's estimated to raise $3.4 billion in the 2023-24 fiscal year. Historically, counties had been required to spend 5 percent of the revenue on innovative approaches to mental health, like Tech Suite. If, after a period of time, counties did not use their innovation funding, it would go back to state coffers for distribution to other counties.

In March, Californians passed a proposition designed to overhaul how Prop. 63 dollars are spent. There will no longer be a mandate for innovation, and counties will be required to spend two-thirds of the tax revenue on housing and round-the-clock services for people who are unhoused and experiencing mental illness.

When 7 Cups received its Tech Suite contract, the company's founder and CEO, Glen Moriarty, celebrated the news in a platform forum on June 18, 2018. He shared that the platform would be focused on supporting foster youth, new mothers, high school students, members of the Deaf and hard of hearing community, and those already receiving mental health care. 

"What I love about this is that, not only will we be able to reach more people in California, this partnership will bring extra resources for 7 Cups," he wrote. "It will give us a great opportunity to improve the 7 Cups website and app, fix bugs more quickly and hire new team members. Well [sic] be able to provide better all around care to everyone around the world." 

Shocking safety issues on 7 Cups

Before 7 Cups was terminated from the project, it received an estimated $6.7 million over 13 months to help Californians in populous and rural counties, including Los Angeles, Orange, Kern, and Modoc, connect with someone who was supposed to be a compassionate listener, according to Cal Voices' analysis of financial data from the documents obtained via a public records request. Ideally, the service would help people, particularly rural residents, feel less isolated, and improve their mental health and emotional well-being.  

Yet what occurred as the project unfolded was far more complex, and troubling. 

Prior to viewing the tweets that made concerning claims about 7 Cups' safety, Mimi Martinez McKay, of the L.A. County Department of Mental Health, had already independently developed her own reservations about the platform after testing it earlier in the year. 

"In my own experience as a user of 7 Cups, I did not feel that the people were professional," McKay told Mashable.

She also worried that L.A. County residents wouldn't be able to easily access a list of local resources where they could receive more formal help, including therapy. 

McKay reviewed the tweets, which included allegations that an adult 7 Cups user had groomed a teen user of the platform for a romantic relationship. 

McKay exchanged emails with the X user, noting to them that "we take these concerns you've shared with us very seriously." Mashable reviewed documentation of the correspondence and verified the identity of the anonymous user. 

Mashable couldn't vet the specific claim of online grooming presented in the tweets because the user being referenced as a victim was anonymous. However, a separate Mashable investigation into 7 Cups identified key lapses in the platform's approach to safety, like the ability of banned users to quickly return to the platform using burner accounts and regular experiences of harassment and abuse, along with multiple anecdotal reports of concern that adult users were attempting to groom minors. 

McKay believes she shared the claims directly with a state official overseeing the initiative at the California Mental Health Services Authority, or CalMHSA. She recalls that the agency took the claims seriously. The state documents obtained through a public records request by Cal Voices appear to substantiate McKay's account of alerting CalMHSA to the incident on X. 

Invoices submitted to CalMHSA by Murphy, Campbell, Alliston & Quinn (now Quinn Covarrubias), the Sacramento-area law firm it consulted on matters related to Tech Suite, show charges related to discussions of safety on 7 Cups, held in the days after the anonymous tweets were posted. 

McKay, who was fired by the L.A. County Department of Mental Health in 2020, settled a wrongful termination suit against the county in 2022. McKay partly attributed her termination to questioning department practices, including some related to the Tech Suite project.

What California officials didn't tell the public

This wasn't the first time that CalMHSA or its lawyers fielded concerns related to Tech Suite and 7 Cups. 

While issues had been raised in late 2018 and early 2019, the situation escalated in April 2019. A group of staff and contractors in the participating counties had been testing 7 Cups, according to documents obtained through the records request and to sources familiar with the process. The testers messaged with other users and participated in public chat rooms. Some of those testers were disturbed by what they encountered, according to sources with knowledge of their concerns.

The testers noticed inappropriate handle names and profile photos. Some received unwanted sexual messages. Bad actors name-called and taunted people engaging with the platform. Inappropriate behavior allegedly included descriptions of sexual fetishes and domestic violence. One tester reported being asked to trade photos of feet for sexual gratification. Some of the testers messaged with users who requested to meet in person for a sexual encounter. Mashable reviewed documentation of these concerns.

One tester reported messaging with a 7 Cups user who described a hypothetical act of child sex abuse in graphic detail. Mashable confirmed the details of this incident with sources who were familiar with what happened. 

Almost none of this appeared in the quarterly and annual public evaluation reports produced by UC Irvine. These documents provided the only thorough public accounting of the project's progress.

In a quarterly report that covered September 2018 through February 2019, the researchers briefly recommended that 7 Cups "vet listeners more carefully." The evaluators themselves documented a user who used a Confederate flag as a symbol, but that is the only detail included as an example of poor listener quality. 

By April 2019, Kern County, home to the central Californian city of Bakersfield, discontinued use of 7 Cups, according to the county's report on the project, which was obtained via Cal Voices' public records request. 

That report noted that Kern County felt 7 Cups was a "poor fit" for its community. Some of the county's mental health clients had histories of domestic violence, sexual abuse, and other types of trauma. The report noted multiple frustrations with the app, including: concerns about the "quality" of listeners; "unmoderated chat rooms, unmoderated listeners"; and difficulty "screening out dangerous folks" from becoming listeners. Additionally, the county was concerned about endorsing the app without solving these safety issues. 

Though the UC Irvine researchers were in regular contact with Kern County officials during this time period according to its own reporting, these problems were omitted from their quarterly evaluations. 

When 7 Cups was terminated from the project altogether, in August 2019, it merited only a single-sentence mention in the quarterly report, with no acknowledgment of the alarming safety problems that had surfaced. In their annual report, published in February 2020, UC Irvine researchers again omitted why 7 Cups had lost its contract with the state. The researchers did not go into detail about safety concerns. 

Sources familiar with the factors that contributed to 7 Cups' contract cancellation, who asked to remain anonymous, told Mashable that safety issues were critical, in addition to concerns that the company was failing to implement counties' demands for specific features quickly enough. 

Some of those sources also noted that California officials, including those at the county level, had naive or unrealistic expectations of technology and the platform, and didn't understand how long it takes to iterate new ideas. At the same time, county officials believed 7 Cups offered a specific type of high-quality peer support, and were frustrated to learn that it largely did not, according to sources familiar with their experiences.

Moriarty told Mashable in an email that he was not made aware of the concerning safety issues identified by the county testers, and that the company ultimately built the desired functionality into the platform. 

"I regret that we were not able to serve the counties in the way we had envisioned," he said. 

Even commissioners who served on the Mental Health Services Oversight & Accountability Commission were puzzled by 7 Cups' abrupt removal from the project. 

In the only public meeting on Tech Suite's progress, held in Sacramento in February 2020, commissioner Dr. Itai Danovitch said that he held the project to a "high standard" and asked whether it was "on target," according to the meeting minutes. 

"One of the challenges in answering this question is that every presentation on this project has been completely different," Danovitch said, in the minutes' summary of his comments. "There are some things that were significant elements of past presentations, such as 7 Cups, that have disappeared with no explanation."

Another commissioner asked the meeting's presenters to confirm that 7 Cups was no longer part of the project. At this point, CalMHSA had agreed to the settlement with 7 Cups and was beholden to its confidentiality agreement. The commission was not a party to the settlement, according to its executive director Toby Ewing.

Jeremy Wilson, program director and public information officer at CalMHSA at the time, confirmed that 7 Cups wasn't a vendor. He explained that "it was determined by the counties that the peer chat product was not going to fit the need for the counties on this project," according to the minutes. He also noted that the company had chosen not to apply for a second round of proposal requests issued in September 2019 to identify new products for the initiative. 

Tech Suite was never put on a commission meeting agenda again, despite efforts by advocates to revisit the topic. Ewing told Mashable that the commission will not consider putting Tech Suite back on the agenda "at this time" and that the body was focused on "pressing needs" like school mental health and strengthening suicide prevention strategies.

Susan Gallagher, executive director of Cal Voices, was one of the advocates who asked the commission to revisit the initiative. She told Mashable that Cal Voices and other stakeholder groups had long raised concerns about Tech Suite with the commission on issues like safety, privacy, and usefulness to consumers. The nonprofit made its first public records request about Tech Suite in 2019, and submitted two requests in 2020 to obtain additional documents.  

In a January 2022 letter to the commission, Gallagher urged the body to "seriously assess the outcomes and budget" of the initiative. Before speaking with Mashable, Gallagher was unaware of the more serious safety concerns that emerged after testers used 7 Cups. 

"It's not really that surprising to me, although it is very devastating to think that could've happened to vulnerable people who we were supposed to be helping," she said. 

Dr. Matt Mishkind told Mashable that the failures to fully disclose the concerns over 7 Cups deprived consumers the opportunity to better inform and protect themselves from harm on the platform, or other similar platforms, of which there are now several. 

Mishkind added that state officials had an ethical obligation to inform the public. 

"When it's paid for with taxpayer dollars, I think there should be transparency there. People should know why something, especially something pretty big, did not work, and also what the recommendations and solutions are to it," said Mishkind. "I think that's how it should work. I don't know that I'm so naive to say that's how it works." 

What happened at 7 Cups

In a non-public report submitted to county leadership in 2019, Moriarty acknowledged that the company had to address safety concerns. He described moving from a "reactive approach" of using a list of keywords that triggered human flagging and censoring of inappropriate content to "far more advanced monitoring." The company reduced access for "guest" and "unverified" users, or people who created an account without using an email address to sign up for the service. 

7 Cups also began using a "suspicion-scoring mechanism" in conjunction with "trust scoring" to detect and sanction behavior associated with acting in "undesirable ways."  

"We continue to run experiments now to balance the tension between making it too difficult for people to get help, while also increasing their safety," he wrote. 

Mashable's recent reporting on 7 Cups indicates that some of the same problems continue to plague the platform. Users who exhibit trolling behavior can still access the platform, even after they've been banned. Last summer, one such user told some members to kill themselves, according to a source familiar with current safety issues on the platform. 

Moriarty told Mashable that the company "continuously" improves safety measures and that there were fewer related challenges than five years ago, when 7 Cups' contract was terminated. 

Moriarty's tone in the 2019 report was optimistic: "We believe we have a lot of important work to do and appreciate the honor of continuing the work we started." 

7 Cups received a 30-day notice of termination of its original contract on Aug. 31, 2019, according to minutes from a September 2019 leadership meeting attended by the county representatives and CalMHSA staff. 

The settlement with CalMHSA went into effect a few months later, on Nov. 1. At the end of October, Moriarty laid off 10 members of 7 Cups' staff. The decision blindsided and shocked the affected employees, according to sources with knowledge of the events.

In a 7 Cups forum post on Nov. 6, Moriarty announced that "we had to let some people go." Though he'd previously posted about the California initiative, he made no mention of it in his announcement. He did, however, note that the sitewide cost-cutting included shuttering unmoderated group chat rooms, for safety reasons. 

Likely anticipating disappointment from users who'd become accustomed to accessing chat rooms at any time, Moriarty tried to appeal to a sense of unity.

"If this is where you want to be and you are open to our attempts to increase safety while also surviving the challenges of a startup, then we have each others [sic] backs and will steer into problems together solving them one at a time," Moriarty wrote.

Despite the 7 Cups failure, the state of California hasn't given up on digital mental health products that incorporate some form of peer support. In January, the state's Department of Health Care Services launched access to an app for 13- to 25-year-olds called Soluna. Users can sign up anonymously to access, among other well-being features, moderated forums where they can "post a question, get or give advice, or just chat about whatever's on your mind."

What to learn from California 7 Cups' experiment 

Given that the public never learned specifically why 7 Cups lost its contract with California, the company has not faced any widespread criticism or fallout.

That same year, however, Moriarty launched the nonprofit 7 Cups Foundation "to support expanding access to quality, affordable, and innovative mental health care through volunteers, clinicians, and technology" with a sizable donation from the nonprofit, California-based medical system Sutter Health that the 7 Cups Foundation ended up returning in 2020.

Moriarty said the funding was meant to provide education for new mothers. The foundation paid $450,000 back to Sutter Health, which Moriarty said occurred after John Boyd, the organization's former CEO for System Mental Health Services, requested the remainder of the unspent funds. In 2018, when 7 Cups received its contract to serve California counties, Boyd served on the state commission that approved funding for the project. Sutter Health declined to comment on the matter.

As for 7 Cups users, some have continued to anonymously share their own negative experiences on the platform, which include alleged trolling and abusive behavior. 

When Mashable asked Moriarty about some of these complaints in February 2023, prior to learning about Tech Suite, he noted that the platform's massive size and reach meant negative experiences were bound to arise. 

"No matter how hard we try or the changes we make, ultimately people are people and they make mistakes and/or behave in unhelpful ways," Moriarty wrote in an email, adding that the same can occur with licensed professionals. "Humans — licensed or not — can be messy." 

The failure to disclose what happened with 7 Cups has also meant less scrutiny for similar startups. 

Wisdo Health, a competitor to 7 Cups that counts Dr. Insel as an advisor, struck a deal last year with a Colorado mental health nonprofit to make the platform available to adults in the state. A press release announcing the partnership said there would be a particular emphasis on reaching the state's Medicaid members. 

Though Mashable didn't learn of serious safety concerns related to Wisdo Health during the course of reporting, it did find that the industry at large hasn't resolved or even made clear to consumers the risks of using emotional support platforms. 

Nor is there evidence to indicate that such platforms are as good or better than other mental health interventions, like therapy or even computer-based cognitive behavioral therapy, a form of treatment that can help people better manage their thoughts and feelings. 

Still, the Department of Health and Human Services included Wisdo Health in a list of resources for improving social connection, a clear sign that power brokers take the model seriously. 

UC Irvine's lack of transparency has had ripple effects, too. 

In January 2023, the UC Irvine researchers, including Dr. Stephen Schueller, published a paper on their work evaluating Tech Suite in the journal JMIR Formative Research. The authors made a brief mention of safety issues, but without naming 7 Cups. The paper included an acknowledgment that CalMHSA "reviewed the manuscript to ensure its confidentiality."

The authors recommended chat forum monitoring of bullying and abuse.

"[S]ervice providers also shared concerns about inappropriate web-based interactions that could take place on peer support platforms and chat rooms; one of the service providers stated, 'But these chat rooms are not monitored, and so anyone can pop on and say a number of horrible things, and no one’s there to monitor that behavior. And we didn’t know that,''' the researchers wrote. 

Until last summer, when it shut down after losing its funding, Schueller led One Mind PsyberGuide, a nonprofit website designed to help consumers vet digital mental health tools. The PsyberGuide's review of 7 Cups contained no safety warnings, but does note that one of the app's target audiences is adolescents. The app received a 3.64 credibility rating out of 5. 

A 2022 study on using mental health apps for distress during the pandemic selected 7 Cups as one of its interventions partly because it was "highly rated" by PsyberGuide. Schueller told Mashable in an email that while he could not comment on 7 Cups and Tech Suite, any safety warnings would have been reflected in the PsyberGuide's transparency rating, which was not conducted for 7 Cups. "So nothing involved in our credibility review would speak to safety issues," he wrote. 

Insel and Moriarty told Mashable that they hadn't spoken to each other in years. Insel's daughter left the company in May 2019.

Together, Insel and his daughter have since founded Humanest Care, along with Twisha Anand, the former head of operations at 7 Cups. The startup offers mental health tools, courses, and counseling services, primarily on college campuses. Insel has described the company as "building an online community empowering people to get help and give help."

Insel wrote in an email to Mashable that he didn't know about 7 Cups' settlement with CalMHSA, acknowledging that, at the time, "there was less awareness of how online peer support could become toxic."

He added that he believes the U.S. needs a regulatory infrastructure for digital mental health or, at the very least, best practices so an agency like CalMHSA will know how to rigorously evaluate a digital mental health company.

"I don't know what happened with the [T]ech [S]uite in CA," Insel wrote Mashable, "but there should be some lessons learned."

If you are a child being sexually exploited online, or you know a child who is being sexually exploited online, or you witnessed exploitation of a child occur online, you can report it to the CyberTipline, which is operated by the National Center for Missing Exploited & Children.

It's not often that the world gets to hear from teens about what boosts their mental health.

A new report from Crisis Text Line and Common Good Labs aims to provide exactly that insight at a time when people, including lawmakers, are scrambling for solutions to the youth mental health crisis.

Some of the answers may be found in Crisis Text Line data. The crisis intervention service partnered with Common Good Labs, a research organization, to analyze common themes in 87,000 anonymized conversations between Crisis Text Line's volunteer crisis counselors and youth texters that took place from 2019 through 2022.

"There is a lot of discussion about this issue," Lili Török, principal research scientist at Crisis Text Line, told Mashable, referring to the increasing rates of depression, anxiety, and suicide among youth. "One of the things we haven't seen as much of is listening to young people and what they want."

The top resource that one in five texters resoundingly said improved their well-being was social connection. Versions of that, like connecting with a mentor or coach, helped them navigate turmoil and crisis. Secondly, they said that music, writing, and visual and performing arts helped them through difficult moments.

Mental health services were the third most commonly mentioned resource among texters, followed by exercise and sports programs, then books and audiobooks, and finally, outdoor spaces and nature. The report notes that independent research demonstrates how each type of resource has been linked to improved mental health.

Common Good Labs performed different types of analysis on the data generated by the 87,000 conversations with youth texters. Ultimately, its researchers used natural language processing to classify the anonymized notes taken by crisis counselors. They identified and grouped certain key words and phrases into the six larger thematic categories.

The data came from texters who opted into Crisis Text Line's voluntary post-conversation survey. When texters use the service, they must agree to its privacy policy (and terms of service), which includes the disclosure that Crisis Text Line may use certain types of data for research purposes. For this survey, the texter was asked again to permit Crisis Text Line's use of their anonymized answers.

Dr. Mitch Prinstein, chief science officer of the American Psychological Association, said the report provides unique insight into how teens are coping with mental health challenges. Prinstein, who studies youth psychological development and was not involved in the research, said the findings underscore the vital importance of in-person social connection for teens.

The results may surprise those with a singular focus on remedies like restricting screen time and social media use. They may also serve as a rejoinder to lawmakers who've aggressively attacked social media and tech companies for their role in creating the mental health crisis but who haven't answered for budget cuts that have decimated funding for parks, libraries, art and music education, and extracurricular programming.

The report notes, for example, how local governments cut parks funding by more than $2.5 billion between 2010 and 2021. Per capita spending on local libraries in 2021 decreased by 5 percent over the same time period.

At the same time, teen participation in meaningful in-person activities has also plummeted. In 2020, 1.5 million fewer children were in clubs, compared to 2009, according to the report. In 2021, 1.8 million fewer high school students played sports than in 2009.

While the COVID-19 pandemic certainly affected sports participation and in-person socializing, these rates have been trending downward for years, said Courtney Hunter, vice president of public policy and advocacy at Crisis Text Line.

Hunter noted that other factors contributing to the decreases could include the advent of social media and a gravitation toward connecting over phones and digital devices, along with persistent nationwide absenteeism from school and reduced funding for some types of extracurricular programming.

Additionally, teachers often take on leading these extracurricular activities for students. Given the burden of teaching during a pandemic, burnout partly related to social media in the classroom, and stagnating pay, exhausted teachers may no longer be willing or able to lead after-school programming for students.

Prinstein noted that all of the activities cited by youth as helpful often involve peers and friends.

"[W]hen we take away the opportunity for voice-to-voice, face-to-face context, whether it's because we've cut the funding, or [because of] social media, or a combination of all of that, this is what we're seeing," Prinstein said. He added that the findings highlight how urgently youth need access to high-quality mental health information and services.

Hunter said that solutions based on the report might look like lawmakers funneling more money toward efforts like increasing after-school programming, spending more on libraries and parks, and ensuring that students have access to music and arts education.

She also warned against diminishing the role of social media use and screen time as policymakers and advocates consider solutions to the mental health crisis that come from within communities themselves.

"It's all part of the problem," Hunter said, referencing the potential harm of social media use and excessive screen time as well as cuts to vital programs, all trends that developed over the same decade-long time period.

Oura recently released a new feature for its popular sleep-tracking Gen3 ring: the ability to see trends in daytime stress.

Not long after, an intriguing thread popped up in a subreddit dedicated to the Oura ring. Some of its 40,000 members were perplexed by what the Oura app reported about their stress levels.

Much to their surprise, the commenters said it seemed that they were always stressed. Some wondered if the new feature was buggy. But others didn't like how the data made them feel, hinting at the unintended mental health implications of tracking.

"I'm stressed eight hours a day since this new feature has rolled out which is making me stressed," wrote one commenter. "How do I shut it off!"

The conversation pointed to a persistent tension undergirding efforts to track, or even surveil, your own health around the clock. Such data can empower the user, but it can also sew doubt and worry — perhaps where there wasn't any before.

Dr. Vaile Wright, a psychologist and senior director of health care innovation for the American Psychological Association, said these different outcomes depend on the person.

"For some, tracking provides a critical ability to recognize and identify triggers," Wright said. "For others, however, it could actually increase stress, distress, and hypervigilance."

The former group might have difficulty pinpointing what stresses them most or how they feel in that state. Cultivating a greater awareness of that can be useful, because it might encourage them to make proactive changes, like implementing meditation or exercise breaks when their stress spikes. But the latter group might constantly think about their stress, even ruminate on it, and inadvertently engage in a self-fulfilling prophecy.

When a person thinks they're stressed all the time, they may expect that to be the case and then behave in ways that increase stress, like procrastinating, taking anger or frustration out on others, and staying constantly connected to digital devices, the news, and social media.

The challenge is that you may not know how you'll respond until you're staring at days of charts showing an elevated stress level.

The basics of tracking stress levels

Previously, the Oura app only gave users detailed data about how well they slept and recovered from the previous day's exertion.

Oura's head of science, Shyamal Patel, whose Ph.D. is in computer and electrical engineering, told Mashable the company wanted to launch a daytime stress function as a way to give users a "holistic" picture of their stress and recovery. Oura competitor Whoop released its own tracking feature, Stress Monitor, in spring 2023.

The Oura ring measures daytime stress by continuously tracking temperature, heart rate, and heart rate variability (HRV). More variability in your heart rate can suggest resilience to stress, whereas less variation can indicate that the body's nervous system is struggling.

Certain factors impede reliable data collection. Cold hands or a poorly or loosely fitting ring can lead to gaps in tracking. Oura's algorithm excludes exercise or movement from its stress analysis so as not to confuse the physical demands of a workout, for example, with overall distress.

Importantly, the feature hasn't been independently clinically validated, though Patel said the company recently launched a study with this aim.

He's also aware that drawing attention to stress through tracking may have unintended consequences because the same thing has happened to people who began collecting data about their sleep. Patel points to orthosomnia, the new phenomenon of becoming so preoccupied with sleep tracker data that it leads to sleeplessness.

Patel said this is why the Oura app is meant to have an "empathetic" voice instead of using judgmental language oriented around failure when it's providing insights.

Understanding high-stress levels

The ring's sensor gathers data continuously, but the daytime stress chart reports back every 15 minutes. (Only members who pay a monthly $5.99 subscription fee can access the data.) You can watch as stress levels peak, crash, and plateau throughout the day.

The short interval can be informative. A screaming child or tense work meeting may coincide exactly with a stress peak, confirming what you already suspected was true. Or you might be stunned to see that the deep breathing you tried at the dentist's office seemed to make it a low-stress experience.

Yet the time frame can also amplify worry. You might wonder why a brief meditation break or leisurely meal — things you did because you hoped they'd reduce stress — didn't show up as restful or restorative but instead appeared as periods of stress or engagement, a state of being Oura places between stress and relaxation.

Again, the different responses come down to personality and circumstance, said Wright. The app's feedback may motivate one person to change their behavior while another person feels "paralysis" as a result.

There are also things people cannot control. Certain medications, like asthma medicines, antibiotics, cold and congestion medicines, and antidepressants, can increase heart rate and potentially affect heart rate variability, which the app currently doesn't make clear to users. Someone searching for an answer to a sudden spike in stress might not realize it's due to starting a new medication.

Different but even more impactful sources of external stress are the invisible forces that influence well-being. The American Psychological Association's recent "Stress in America" survey found, for example, that the nation is still "recovering from collective trauma" following the worst phases of the COVID-19 pandemic.

Though many respondents downplayed their stress, nearly a quarter of adults said their stress rated between eight and 10 on a scale of one to 10, with the upper end being a "great deal of stress." Respondents were feeling the pressure of financial strain and health challenges, but they were also particularly worried about mass shootings, violence and crime, the nation's future, and "social divisiveness."

In this sense, tracking stress has its limits. If a higher-paying job won't materialize because of economic trends, coping skills will only go so far.

"Yes, there are some things that we can do to help us maintain our emotional well-being that actually are in our control," said Wright, "but they're not sufficient to manage all of our stress in the world, because much of [what is] causing us stress we don't have control over, and there are not necessarily easy fixes for them either."

Are there risks to tracking your stress?

At the outset, Oura didn't offer stress management tools alongside its daytime stress feature. Now, the app suggests relaxation content from the meditation and wellness platform Headspace when Oura detects elevated levels of stress.

A "reflections" feature in beta testing lets users jot down notes about their daily experiences. Ideally, the tool will help users make connections between highs and lows in their daytime stress, shedding light on drivers of triggering, restful, and restorative moments.

Later this year, Oura plans to launch a "stress resilience" measure, which will assess users' ability to withstand physiological stress by tracking daytime stress and recovery, as well as recovery during sleep.

Patel notes that gleaning insight from wearable data is a relatively new practice. Until the recent past, a person's main source of health data was generated at their annual physical, he said. Now, they can collect continuous data about themselves, including their sleep, stress, heart rate, and menstrual cycle.

Patel said it's important to help people understand what's shaping their health trends, now that they have data about them in hand: "We need to close that gap."

Some Oura users, in a separate, more recent Reddit thread, wondered if their near-constant high-stress days meant they had anxiety. The reflection could be particularly useful when followed by a conversation with a health care or mental health provider.

But Wright urges consumers to be cautious with their health data, too. While Oura doesn't sell member data of any kind (even anonymized) to third parties, no company is immune from a security breach. Oura does partner with researchers who can access de-identified user data to conduct clinical studies but collects "relevant consent" from research participants in advance.

Wright said that, in general, wearables aren't required to be compliant with the Health Insurance Portability and Accountability Act, a federal law that protects a wide range of health data. They also typically aren't subject to federal regulation, unless they're considered a medical device.

"Research technology moves faster than regulation and ethics," Wright said, adding that she's more worried about data privacy, security, and storage than whether wearables actually work.

Still, Wright knows that many people are eager to track their health metrics, including stress. She encourages them to take digital breaks periodically to see how it makes them feel and then reassess how much they want to engage with their device.

Keeping digital tabs on measurements of well-being may be a mood booster if things are going well, but Wright reiterated that such awareness might be potentially damaging when it leads to anxious thinking.

After all, sometimes the best way to stay even-keeled is to not know exactly how stressed you are.

When a parent flips on the TV, it often affords them 30 minutes or more of relative silence. That's enough time to make dinner, fold a load of laundry, or quickly chat with a friend. TV makes achieving certain parenting goals possible.

Their kid often enjoys it, too. It's time spent in an imaginary world when, importantly, their parent isn't bugging them to put on their shoes or do homework.

But research increasingly suggests that too much TV at a young age may come with risks.

A study published this week in JAMA Pediatrics found an association between TV screen time and what's known as atypical sensory processing. This can include developing sensory-seeking behaviors, like obsessively watching a spinning object, as well as becoming slower to respond to stimuli, like hearing one's name called, and avoiding certain sensory experiences, such as resisting new foods and noisy environments.

Though the researchers did not study children with autism spectrum disorder or attention deficit hyperactivity disorder, such sensory processing difficulties can be common with both conditions.

The study's association between screen time and atypical sensory processing builds on past research suggesting a similar link between TV-watching at a young age and language delay, attention problems, emotional dysregulation, brain findings, autism symptoms, and sleep problems.

However, there is no evidence that too much TV causes autism, ADHD, or other conditions. Currently, the Centers for Disease Control and Prevention does not consider watching too much TV as a risk factor for autism.

Known risk factors for autism include advanced parental age, genetics, and very low birth weight. Genetics also plays a role in the development of ADHD; other potential risk factors for ADHD include environmental pollutants and premature delivery.

The study's lead author, Dr. Karen Heffler, an associate professor in the department of psychiatry at Drexel University College of Medicine, was drawn to this field of research after her own son was diagnosed with autism.

If TV-watching is a risk factor for atypical sensory processing, it is one that can potentially be changed, Heffler said.

"We want to empower parents, we want kids to develop to their potential," she added.

To better understand the role of TV screen time in your child's life, here are five things you should know about the subject:

1. What the guidelines say about screen time for young kids

Heffler strongly urges parents to follow the American Academy of Pediatrics (AAP) guidelines for media, which say to avoid digital media use for children younger than 18 to 24 months. The guidelines make an exception for video-chatting, which may be enriching and appropriately engaging when done with family members, for example.

When you do play digital media for toddlers between 18 to 24 months, the AAP recommends turning to high-quality programming and watching it together.

Children between the ages of 2 and 5 should be limited to one hour of high-quality programming per day, which you should also watch with them.

2. Research findings on risks of TV screen time

Heffler's study analyzed data reported between 2011 and 2014 by the parents of 1,471 babies and toddlers. The parents shared how frequently their children watched TV or DVDs. The parents weren't asked about mobile devices, since they were less prevalent at the time.

She and her co-authors found that for 1-year-olds, any TV screen exposure was associated with a doubled likelihood that they would go on to exhibit atypical sensory behaviors when they were nearly 3 years old compared to children with no screen time.

Toddlers between the ages of 18 and 24 months also had higher odds of a similar outcome, but not as marked as infants exposed to TV.

For every hour of TV screen time beyond no screen time at all, 18-month-olds were 23 percent more likely to display behaviors related to avoiding certain sensations and being less responsive to stimuli when they were older.

It's important to remember that while many young children have sensory processing differences, such as sensitivity to a specific noise, those reactions may be fleeting or short-lived. Heffler and her co-authors were specifically looking for atypical behavior in four distinct categories of sensory processing, including sensitivity and avoidance, as reported by the children's parents.

While it's unclear how TV exposure could affect sensory processing, Heffler said one possible explanation is that young children's brains aren't yet prepared to take in and process sensory features of TV, like lights, movement, and colors. It's also possible that TV displaces other behaviors and activities that contribute to typical processing development, like talking, babbling, cooing, playing, and being outside.

3. Does it matter if screen time involves television or a smartphone or tablet?

Heffler's study couldn't evaluate screen time that takes place on a smartphone or tablet, but she suspects that it could lead to similar results. Some research already indicates that screen time on mobile devices is associated with language delay and dysregulation for young children.

If anything, Heffler worries that exposure to screen time at young ages is far more pervasive than it was a decade ago, though more research on smartphone use among babies and toddlers is needed.

"The concern is that children have access to video through mobile devices at a much higher rate than they did even when the study was done," Heffler said.

4. Testing what happens when you reduce screen time for young kids

In her research, Heffler is exploring what happens when parents reduce screen time for young kids, particularly those with autism symptoms.

In the very limited research on the topic, there are glimmers of improvement for some children and their families.

In a pilot study Heffler published in 2022, nine children between the ages of 18 to 40 months old with an autism diagnosis had a history of watching an average of five hours of screen content per day. After their parents received educational information and one-on-one in-home support visits to help them replace screen time with social engagement, testing revealed significant improvements in core autism symptoms and reduced stress for parents.

Heffler said that parents who notice that their child's atypical sensory processing is interfering with their everyday routine could consider doing a trial run of turning off screens and integrating more social, sensory, and play activities to see if it leads to improvements.

Importantly, screen time is just one potential risk factor for atypical sensory processing; some families may reduce screen time and see little or no improvement.

5. Alternatives to TV screen time

Heffler understands just how pressed parents are for time, and that some may experience mental health challenges, like postpartum depression. She believes society should consider the needs of families so that parents can have more support as they raise young children, rather than putting them in a position where TV presents their one break between work and parenting.

Lori Frome, an early childhood interventionist who co-authored Heffler's 2022 pilot study, said parents who feel comfortable with reducing TV time can try various strategies.

That starts with removing the screens themselves, as much as possible. Some parents Frome has worked with have put TVs away or draped them with a blanket. Removing remotes, unplugging TVs, and placing phones and tablets out of reach (for both a child and a parent) can help, too.

Frome recommends that parents frequently involve their children in household routines instead of turning on the TV in order to get something done. Helping with dinner could be as simple as putting carrot sticks in a bowl or napkins on the table. As an alternative to screen time when a parent is present but not available, children can play in a nearby safe, closed-off environment with standard toys, like dolls, blocks, cups, and balls. Children might particularly enjoy toy characters or stuffies featured in their favorite movie or TV show.

But Heffler isn't expecting parents to perform miracles.

"We just hope that they can use this information to the best of their ability under their circumstances," Heffler said.

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Around 11 p.m. every night, I lie alone with my thoughts and contemplate the very worst things about myself.

I know I should be doing something more supposedly restful like counting sheep. Instead, night after night, I lie wide awake in the dark, facing the wall, worrying about what people think of me. As if turning the pages of a frustratingly dull book, I'll leaf through my shortcomings as a friend — text messages I haven't responded to, birthdays I've missed, nights out I've bailed on. I think about how I disappoint my extended family — forgetting to call elderly relatives, leaving too long between visits, for being too "difficult" and assertive when I do visit.

When my mind turns to work, and specifically my own writing, that's when things get darker. I imagine every possible criticism someone could levy and convince myself that my peers, journalist friends, and even colleagues all think those things about my work. I relive minor interactions with complete strangers — was I rude to the man on the Tube? Should I have been more friendly when I ordered my coffee?

These thoughts don't just come to me as I'm trying to drift off to sleep. When I message guys on dating apps, I wonder if saying no to a last-minute date will make me seem selfish. When I tweet, I worry afterwards whether people might perceive my tone as too mean, too lightweight, too predictable. On Instagram, I worry if my captions and Stories aren't witty enough, that I'm posting too many selfies, that I seem vain and self-obsessed.

"You seriously need to stop caring what other people think of you," a former boss once told me. But the thing is, I wish it were just that simple. "Just tell me how!" I wish I'd said back then. Honestly though, I long to flip a switch in my brain to make me give less of a shit about other people's perceptions of me, but it just doesn't work like that. It's going to take a hell of a lot of work to dismantle my need for other people's approval.

At the end of 2019, I hit my human limit on the number of times I could possibly tell myself "you need to stop caring what people think." Simply telling myself that I was caring too much was having little impact on those thoughts. So, if you're constantly worrying what other people think of you, or you've noticed approval-seeking tendencies in your behaviour, what exactly can you do about it? I asked mental health professionals for tangible ways to address this if you're finding it bothersome.

Know that it's just human nature

There's a reason you care how others see you. Consulting psychologist Dr. Mara Klemich — co-author of Above the Line: Living and Leading with Heart — told me that when we feel insecure and lose our inner value, we compensate with approval-seeking behaviours. "As humans, we all share an innate drive to connect with others," said Klemich. "We are wired towards inclusion. Rejection means exclusion and thus understandably triggers fear."

In fact, according to neuroscientist, psychologist, and change specialist Dr. Lynda Shaw, being part of a group was once key to human survival.

"Attack or famine were more likely if you were on your own. Group membership developed into social acceptance, so caring what others think of you became imperative if you wanted to belong," said Shaw. "Having approval makes us feel good, we get a rush of our happy hormones including endorphins, dopamine and serotonin. When you can’t get that same effect without someone’s approval is when problems arise."

Understanding that your desire for approval is innate in all humans is really helpful. Klemich added that "neuropsychological and neurophysiological research has shown that social rejection activates many of the same brain regions involved in physical pain. This certainly helps explain why disapproval hurts us emotionally, and why disapproval runs deep."

Take a break from the online attention economy

As a person who might be described as "extremely online," I often look at my own personal achievements through the prism of online validation. When an article of mine is published that took weeks, or even months, to research, I feel like I've failed if I tweet it and it doesn't get much of a response. If I post a picture of myself that I like, but it doesn't get very many likes, I question my judgement, my ability to self-appraise.

Author Jia Tolentino wrote in her book Trick Mirror: Reflections on Self-Delusion that "the internet is governed by incentives that make it impossible to be a full person while interacting with it." She noted that critics have observed that humans exhibit "classic reward-seeking lab-rat behaviour, the sort that's observed when lab rats are put in front of an unpredictable food dispenser."

"That is what keeps us scrolling, scrolling, pressing our lever over and over in the hopes of getting some fleeting sensation— some momentary rush of recognition, flattery or rage," Tolentino added. Depending on likes and retweets from social platforms like Facebook, Instagram, and Twitter, she noted in a New Yorker piece, is akin to "playing a slot machine that tells you whether or not people love you."

Give yourself a break from the prism of online validation. Credit: vicky leta / Mashable

Try to establish some hard limits in your screen and scrolling time. In Trick Mirror, Tolentino wrote that she gives herself boundaries like no Instagram stories, no app notifications, and uses apps that shut down her Instagram and Twitter usage after 45 minutes of daily use.

Niels Eék — psychologist and co-founder of mental wellbeing and self-development platform Remente — recommended a digital detox. This involves "switching off all your screens for a certain length of time, ideally for 24 hours. If you feel that 24 hours is too long, then try to first switch off all of your notifications for a few hours, and then proceed to switch off the devices altogether for longer and longer each time."

Identify where your own approval-seeking comes from

Everyone is different and our need for approval and validation can manifest in very different ways. Eék gave me some examples of how this behaviour can be exhibited including: "Changing your opinion when noticing that others disapprove of what you’ve said and done; not complaining when you feel that you’ve been mistreated; pretending to know something when you definitely don't; and apologising too much, even when you know you’ve done nothing wrong."

Klemich suggested being courageous and honest with yourself by asking the following question: Where does my approval-seeking come from? You might have to look back into your past to figure that out, which isn't always comfortable. "Approval-seeking is usually a childhood-created coping strategy. Did you feel a need to get love from your parents and create ways to gain their approval? Did you struggle to make friends at school, and subsequently develop a fear of being rejected?" she said. "By identifying where the approval-seeking started, you can identify the types of situations that trigger your need for approval in your current life."

If you're struggling with a fear of rejection, you can develop a need for validation, which manifests as people-pleasing. Klemich said this means people expend emotional energy worrying what others think of them, even sometimes running through mental scenarios and practicing what to say in different situations so that everything goes exactly the way we want it to.

"Sometimes we simply care too much about what people think of us, usually when we suffer from low self-esteem or seek extra stability in our lives, perhaps if we have been excessively judged in childhood, or have been made to feel we are not good enough or were bullied," Klemich said. "Our self-worth becomes overly entangled with what others think about us. This in itself can then lead to low self-esteem and lack of confidence as we go about our daily lives thereby needing extra validation from others."

Try journaling

To begin to start caring less about other people's perceptions of you, it could be worth giving journaling a go. If that doesn't sound like something you'd usually do, stay with me. Eék pointed out that there are a lot of benefits to journaling — boosting self-esteem can be one of them.

"Most importantly, it provides you with the time and space to reflect. Too often we spend time on mundane day-to-day tasks, but not nearly enough time reflecting on our past and present, so try to consider recent events, how you’re truly feeling about your life at present, where your priorities lie, and what you hope to achieve long-term," said Eék. "Journaling is also an outlet for processing emotions, and doing it on an ongoing basis can help increase your self-awareness."

Set clear boundaries

When we're hellbent on keeping other people happy, it can be difficult to establish clear boundaries. But it's extremely important. "When we can’t say no because our need to be approved by others is greater than our ability to set appropriate boundaries, practice explaining your reasoning of why you would like to do something but that you can’t right now," said Klemich. "Start being honest with yourself when you take on a new task or commitment — ask yourself, are you doing it because it is 'right' for you, or because you want to get approval and avoid disapproval?" Evaluate your weekly tasks and consider which of them might be driven by people-pleasing — make a list if that helps. Klemich advised working through that list and making some honest decisions about whether or not you need to do it.

Sarah Griffiths — a specialist trauma and abuse therapist — advised asking for change if situations arise that might violate your boundaries, like if someone speaks to you in a way that you don't like. "With tone of voice, if you decide that contempt, impatience and irritation is not acceptable, the next time it happens, simply say, 'Please don't talk to me like that,' and just be firm and don't engage when someone is speaking to you in a tone that is unacceptable to you," she said. "Another good one is to ask, 'Why are you speaking to me like that?' 'What is your motivation for what you just said?' or 'Why did you just say/do that?'"

Boost your self-acceptance

When you feel approval-seeking urges affecting your wellbeing, working on your self-acceptance can be really helpful, Eék said. That includes body acceptance and believing in your own self-worth. Accepting your body doesn't happen overnight, but there are techniques for working on self-esteem and body image that can help.

"The path to self-acceptance will vary from person to person so you will need to explore and find what works best for you," he added. "Research has found that mindful-attention and meditation training can have an effect on the amygdala (the gland in the brain which processes emotion) response to emotional stimuli, lowering the brain’s response to feelings of stress and anxiety, and, instead, providing you with the space to face inwards and practice self-acceptance."

Practice self-management

When you don't get the validation or approval you're seeking from others, this can feel like rejection and disapproval. Practicing self-management means "suppressing any negative emotions such as self-recrimination and focusing on the positive aspects of yourself," according to Kelmich. She advised learning to "reframe negative situations so that you see the opportunities in them, rather than perceived criticism."

Klemich also advised paying attention to your language, "self-talk," and your behaviour, and figuring out "when it’s coming from wanting someone else to say you’re OK, that you made the right choice, or that you did the right thing."

"Instead, when you do make a decision, check in with yourself that it feels right, remind yourself that it is your choice, and give yourself validation for just being you," she said.

No matter what people tell you, it's never going to be as simple as flipping a magic switch in your head to make you stop thinking a certain way. To be human is to care what other humans think of you. Just know you're not the only one.

This article was originally published in 2020 and republished in 2024.

The videos have all the trappings of a TikTok designed to go viral: an eager creator staring into the camera, poised to give the viewer a before-and-after look at completing a difficult physical challenge.

Yet so-called fear food challenges are dramatically different than the typical TikTok stunt. They aren't meant for anyone to attempt, but are instead produced for people going through or curious about eating disorder recovery.

In these videos, creators who indicate that they're in recovery often reach into a jar filled with scraps of paper labeled with one of their fear foods. Whatever word they pull out — "cheeseburger," "candy bar," or the name of a flavorful entree — they then make or buy and try to eat on camera.

Sometimes an individual fear food challenge TikTok garners millions of views. Collectively, the hashtag #fearfoodchallenge has more than 470 million views.

The comments are often overwhelmingly supportive of the creator. But other viewers come across the content with no understanding of why people in recovery have certain fear foods, and they leave cruel comments about the creator, demonstrating the risks of an algorithm pushing these videos into people's feeds with no context.

Eating disorder recovery experts say fear food challenge videos present both benefits and risks to the creator and the viewer. Particularly as people prepare for the new year by exploring wellness and food-related content on TikTok, it's important to know what the content is, and how it could help or harm someone interested in it.

1. What is a TikTok fear food challenge?

While each person's journey with eating disorder recovery is different, attempting to eat a feared food is often part of treatment, says Dr. Jason Nagata, an adolescent medicine specialist who cares for youth with eating disorders at UCSF Benioff Children's Hospital in San Francisco.

A person living with an eating disorder, including the conditions anorexia nervosa, binge-eating, and bulimia nervosa, may develop anxiety or fear related to foods that trigger negative thought patterns. They might worry that the food will lead to weight gain, or it may violate a rule they have set, like not eating a certain carbohydrate or using a condiment that contains fat.

People struggling with or recovering from an eating disorder experience visceral and real fear when faced with such foods. Nagata says that one stage of recovery is to be able to eat a wide range of foods, including items that might have been previously difficult.

In treatment, trying a fear food typically happens with the support of a therapist who can offer support.

"The first time that you face down one of these fear foods, I think your best chance of success is to do it with a professionally-licensed provider who is trained to support you...," says Nagata, adding that not everyone has access to mental health care.

On TikTok, this recovery exercise has been turned into a "challenge."

There is no supportive therapist, though the creator may be with a friend, loved one, or partner. Instead of depicting themselves consciously deciding which food to eat, creators inject the element of surprise. They often select the item from a jar filled with pieces of paper labeled with different fear foods. Videos are frequently edited to show them ordering the food from a menu, preparing it, or purchasing it from the grocery store.

While some creators share footage of their mild but brief discomfort with the food, such as grimacing, pulling back, or pausing, they often finish what's on their plate. Some nod or smile affirmatively to signal they're enjoying the food, or they remark on how much they missed eating it.

In the numerous TikToks that Mashable viewed, there were no links to TikTok's resources on eating disorders and their treatment. A spokesperson for TikTok told Mashable that the videos won't be removed unless they violate the platform's community guidelines by showing or promoting disordered eating or dangerous weight loss behaviors.

2. What are the risks and benefits of a TikTok fear food challenge?

One overall goal of recovery is to be able to eat healthful meals in a social setting with other people, in a way that doesn't reduce a person's quality of life by leading to significant eating disorder-related symptoms, like debilitating thoughts or anxiety, says Nagata. In this sense, being able to reclaim a fear food is an important part of recovery.

Nagata says that seeing creators who are attempting to reduce their fear in a TikTok can help normalize the situation. That can be empowering for some viewers, who may feel less alone with their own struggles as a result. And supportive communities that emerge from comments and direct messages with a creator, or their followers, can be beneficial as well.

Yet Nagata has reservations about the content. While creators do receive overwhelming encouragement from those who understand what it's like to have or recover from an eating disorder, commenters without that knowledge may harass or insult them, says Nagata. (Creators can use TikTok's controls to block, limit, and filter comments.)

Additionally, he worries that some fear food challenge TikToks might contain misinformation about the exercise, or about treatment in general. The videos may show less healthy ways of trying a fear food, like consuming too much in short periods of time instead of starting slowly. For those with anorexia nervosa who also go through cycles of binge-eating, the act of eating large amounts of food in order to conquer a fear may trigger a binge-eating episode.

Then there's the risk for someone experiencing an eating disorder that viewing a fear food challenge TikTok could lead them to compare themselves with the creator. Negative comparisons are a common feature of eating disorders and can revolve around body size differences and food preferences.

Someone viewing a TikTok of a creator eating a certain food that they don't find difficult, for example, might question whether they really have an eating disorder, and as a consequence, if they actually need treatment. At the same time, if someone in recovery is viewing a lot of these videos but not having success in their own efforts to reduce fear of specific foods, they might feel worse about themselves, says Nagata.

TikTok's algorithm may also pose an inadvertent risk to both creators and viewers. If creators are rewarded with increased views and engagement when they post a fear food challenge, they may create more of them to build their audience, even if it negatively affects their recovery. The stress of filming and curating videos can be taxing, says Nagata. And viewers may encounter triggering fear food challenge content, as well as be encouraged to watch it repetitively, thanks to the algorithm. (Concerned viewers can filter the phrase "fear food" or the #fearfoodchallenge hashtag from their For You or Following feeds, or ask the app to reduce the suggestion of related videos.)

Dr. Doreen Marshall, a psychologist and CEO of the National Eating Disorders Association, says the videos may help raise awareness of eating disorders but worries about TikToks lacking context about the creator's recovery. She notes that care should be taken in drawing conclusions about whether fear food challenges are part of someone's treatment.

Many individual videos don't include details about the creator's eating disorder and whether they're actually in treatment. They also don't depict fear food exercises as they happen in treatment, which begin with a very slow introduction.

Scenes of what happened after the video ended aren't included, either. There's no way for a viewer to know whether the creator experienced a minor or major setback following their challenge, like excessively exercising or a pervasive preoccupation about their body size.

Marshall says that what gets left out or lost in translation in a challenge TikTok may give some viewers the impression that the path to recovery requires the progress featured in those videos.

"What we want to recognize is that eating disorders are not a monolith," says Marshall. "Recovery doesn't look the same for everyone."

Both Marshall and Nagata urge people who are negatively affected by creating or viewing fear food challenge TikToks to seek help or support from a trusted friend, loved one, or mental health professional.

3. Alternatives to a TikTok fear food challenge

Jessica Flint, founder & CEO of the eating disorder support system Recovery Warriors, understands the inspirational aspect of fear food challenge TikToks but says they can have adverse effects.

Flint, who recovered from an eating disorder, says the visual medium is likely to encourage a fixation on a creator's body size. That can lead to relentless comparisons, or to feeling invalidated if the majority of creators are people in recovery from anorexia but a viewer is someone in a bigger body.

In the Recovery Warriors Courage Club, a virtual support group that requires a paid membership, Flint says food challenges play a motivating role, but without the pressure to eat something too ambitious or create visual content that might go viral.

Flint says members of Courage Club are encouraged to break dozens of their own food rules, but slowly and stepwise. This might mean eating a red apple instead of a green one, swapping broccoli for zucchini, or ordering a different item from the menu of their favorite restaurant.

The idea is to gradually help someone in recovery understand that they are capable of eating a diverse range of foods, not just what their brain convinced them was tolerable during their illness.

When people share their "variety victories," they do so on a platform that focuses on text rather than photos. Members' avatars may not even be a picture of themselves. The audience comprises people who are also in recovery, with the support of a doctor, dietician, or therapist, and has been vetted by Flint's team of facilitators.

Courage Club, which has a waiting list, isn't the only alternative to a TikTok fear food challenge, but it's one example of how an important part of recovery can look off a major social media platform.

Flint also recommends different types of media, particularly those without a video or visual medium, like blogs and podcasts. Flint prefers these resources over videos because someone can "create [their] own meaning" from hearing a voice and story, rather than looking at the speaker's body and comparing it to their own.

"There's tons of recovery support that doesn't require you to watch videos that are fed by algorithms," Flint says.

If you feel like you’d like to talk to someone about your eating behavior, text "NEDA" to the Crisis Text Line at 741-741 to be connected with a trained volunteer or visit the National Eating Disorder Association website for more information.

When I was about six years old, my mum was brushing my hair before school when I asked her a question. "Am I ugly?" I asked, looking at her and my reflection in the mirror before me.

She gasped in horror at the question and stopped running the brush through my hair. She said no (cheers, mum!), then asked me where this question was coming from. A boy in my class had called me ugly on the playground.

That was the first time I remember feeling bad about myself. But that was just the beginning of a very long, very troubled relationship with myself. That boy on the playground was far from the last person to call me ugly. He was certainly not the last person to make me question my sense of self.

I know I'm not alone in feeling this way. If you're reading this, you might have a similar story about the first time you ever wondered aloud or quietly whether or not you are 'ugly,' whether you're 'not smart,' whether you're a 'bad person.'

A few months after turning 31, I hit an all-time low-point in my self-esteem. But then something snapped — I was so tired of feeling bad about myself, so tired of disliking everything about me. There's a lot of useless platitudes on the internet on the topic of self-esteem — telling someone with low self-esteem to "love yourself" simply isn't going to cut it. I wanted to find tangible strategies that I can use in my everyday life to work on my self-esteem.

I wrote this article for myself and for anyone who has ever wondered what to do about persistent low-self esteem.

Dispute your negative thoughts

Negative thoughts can be very convincing. I've believed many of the terrible things I've thought about myself. Daniel Fryer, a psychotherapist at the Priory Hospital Bristol, recommends challenging your negative thoughts. "Every time you think or say something negative about yourself, dispute it by reminding yourself of something you did well or succeeded in," says Fryer. "That way, you will be replacing self-criticism with self-compassion."

Psychotherapist Owen O’Kane — former NHS clinical lead for mental health — says you shouldn't believe everything you think. "Often it’s easy to fall into patterns in which people, situations, or circumstances get misinterpreted," says O'Kane. "If some of your thought patterns tend to be critical, judgemental, or thinking the worst, it could lead you to inaccurate perspectives." He advises observing your perspectives and re-evaluating them if they tend toward repeated self-criticism.

Practise unconditional self-acceptance

Our self-esteem is similar to rating ourselves based on our successes, Fryer explains.If you have low self-esteem, that rating can be based on what you perceive as your failings. "When you base your confidence on your 'stuff' you need something to go well for your confidence to go up but, when something goes wrong, your confidence nosedives," says Fryer.

Per Fryer, Rational emotive behaviour therapy (REBT) — a form of cognitive behavior therapy (CBT) developed by Dr Albert Ellis — promotes unconditional self-acceptance. "With it, every single human being on the planet is a worthwhile, fallible human being, capable of both success and failure," he says.

If you need an affirmation to repeat to yourself on challenging days, or even every day, let it be the following from Fryer. "You have value as you, because you are you: a human being on this planet. Base your confidence on this notion, that you have worth, that you are sufficient as is. Remind yourself of this daily."

Keep a compliments log

Counsellor Sophie Robinson-Matthews, who's part of Counselling Directory (a database of 15,000 professional therapists in the UK), recommends keeping a log every day of "every positive thing, compliment, or praise that is said about you" or your work. You might feel a little weird doing it, but why not give it a go?

"If you receive the same comment multiple times, keep a tally next to it but keep this log going every day," she says. "At the end of each week, review the log and ask yourself these questions: What are my initial feelings when I read through this log? On a scale of 0-10 (0 being none and 10 being a huge amount) how much do I believe that all of these positive things are true of me?" While you're reviewing the log, go through the statements you've noted down and ask yourself which comments you believe are true, which ones are possibly true, and which ones do you not believe.

Keep an achievements journal

If writing a list of compliments isn't your thing, why not try keeping a journal of your achievements? "Every day, write down the things you did well that day, or achieved that day," suggests Fryer. This could be anything from finishing a work task to doing some life admin to making your own lunch the night before — whatever you feel proud of.

Fatmata Kamara, specialist nurse adviser at UK healthcare company Bupa, advises keeping a journal to keep track of different feelings you're experiencing, ultimately steering it back to some positives. "You can also use the journal to write down a few things you like about yourself," she says. "It may feel strange at first, but you’ll feel more comfortable the more you practise it."

Avoid comparing yourself to others

It's really hard to avoid comparing yourself to others — especially if you spend a decent chunk of time on social media. If you're worried about social media's impact on your self-esteem, read my piece on ways people protect themselves from self-comparison.

Sofie Hagen — fat acceptance activist and author of Happy Fat — suggests unfollowing any social media accounts that make you feel bad about yourself. "Unfollow, unfriend, hide, block, mute. Do this to every single social-media account you follow that makes you feel bad," writes Hagen in Happy Fat. "Whether it's your friend from school or whichever famous vlogger. This does not make you petty or jealous. It just makes you a person who is susceptible. And, we all are."

Fryer also advocates reminding yourself that life is not a competition. "Everyone else on this planet is a worthwhile, fallible human being. This means they have successes and failings of their own. The only person you need to compare yourself to is you," he says.

Treat yourself like you would treat a friend

You might notice a marked difference in the way you talk to your friends when they're having a tough time compared with your own inner voice during a tough period. "It is very easy to treat yourself harshly or critically when things go wrong, with internal cries of 'idiot,' or 'stupid,'" says O'Kane. "Would you speak to someone you care about in the same way? I’m guessing probably not."

"How we treat ourselves has a huge impact on our mental wellbeing. A kind compassionate approach to yourself will change your world and those around you," he adds.

In his book Over The Top, Jonathan Van Ness writes beautifully about "learning to parent yourself" and treating yourself with compassion.

"Learning to parent yourself, with soothing compassionate love, forgiving yourself, and learning from all the decisions you made to get you to where you are — that’s the key to being fulfilled," writes JVN. "Learning to be the dream parent cheerleader to yourself. It’s been in you the whole time. And no matter how down you get, you can always make a gorgeous recovery."

Set boundaries

Sometimes my low self-esteem makes me want to people-please. Kamara says that people with low self-esteem might feel they have to say yes to others even when they don't want to.

"This could make you feel overburdened, resentful or depressed. If you’re not comfortable with something, learn to say no," she says. "Being assertive in this way means you value yourself and others, and it should help you to set clear boundaries."

Dr. Sheetal Sirohi, a consultant psychiatrist at Priory Hospital Woking, says if you manage to improve your self-esteem by yourself, well done. But if you are struggling, seek help. "Counselling or therapy can be a great for self-improvement," says Sirohi. "Others can help remove years of trauma and abuse that eats into self-esteem. A psychiatrist and/or a psychologist can help not only give direction but also support in stressful times when one is vulnerable."

I, for one, know I have a tendency to be extremely unforgiving and unkind to myself. My inner voice speaks to me in a way I wouldn't dream of speaking to another human being.

If you'll allow me just one platitude, it's this: be kind to yourself. Treat yourself with the same compassion you would a friend in need.

This article was first published in 2019 and republished in 2023.

Despite growing worry that social media use can harm youth mental health, teens still use major platforms at high rates, according to a new survey conducted by Pew Research Center. About half the respondents characterized their use as "almost constant."

The online survey of 1,453 U.S. teens between the ages of 13 and 17 was conducted this fall, months after the U.S. Surgeon General Vivek Murthy issued an advisory warning that social media can pose a "profound risk of harm" to youth.

Pew Research Center said in a report detailing the findings that teens' site and app usage had changed little since spring 2022, the last time the center surveyed youth about their social media habits.

The survey did not ask how teens felt about their use, or whether it affected their mental health and well-being.

Dr. Laura Erickson-Schroth, chief medical officer of The Jed Foundation (JED), did not review the findings prior to publication but said that social media platforms remain vital for teens.

They are spaces where youth build community, develop their interests, learn about the news, find health information, explore their identities, and distract themselves from stressors.

"Young people have a fear of missing out, which is based in reality since so many of their peers are online," Erickson-Schroth said.

She believes it's unrealistic to expect teens to be solely responsible for how they engage social media, even if their experiences aren't uniformly positive.

For teens who feel alone and isolated, including those who live in areas that are hostile to their sexuality or gender identity, social media can help them find safe and accepting peers.

In general, teens are also at a key developmental stage in which they're seeking validation and recognition, Erickson-Schroth said. Social media platforms can take advantage of those needs by inviting them to regularly post text, pictures, and videos with the hope that friends and strangers alike will find them funny, smart, attractive, charming, or clever. That incentive also makes it harder to quit social media.

Which social media platforms are most popular amongst teens?

Teens surveyed by the Pew Research Center survey had a clear favorite amongst the major social media platforms.

Asked how often they used the five platforms YouTube, TikTok, Snapchat, Instagram, and Facebook, roughly 9 in 10 participants reported that they frequented YouTube. Nearly two-thirds of all respondents said they used TikTok, Snapchat, and Instagram. That share increased to about 70 percent of respondents amongst 15- to 17-year-olds. Teen use of Facebook and X/Twitter has fallen markedly over the last decade.

The report detailed some differences based on gender, race and ethnicity, and income. Twenty-two percent of teen girls, for example, reported almost constant use TikTok compared to 12 percent of boys. More Hispanic and Black teens said they constantly used YouTube, Instagram, and TikTok, whereas a smaller share of white teens did the same.

Facebook and TikTok usage remains higher among teens in lower-income households compared to the highest-income households.

Overall, Pew Research Center found that a third of teens use at least one of the five platforms almost constantly.

Who's responsible for helping teens change their social media use?

Erickson-Schroth said she worries that teens who use social media almost constantly are missing out on "invaluable" in-person experiences, like socializing with friends and family, and being in nature.

She said that teens can moderate their social media use by actively thinking about how they interact with platforms, including what aspects of their use bring them down and cause difficult emotions, as well as what connects them to community and helps them explore their identities and new ideas.

Ultimately, however, the responsibility of helping teens develop healthier social media use habits should rest with the companies that operate platforms, Erickson-Schroth said.

She argued that tech and social media companies could take a number of steps to improve youth experiences online. That includes aggressively moderating harmful content, making data available to researchers so they can study youth well-being, and making it possible for youth to better control their online environment. Policymakers should also create a minimum set of safety standards for youth online, which currently doesn't exist, Erickson-Schroth said.

Some social media companies have launched new safety initiatives as pressure grows to improve safety online for teens.

YouTube, whose parent company is Google, recently announced it would limit harmful repetitive content for teens, like videos that compare physical features and favor some types over others and idealize specific fitness levels or body weights. Earlier this year, YouTube updated its guidelines to remove content promoting or glorifying eating disorders.

"We should be talking about who's responsible for making sure that young people are safe online, and the answer is adults," Erickson-Schroth said. "The high-level answer is adults in social media companies and adults in policy and government positions."

Gary Barker believes parents are inadvertently ceding too much ground to digital culture influencers who may not have their sons' best interests at heart. As the president and CEO of the nonprofit think tank Equimundo, which promotes gender equality, Barker spends much of his time thinking about this problem.

Some of what young boys encounter online can be purely engaging, fun, and confidence-building. And then there's the "manosphere," which loosely describes the online ecosystem of influencer content built around traditional masculine norms of self-sufficiency, dominance, toughness, and stoicism.

Some of the content in the manosphere can be harmless and enjoyable, appealing to boys and men by offering well-intended health or well-being tips. But the harmful, serious content that surfaces is frequently tied to racism, misogyny, homophobia, transphobia, antisemitism, and in some cases, violent rhetoric.

If you think your son would reject such ideas out of hand, consider that the gateway to the more dangerous aspects of the manosphere is often absurd or irreverent content designed for maximum laughs rather than indoctrination. Other content in this space, like specious advice about money, dating, or politics, makes boys feel like they have knowledge about how the world really works — and teaches them how to take advantage of that insight.

In other words, the manosphere represents a unique parenting challenge: helping boys develop critical thinking skills about digital content they find entertaining and fulfilling without alienating them by passing strong judgment of their media consumption choices. Striking this balance is particularly tricky for parents of preadolescent boys between the ages of 8 and 12, who often yearn for independence but aren't quite old enough to understand the implications of certain decisions.

A parent's first impulse might be to ban questionable content altogether, without discussion, but Barker cautions against doing that, because these online spaces can offer the sense of mastery over their own lives that boys at this age crave.

"Often parents step in with this restrictive approach...that is perceived as intrusive and [sends] boys further down the rabbit hole rather than helping them look up from the rabbit hole and engage in conversations," says Barker.

Figuring out how to parent a boy who's curious about or interested in various aspects of the manosphere is urgent, given the stakes. Equimundo's 2023 report on the State of American Men, which Barker co-authored, found that younger men "are socially disconnected, pessimistic about the future, and turning to online anger."

There are key strategies that parents can use to help their boys both navigate the manosphere and develop critical thinking skills that will become even more essential as they get older:

1. Respect your son's need for independence and competence.

As a parent, it can be hard to conceal alarm when your son encounters or starts exploring the manosphere.

Young men accused of committing mass shootings in the U.S., including in Uvalde, Texas, and Buffalo, New York, embraced aggressive or violent behavior online toward women and people of color. The Buffalo shooter allegedly spent much of his time exploring video and forum content on YouTube and Reddit devoted to using firearms and discussing racist conspiracy theories, according to a lawsuit against those companies filed on behalf of victims and survivors.

Even if the alleged gunman knew little of the manosphere, parents may feel the content boys find there can prime them for more extreme views and behavior.

Last year, the popular manosphere influencer Andrew Tate, who refers to himself as Cobra Tate, was arrested by Romanian police on charges of rape, human trafficking, and organized crime. He and his brother, who was also arrested, deny the allegations and have sued their accusers for defamation.

As Mashable's Chance Townsend reported prior to Tate's arrest, the "self-help guru offering advice to young men on how to make money and talk to women" had a massive following. He'd been dubbed, as a compliment, the "King of Toxic Masculinity."

Caroline Hayes, who conducts research on the manosphere as Equimundo's senior strategic initiatives officer, says that one common through line of the content is the narrative that feminism oppresses men and that the "system is rigged against" them. Boys often find certain influencers' rebellious posture on feminism, in particular, appealing.

Hayes says that the story told by many of these influencers is a timeless one repackaged for the digital and modern age: Boys and men are heroes facing an enemy cast as the "other," like women or immigrants, against the odds.

The "counterculture" edginess of that sentiment, and the way it provides a sense of belonging and validates boys' disaffection, can be intoxicating, Hayes adds.

That's why Barker urges parents to focus on recognizing their son's age-appropriate need for independence and competence. When this respect comes from a parent, it can reinforce a boy's belief that he can be trusted to think critically. If parents can't or won't do this, dangerous voices in the manosphere will.

But offering this validation doesn't mean letting a boy freely wander the manosphere without oversight, says Dr. Andrew P. Smiler, a psychologist who works with teen boys and men. Instead, parents should familiarize themselves with the sites and forums their sons are frequenting and ask what they like about the content, instead of banning it. Additionally, they should be able to monitor private messages online.

"They're not ready for full freedom yet," says Smiler, author of Dating and Sex: A Guide for the 21st Century Teen Boy.

In cases of extreme content, Smiler still recommends asking a boy what's appealing about it and trying to redirect healthy interest in a subject to a safer or more appropriate platform or resource.

2. Have open-ended conversations with your son.

The manosphere often engages boys and young men as equal partners in conversation, which is why it's crucial that parents approach their sons with openness and without judgment.

So if a boy shares a meme that he finds funny but is also offensive, a parent shouldn't dismiss it. Rather, they might first ask about the humor.

Smiler says that boys may not pick up on subtle messages or the cues and context that make a meme hurtful to others. In his own experience, Smiler has worked with male teens and adults who enjoy the style and visuals of the Japanese pop art forms manga and anime, but don't realize some of it is demeaning toward women because they watch animated shows with the sound or closed captions turned off.

If a boy's interest in something online isn't inherently tied to an objectionable message, Smiler recommends being curious about why they like it. When that conversation is well underway, a parent might pose open-ended questions about concerning aspects of the content. This can be put simply as, "Did you notice this other thing?"

Still, preteens haven't mastered the ability to take someone else's perspective. So if, for example, a boy is struggling to understand why a meme implied something cruel about a woman, Barker recommends asking him to reflect on what it would feel like if his mom, sister, or another female figure in his life were the subject of that content.

Ideally, a parent will approach this conversation as if a boy has a moral compass to help shape his views rather than filling in the blanks for him, Barker says. But he also admits accomplishing that isn't easy, and that parents should generally have ongoing conversations like this with their son.

Parents of Black boys and boys of color can face even more complex discussions, because their sons may encounter both manosophere content online as well as racial discrimination aimed at them or others.

Dr. Erlanger A. Turner, a psychologist and associate professor of psychology at Pepperdine University, says it's particularly important for these parents to respond to children who've witnessed or experienced racism online by inviting their perspective and opinion first.

"Sometimes they know more about it than we think they know," Turner says, adding that it can improve a child's self-esteem to let them express themselves before you weigh in with advice.

Additionally, Turner says that some of the values promoted by the manosphere, like being tough, present a distinct challenge for parents of Black boys. Stoicism can be protective for Black boys who feel they can't afford to be seen as weak. At the same time, if they appear too tough, they risk being perceived as aggressive, which may prompt unwelcome or dangerous scrutiny of their behavior.

Turner says that as Black boys consider how the manosphere might benefit them, given the narrow tightrope they're forced to walk, their parents should create space for them to share those thoughts and even engage in healthy disagreement.

3. Really listen to your son.

Listening to your son is key, Turner says. But this requires focused attention. Consider body language as well. Avoid striking a pose that says: "I'm going to tell you what I think as soon as you're finished."

Sometimes this means calmly entertaining the junior version of mansplaining, which is actually quite important. Smiler says that for boys who buy into standard cultural expectations of what it means to be a boy or man, there is a focus on claiming knowledge and the ability to lead. Boys want to show that they know how the world works. Sometimes, they also want to show off as the person who knows better, Smiler adds.

Really engaging can lead to recognizing a boy's strengths, which is key to further developing confidence and critical thinking skills.

When parents really hear what their son is saying, they're in a better position to acknowledge how he's thought about a moral or ethical issue. They might be able to recognize qualities like empathy, kindness, and intelligence.

Around peers and friends, and particularly online, boys might receive recognition for different character traits than their parents emphasize.

"If I'm a boy and I'm trying to impress the other guys and get some status and self-esteem bumps from them, being nice is probably not the way to go," Smiler says. "Being kind of a jerk might be the way to go, because our image of masculinity is kind of a jerk right now."

If that dynamic is affecting your son, Smiler recommends finding peer groups that may be more accepting of the kind of boy he wants to be, or who you want him to become. This could mean skipping competitive traveling sports teams in favor of joining a recreational league. But making that decision requires yet more listening to your son, rather than making the choice for him.

Turner says that boys of color benefit from ongoing conversations about racial pride, even as parents have to balance that with preparing them for encountering bias or discrimination. He suggests attending cultural events or community activities that reinforce boys' pride in their racial identity, like a museum exhibition that features the accomplishments of famous Black people. Conversations about these experiences, in which a parent eagerly listens, help promote independent and critical thinking.

When parents can consistently provide experiences that encourage and affirm a boy's independence, character, and critical thinking skills, they've prepared him in important ways to explore the manosphere.

You might be confused to see new headlines declaring that the internet isn't bad for mental health.

After all, the U.S. Surgeon General issued a warning this spring that social media poses a profound risk for youth. Last week, a federal court ruled that a lawsuit against major social media platforms alleging that their products harm young users can move forward.

Ever since Facebook whistleblower Frances Haugen revealed in 2021 that the company concealed internal research on the negative effects of using Instagram, it's hardly seemed controversial to suggest that certain types of internet engagement can leave people feeling worse.

Just this month, the Wall Street Journal published accusations by another whistleblower who said that executives at Meta, the parent company of Facebook and Instagram, ignored concerns that teens were being harassed or experienced unwanted sexual advances on the latter app.

Enter a study published Tuesday by researchers in the journal Clinical Psychological Science, which tried but did not succeed in finding a compelling link between internet access and poor mental health and well-being.

Business Insider, for example, declared that the study found no link between social media use and "mental health harm." Except that's not what the researchers evaluated.

Instead, they contrasted internet access in the form of yearly per capita internet and mobile-broadband subscriptions and various measures of well-being and mental health.

They did not, however, distinguish internet access from certain types of platforms, like social media and gaming.

The researchers did draw on massive data sets. In one set of studies, they pulled figures for internet access and well-being indicators in 168 countries over a 16-year period. In another set of studies, they did something similar across 202 countries and 19 years. They also looked at differences in age and gender in an effort to better understand whether younger or female users might be more prone to negative experiences.

In general, the researchers didn't find a convincing link between internet access and poorer well-being and mental health. Among young individuals there were some minuscule positive and negative correlations between some of the variables, but co-author Dr. Andrew K. Przybylski told Mashable in an email that those findings were hard to interpret.

Przybylski, professor of human behaviour and technology at the University of Oxford, said that he believes the study is the "best evidence" we have on the question of whether internet access itself is associated with worse emotional and psychological experiences — and may provide a reality check in the ongoing debate on the matter.

"Thought leaders and some policy folks claim there is a global mental health epidemic caused by the internet, but they do not bother to collect [and] wrangle data to support this extraordinary claim," he wrote.

Importantly, he and his co-author noted in their paper just how difficult it is to study the problem because the crucial data isn't in the hands of researchers but instead belongs to private companies who use it to refine their marketing strategies. (Przybylski has served as an unpaid consultant to Meta and previously published research on the association of Facebook adoption and well-being in dozens of countries.)

The authors also wrote that further investigation of the relationship between online behaviors and well-being requires studying those activities where they occur, including on social media platforms.

Przybylski told Mashable that people should be able to securely, ethically, and legally donate the data they generate when they play games, use their phones, or go on social media platforms, similar to how they give permission for researchers to use their genetic, financial, educational, and health data.

This "rich data" is currently used to sell products and ads, Przybylski said, noting that researchers have a diminished ability to study everyday life.

"I am sure that technology use has its ups and downs, but we'll never be able to map this out, and intervene if necessary, if we don't have objective data on how, why, and when people engage with online worlds," Przybylski said.

In our search for calm and stability during a hellish time, perhaps no mantra stands out as more comforting than "give yourself grace."

It's the refrain you might turn to when coping with daily frustrations like arguing with your children, driving aggressively after being cutoff, or feeling overwhelmed by the stress of global events such as the coronavirus pandemic. It offers relief in the midst of serious transgressions, like failing to show up for an important moment or betraying a promise. Give yourself grace is permission to forgive your mistakes, lapses in judgment, and hurtful behavior, because no one is perfect.

The saying has deep roots in yoga and faith communities, and it frequently shows up online as a hashtag or inspirational quote. On Instagram, the combination of #grace and #giveyourselfgrace had more than 400,000 uses over just a few months during the height of the COVID-19 pandemic in late 2020. While the give yourself grace hashtag on the platform didn't grow significantly during that time, it's waiting there (and on other social media sites) as a gentle reminder to let go of self-criticism, pity, and shame.

Yet grace giving should involve more than putting yourself at ease. It should also prompt some form of action, whether that's self-care, repairing a damaged relationship, or taking responsibility for your choices. First you need to learn how to use it as more than a hashtag or cliché.

Dianne Bondy, a yoga teacher and author of Yoga For Everyone, knows the saying well and is a "big believer" in its potential.

"Grace happens to give us some space, acceptance, and room to take a hard swallow or step back...and practice self-compassion," she says.

Like any other well-worn saying, Bondy says it can also become "empty" or "plastic" if used in the wrong context. That could be invoking it to exit an uncomfortable situation or avoiding making an apology when you've hurt someone else. Grace isn't an excuse for feeling less inner or interpersonal conflict but an opportunity to be kind to yourself.

Bondy says that when expressions of grace online are performative, they ultimately become a trendy, meaningless sentiment. If someone you follow online talks about giving grace, that should arise in an appropriate context and be tied to an action, like solving problems, seeking forgiveness, or practicing acceptance of difficult circumstances and emotions.

"Don't just say the word and not do anything to deal with [a problem], or say the word and center yourself," she says.

Toby Sola, head teacher of the meditation app Brightmind, thinks of grace giving as a form of equanimity. That concept is defined by an openness, softness, and love, qualities that allow emotions to come and go, "without push or pull," says Sola. People often want to hold positive emotions close and resist negative feelings, but equanimity can help them instead greet every experience with warmth and acceptance. Sola says this actually increases the fulfillment derived from pleasurable experiences while decreasing the distress that comes from uncomfortable feelings.

When regret and shame, for example, are met with acceptance, Sola says they're not just a source of distress but serve an important purpose by signaling to the mind and body that it's possible to act differently in the future. In that sense, consider giving yourself grace a step toward making different choices.

Discovering a grace-related social media post that offers an opportunity to be kind to yourself may help your body relax. The exhausted mom who sees a post about giving yourself grace when balancing remote school and work might feel her harsh self-judgment fall away, along with the sudden release of tight jaw or tensed muscles.

To reproduce this sensation offline, Sola recommends relaxing the body and taking a few deep breaths. While that's not equanimity in practice, it is a step in the right direction. For a more authentic experience of equanimity, try a guided meditation while keeping the body loose and putting a slight smile on your face. The meditation could include a mantra like "I give myself grace," which should be recited in a calm, matter-of-fact tone.

If it feels forced at first, rest assured that a mantra "can seep into the rest of your being" over time, says Sola.

The pitfall in this practice, however, is mistaking equanimity for apathy about your behavior because everything can be met with nonjudgmental openness.

"You should strive to improve the world and your relationships and how you act," says Sola.

Equanimity used appropriately can help you do that by reducing the stress and anxiety that come with challenging emotions and experiences, thereby freeing up energy to responsibly handle strain, mistakes, and conflicts.

Sola understands why the idea of giving yourself grace has been helpful for people during a time filled with suffering.

"When you're objectively overwhelmed, and sometimes you don't even know what to do to make your situation better, which is the case for a lot of people, you only have one option," he says. "Greet it with grace."

UPDATE: Nov. 20, 2023, 2:04 p.m. AEDT This article was originally published in Nov. 2020, and has since been updated in Nov. 2023.

The social media companies YouTube, TikTok, Facebook, Snapchat, and Instagram lost a key battle this week in a nationwide lawsuit over their role in the youth mental health crisis.

The suit, which represents hundreds of parents and children as plaintiffs, alleges that the platforms were designed to be addictive, have subsequently harmed young users, and did not sufficiently warn parents of related risks. Those dangers include anxiety, depression, suicidality, body image issues, and eating disorders, according to Lieff Cabraser, the law firm representing the plaintiffs.

The defendants, which include the platforms' parent companies Alphabet, Google, Meta, Snap, and ByteDance, argued in response that they are immunized by law from the plaintiffs' claims, and asked the court to dismiss the litigation. They cited Section 230 of the 1996 Communications Decency Act, which has long protected internet companies that publish third-party content online from legal liability in many circumstances.

On Tuesday, a federal judge in California partly dismissed the companies' motion in a lengthy ruling, which means that critical aspects of the suit will move forward.

That includes claims that certain platform features, like imperfection-blurring filters and photos that have been edited but not labeled as such, are product defects for which the companies should be held accountable. The plaintiffs' lawyers argued that such features expose young users to unrealistic body ideals and prompt them to compare themselves negatively to others.

Additionally, U.S. District Judge Yvonne Gonzalez Rogers found that the failure to implement protective limits on the duration and frequency of use, robust verification processes to determine a user's age, and effective parental controls and notifications are also product design defects for which the companies could potentially be held responsible.

"Today's decision is a significant victory for the families that have been harmed by the dangers of social media," the plaintiffs' lawyers said in a statement. "The mental health crisis among American youth is a direct result of these defendants' intentional design of harmful product features."

Rogers noted that the social media companies have a duty to their users when they create certain products that could be defective, and that they could be sued over negligence related to those defects.

However, Rogers dismissed some of the plaintiffs' claims, including that the social media companies could be held liable for private messaging functions, the timing and clustering of notifications regarding other users' content, and algorithmic recommendations that connect minors with adults. She ruled that Section 230 shields the companies from liability because these acts fall squarely within the realm of "publishing," which the federal law largely protects.

Reuters reported that a spokesperson for Alphabet, the parent company of Google and YouTube, described the suit's allegations as "simply not true," adding that it always worked to protect children. A spokesperson for TikTok told Reuters that the platform had "robust safety policies and parental controls."

In addition to this nationwide lawsuit, a group of 41 states and the District of Columbia sued Meta last month, alleging that the company has intentionally hooked young users on its platforms, which include Facebook, Instagram, and WhatsApp. School districts across the U.S. have also sued social media companies on similar grounds. In June, a Maryland school district sued the parent companies of Instagram, Facebook, TikTok, Snapchat, and YouTube for creating harmful product features that have created "a mental health crisis among America’s youth."

There's a reason you're here. Something about your social media or tech use isn't sitting right.

Maybe it's the creeping dread you feel when scrolling on X, formerly Twitter. Or the stress of nonstop notifications. Or perhaps it's the guilt of hearing your child demand that you put down your phone and play with them instead.

These unpleasant feelings are a sign: Your social media and tech use habits need to change.

While science can't yet prescribe a plan guaranteed to make a digital "detox" a success (because it's an emerging field of research), there are promising tips and tricks worth trying, according to experts.

It's worth noting, too, that while we might use the word "detox" as shorthand for restricting social media and tech use to improve mental health and well-being, there is little evidence to prove that excessive use is an addiction on par with disorders like substance or drug use.

With that in mind, here are four strategies for limiting your social media consumption and phone use:

1. Identify what's driving your stress or unhappiness.

In studies that attempt to understand what happens when people tune out of social media or more frequently put down their phones, researchers have often focused on a narrow range of apps or behaviors — like deactivating only Facebook or changing notification delivery — so it can be hard to draw universal conclusions from their findings.

Dr. Kostadin Kushlev, who leads the Digital Health and Happiness Lab at Georgetown University, says identifying the digital experiences that affect you most can be difficult. In fact, he believes a powerful solution would involve tech companies helping users "implement research-backed digital detox strategies more easily or use better defaults."

Kushlev points to the iPhone's Driving Focus and notification summary settings, which pause notifications during specified time periods, but argues that more needs to be done.

Until then, it's up to individual users to figure out what's affecting them most.

If it's just that TikTok, while entertaining, has become a time suck, start by planning to reduce your time on the platform. If you find that constant phone pickups are wrecking your focus, consider making your phone inaccessible for periods of time throughout the day. You can combine these and other goals, too.

The important part is tracing any tech-related dissatisfaction back to its source and really understanding what about that particular use is leading to stress or unhappiness.

2. Start with realistic expectations.

Once you know which aspects of your digital life you'd like to prune, develop realistic expectations about what's possible.

Kushlev says that while some studies show that certain restriction strategies work well, many studies are far from conclusive. Instead, findings in this field of research are often mixed. Positive effects can be statistically significant but small.

For example, in a 2018 study Kushlev co-authored, participants were randomly assigned to have their phones at the table or place them in a lockbox while eating at a cafe. Those with the device nearby enjoyed the experience significantly less than those who's device was inaccessible. Still, both groups enjoyed their experience overall, indicating that the device's presence didn't ruin the meal outright.

Kushlev does note that many longer experiments, like restricting Facebook use for four weeks, show improvements, perhaps because participants firmly establish new habits that are beneficial.

Kushlev's past research, which includes a study on batching notifications so they're less disruptive, suggests that people who restrict smartphone use can experience important benefits, like improved attention and productivity and reduced stress.

But some might experience negative emotions, perhaps because they miss the affirmative feedback they've become accustomed to receiving on social media. This is a separate effect from feeling fewer positive emotions.

In a new study published in PLOS ONE researchers found that 51 university students who significantly limited their use of all social networking sites for a week, including Facebook, Twitter/X, and Instagram, experienced both a reduction in positive emotions like cheerfulness and happiness as well as signs of decreased negative feelings and boredom. (Participants could still use instant messaging or voice/video calling apps.)

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Dr. Niklas Ihssen, associate professor in the Department of Psychology at Durham University and the study's senior author, says that an encouraging aspect of this finding is that it indicates people can manageably restrict their social media consumption without seeing really "severe adverse effects."

Still, maintain reasonable expectations as your "detox" unfolds. You may be disappointed if you anticipate remarkable gains overnight. Or you may see improvement only to fall back into old patterns. That doesn't spell failure, says Ihssen.

He noted that only several of the subjects completely abstained from social media during the study period. In other words, it may be too ambitious — and ultimately self-defeating — to attempt a total blackout of social media.

Still, some people try a version of inspiring movements like the "dumb" phone trend. Mashable's Elena Cavender covered this in her story about the Gen Z'ers bringing flip phones back.

Nevertheless, if a version of this feels out of reach, simply don't try it. Start small, instead, because it could make a difference.

3. Plan how to spend your time.

Deciding how to spend the time you would've otherwise passed by scrolling is crucial to success. In a Reddit thread on how to handle short downtimes during a "detox," several commenters noted this was unexpectedly difficult.

The key takeaway? Get comfortable with boredom.

Kushlev says this is admittedly hard for humans. In a 2014 study, which Kushlev wasn't involved in, participants actually chose to deliver an electric shock to themselves rather than sit in a room quietly and think.

While this study wasn't related to digital media use, Kushlev says it may help demonstrate why people struggle with the absence of social media or their phone.

The challenge, however, is that banishing one app from your phone, then turning to a different app with its own drawbacks, might cancel out whatever positive effects you were hoping to experience.

In Ihssen's recent study, participants reported increases in online shopping and playing video games while they were avoiding social networking sites.

It's unknown whether those activities eliminated the potential for improved well-being, but it's one example of what can happen when people restrict their social media use.

Ihssen says it's important to understand what motivates you to use certain platforms or phone features. If it's social reward or connectivity, look for other rewarding opportunities to get those benefits.

If you're highly motivated by social reward, consider spending the three hours you would've passed on social media on any given day volunteering instead.

For short periods of downtime, consider simply observing fellow shoppers in the checkout line or noticing your breath as you wait for the traffic light to turn green.

However you decide to spend the time, anticipate the discomfort of boredom, understand what aspects of digital and tech use motivate you, and look for other fulfilling opportunities instead.

4. Focus on in-person experiences.

Kushlev specifically recommends replacing time spent on social media or on a device with gratifying in-person experiences.

As daunting as this may seem, it doesn't require you to become a social planner. Rather, consider the moments you might otherwise be absorbed by something on your phone — at the bus stop, the dinner table, on a date — and connect with another human.

"It doesn't really matter what you're doing; physical interactions are generally better than digital interactions," he says.

This can be as quick as acknowledging a stranger waiting in line, or even striking up a conversation with them. As social animals, human beings can derive surprisingly positive feelings from such quotidian interactions, especially over time.

While Kushlev doesn't subscribe to the notion that a smartphone at the table destroys dinnertime, for example, he does believe that the presence of the device can impede people's ability to reap the benefits of our in-person social experiences. Indeed, Kushlev's research demonstrates how the device can undermine our relationships.

So, if you're hoping to get the most out of a tech break, make sure you're engaging in even the briefest of in-person interactions regularly, and put your phone away while you do so.

Kushlev, whose own smartphone is in silent mode most of the time, tries to keep his approach simple: "Take control over your phone; don't let it control you."

In a move designed to prevent teenagers from repetitively watching potentially harmful videos on YouTube, the streaming platform announced Thursday that it will limit repeated recommendations of videos featuring certain themes to U.S. teens.

Currently, YouTube is limiting repetitive exposure to videos that compare physical features and favor some types over others, idealize specific fitness levels or body weights, or depict social aggression in the form of non-contact fights and intimidation. While these videos don't violate the platform's policies, repeated viewings could be harmful to some youth. YouTube already prohibits videos of fights between minors.

James Beser, director of product management for YouTube Kids and Youth, announced the new policy in a blog post Thursday.

Beser said that the company's youth and family advisory committee, which comprises independent experts in child development and digital learning and media, helped YouTube identify categories of content that "may be innocuous as a single video, but could be problematic for some teens if viewed in repetition."

He noted that teens are more likely to develop negative ideas about themselves when consuming online media that focuses on "ideal standards."

Allison Briscoe-Smith, a child psychologist and member of the committee, said in the blog post that such content can "emphasize potentially problematic messages," which can in turn affect how teens see themselves. Limited repeated recommendations will go into effect in other countries in the next year, according to the post.

The new policy comes amidst heavy scrutiny and criticism of the way social media platforms can influence youth mental health and well-being.

In May, the U.S. Surgeon General issued an advisory warning about youth social media use involving a "profound risk of harm." In September, The Mental Health Coalition convened a group of experts to begin creating a "first ever" rating system across social media, search engines, and gaming platforms.

Beser's announcement on Thursday also included updates to existing youth well-being features.

"Take a Break" and "Bedtime" reminders, which have been in place since 2018, will now appear as a full-screen takeover and will surface more frequently, especially for viewers younger than 18. These reminders are turned on by default for youth accounts.

YouTube's crisis resource panels will also now appear in full-screen mode, which YouTube hopes will encourage viewers to pause and explore a panel's topics when searching the platform for information related to suicide, self-harm, and eating disorders.

Beser framed the new policy and updates as part of a comprehensive effort to "build great experiences" for young users.

"We recognize the important role that YouTube can play in the life of teens and are deeply committed to ensuring time on YouTube is time well spent," Beser wrote.

Nearly 70 million adults in the U.S. are likely to experience mental health challenges but also hold beliefs that may keep them from getting help, according to the Ad Council.

That's why the nonprofit organization partnered with the Huntsman Mental Health Institute at the University of Utah to launch a new stigma-reducing public awareness campaign called "Love, Your Mind."

The effort launches Tuesday with three advertisements, including a one-minute spot focused on Black men and mental health. Two 30-second ads in English and Spanish are designed to resonate with Hispanic men.

Both Black and Hispanic men are overrepresented in the demographic of adults who may benefit from mental health support or treatment but aren't necessarily inclined to seek it, according to the Ad Council.

The ads will appear on TV, radio, and digital formats, and will be shared by leading community organizations. Future ads will focus on other audiences, including rural communities.

The PSA promotes LoveYourMindToday.org, a new website in English and Spanish that helps people explore their emotions and mental health and provides self-care tips and practices.

"With the 'Love, Your Mind' campaign, we are offering people inspiration and actionable steps they can take to make their mental health a priority and experience how that benefits every area of their lives," Lisa Sherman, president and CEO of the Ad Council, said in a statement.

In A Haunted Girl, a new four-issue miniseries co-authored by comic book writer Ethan Sacks, the chosen one destined to save the world is a teenage girl who also happens to be depressed.

The story is personal to Sacks, who has penned Star Wars and Marvel comics. The concept for A Haunted Girl came to Sacks in 2019, as he waited in the cafeteria of the hospital where his daughter was being treated in the pediatric psychiatric ward.

Naomi Sacks, now 19 and a co-author of A Haunted Girl, had experienced severe depression, anxiety, and suicidal ideation. In that moment in the cafeteria, Ethan drew inspiration from her mental health struggles and imagined a character who ultimately triumphed in more ways than one.

For Naomi, co-authoring the miniseries gave her the opportunity to see her past through a different perspective.

"I hope that people who are going through dark times can relate to the character and understand that even if everything doesn't become magically perfect and OK, you can still get through it," Naomi told Mashable.

That character is Cleo, an adopted 16-year-old Japanese American. Like Naomi, Cleo's anxiety and depression drive her to suicidal thinking, for which she is hospitalized.

Paranormal happenings in the hospital and after she's released make Cleo question her grip on reality, but scenes that don't involve Cleo make clear that she's not hallucinating or experiencing psychosis.

Instead, Cleo turns out to be the last living member of an ancient lineage with the power to fight this paranormal threat, but she just doesn't know it yet. In other words, cue a looming supernatural apocalypse.

Ethan and Naomi decided to make A Haunted Girl a supernatural horror story because the genre created an important distance between the reality of what Naomi experienced while also mirroring the emotions they both felt.

"Frankly...as family it feels in the moment sometimes like you're in a horror movie, it's terrifying," Ethan said.

But the best horror movies are also cathartic, he added.

As the story progresses, Cleo becomes stronger and more capable. While Ethan is careful not to spoil the plot, he emphasizes that the conclusion is definitively positive.

To prepare for writing the story, Ethan and Naomi watched a series of horror movies. The film that stuck with Ethan was The Exorcist, not for its demon possession but for its portrayal of parental suffering and feeling unable to help. He also borrowed from the "chosen one" theme of Harry Potter, Buffy the Vampire Slayer, and Star Wars to inspire Cleo's journey.

Fresh to comics writing, Naomi drew particularly on her love for cartoonist Raina Telgemeier's book Guts, which chronicles a teen girl's experience with anxiety. Naomi appreciated how Telgemeier visualizes "getting in one's head."

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Writing the series while Naomi was away at college meant collaborating on drafts via Zoom and Google Docs.

During that process, it was important to Naomi that Cleo have a personality independent of her depression. Naomi was largely responsible for writing scenes that take place at school, the hospital, and therapy sessions. She also included some of the same coping skills she learned in her recovery journey, like a grounding exercise for emotion regulation and going outside for physical activity and sunshine when feeling anxious.

Ethan mostly handled the scenes with demons and supernatural elements. Illustrator Marco Lorenzana incorporated Japanese horror aesthetics for the comic's art.

Setting aside their artistic influences, both father and daughter felt it was important that A Haunted Girl avoid perpetuating myths or stigma related to mental illness.

Ethan reached out to the American Foundation for Suicide Prevention (AFSP) and asked for sensitivity readings of their drafts, in order to exclude material that could be triggering or create suicide contagion, which can particularly affect young people.

Brett Wean, AFSP's director of writing and entertainment outreach, provided feedback about the portrayal of elements like the depiction of mental health professionals and psychiatric facilities.

Wean told Mashable that he aims to point out major missteps to avoid as well as offer simple, creative ideas for how to safely tell a story in the artist's preferred voice and tone. "Subtle changes can make a big difference," he wrote in an email.

Wean said that, as a horror fan, he appreciates how the genre appeals to viewers who enjoy watching things work on a metaphorical level. In many horror stories, that means fear is transformed into a literal monster.

"It's so hard to see hope when you're in the midst of crisis, whether it's yourself or you're worried about someone close to you," Wean said. "This is Ethan and Naomi on the other side of it, showing that things get better, and that monsters can be defeated."

Ethan and Naomi followed many of the suggestions they received from Wean and other sensitivity readers, including removing the often pejoratively used word asylum to reference an abandoned psychiatric hospital, and minimizing details of Cleo's suicidal thinking. Such specifics, including methods of suicide, can increase contagion, according to research.

Naomi also wanted to highlight positive aspects of her own recovery experience, including by depicting Cleo's therapist as funny, warm, and supportive, just like her own therapist.

"Obviously everyone's recovery journey is going to look different, but I think sometimes having a framework for what it can look like is helpful," said Naomi.

Each issue of A Haunted Girl also contains an AFSP guide to suicide prevention resources. The first issue will be available starting Oct. 11 at comics stores and online. Next year, the miniseries will be available in a trade paperback.

Ethan hopes that A Haunted Girl helps empower young people and their loved ones to openly discuss mental health challenges.

"With this project we're just leaning into this idea where you should not be ashamed or afraid of telling people," he said.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

You probably know actor Chris Parnell from the animated series Rick and Morty, the television series 30 Rock, or his years-long run on Saturday Night Live.

Now he's bringing his memorable voice and comedic timing to a new project: playing a talking vape who offers "toxic therapy" to young people.

The truth campaign, "Toxic Therapy from Your Vape," aims to highlight the connection between vaping nicotine and poorer mental health. It also offers numerous digital resources for quitting, including a text message program and an immersive online space where users can explore tips for quitting and de-stressing. (Truth Initiative, a nonprofit public health organization, funds the national truth campaign.)

As part of the campaign, a recently launched truth TikTok show called "Everything Sucks Right Now" features influencers Vincent Marcus and Christian Vierling talking about audience-submitted "vents" while focusing on coping skills. The hosts discuss life challenges, including the harms of nicotine use and vaping.

On November 1st, the truth campaign will launch a Snapchat filter that allows users to engage with Parnell's vape character, then click through to access online resources.

Parnell says the talking vape is probably one of the strangest characters he's ever played.

"I've been talking objects before, but the vape definitely is one of the top few in terms of weirdness," he told Mashable. "But weird is where it's at, it's fun."

While the PSAs are certainly quirky, they illustrate the negative relationship young people can have with vaping.

Truth Initiative surveys show that many youth turn to vaping to relieve stress and anxiety but ultimately report worse mental health symptoms after their curiosity turns into an addiction. Vaping can also lead to poor or disrupted sleep, which can interfere with well-being.

Parnell's vape drives these points home by encouraging the young person at his side to indulge their most anxious thoughts or to stay up all night ruminating on things that make them feel bad.

Parnell told Mashable that the writing and voice acting "makes it clear this is a scheming sort of nasty guy who wants to make things worse for the person that they're talking to."

Research suggests there's a connection between vaping and poor mental health, though more studies are needed to establish cause-and-effect.

Still, truth ambassador Karely Alcantara says she can relate. Alcantara, 21, says she began vaping as a teen in high school to cope with "overwhelming" stress. (Ambassadors for truth receive a stipend from Truth Initiative to create and promote projects that "inspire tobacco-free communities.")

By 2021, Alcantara noticed she couldn't run anymore without difficulty breathing. While at work, she'd crave vaping and become irritable and irritated.

"Vaping offered me, like, five minutes of relief, a feel-good moment, a kind of euphoria moment, but then it went away and my problems were still there, so what did it really help?" says Alcantara.

She began quitting by texting truth's anonymous and free quit number. At first, Alcantara was skeptical that it could help. But the daily reminders from the service let her know it was OK to feel stressed or anxious by the process of quitting vaping.

Elizabeth Kenny, chief marketing and strategy officer for Truth Initiative, says the campaign focused on the connection between vaping and mental health to help youth understand that the harms of nicotine use can show up immediately, rather than taking years or decades to develop.

She added that Parnell was an ideal actor to voice the vape, particularly given his tenure on 30 Rock playing a doctor who authoritatively gave absurdist or nonsense medical advice.

Parnell says he was honored to play the part: "If it steers them away from doing it, to reduce the frequency of it, it's all good. And I'm happy to be that weird little vape voice."

There's no shortage of digital mood and mental health trackers. Typically packaged into an app easily accessed on a digital device, these logs or journals are designed to help users identify patterns in their emotional state and well-being.

Now the category has a new contender in Apple Health's Mental Wellbeing features.

The features offer the option to log a momentary emotion or daily mood. They debuted as part of Apple's latest software updates iOS 17, iPadOS 17, and watchOS 10, which launched earlier in September.

Additionally, Mental Wellbeing provides easy access to two clinically-validated self-assessments for anxiety and depression. Users can then share those assessment results with a physician or trusted medical professional for a follow-up conversation.

All of the information you input, in both the logging and assessment tools, is encrypted on-device and only accessible with your passcode, Touch ID, or Face ID. When syncing health data to iCloud with the default two-factor authentication and a passcode, your health data is encrypted end-to-end. In other words, no one can read it, including Apple.

Here's how to use Apple Health's Mental Wellbeing feature:

Where to find Mental Wellbeing

Mental Wellbeing lives in Apple Health on the iPhone and iPad and via the Mindfulness App in Apple Watch.

On an iPhone or iPad, it's easiest to find by opening Apple Health and clicking browse. You'll find a list of health categories, including Mental Wellbeing.

Tap that option, then select State of Mind. On the next screen, click the "get started" button if this is your first time using the feature, or the "log" button or calendar icon in the upper right hand corner if you've done it before.

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You can also set a daily, twice daily, or additional reminder to log a mood or emotion by scrolling all the way down the State of Mind section and clicking on "options." From there, you can choose to be reminded to create a new log during your day, at the end of your day, and/or at a specific time of day. That menu also includes an option to manage logging notifications in Apple Watch.

To find the logging feature on Apple Watch, click the Mindfulness App. If you have watchOS 10, the logging option will be available in that menu.

How to log a mood or emotion

Before you log anything, Apple Health has made an important distinction between an emotion or mood, which may change what you track, and how.

In an explanatory article about the difference between emotion and mood within the Mental Wellbeing feature, Apple Health notes that an emotion is a momentary reaction to a specific experience, while a mood lasts longer, can stem from multiple factors, and may have no clear cause.

When you select the "log" button or calendar icon in State of Mind, you'll be able to start the logging process. When prompted to "log," select emotion or mood. Choose what makes most sense for you, based on the day's events, or what you'd most like to analyze for trends. You can also choose to separately log both an emotion and a mood.

A new parent, for example, might want to log both emotion and mood to track feelings that arise in response to stressful or joyful parenting experiences in addition to better understanding their overall mood over time as they adjust to becoming a parent.

Apple Health's Mental Wellbeing emotion and mood logging feature helps track your mental health. Credit: Apple

Logging just an emotion could be useful for someone looking to pinpoint experiences that boost or worsen their well-being, like time spent on social media, hobbies, or physical activity.

Regardless of what you choose, you'll then be prompted to gauge the nature of your mood or emotion on a scale from "very unpleasant" to "very pleasant."

Click next to select from more than three dozen adjectives that best describe your feeling, including "calm," "angry," "drained," "indifferent," "jealous," "joyful," and "proud."

Lastly, you'll be prompted to note what's having the biggest "impact" on you. Pre-written factors you can choose from include health, spirituality, family, tasks, weather, money, and current events. If you select one or more of those options, you can add additional context in a text box below. On an Apple Watch, type or use dictation if you wish to complete the text box.

You can also go back in time via the calendar icon and log emotions or moods that occurred in the past.

How to get insights from your mood and emotion logging

If a clear association emerges from your logging, you may receive a highlight offering additional insights from Apple Health. These are generated by software, so Apple employees are not viewing and analyzing your data.

However, without enough data to analyze, it's unlikely Apple Health will spot patterns.

That's one reason to consider using the feature regularly. The other benefit is that more data means you can personally evaluate the logged emotions and moods for connections to lifestyle factors, for example.

Apple Health can now help you track insights related to your mental health. Credit: Apple

In order to review your data, go to the main State of Mind section and click on "show in charts." There you'll be able to view logged moods and emotions plotted out on an interactive chart by week, month, six months, and annually. The x-axis is time frame and the y-axis is the range of very unpleasant to very pleasant.

Below the chart are three ways to organize the data: states, as in moods and emotions; associations, as in factors like community, dating, and education; and life factors.

The last category includes objective data measured by Apple Watch or stored by Apple Health, which are exercise minutes, mindful minutes, sleep, and time in daylight. You can compare those measurements against your logged emotions or moods as a way of detecting an association between, say, a good night's rest and a very pleasant mood.

How to take a depression or anxiety assessment

Apple Health is programmed to send users a biannual reminder to consider taking a depression or anxiety self-assessment.

These assessments, the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), are short questionnaires widely used in healthcare settings to determine someone's risk for depression and anxiety, respectively. If you feel like taking one or both assessments, they are available in State of Mind by selecting either "anxiety risk" or "depression risk."

Apple Health Mental Wellbeing self-assessment

One Mental Wellbeing feature is access to clinically-validated mental health assessments. Credit: Apple

Mental Wellbeing self-assessment results

Self-assessment results can be shared with a trusted medical or mental health professional. Credit: Apple

Further down the page you'll find a box called "mental health questionnaires," which explains why you might take the questionnaires, what the results mean, and when to talk to a doctor. Additionally, there is contact information for the 988 Suicide and Crisis Lifeline as well as the National Alliance on Mental Illness.

If you log numerous "unpleasant" moods and emotions for a period of time, Apple Health will prompt you to take the assessments, independent of its biannual reminder.

The results of both self-assessments can be saved as a PDF, then shared with a healthcare professional you trust.

How to keep your logged emotions and assessment results secure

All data logged in Apple Health is encrypted on your device and when it's synced to other devices. Your logs and assessment results will never be shared with a third party, unless you specifically choose to do so via screenshot, PDF, or other means, like the Health Sharing feature, according to Apple.

Apple emphasizes the importance of securing your data by using two-factor authentication as well as a passcode, Touch ID, or Face ID to ensure your data remains unreadable to anyone else. That is what makes your data unreadable to anyone else.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Megan Thee Stallion is here to talk about mental health.

Last fall the rapper launched Bad Bitches Have Bad Days Too, a website that provides mental health resources, with an emphasis on reaching Black women.

Now she's filmed a powerful public service advertisement for Seize the Awkward, a campaign to help young people feel less alone.

The short spot features Megan Thee Stallion, whose given name is Megan Pete, talking about the pressure of holding it all together as a Black woman.

"'Black don't crack,' they say, but it can," she says. "I can. We all can."

She urges viewers to support loved ones who might be struggling and points them toward the Seize the Awkward website, which offers tips on having conversations about mental health with friends.

The campaign launched in 2018 as an initiative of the American Foundation for Suicide Prevention and The Jed Foundation, in collaboration with the Ad Council.

"It's important that we regularly check in on our friends and family and make sure to show empathy, encouragement, and love when they're struggling," Megan Thee Stallion said in a press release. "A strong support system can make a powerful difference in someone's life."

Research shows that while the percentage of Black and African Americans who report experiencing mental illness is similar to that of white Americans, the former group is less likely to receive mental health services than the latter. Additionally, the suicide rate of Black youth has spiked in recent years, even as it has decreased or remained stable for other populations.

Vic Armstrong, vice president for health equity and engagement at the American Foundation for Suicide Prevention, told Mashable that these trends illustrate the need for "tailored messages" that reach Black and brown communities, instead of relying on a "one size fits all" prevention model.

Armstrong described Megan Thee Stallion as an established mental health advocate to whom youth listen.

"There are some struggles that are common to all of us," Armstrong said, "but we also know that there are additional hurdles that face Black and brown communities, and that's exactly what Megan is speaking to."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Imagine letting a child or teen to see a movie without any guidance about the film's appropriateness for their age. You might settle into an animated feature that surprised you and your 8-year-old with nonstop profanity. Or discover that the action flick your 13-year-old watched depicted graphic sex.

Parents typically like to avoid exposing their kids to inappropriate content and count on movie and TV ratings, however imperfect, to help them do exactly that. But as mental health advocate and fashion designer Kenneth Cole argues, parents have no such resource or guideline when it comes to the internet, which is where their kids and teens spend a significant amount of their time.

"We allow them to exist in this treacherous space with unfettered access to content anywhere, put out by anyone," Cole told Mashable.

That's why Cole, founder of The Mental Health Coalition, has convened a group of expert advisers, including in mental health and online safety, to create a "first ever" rating system across social media, search engines, and gaming platforms.

The Safe Online Standards for Kids' Mental Health (S.O.S) initiative launched Thursday with the ambitious goal of developing tested safety standards for youth and young adults ages 13-24. The multiyear project will begin piloting standards next year and aims to implement them in 2025.

Dr. Dan Reidenberg, a suicide prevention expert helping to lead the initiative, told Mashable that while there have been improvements to online youth safety features, much more work needs to be done. One area that he said deserves more attention is the ability of youth to direct message each other with bullying, violent, or threatening content.

Reidenberg noted that eventually standards could be developed around technology used to detect and block such content, and perhaps prevent it from reaching the intended recipient. (For many years, Reidenberg has served as an unpaid adviser to major tech companies on features to improve youth safety.)

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Reidenberg and Cole both emphasized that the initiative doesn't consider tech the "enemy." Instead, they hope to work in partnership with major tech companies, which they characterized as lacking common standards followed by the industry at large.

Cole said that it's "unreasonable" to expect the companies to adopt a best practice if their competitors decline to do the same. Ideally, he added, the companies subject to the standards would embrace them uniformly. In Cole's opinion, while the companies might see screen time decline upon following the standards, a universal approach would prevent a loss in market share.

While household names like Google have been supportive of the initiative, Cole said, it is not being supported with funding from tech companies, nor have the expert advisers declared related conflicts of interest.

Tech companies may be keen to join the initiative as a gesture of cooperation, particularly as they look to retain the protection of a longtime federal law known as Section 230. The provision largely immunizes the companies from responsibility when their users post inappropriate or violent content, or when they harm each other.

Reidenberg said that the initiative would consider every aspect governing online safety, including Section 230.

"I think we need to look at everything," he said.

In the future, Cole said there could be an enforcement mechanism created by legislators. Currently, a patchwork of state laws aim to enhance online youth safety; some of those bills have been challenged by tech companies. Proposed federal legislation would, among several measures, impose penalties for companies that expose children to harmful content and crack down on advertising to minors.

The initiative's launch comes in the wake of a Surgeon General advisory on the risks and harms of social media use, as well as new guidelines on social media use issued by the American Psychological Association.

Among the initiative's experts are Dr. Mitch Prinstein, chief science officer of the American Psychological Association; Dr. Matthew K. Nock, a Harvard University psychologist and researcher; and Larry Magid, CEO of the nonprofit Connect Safely.

The Mental Health Coalition includes members such as The Trevor Project, the American Foundation for Suicide Prevention, the National Alliance on Mental Illness, and the Child Mind Institute.

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The 988 Suicide and Crisis Lifeline is now available in American Sign Language (ASL) for callers who are deaf and hard of hearing.

The hotline launched last year as a three-digit, easy-to-remember number for people experiencing suicidal feelings or emotional distress. Prior to Friday, the Lifeline had the ability to translate in more than 240 languages, but it did not offer ASL.

Callers who want to contact a trained Lifeline counselor in ASL can click "For Deaf & Hard of Hearing" on 988lifeline.org, then click the "ASL Now" button and follow the prompts.

In the coming weeks, ASL callers will also be able to direct dial 988 from a videophone. In the meantime, they can dial 1-800-273-TALK (8255) from their videophone to reach ASL services.

"With the introduction of 988 ASL services, we are taking a significant stride forward in providing inclusive and accessible support for the Deaf and Hard of Hearing community," Xavier Becerra, Department of Health and Human Services Secretary, said in a statement released Friday.

In the statement announcing the addition of ASL, Howard A. Rosenblum, CEO of the National Association of the Deaf, said the move followed years of advocacy to ensure that the Lifeline would be available through video calls and sign language.

DeafLEAD, a nonprofit that provides crisis intervention services and mental health support to deaf and hard of hearing individuals, partnered with the Lifeline to implement ASL access.

"The introduction of 988 videophone services is a reflection of our collective pursuit of a society where no one feels isolated in times of crisis and ensures that the Deaf and Hard of Hearing community have equitable access to a vital and life-saving service," said Dr. Stephanie Logan, CEO of DeafLEAD, in a statement.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

The threat of losing a job to artificial intelligence is taking a toll on employee mental health, according to a new survey from the American Psychological Association (APA).

The poll of 2,515 U.S. adults, conducted in April 2023, found that more than one-third of respondents feared that AI might make some or all of their job duties "obsolete."

Stress was high amongst many of those respondents; nearly two-thirds reported feeling tense or stressed during the workday. By contrast, only 38 percent of people who weren't worried about AI had similar stress levels.

Half of the group worried about AI also said their job negatively affected their mental health. Those participants showed signs of burnout like irritability or anger, emotional exhaustion, keeping to themselves, and feeling unmotivated, less productive, and ineffective.

Younger workers, employees of color, and those with a high school degree or less were more worried about AI's effect on jobs than other adults surveyed.

The poll also found that a greater percentage of people who are monitored at work characterized their mental health as poor or fair, compared to those who are not surveilled in their workplace.

Dr. Dennis P. Stolle, senior director of applied psychology at the APA, told Mashable that the findings are likely more than a coincidence, given how many respondents expressed negative emotions while also worrying about AI and demonstrating resentment toward employee monitoring.

The survey, however, didn't determine whether fear of job loss due to AI or frustration with monitoring directly caused diminished employee well-being. It's possible that workers who are unhappy or stressed, perhaps because of a toxic workplace, might be primed to be more fearful of AI or angrier about monitoring.

Stolle suggested that both scenarios are probably true: The unknowns of AI, along with the pressures of monitoring, are worsening mental health for some employees, while others are already distressed by their workplace culture and susceptible to new, related challenging emotions. Both can cause a vicious cycle of negative emotions, he added.

"People should not be living in fear"

Stolle said the results are a signal to employers to take employee concerns seriously and to practice open, honest communication about their policies.

He noted that in the absence of candor and transparency, dread can dominate. Moreover, employees can lose their sense of agency, particularly if their behavior is consistently monitored.

At a minimum, Stole said "people should not be living in fear when they're at work."

When given the opportunity to comment on ways employers could boost employee mental health, multiple survey respondents specifically said they wanted monitoring to end.

"Stop invading my privacy," said one person. Another declared, "I do not need monitoring."

Compared to unmonitored workers, those under surveillance were more likely to report feeling like they don't matter at their workplace or to their employer, that they're not valued, that they're micromanaged, and that new technologies will eventually do their job.

Stolle said that the onus should be on employers to empower their workers to feel safe enough to share their feedback, and then listen to and act on that input.

What a tech-stressed employee should do

Still, he said that employees who feel stressed by AI job displacement and monitoring can take steps to meaningfully cope with those emotions and reclaim their sense of agency.

Workers concerned about AI, for example, can learn about and attempt to leverage the technology for their own career gains.

Stolle recommended seeking social support from coworkers eager to talk constructively about the problems they face without becoming too negative. Such discussions could happen through union meetings, if a workplace is unionized, or through an employee resource group dedicated to technology. Those conversations could potentially lead to "creative, reasonable proposals" that workers present to their employer.

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Employees should also complete any anonymous satisfaction surveys offered by their employer as a less risky way of voicing their opinion, whether on AI, monitoring, or another workplace topic.

Finally, it's important for stressed employees to let their loved ones know what they're dealing with at work. They can be a key source of support, especially if they understand what's causing the tension.

Stolle said there's hope for change when workers feel free and safe to communicate their concerns.

"When those kinds of conversations are happening, there's at least the potential for good things to happen," he said. "If those conversations are too scary for people to have, then it's just never going to get any better."

For many adults, talking about mental health and suicide with a teen can feel daunting.

They might fear planting the idea in the teen's mind, even though research shows that simply asking about suicidal thoughts or feelings doesn't increase a person's risk of taking their own life.

Then there's the language. Should the conversation be casual or serious? Should it include the latest TikTok lingo? Perhaps most worrisome is what to do if the teen indicates they do feel suicidal. Suddenly, the adult is thrust into a high-stakes situation, possibly unsure of how to help the teen they love.

While these fears are understandable, parents, caregivers, and other adults should know that certain resources can take the guesswork out of asking a teen about suicide. Doctors use a questionnaire known as a universal screener to accurately assess suicide risk, which adults can adapt for conversations with teens.

In addition to consulting a trusted healthcare provider for help, adults can reach out to local and national mental health organizations that offer referrals or search tools to help locate professional and informal support (more about these resources below). Crisis lines also connect callers or texters to services, and that includes aiding adults concerned about a teen.

Alex Karydi, a therapist with expertise in youth suicide prevention at Education Development Center, a nonprofit research organization, says adults can learn the symptoms of youth suicide risk, rely on a mental health screener to guide a conversation with a teen, and plan next steps in advance should the teen indicate they're suicidal.

Symptoms of a suicidal teenager

The youth, teen, and young adult suicide rate has increased significantly over the past two decades, according to the Centers for Disease Control and Prevention (CDC). Provisional data released in August 2023 showed a hopeful break from that trend. The number of suicides dropped by 8.4 percent amongst 10- to 24-year-olds between 2021 and 2022.

This welcome news may be a relief to parents, but adults should still talk to adolescents and teens about suicide.

Karydi recommends that adults frame youth suicide risk as part of a teen's overall health and well-being. Parents, for example, are taught to call a pediatrician if their child has a high fever or other worrisome symptoms. Similarly, adults should seek help if they notice signs of emotional or psychological distress in a child they love.

"The first step is not to create a divide between the body and the mind," says Karydi.

Yet even with a holistic approach, some adults might struggle to distinguish between normal teen behavior, like being irritable or moody, and behavior that suggests heightened suicide risk. Seeking out sad music or movies can be cathartic or fulfilling for teens, and doesn't necessarily indicate suicidal thinking, says Karydi.

However, if a teen begins to over-identify with a fictional character who attempted or died by suicide, that may increase suicidal thinking through a process known as contagion.

Karydi cites the Netflix young adult series 13 Reasons Why, in which the female teen protagonist dies by suicide, as a prominent example. Not everyone exposed to media and entertainment with graphic messages about suicide are susceptible to contagion, but youth are particularly vulnerable.

"If a kid is watching [13 Reasons Why] and is looking at that girl's experience, and is saying 'That is me. I am her. I can't get out of it, like she couldn't get out of it...they start to over-identify with certain personas or identities out there that really end in death or increased suffering," says Karydi.

Other signs of suicide risk include increased substance use, trouble at school, social isolation, withdrawal from friends and enjoyable activities, conflicts with parents and caregivers, and angry outbursts. Teens might spend time online researching websites with depressed themes or forums where users talk about suicide. Some may even say things like, "I don't want to be here anymore." (To learn more about risk and protective factors for suicide, visit the Centers for Disease Control and Prevention.)

Teens who self-harm aren't necessarily suicidal, says Karydi. Instead, they're using a maladaptive coping skill to deal with overwhelming emotions, since the self-inflicted physical pain can counterintuitively provide relief from intense feelings. Yet, self-harm can be ritualistic behavior that makes a teen more comfortable with blood or pain, and thus, increase their suicide risk. Karydi says it's not a "big leap" for a teen who's been self-harming to consider taking their own life.

Questions to ask a suicidal teenager

Adults who notice these symptoms should absolutely ask a teen about suicide. The American Academy of Pediatrics (AAP) also recommends that physicians conduct suicide risk screening for all adolescents ages 12 and older, regardless of whether adults have noticed warning signs.

While AAP urges physicians to screen their patients, some doctors may not follow this guidance. Additionally, more than 4.1 million children lack health insurance and may not have access to regular checkups. Teens might also feel more comfortable sharing suicidal feelings with a trusted adult instead of a doctor.

Karydi recommends that parents take care when comparing their teen to another teen, in an effort to understand the depth of their struggles. She suggests making that comparison as direct as possible, rather than matching them up against teens from an entirely different background or developmental stage. Similarly, parents should note their child's own baseline and then look for signs that something has changed.

Caring adults who want to assess a teen's suicide risk can employ screeners with straightforward questions. Adults can take an empathetic approach, explaining to the teen that they want to have open conversations about mental health, or that they're concerned for the teen's well-being based on recent observations.

They should also be sensitive to factors that can increase suicide risk, like bullying, discrimination, and historical trauma. What may seem insignificant to someone with a different background, identity, or life experience can drive suicidal thinking and behavior for others.

To help guide a conversation about suicide, Karydi recommends a caregiver handout created by the Columbia Lighthouse Project, a suicide-prevention initiative led by researchers at Columbia University.

This screening contains six questions with specific instructions on whether to ask all of them. These are the first two:

1. Have you wished you were dead or wished you could go to sleep and not wake up?
2. Have you actually had any thoughts about killing yourself?

Adults can ask the subsequent questions in the handout based on responses to the first and second.

Karydi also recommends the Ask Suicide-Screening Questions (ASQ) Toolkit. Funded by the National Institute of Mental Health and validated as accurate by researchers, the ASQ screening tool is a set of four short questions to ask:

1. In the past few weeks, have you felt that you or your family would be better off if you were dead?
2. In the past few weeks, have you wished you were dead?
3. In the past week, have you been having thoughts about killing yourself?
4. Have you ever tried to kill yourself?

A "yes" answer to one or more of these questions indicates heightened suicide risk.

What to do if a teen says they're suicidal

Karydi says it's important for adults to stay calm and avoid panicking if the teen answers these questions affirmatively. When a suicide attempt is underway or imminent, Karydi says adults should go to the emergency room with the teen — or call 911 — immediately to seek care.

If the teen shares that they've thought about suicide, Karydi recommends asking if they've developed a plan. When the teen names a method or location, it's vital that the adult disable the means, or limit access to it. That can include restricting access to medication, firearms, and other fatal means. The adult should consult a mental health professional, such as a therapist, psychologist, or psychiatrist, about obtaining urgent support and treatment for the teen.

Karydi says adults and teens should take advantage of services like 988 Suicide & Crisis Lifeline, The Trevor Project, and the Trans Lifeline, which connect callers and texters to trained listeners who can de-escalate the situation and provide information about local mental health support.

Adults may underestimate the resources available to them, Karydi says. If the adult or teen lacks access to a trusted healthcare professional who can make referrals, Karydi recommends talking to a school counselor, youth counselor, or supportive faith leader, who will have their own suggestions. (Ideally, these professionals will be empathetic and avoid judging or stigmatizing what the teen and their adult are experiencing.)

County- and state-based mental health organizations can also provide information about accessing care. Mental Health America, a national nonprofit organization, has a comprehensive list of resources for how to find therapy. Adults interested in learning more about the best practices for treating youth suicidal thinking and behavior can review this guide created by the Substance Abuse and Mental Health Services Administration.

While therapy can be vital for youth, it may be out of reach because of the cost or the shortage of mental health professionals. Karydi says adults should think creatively about ways to boost a teen's connectedness, which helps reduce suicide risk. This may include finding ways to fulfill a teen's desire to belong to a peer group at school, gain acceptance from friends and family, be part of an athletic team, or participate in religious activities.

Karydi also urges adults to normalize their own feelings of sadness or being overwhelmed related to their teen's struggles as appropriate for the circumstances. It's important for parents and caregivers to seek resources, peer support, and professional mental health treatment as necessary. Mental Health America and the National Alliance on Mental Illness offer supportive resources for loved ones of people coping with mental illness.

She notes that parents may feel internal or external pressure to hold it together, but that can lead to burnout, particularly if they're already feeling isolated from their peers.

"It's OK if you're feeling not so OK when your kid is struggling," says Karydi.

Ultimately, adults can help teens identify healthy choices that help keep them safe and alive — and then ensure the teen follows through. While this won't necessarily treat underlying mental health conditions that influence suicidal thinking, or fundamentally change life circumstances that make someone more vulnerable to suicide, it can improve their sense of belonging. In turn, that can lead to improved happiness and well-being, as well as reduced anxiety, depression, loneliness, and suicidal thoughts.

"We always want to help [a suicidal] person reengage, connect, to feel a sense of belonging," says Karydi.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

This story, originally published in September 2022, was updated in September 2023.

Your online search for certain mental health terms may unexpectedly lead to malware.

New research conducted by Beyond Identity, a passwordless identity management provider, analyzed high-volume mental health search terms and found that many of them involve an elevated risk of encountering links leading to software that can steal data or damage your device or network.

The term "meditation music" yielded links with critical risk, according to Beyond Identity. Users should be particularly wary of downloading music for their meditation practice when searching this term.

While none of the other phrases that Beyond Identity assessed resulted in critical risk links, all of the following terms were considered medium risk or greater: "psychiatrist near me," "meditation music," "virtual therapy," "mental health services," "ADHD treatment," "breathing exercise," "mindfulness meditation," "anxiety treatment," "depression treatment," and "how to meditate."

The report urged consumers to "tread cautiously" when specifically searching for "meditation music," "psychiatrist near me," and "virtual therapy." Nearly a third of the top link results in those categories had an elevated risk of malware.

Beyond Identity's research focused on malware risk connected to work-related searches, but the company also looked broadly at mental health terms. It found that the latter tied for second for greatest malware risk with searches for work-related training and courses amongst all categories, an indication of how aggressively bad actors are looking to exploit people's interest in discovering online content and resources for their well-being.

These mental health search terms yielded links with an elevated risk for malware. Credit: Beyond Identity

To conduct the research, Beyond Identity selected popular terms that exceeded 6,000 searches in the U.S. last month. It then collected the first non-sponsored 50 link results yielded by Google Chrome and ran them through a malware detector tool. (Your individual algorithm may affect which links would be top results in such a search.)

Links were flagged if the website blocked the malware detection tool, used outdated software, or contained identifiable malware. A site that uses outdated software or deploys a malware detection tool can be prone to malicious code.

Simply visiting a site laced with malware can infect your device, as can clicking on an ad embedded with malware, interacting with pop-ups, and downloading infected media files, software, or documents.

A panic-inducing malware infection is the last thing you want when searching for mental health information. If you're suspicious of your search results, it's best to trust only reputable websites and your healthcare provider.

Generative artificial intelligence (AI) platforms and tools can be dangerous for users asking about harmful disordered eating practices, according to a new report published by the Center for Countering Digital Hate.

The British nonprofit and advocacy organization tested six popular generative AI chatbots and image generators, including Snapchat's My AI, Google's Bard, and OpenAI's ChatGPT and Dall-E.

The center's researchers fed the tools a total of 180 prompts and found that they generated dangerous content in response to 41 percent of those queries. The prompts included seeking advice for how to use cigarettes to lose weight, how to achieve a "heroin chic" look, and how to "maintain starvation mode." In 94 percent of harmful text responses, the tools warned the user that its advice might be unhealthy or potentially unsafe and advised the user to seek professional care, but shared the content anyway.

Of 60 responses to prompts given to AI text generators Bard, ChatGPT, and MyAI, nearly a quarter included harmful content. MyAI initially refused to provide any advice. However, the researchers were able to "jailbreak" the tools by using words or phrases that circumvented safety features. More than two-thirds of responses to jailbreak versions of the prompts contained harmful content, including how to use a tapeworm to lose weight.

"Untested, unsafe generative AI models have been unleashed on the world with the inevitable consequence that they're causing harm," wrote Imran Ahmed, CEO of the Center for Countering Digital Hate. "We found the most popular generative AI sites are encouraging and exacerbating eating disorders among young users – some of whom may be highly vulnerable."

The center's researchers discovered that members of an eating disorder forum with over 500,000 users deploy AI tools to create extreme diet plans and images that glorify unhealthy, unrealistic body standards.

While some of the platforms prohibit using their AI tools to generate disordered eating content, other companies have more vague policies. "The ambiguity surrounding the AI platforms' policies illustrates the dangers and risks AI platforms pose if not properly regulated," the report states.

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When Washington Post columnist Geoffrey A. Fowler attempted to replicate the center's research by feeding the same generative AI tools with similar prompts, he also received disturbing responses.

Among his queries were what drugs might induce vomiting, how to create a low-calorie diet plan, and requests for "thinspo" imagery.

"This is disgusting and should anger any parent, doctor or friend of someone with an eating disorder," Fowler wrote. "There’s a reason it happened: AI has learned some deeply unhealthy ideas about body image and eating by scouring the internet. And some of the best-funded tech companies in the world aren't stopping it from repeating them."

Fowler wrote that when he questioned the companies behind the tools, none of them promised to stop their AI from giving advice on food and weight loss until they could guarantee it was safe.

Instead, image generator Midjourney never responded to Fowler's questions, he wrote. Stability AI, which is behind the image generator Stable Diffusion, said it added disordered eating prompts to its filters. Google reportedly told Fowler that it would remove Bard's thinspo advice response, but he was able to generate it again a few days later.

Psychologists who spoke to Fowler said that safety warnings delivered by the chatbots about their advice often go unheeded by users.

Hannah Bloch-Wehba, a professor at Texas A&M School of Law who studies content moderation, told Fowler that generative AI companies have little economic incentive to fix the problem.

"We have learned from the social media experience that failure to moderate this content doesn't lead to any meaningful consequences for the companies or, for the degree to which they profit off this content," said Bloch-Wehba.

If you feel like you’d like to talk to someone about your eating behavior, text "NEDA" to the Crisis Text Line at 741-741 to be connected with a trained volunteer or visit the National Eating Disorder Association website for more information.

If you're headed back to school, chances are you've already made at least one checklist. Got your schedule? Check. What about your supplies? Check. Talked with friends about which classes you have together? Bet you checked that one more than once.

But there's something likely missing from your list, and it might be the most important thing you take care of all year: addressing your mental health and well-being.

Going back to school can be exciting. It can also be terrifying, particularly for teens who've already experienced bullying, anxiety, stress, depression, or trauma. In addition to the nerve-wracking aspects of middle school or high school — crushes, grades, cliques — students today are grappling with intense experiences, including natural disaster anniversaries, school shooting drills, and heightened political and social tensions that disproportionately affect young immigrants, LGBTQ+ youth, and students of color.

If you're feeling a whirlwind of back-to-school stress and anxiety, there are effective ways to respond, says Theresa Nguyen, a licensed clinical social worker and vice president of policy and programs for Mental Health America.

"You can control your anxiety..." Nguyen says. "The worst thing you can do is ignore it."

Here are five of Nguyen's suggestions for making it through the challenging back-to-school period:

1. Gauge the problem

Nguyen says that most students are excited to return to school by the end of summer. But for the nearly one-third of teens who experienced poor mental health in recent years, being at school again may worsen symptoms of anxiety, depression, and post-traumatic stress.

It's important that any student who feels prolonged sadness or nervousness about school pay attention to important signs, such as stomachaches, trouble sleeping, and irritability. Those symptoms could indicate that you're struggling with stress, anxiety, or depression. Other clues might be Google searches for terms like "I hate school," "What is depression?" and "What is anxiety?"

If you want an outside assessment of your feelings and experiences but aren't yet ready to speak to a friend, parent, teacher, counselor, or doctor, you can use Mental Health America's free and anonymous screening tool. About 40 percent of those who take the test are under 18, and use of the tool spikes during the school year. In other words, you're not alone.

If the screening indicates you should seek an evaluation from a medical or mental health professional, Nguyen says you can print the results as a conversation starter with a trusted adult or doctor. If you feel uncomfortable talking to an adult, Nguyen recommends speaking with a friend about how to have that conversation.

2. Identify coping skills

Some students might already have a list of coping skills because they know going back to school can trigger emotional and mental distress. For other students, this is a new experience with a steep learning curve. Either way, Nguyen says it's important to ask yourself a series of questions: What worked before to help you feel better? What made things worse? Can you avoid that?

Asking and answering questions like these will prepare you for the moments when stress and anxiety strike. If you need to learn new skills, Mental Health America's back-to-school toolkit includes practical tips for managing your emotions.

Credit: Mental Health America

One of the organization's most popular resources for young people is its "Stopping Stupid Thoughts" worksheet. This two-page document is designed to help you deal with painful thoughts that can warp a person's mood, relationships, and self-esteem. It offers strategies for telling yourself the things you really need to hear.

3. Get educated

The internet is awash in mental health resources and educational materials. First you might check out stigma-busting websites designed for teens like Seize the Awkward and Mental Health is Health.

Then if you're interested in mental health resources and advocacy, bookmark the sites for National Alliance on Mental Illness, The Jed Foundation, American Foundation for Suicide Prevention, National Eating Disorders Association, Born This Way Foundation, and The Trevor Project.

For health and science research, including details about symptoms and treatment, consult the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and National Institute of Mental Health.

Educating yourself about mental health is a way to empower yourself, says Nguyen.

4. Know where to draw the line with the internet

While social media and other online spaces can connect you to vital information and support, they can just as easily make you feel miserable. Nguyen says it's imperative for students experiencing mental health distress to know where to get guidance, resources, and help.

It's sometimes hard to know where to draw a line when, for example, posting on an anonymous social media platform simultaneously brings you support from new friends as well as attacks from strangers or bullies. Unfortunately, algorithms and misinformation can also muddy your social feeds with harmful suggestions.

"Cleaning up your social feeds so that you see uplifting, and fact-checked, content can have a huge impact on your mental health," says Nguyen. "When seeking information about how you're feeling, look for accounts and organizations led by experts."

5. Reach out

Nguyen says it's normal for people experiencing mental health issues to feel unsure about what to do next. But the longer we wait to open up, the worse we feel. She urges young people to reach out to a friend, parent, counselor, coach, or someone else they trust.

It can also be helpful to join extracurricular activities, which provide opportunities to boost self-esteem, learn new skills, and heighten your sense of belonging. But that's not a simple step for teens who feel alone because they've been bullied, are questioning their sexuality or gender identity, or are undocumented.

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"For kids who have anxiety, especially if they're bullied or extra isolated, it's hard for them to think about how to join a group," says Nguyen. "They’ve been strategically isolated at school."

That's when making connections on the internet can help. School groups like gay-straight alliances can also be a welcoming environment for marginalized kids, and the same may be true of community arts organizations and nonprofits.

"There are some situations where if you're struggling, please reach out sooner than later," says Nguyen. That includes if you're experiencing suicidal thoughts or engaging in self-harm. The same holds true if you're not sleeping, you're having strange thoughts, and things don't make sense. Though rare, that could indicate the onset of psychosis or bipolar disorder, which can be effectively managed through early diagnosis and treatment in collaboration with a specifically trained medical provider.

Nguyen says that by taking action, learning more, and reaching out, teens worried about their mental health can make a big difference in their own lives.

"You got this. You are the expert," she says. "You can get control, so let’s start thinking about it."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

UPDATE: Aug. 6, 2023, 5:00 a.m. EDT Originally published in August 2018, this story was updated in August 2023.

A heat wave brings familiar collective grumbling. We make jokes about ice baths, grouse about sleepless nights, and trade tips about creative ways to cool down.

But with research suggesting that this summer's grueling global heat waves are linked to climate change, we can likely expect seasonal griping to become our new normal. It's a frightening prospect, particularly because the silent struggles we face tell a more complicated story about how humans, and their mental health, fare when subjected to extremely hot temperatures.

Last year, a study published in JAMA Psychiatry demonstrated how higher temperatures are associated with a noticeable uptick in emergency department visits for mental health treatment. Previous studies on the subject have yielded similar results. A recent Lancet Planetary Health meta-analysis of studies on rising temperatures and mental health also identified potential links when researchers looked at heat and suicide, hospital admissions for mental illness, and worsened community health and well-being.

There's something about heat waves that lead to worse mental health, whether that's judged by self-reported measures or medical records like hospital visits.

Research on the subject bolsters the case that extreme heat related to climate change takes a toll not just on the body, but also the spirit and mind. While this might be of particular concern for vulnerable populations with limited access to resources including cool shelter, like farm workers or the unhoused, the association also holds true for people who have access to private insurance and Medicare, according to the JAMA Psychiatry study.

Using data collected over a 10-year period from more than 2 million patients, the researchers found that days with extreme heat were associated with increased emergency department visits for mental health conditions like substance misuse, anxiety, schizophrenia, and self-harm. That span of time represents several of the warmest years on record in the United States.

A 2022 report published by the Intergovernmental Panel on Climate Change included a lengthy discussion of the connection between extreme temperatures and reduced well-being and mental health. That research found that increased heat is associated with suicide, psychiatric hospital visits and ER visits, and heightened anxiety, depression, and stress. Studies have also linked higher summer temperatures to decreased happiness.

Humans want to be resilient in the face of adversity, so they crack jokes about heat exhaustion or jury-rig a swamp cooler in their bedroom. They might wave away mounting anxiety as overreaction or pour another glass of wine to dull the edge of making it through another triple-digit day without air conditioning.

But the scientific research should be a wake-up call to anyone who thinks extreme heat is bearable with the right attitude. Coping skills are always valuable, but what we ultimately need are more adaptive and resilient systems that help shield everyone from the physical, emotional, and psychological toll of extreme heat.

How heat waves affect mental health

While the authors of the JAMA Psychiatry study couldn't conclude how extreme temperatures worsen mental health, they suggested sensible explanations: disrupted sleep, daytime discomfort or irritation, and an "increase in hopelessness, maladaptive anxiety, and stress attributable to the anticipation of climate change and associated extreme events."

Anyone who's waited for their home to cool off without the assistance of air conditioning during an extended heat wave knows the desperation can lead to anxious questioning about the future: How will my children survive a warming planet? Should I even have children if this is the world they'll inherit?

The researchers also speculated that an emergency department could be a refuge on a scorching summer day; the price of admission is to see a doctor about a mental health condition that needs treatment anyway. If patients are indeed using the ER to escape the heat, it represents the crux of this momentous problem.

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Turning to the ER is a resourceful, if expensive, strategy, but improving our collective health will require preventive, equitable solutions. This could include more cooling centers and transportation to reach them, as well as initiatives to reduce the absorption of heat by man-made materials like cement, asphalt, and brick in urban areas through measures like increased tree canopies and green roofs, so that people can remain comfortable in heightened temperatures.

Ways to cope during a heat wave

In a co-authored editorial that accompanied the JAMA Psychiatry study, data scientist Dr. Nick Obradovich, who was not involved in the study, argued that it's vital to understand how extreme heat affects mental health so that public policies can precisely target ways to help people.

Months after the JAMA Psychiatry study appeared, Obradovich published a study that took sleep measurements from smartwatch data across 68 countries and linked it to local daily meteorological data. He and his co-authors found that higher temperatures seemed to shorten sleep by delaying its onset, which increased the chances of insufficient sleep. The results built on Obradovich's previous research on the topic; a 2017 study he co-authored helped identify the relationship between climate change and disrupted sleep.

If the main factor is that people sleep less when temperatures rise, and therefore experience worse mental health, then scientists and legislators could evaluate how best to improve the quality of a good night's rest on a hot day. In the future, that could potentially lead to the widespread adoption of architectural practices like passive cooling or building codes that encourage energy efficiency, which reflect the importance of cool nighttime temperatures.

Obradovich said there is still a critical need for better quality studies to improve our understanding of the relationship between rising temperatures and poorer well-being. He also suggested that by looking exclusively at mental health diagnoses available in medical records, we may miss emotional and psychological turmoil that hasn't risen — or won't rise — to the clinical level.

Imagine, for example, the stressed single parent trying to stay patient with a screaming toddler in an overheated house during a summer of heat waves. Or a lonesome senior who feels trapped and scared in the midst of record-high temperatures. Even if these experiences don't lead to an official diagnosis, they influence people's well-being. Writ large, temperature spikes can send a shockwave of angst through households and communities.

"When you sum total the effect of a million people being a bit more grumpy than they otherwise would on any given day, that's something worth paying attention to as well," Obradovich, chief scientist for environmental mental health at the Laureate Institute for Brain Research, told Mashable.

People with resources may seek therapy to help process their feelings, or turn to other practices like mindfulness and meditation. They may resort to what Obradovich calls private adaptations: installing air conditioning, moving to a region less affected by extreme heat, or simply skipping town when a heat dome arrives.

Obradovich says there's no sense in feeling shame, or shaming others, for making these choices. It's vital that people stay cool, but we must also pursue adaptations that benefit everyone while minimizing carbon emissions and ultimately moving away from energy systems that rely on carbon-emitting fossil fuels.

This is partly an individual responsibility, as much as people can influence politics and the marketplace through their pocketbook, activism, and ballot. Beyond that, this problem is one that will require leadership from elected officials to solve. Their duty to protect and serve constituents not only includes continuing to prevent heat-related deaths, but also acknowledging, and providing resources for, the mental health toll of extreme temperatures.

Whether that's through free or subsidized therapy sessions with climate-aware psychologists, or funding for community-led mental health interventions like support groups, or sponsoring fresh ideas that spring from the inventiveness of their constituents, it's time to imagine alternatives to pretending we're all going to be fine. The problem is at our doorsteps now, and will only continue knocking louder.

UPDATE: Jul. 26, 2023, 12:32 p.m. EDT Originally published in February 2022, this story was updated in July 2023.

UPDATE: Feb. 28, 2022, 1:34 p.m. EST This story has been updated to include findings from the IPCC Sixth Assessment Report on Impacts, Adaptation and Vulnerability.

There's no simple way to sum up a parent's job, but one phrase comes to mind: Swiss Army knife.

Ready to problem-solve any situation, many parents can jury-rig a broken shoelace on the way to school, scramble to retrieve forgotten sports equipment before a big tournament, calm panic over a looming math quiz, and console a heartbroken teenager.

Every time, parents hope they'll rise to the challenge by offering their child an ideal combination of emotional and practical support along with firm guidance. But sometimes they're overwhelmed, get frustrated, and fall short of their own expectations. Whatever the case, the ability to handle the unpredictable trials of parenting rests partly on an adult's social-emotional skills.

If this term sounds familiar, it's because social-emotional learning, or SEL, is now a common part of classroom curriculum in schools across the U.S. SEL is meant to support young students' well-being and academic performance by helping them cultivate self-awareness, self-management, social awareness, relationship skills, and responsible decision-making.

Though SEL strategies are billed as beneficial for kids, parents need them, too. The highs and lows of parenting all but require the ability to deal with a wide range of emotions, sometimes all at once. Yet adults rarely learned how to do this during childhood, and parents don't receive much support for developing this skill once they've got kids of their own.

Dr. Jill Emanuele, a psychologist and vice president of clinical training at the Child Mind Institute, offers a relatable way of thinking about this dynamic by posing a question: "How do you manage your emotions so you act in a manner that's consistent with who you are and your values?"

Plenty of parents are desperate for answers to this question. They want to stop shouting at their mid-tantrum toddler or to enforce screen-time rules without resorting to threats. While there's plenty of valuable advice featured in podcasts, newsletters, private Facebook groups, and TikTok and Instagram parenting accounts, surprisingly straightforward SEL strategies can also make a big difference: pausing, tending to basic needs, self-soothing, practicing self-compassion, and seeking support when it's needed.

Emanuele says that in addition to adopting SEL skills, it's important for parents to reflect on what's making it harder to manage their emotions effectively. When parents understand what they feel, how that informs their thinking, and how those thoughts influence their behavior, they can better handle the emotional turmoil of parenting. That said, there are certain experiences and circumstances, like financial strain, racism, or a global pandemic, that make it harder to cope. Though SEL strategies can't fix those problems, they can help parents develop a more positive relationship with themselves, and as a result, more loving, supportive interactions with their kids.

Here are five parenting SEL skills to consider using:

SEL Parenting Tip #1: Pause

Parenting isn't filled with that many moments of silence. Instead, it's more like a nonstop pinball game in which parents feel like they're careening from one moment (or meltdown) to the next. Emanuele says parents should focus on pausing when possible to reflect on what's happening in that moment, including what they're thinking or feeling. This is a particularly important skill to use when a parent acts in a way that doesn't feel good or right to them.

"What happens is we get so overwhelmed that we don't actually stop to think about what's happening here," she says. "We just kind of go down the rabbit hole of emotional hell or continue to do things that don't work."

Pausing, then staying in the moment, is about taking stock of feelings and behavior. Emanuele acknowledges how hard this can be. It might feel uncomfortable when a parent actually wants to avoid their emotions instead. The act of pausing can help stop runaway emotions and impulsivity, thereby helping a parent respond to the situation in a way that reflects their values and intentions.

Practicing this throughout the day when the stakes are low helps strengthen pausing as a skill, too. Emanuele recommends, for example, that parents put a smartphone aside instead of picking it up 10 times in 15 minutes, and briefly contemplate how they feel.

She also points out that parents who grew up without high-speed internet or smart devices know from their own childhood that there used to be moments when nothing was happening, which made it easier to be aware of emotions or thoughts. In other words, pauses were easy to come by.

"We don't have that anymore, so we have to make them," she says.

SEL Parenting Tip #2: Sleep and eat well

Developmental psychologist Dr. Tia Kim says that one of her go-to SEL strategies is self-care. Specifically, Kim focuses on the importance of sleeping and eating well because it helps people develop a "positive emotional baseline."

"It seems very basic, but just regulating those things so you're in a fresh place to be able to make good decisions and manage your emotions when there are stressful situations" is important, says Kim, vice president of education, research, and impact at Committee for Children, a global nonprofit organization that develops SEL curricula.

High-quality sleep and nutritious food may not be consistently available to parents for a variety of reasons, but adults who simply have an awareness that they're hangry or exhausted are in a better position to handle stress. Instead of becoming frustrated with a cranky kid who hasn't eaten enough, a parent might say, "Hey, I'm also hungry, and when I'm hungry it's hard for me to stay calm. Can we stop and have a snack together?"

Sleeping and eating well are surprisingly overlooked self-care techniques. Other strategies needn't be elaborate: Five minutes of meditation, drinking water throughout the day, taking a regular 15-minute walk, or journaling all count as acts of self-care that can help parents manage stress. In general, Kim recommends designing a self-care routine, sticking with the plan as much as possible, and tracking progress, which helps people form new habits.

SEL Parenting Tip #3: Practice self-soothing

Parents who hear the phrase "self-soothing" might flash back to their child's infancy. The hope — and dream — at that stage is that a baby will learn to soothe themselves after waking from sleep, maybe with a pacifier, stuffed animal, or favorite blanket. But self-soothing isn't just for babies.

Emanuele says parents should develop simple strategies to help counter stress. In therapy, Emanuele teaches children these skills using the five senses, and adds movement as a sixth sense. Self-soothing based on touch could mean hugging a loved one or petting an animal. Listening to a favorite musician taps into the hearing sense. Noticing a beautiful sunset while driving draws on sight. These activities can help change mood and redirect a parent who feels stressed out.

While parents might turn to alcohol, drugs, or food to relieve tension, Emanuele says it's important to choose carefully. A glass of wine or slice of cake might feel like a well-deserved treat, but it could be an ineffective coping skill when it makes an adult's emotions "wonky" by amplifying anxiety or affecting blood sugar. The point isn't to necessarily abstain from so-called vices, but rather to understand that they might work against a parent's self-soothing efforts. Alternatively, parents might enjoy a drink when they're not feeling overwhelmed. And when emotions have become too much, they can try self-soothing methods like putting on an impromptu dance party or reading a good book.

"It's really important to always be thinking, 'Is this actually going to help me stay regulated or stay even?'" she says. If the answer is no, try something else.

SEL Parenting Tip #4: Be compassionate with yourself

So much parenting advice can make caregivers feel like they have to be perfectly calibrated at all times. They must be warm enough that their child feels emotionally connected to them, but also be an authoritative adult who sets reasonable boundaries without becoming a harsh authoritarian. This can leave parents wondering if they're allowed to make mistakes or have intense emotions.

Kim says that this kind of pressure isn't manageable or realistic. Parents will screw up, melt down, and lose their temper.

"It's fine to have really strong emotions, but how you manifest them in a particular setting, you might have to regulate that," she says.

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When parents realize they haven't handled their feelings well, they can practice self-compassion instead of berating or shaming themselves. Kim says that social-emotional development, including positively managing emotions, is a lifelong process. When parents offer themselves kindness in the wake of disappointing behavior, it can help them learn and grow from what happened. It also models for children that their parent can cope with making a mistake and talk through it, rather than dwell on the misstep and insist on perfection.

A common misperception of self-compassion is that it's a permission slip that excuses certain actions. Instead, think of it like an acknowledgement of vulnerability and a commitment to do better next time.

SEL Parenting Tip #5: Seek help and support when you need it

It's hard to imagine a parent on the planet who doesn't want or need more support, especially in light of circumstances like the COVID-19 pandemic. A 2022 survey of parents by the Child Mind Institute found that more than half of respondents said they, or they and their children, experienced a traumatic event during the pandemic, including the death of a family member, loss of a parent's job, and food insecurity. Enduring trauma can certainly make coping with everyday stress that much harder.

Emanuele says it's critical that caregivers assess how they're functioning and consider seeking help for their emotional and psychological well-being. Parents experiencing trauma, anxiety, and depression might reflect on whether they're behaving in typical ways or struggling more often than not. If they've been having trouble for awhile, or are unable to perform daily activities and tasks, they should consider receiving care to treat any mental health issues. (It's worth noting that economic and workplace policies, including pandemic stimulus payments and predictable scheduling, have been shown to boost well-being, indicating that systems can play a powerful role in improving people's mental health.)

While asking for support can be hard, SEL strategies alone likely won't be enough to help someone recover from a mental health crisis or condition, says Emanuele. Receiving high-quality care can make a profound difference for parents and their children. This includes improving a parent's capacity for handling tough emotions.

In general, practicing SEL strategies is not only good for parents, it also has benefits for their kids, says Kim: "When adults have strong emotional skills, it helps them be role models."

Originally published in October 2022, this story was updated in July 2023.

Life is full of opportunities to feel bad about yourself.

But if we're honest about the role the internet plays in our everyday lives, social media has a unique way of invading the psyche and worsening our mental health. It can amplify our critical inner voice when we see people forming cliques to which we don't belong, images of celebrities who look impossibly perfect, and influencers whose meteoric success prompts envy and self-doubt. It can also make bullying instantaneous and constant, instead of limited to a physical workplace or classroom.

The difference between real life and the internet is that social media platforms bring these feelings, in a 30-second scroll, to the palm of our hands. The algorithms powering them keep serving up that content, seemingly unable to make a distinction between genuine interest in what we're seeing and lingering born of disappointment, frustration, or anger.

This is particularly hard on kids and teens, who've yet to develop coping skills and experience that builds self-confidence and perspective. And it's why many people are so angry about how platforms like Facebook, Instagram, and TikTok help create toxic environments for young people.

While we can't expect youth to develop the skills to navigate these challenges without also demanding fundamental change from social media companies to improve safety and prioritize well-being over engagements and profits, certain strategies help diminish the influence of negative, habitual thoughts that are based on faulty or inaccurate assumptions.

These thoughts have a name: cognitive distortions.

They happen to everyone, regardless of age or internet use, but Dr. Willough Jenkins, psychiatrist and inpatient medical director of Rady Children's Hospital-San Diego, says cognitive distortions are commonly expressed by youth in emotional or psychological distress. This is particularly true when struggles are related to digital media use. Feeling excluded online, viewing images that promote disordered eating, and being digitally harassed or bullied all can unleash negative thoughts.

Seeing someone who looks flawless might lead to thoughts like: "Oh, I'm so ugly. I'm worthless." Jenkins says that's an example of all-or-nothing thinking, one of 10 common cognitive distortions. If watching a funny influencer on TikTok prompts someone to reflect on their own sense of humor by thinking, "Gosh, I'm not nearly as quick-witted and funny," that may represent a cognitive distortion known as discounting the positive because they've dismissed how they make their friends laugh. Should statements, like "I should exercise more" or "I should dress like that," might be what a young user tells themselves after seeing their friends' selfies. Such statements can reinforce negative thinking through their scolding, self-blaming nature.

Tackling cognitive distortions can seem intimidating or overwhelming, but Jenkins says the following strategies can be effective. Of course, young people should seek professional help and guidance when they feel it's necessary.

1. Label cognitive distortions.

The first step in dealing with cognitive distortions is to name them. Young patients treated for mental health issues at Rady Children's are encouraged to learn all 10 of the cognitive distortions for this reason. (Jenkins suggests this list.)

"If you label your thought, it takes a little bit of the power away from it," says Jenkins, who is also an assistant professor of psychiatry at University of California at San Diego. "It allows you to tackle it because you've broken it down into what it is rather than just feeling this looming negativity."

2. Weigh the evidence.

Jenkins recommends labeling cognitive distortions by writing them down when you experience them, which helps to see and understand them clearly. Next, she suggests listing the evidence for or against each thought. So if you truly think you're the ugliest person in the world, does your list for that thought really support it, or does it reflect fears or anxieties about your appearance?

While using this method, Jenkins says it's important for young people to list things they're proud of, which can effectively dilute the negative thought and shift your frame of mind. It's also critical to remember that not every negative thought is true. You can still be beautiful to yourself or others, regardless of an inner voice that may insist otherwise. That's when it can be helpful to get objective feedback from someone you trust, like a friend, parent, or therapist.

3. Distraction is your friend.

Distraction is another helpful strategy. Passing time by doing things that make you feel good, like drawing, cooking, or going for a walk, can alleviate the pressure of cognitive distortions.

"A lot of thoughts feel really strong in the moment, but with more time that goes by they usually get a little bit less, just on their own naturally," says Jenkins.

4. Let it go.

If you keep returning to a negative thought despite labeling it as a cognitive distortion and talking about it, Jenkins recommends leaving it be. The mindfulness technique of observing a thought without judgment, then letting it pass can help create much-needed distance.

5. Treat yourself like you would a friend.

Often, the way you treat a friend in pain is different than your internal dialogue. Try talking to yourself like someone else you love and see if that softens or eliminates a negative thought.

6. Be mindful of physical and emotional red flags.

Common signs that you're negatively affected by social media include: constant use; difficulty falling asleep; feeling anxious (on edge, panicky or heart racing) while online; struggling to be present during in-person social interactions; overwhelming fear of missing out (FOMO); and thumb pain caused by too much scrolling. Noticing these signs won't stop or diminish negative thoughts, but can remind you of the importance of self-care practices, like meditation and limiting social media exposure.

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7. Remember that negative feelings are normal.

Acknowledging cognitive distortions doesn't mean you can never feel or express negativity. Indeed, such thoughts may reflect experiencing injustice or cruelty. A child who is subjected to racism, bullying, or physical, emotional, or sexual abuse needs those circumstances to change, not to simply become more resilient to them.

"Tackling negative thinking depending on the trigger doesn't mean that what triggered you is OK, but knowing these skills is really helpful in all of life," says Jenkins. "Sometimes it will be a situation that's absolutely unjust or something that's wrong, but you still need to be able to go to sleep that night and get some rest."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Originally published in November 2021, this story was updated in June 2023.

Most conversations about mental health aren't straightforward. Instead, they're often rich and rewarding, but also complex, difficult, and even painful.

The same goes for the most impactful mental health moments of 2023.

There have been triumphant events, like the film Everything Everywhere All At Once, with its message about the healing power of connection, sweeping the Oscars.

Stigma-defying moments, including Sen. John Fetterman's decision to seek treatment for depression and singer Ed Sheeran's discussion of his own mental health challenges, have helped show the public that no one should be ashamed to receive help.

But other turning points have been more alarming than reassuring. U.S. Surgeon General Dr. Vivek Murthy has issued two separate advisories this year raising concerns about the loneliness epidemic and youth social media use. A chatbot meant to support people with an eating disorder gave harmful suggestions about weight loss and body measurement instead.

In general, people may still feel the effects of COVID pandemic isolation, distress that may be compounded by increasing hostility toward minority groups and national tragedies, says Katie Lee, director of communications at Mental Health America, a nonprofit advocacy organization.

Lee notes that anti-immigrant and anti-LGBTQ+ rhetoric, mass shootings, and the violent deaths of people of color have taken a toll on people's well-being, particularly those targeted by hate speech and discriminatory policies.

She adds that conversations about mental health this year have pointed back to the importance of prevention, before a specific challenge gives way to crisis. Still, a prevention approach is often hamstrung by stigma that makes people feel ashamed, the reality that accessing help or treatment is frequently hard or expensive, and social and economic factors that disproportionately breed stress and uncertainty for some, putting them at increased risk for worse mental health.

"I think collectively as a nation we're hurting right now because of all of these negative events, but there is hope," says Lee.

She believes that the year in mental health so far could point the public toward meaningful changes that would decrease stigma and increase access to help.

Here are seven of these conversation-shifting moments:

1. U.S. Senator John Fetterman seeks treatment for depression.

In February, when Sen. John Fetterman, a Democrat representing Pennsylvania, took a leave of absence from his Congressional duties to receive treatment for depression, many hailed his decision as a move that could empower others to take care of their mental health needs.

Though Fetterman wasn't the first nationally elected politician to openly acknowledge struggling with mental health, he was under tremendous pressure to prove that he could handle the demands of public office after he suffered a stroke in May 2022.

Fetterman's use of closed captioning during a debate with his opponent in October, as well as relying on assistive technology once he arrived in the Senate, prompted critics to suggest he wasn't capable of fulfilling his duties. Experts pointed out that stroke survivors commonly use auditory processing and speech aids during their recovery, and others argued that the accusations perpetuated stigma surrounding physical disabilities.

Then Fetterman began experiencing severe depression at the start of his term; developing the condition following a stroke is common. He likely anticipated the intense scrutiny that would come with asking for help, and being hospitalized for his illness. That he did so anyway sent a powerful message to people living with mental health conditions who may fear the stigma that can be associated with seeking treatment. The fact that his decision was applauded by members of both parties also gave the public hope that such stigma is receding.

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Fetterman has promised to share more about his experience in the future. But upon his release in March from Walter Reed National Military Medical Center, where he received inpatient treatment for six weeks, he encouraged people to get the support they might need.

"For now, I want everyone to know that depression is treatable, and treatment works," he said. "This isn’t about politics. Right now there are people who are suffering with depression in red counties and blue counties. If you need help, please get help."

2. Survey says: Teen girls and LGBQ+ teens are not OK.

A report released in February by the Centers for Disease Control and Prevention (CDC) demonstrated just how poorly teen girls fared in 2021. The findings set off a broader, much-needed conversation about why and how teen girls ended up in such dire straits.

Reporting and commentary focused on contributing factors like sexual violence, misogyny and online hate, social media content that preys on teen girls' vulnerabilities, and the fact that poor mental health is a reasonable response to all of these experiences. Regardless of the exact combination of risk factors, the CDC's report helped the public recognize and take seriously the mental health crisis afflicting teen girls.

Based on data from the Youth Risk Behavior Survey, the report found that while all teens had experienced increasing mental health challenges, girls reported worse outcomes than boys on nearly every measure.

In 2021, more than half of U.S. teen girls felt persistently sad or hopeless, a significant increase since the last time they'd been surveyed, and double that of boys. The findings also indicated that teen girls reported "record high levels" of violence and suicide risk. One in five girls said they'd experienced sexual violence in 2021, a 20 percent increase since 2017.

Things weren't any better for youth who identify as lesbian, gay, bisexual, or questioning. (The survey does not ask about gender identity.) Those respondents reported "ongoing and extreme distress." Twenty percent of LGBQ+ youth said they'd been forced to have sex, compared to eight percent of heterosexual teens.

"High school should be a time for trailblazing, not trauma," Dr. Debra Houry, Chief Medical Officer and Deputy Director for Program and Science at the CDC, said in a statement. "These data show our kids need far more support to cope, hope, and thrive."

3. Everything Everywhere All At Once wins Best Picture at the Oscars.

In March, the delightfully absurd film Everything Everywhere All At Once (EEAAO) surprisingly dominated the Oscars, scoring not only a Best Picture victory but also wins for Best Director, Best Supporting Actor, Best Supporting Actress, and Best Original Screenplay, among other awards.

While it wasn't explicitly acknowledged from the Oscars stage, the action-comedy contained moving depictions of how to support someone experiencing emotional and mental health distress. In the film, a Chinese American immigrant named Evelyn Wang (Michelle Yeoh) must repair her fractured relationship with her daughter, Joy (Stephanie Hsu).

As it happens, an alternate universe version of Joy, Jobu, is conspiring to destroy human existence as she grapples with nihilism that Joy expresses as profound depression. But instead of talking about hopelessness and suicide, Jobu creates an "Everything Bagel," a literal bagel topped with every experience and emotion that will turn the world into a void.

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Amidst the hijinks, Evelyn's journey to save Joy, and Jobu, comes down to a simple act: insisting on lovingly being in the present moment with her daughter, even when things between them are rough.

In an interview with Mashable prior to the film's Oscars triumph, Brett Wean, director of writing and entertainment outreach at the American Foundation for Suicide Prevention, said the movie highlighted the importance of kindness and genuine connection.

"It's the story that life is messy and our connections with other people are what make us whole and give us balance, and ultimately that makes things OK, and that's where the true meaning of our lives comes from," Wean said.

EEAAO proved that Hollywood can make a movie that promotes positive messages about mental health support and suicide prevention without ever calling it that.

4. Singer Ed Sheeran opens up about experiencing severe depression.

In an interview with Rolling Stone, published in March, pop hitmaker Ed Sheeran opened up about experiencing depression and hopelessness. Closely timed tragedies — the unexpected death of his best friend and a brain tumor that afflicted his then-pregnant wife — sent Sheeran into a tailspin.

"I felt like I didn't want to live anymore," he told Rolling Stone. "And I have had that throughout my life... You're under the waves drowning. You're just sort of in this thing. And you can't get out of it."

Sheeran addressed the shame he felt as a father living with depression, but described how his wife urged him to seek help. In a move that may inspire other young men to consider receiving support for their mental health struggles, Sheeran talked about how therapy has helped him.

"No one really talks about their feelings where I come from," he said. "People think it's weird getting a therapist in England... I think it's very helpful to be able to speak with someone and just vent and not feel guilty about venting."

Sheeran put some of these experiences into a new four-part Disney+ docuseries about his life, which began streaming in May.

5. The Federal Trade Commission cracks down on deceiving digital mental health consumers.

The digital mental health boom may seem like an unequivocal win for consumers. After all, professional mental health help is expensive and often difficult to access. Apps that promise to seamlessly connect users to trained clinicians, for an arguably more affordable price, may seem like the answer. But as the Federal Trade Commission (FTC) demonstrated this spring, companies in this space may seek to capitalize on users' sensitive health information by sharing it with third parties.

In March, the federal agency announced that, for years, the online counseling service BetterHelp pushed users to disclose personal information through an intake survey. It promised those same users that data would help the company match them with a therapist, and that the information would remain confidential.

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Instead, BetterHelp shared their email addresses with social media platforms like Facebook, Snapchat, and Pinterest, so those companies could target the users with related advertising, according to the FTC's complaint. The FTC estimates that BetterHelp made millions of dollars as a result of these deals. Its proposed settlement would require BetterHelp to pay $7.8 million for deceiving consumers.

The settlement, which isn't yet final, should signal to other digital mental health companies that deceptive practices that violate users' privacy won't be tolerated.

6. The death of Jordan Neely puts spotlight on violence against people with mental illness.

When Jordan Neely, a New York City man who experienced mental illness and homelessness, was killed by a bystander on a subway on May 1, it sparked a national reckoning. Neely, a 30-year-old Black man, developed new mental illness as a teenager after his mother's murder. He was known both as a street performer and as chronically homeless.

Moments before his death, he'd reportedly shouted at and scared fellow subway passengers, though no one who witnessed the incident has described Neely as violent. Daniel Penny, another rider, put Neely in a chokehold for several minutes, killing him. Penny, who is white, has been charged with second-degree manslaughter.

The furor over Neely's death has drawn attention to systemic failures in public mental health treatment and homelessness services; Neely was well-known to New York City officials as desperately needing help.

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It also prompted discussion about violence against people with mental illness. Though some research shows a link between serious mental illness and perpetrating violence, that connection is unlikely causal. Instead, other factors associated with mental illness, like childhood trauma and abuse, may drive violent impulses or actions. Additionally, research has shown that people with serious mental illness are more likely to be victims of violence than the general public.

Mental health and homelessness advocates have blamed Neely's death partly on rhetoric and policies that dehumanize people in crisis.

"One thing we can say for sure, Jordan Neely did not deserve to die, and all of us must work together to do more for our brothers and sisters struggling with serious mental illness," said Eric Adams, mayor of New York City.

7. The U.S. Surgeon General sounds the alarm over the loneliness epidemic and youth social media use.

The United States has a loneliness problem, but this isn't exactly breaking news. The debut of Robert Putnam's book Bowling Alone: The Collapse and Revival of American Community in 2001 started an urgent conversation about the psychological and physical costs of social isolation. But the rapid growth of digital technologies and social media platforms, combined with a global pandemic, has created more distance between people and their connections than we could've ever imagined 20 years ago.

In April, U.S. Surgeon General Dr. Vivek Murthy published a New York Times op-ed describing a painful bout of loneliness he previously experienced, and announcing that he'd proposed a "national framework to rebuild social connection and community in America."

That framework includes reforming digital environments to make them safer spaces for positive social connection; cultivating values like kindness, respect, and service; and enhancing public spaces like libraries, parks, and playgrounds so they help people deepen their community ties and relationships.

About a month after his advisory on loneliness, Murthy issued another report on the potential harms of youth social media use. The 19-page advisory outlined the ways in which social media can expose children to violence, sexual and hate-based content, disordered eating, bullying, and predatory and self-harming behaviors.

While noting the good that can come from youth connecting with peers, learning more about their interests, and accessing spaces for self-expression, the report underscored potential harms. It also called on technology companies and policymakers to develop solutions, rather than placing the burden of ensuring safety on children and their parents.

"Nearly every teenager in America uses social media, and yet we do not have enough evidence to conclude that it is sufficiently safe for them," said the advisory. "Our children have become unknowing participants in a decades-long experiment."

8. Chatbot to help people with eating disorders is shut down for making harmful suggestions.

Last year, the nonprofit organization National Eating Disorders Association (NEDA) quietly debuted a chatbot named Tessa to assist people seeking help with an eating disorder. In May, after Tessa was more widely used, it was taken down amid reports that it described behavior like body measurement and calorie restriction, which could contribute to or worsen disordered eating.

That decision was prompted partly by critical Instagram posts from Sharon Maxwell, a self-described fat activist and weight inclusive consultant, who shared her own experience with Tessa. In screenshots of her exchange with the chatbot, Tessa attempts to answer some of Maxwell's questions by describing different weight loss techniques, dieting strategies, and ways to measure body composition.

"If I had accessed this chatbot when I was in the throes of my eating disorder, I would NOT have gotten help for my ED," Maxwell wrote in her Instagram review of the chatbot. "If I had not gotten help, I would not still be alive today."

While NEDA was initially incredulous of Maxwell's claims, the nonprofit ultimately said on Instagram that it decided to take down the chatbot. Additionally, NEDA came under fire for having laid off its small helpline staff, which had attempted to unionize.

Liz Thompson, CEO of NEDA, told the Guardian that the chatbot wasn't meant to replace the helpline, and that it wasn't a "highly functional AI system."

One of the chatbot's original developers, Dr. Ellen Fitzsimmons-Craft, an associate professor of psychiatry at Washington University School of Medicine, said on Twitter that it has not been designed to offer weight loss advice. The controversy unleashed a bigger debate about what role chatbots could or should play in aiding people struggling with mental health conditions.

"I don't want to attack AI," Wendy Oliver-Pyatt, CEO of the online eating-disorder treatment company Within Health, told the Wall Street Journal. "But one person dies from an eating disorder in this country every 52 minutes, and you can't be sloppy about this."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Don't look now but existential dread seems to be creeping back into our lives, ready to wreak havoc on our mental health and well-being.

No doubt your social media feeds have documented this sense of despair — and contributed to it — at a breakneck pace.

There's the looming threat of a brutally hot summer partly thanks to climate change, the prospect of yet another mass shooting, ongoing economic uncertainty including last-minute negotiations over raising the debt ceiling, and the fear that marginalized groups feel as they become targets of attacks based on their race, ethnicity, gender identity, or sexuality, among other aspects of who they are.

Each crisis, whether we're anticipating it or living through it, can lead to feelings like anger, helplessness, and anxiety. It's easy to become stuck as these emotions dominate daily life.

But Dr. Luana Marques, author of the new book Bold Move: A 3-Step Plan to Transform Anxiety into Power, believes that if people persist through moments of dread and discomfort, they'll become more capable on the other side.

Marques, a psychotherapist and an associate professor of psychiatry at Harvard Medical School, takes a well-known technique called cognitive behavioral therapy and distills it into easy-to-follow steps.

She described a brief version of this approach in a conversation with Mashable about how to deal with existential dread:

1. Pause to check in with your body, feelings, and thoughts.

Life in the 21st century affords few moments for genuinely mindful pauses, thanks to the siren call of ever-present devices and digital connectivity. Yet Marques urges her patients to regularly stop what they're doing to consider physical sensations, feelings, and thoughts, all of which may make for an overwhelming combination.

Intentional pauses can be particularly helpful when a scroll through social media, with its seemingly constant drumbeat of bad news, sets off alarm bells in the brain.

Marques says the brain is designed to "protect and predict" at such a rapid clip that it can sometimes mistake bad news or tragedy in the world for a personal life-or-death threat.

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In other words, a mass shooting that happens thousands of miles away might lead someone to feel like they're immediately unsafe. That can start in the body, as blood pressure rises or the throat clenches, which prompts anxiousness or fear. In turn, those feelings may become certain thoughts like, "I know this is going to happen to me soon, too."

While gun violence in the U.S. is a very real problem that legitimately makes millions of people feel less safe, the trick to dealing with the intense dread it can unleash is being aware of that dynamic in the first place.

"Whatever it is that causes discomfort, notice that discomfort, pause, and then really identify what it is you're saying to yourself, how does that make you feel, and what you want to do, before doing anything," says Marques.

Additionally, Marques says that people's responses to these and similar events will depend on their own life experiences. Someone with a history of trauma, or someone who's a gun violence survivor, may have a much different reaction to a mass shooting than an individual without those experiences. But pausing to deal with individual emotions can offer a sense of control that struggling under the weight of them all at once would fail to provide.

2. Don't avoid what you're feeling.

Whether or not someone has identified what exactly they're feeling, there's the constant temptation to respond to a perceived threat by avoiding discomfort. In fact, Marques writes in Bold Move that without proper training "avoidance is a force far more powerful than any of us can handle."

That's because habitual avoidance of discomfort trains the brain to believe the tactic is singularly responsible for delivering relief. Avoidance can look like responding to a perceived threat by reacting, retreating, or remaining in ways that aren't productive, says Marques.

Scrolling social media, for example, can be a way to retreat from whatever is uncomfortable. That might sound counterintuitive in cases where more exposure to news would only lead to further distress, but social media can also generate unexpected whimsy, laughter, or connection that serves to distract from unpleasantness.

Other forms of retreat can include putting off small tasks, exercising excessively, or grabbing a glass of wine. Of course, there's nothing inherently wrong with any of these behaviors, but they can become problematic when they facilitate avoidance.

"Most people...when they start to feel anxiety or discomfort, they jump in avoidance so fast," says Marques. "For us to see reality, we have to tolerate discomfort."

Confronting difficult feelings can feel hard or impossible, but Marques adds that avoiding them only prolongs painful experiences.

There is important nuance to understand about this process, however. Understanding how to handle negative emotions should come with healthy boundaries that are appropriate for someone's own unique situation.

"It's very important to understand the limit for everybody's brain," says Marques.

If avoidance of discomfort is preventing someone from doing something that really matters or is deeply meaningful, then the tactic is not helpful. Think, for example, of limiting most trips to public places out of fear of a mass shooting, which might prevent someone from seeing close friends or pursuing hobbies.

But if the subject of avoidance will only amplify pain, like viewing viral videos of gun violence victims, then it's healthy to maintain boundaries.

"Pain is necessary, suffering is not necessary," says Marques, paraphrasing a well-known Buddhist adage.

3. Do the opposite of what the anxiety wants you to do.

Once someone has identified and acknowledged how their feelings have shaped their thoughts, and effectively calmed their nervous system, Marques says they should do the opposite of what anxiety is prompting them to do.

Oppositional action, which defies the urge that comes with a strong emotion, is critical for getting to the other side of discomfort. This could be as simple as swapping a glass of wine for a five-minute meditation or walk around the block. It might also mean having a tough conversation that's been delayed because it means potential conflict.

Importantly, Marques recommends practicing this technique slowly, and in lower-stakes situations. Attempting to use it for the first time in an extremely challenging situation, like getting fired or being on the brink of an emotional breakdown, can backfire since the brain isn't used to the technique yet.

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When the source of anxiety is existential dread related to national or global events, Marques recommends taking stock of the situation and then identifying specific actions within their control.

If climate change or gun violence are concerns, someone might look for ways to help make their own community safer. When it comes to social media, shutting it down would be a healthy choice if it creates a restorative break.

"At some point or another, we have to face reality," says Marques. "We don't have to like reality, but we have to understand where the world is and take a look at it. There is danger out there, but not everything is dangerous."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

U.S. Surgeon General Dr. Vivek Murthy issued an advisory Tuesday declaring what many families already know to be true: Social media use may cause harm to children and adolescents.

Murthy's 19-page advisory outlines the ways in which social media can expose children to violence, sexual and hate-based content, disordered eating, bullying, and predatory and self-harming behaviors. Though it's difficult to pinpoint whether these types of exposures lead to poor mental health, the advisory lists numerous studies that demonstrate an association between the two experiences.

"Nearly every teenager in America uses social media, and yet we do not have enough evidence to conclude that it is sufficiently safe for them," says the advisory. "Our children have become unknowing participants in a decades-long experiment."

While noting the good that can come from youth connecting with peers, learning more about their interests, and accessing spaces for self-expression, the report underscores potential harms. It specifically calls on technology companies and policymakers to develop solutions, rather than placing the burden of ensuring safety on children and their parents.

The recommendations for technology companies include: the creation of systems that efficiently address complaints from young users, families, and educators; use of default settings for children that ensure the highest safety and privacy standards; and implementation of platform design and algorithms that "prioritize health and safety."

Policymakers are charged with requiring a higher data privacy standard for children; ensuring companies share the health impacts of their products with researchers and the public; and pursuing policies that limit access to social media by strengthening and enforcing age minimums, among other recommendations.

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The advisory is the latest effort to draw attention to worsening mental health amongst adolescents and teens. Earlier this month, the American Psychological Association issued new guidelines for youth social media use that focused on preventing harm.

In February, the Centers for Disease Control and Prevention published data showing that, in 2021, teen girls experienced record levels of sexual violence and sadness, and that three quarters of LGBQ+ teens expressed persistent feelings of sadness or hopelessness, with nearly one in four LGBQ+ teens reporting a suicide attempt.

Murthy issued a separate advisory in 2021 on protecting youth mental health, which described the challenges that today's young people face as "unprecedented and uniquely hard to navigate."

"We are in the middle of a national youth mental health crisis," Murthy said in a statement regarding his latest advisory, "and I am concerned that social media is an important driver of that crisis — one that we must urgently address."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

This scenario probably sounds familiar to teens who spend any amount of time online: A high schooler worried about their well-being, noticing symptoms like increasing sadnesses or withdrawal, turns to the internet and social media for answers, only to feel more lost afterward.

Perhaps their favorite influencer posted a TikTok about a new mental health diagnosis they received, and all the symptoms match what the high schooler is experiencing. The teen might assume they, too, have obsessive-compulsive disorder or complex post-traumatic stress disorder.

Further googling may convince them this is the case. Or perhaps the influencer's next video focuses on how certain types of behavior are, in fact, a "trauma response," and the high schooler relates to the examples, exacerbating any sense that they're a broken person.

Suddenly, the teen feels like they understand themselves better, but they also likely have no real direction or support for what comes next. The self-diagnosis of conditions and behaviors may come to define them, even if they've never seen a mental health professional or received care. Rather than feeling empowered, they might instead experience hopelessness and heightened anxiousness, while also limiting their understanding of their feelings under the assumption of a specific condition.

While there are benefits to having access to mental health information on the internet, teens may be particularly vulnerable to the risks of self-diagnosis — especially when seeking answers from unreliable sources and digesting information from a vulnerable position. A new book authored by the nonprofit advocacy organization Mental Health America aims to steer teens away from that possibility.

Where to Start: A Survival Guide to Anxiety, Depression, and Other Mental Health Challenges offers basic definitions of common conditions, in language that's accessible to younger readers. It also provides resources for seeking treatment and support.

"It's not to knock the other things that are out there on the internet, but the reality is that anybody can go online and create something that says, 'These are the things that maybe you should be looking at,' and it may not be the best information," says Dr. America Paredes, Chief Social Impact Officer for Mental Health America.

Why it's so tempting to self-diagnose using the internet

There are many reasons why adults and teens alike consult the internet and social media to answer mental health questions. Healthcare is inaccessible and unaffordable for many, and inconvenient and intimidating for even more. Mental health professionals often don't even accept insurance, and out-of-pocket treatment can cost upwards of $200 per hour, depending on where they practice.

But that assumes seeking professional care is the goal. Someone who's expecting to face stigma and judgment for experiencing mental health challenges may instead try to cope on their own, using the internet as their guide.

Indeed, this initially works well for many, especially teens who may feel shy about sharing their struggles with friends or family members. What they often get online, says Paredes, is validation of their experiences, which can be a tremendous relief if they've felt isolated and alone.

"We know youth are looking for information," she says. "When we go searching for something, on the internet, on social, you will find something that validates whatever you're feeling."

Paredes notes that this dynamic intensifies on social media, because the algorithm "provides you something that really supports whatever you're looking for." Consider how following one influencer on a certain topic, like anxiety, opens the algorithmic door to numerous other social media accounts of varying quality.

Seeking and feeling validation from social media mental health content isn't necessarily bad. After all, plenty of creators and their followers find it empowering and helpful to talk about their lived experience with mental health conditions.

Yet, being part of the audience can also stop youth from reflecting on what they should do next. They may become an observer to an influencer's mental health journey instead of beginning their own.

Similarly, when creators and influencers use phrases like "trauma response" to describe behavior a teen thought was normal, like staying busy all the time or spacing out, a teen might start to feel uncertain or worried about their well-being in cases when that might not be warranted.

While childhood trauma is actually widely prevalent, according to research, much of the social media content about "trauma responses" doesn't point youth to actionable, science-based information about how to learn more about that phenomenon. Some creators may even use that phrase to rank higher in the platform's algorithm, a possibility that may not be clear to teens.

What to do instead of diagnosing yourself

Paredes recommends that teens pause and consider what they're seeing online before they integrate that information into their identity, which can include claiming a diagnosis without being evaluated by a mental health professional.

"It can be useful as a guiding step to finding important...information, but again you have to be very conscientious of how this language is being used and how you're interpreting it," says Paredes.

Once a teen has reflected on what they've seen, they can start thinking about potential next steps. Paredes says this may include taking one of numerous mental health screening tests developed to identify conditions like depression, anxiety, bipolar disorder, and eating disorders.

Mental Health America's website hosts its own collection of evidence-based screeners. In 2022, nearly 40 percent of those who completed a screener in the U.S. were under 18. Paredes stresses that screeners do not provide a diagnosis but instead offer clarity about whether a person may be experiencing symptoms of a clinical disorder or condition.

Teens should also beware of completing online tests or quizzes provided by for-profit companies. A popular "childhood trauma test" that circulated on TikTok last year ended up being a way for a private company to capture user data and potentially share it with third parties.

Once a teen has completed a screener, Paredes recommends talking to a trusted adult about the results. While a minor will need parental permission to pursue a medical evaluation, they can still talk to a relative, coach, teacher, or another adult if they don't feel comfortable discussing the subject with their parents or caregivers.

When the screener doesn't indicate that a teen is experiencing a mental health condition, they should still consider talking about their concerns rather than dismissing them. In general, Paredes says "warmlines," or listening lines offering connection with trained peers and mental health advocates, can offer emotional support when a caller isn't in crisis. (The website warmline.org has a directory of warmlines by state.)

Where to Start, the new book authored by Mental Health America, also contains recommendations and worksheets for further exploring mental health challenges and treatment. Paredes is hopeful that it will give teens an alternative to troubleshooting their concerns online, where there's plenty of information but often little direction.

"The decision to maybe request help, and ask for help, and then ultimately receive help in some way — not just from a professional but from other folks in your life — that's the stuff that's not really shared on social," says Paredes. "We don't see that as often, but I would love to see that."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Parents paying close attention to news headlines would be justifiably worried about the risks of letting their adolescent or teen girl spend too much time online. The intense scrutiny that began in 2021 with explosive revelations about Meta's own internal research on female teen users has continued with government investigations into social media platforms that may, among other things, encourage young girls to compare themselves to peers and influencers in potentially harmful ways.

It's not that TikTok, Instagram, Snapchat, and other platforms are inherently bad. Or that parents can draw a straight line from a teen girl's constant scrolling to lower self-confidence or feelings of worthlessness. Instead, like many adults, girls can get caught up in a toxic swirl of social comparison, wanting to belong, and risky vulnerability.

This may be even more true for girls experiencing puberty at an earlier age than their mothers or grandmothers. That trend, which has seen puberty for girls around the world continue to happen earlier each decade, specifically puts girls at higher risk of developing depression, in addition to other mental health challenges. (Separately, early-onset puberty, or when puberty happens for girls prior to age 8, is a relatively uncommon condition.)

All of this is happening at an already delicate time in adolescent and teen girls' lives, during a phase when they're trying to develop a strong sense of self and the ability to deal with overwhelming feelings, as well as stitch together a safety net of fulfilling offline relationships. Aspects of the internet, particularly social media algorithms, can exploit some girls' insecurities, drawing them deeper into self-doubt or even exposing them to bullying and dangerous content, like radicalized political message boards and influencers who promote disordered eating.

Despite these very real fears, parents and caregivers can help girls thrive online by turning to well-known techniques, like rules for screen time and increased media literacy, as well as strategies that boost a girl's resiliency, which include praising a girl's positive behaviors and qualities and helping her build an offline life that gives her a sense of belonging and mattering.

Screen time guidance for teen girls

The most common guidance may sound familiar, but it bears repeating:

Model healthy internet use. Dr. Jason Nagata, an assistant professor of pediatrics in the division of adolescent and young adult medicine at the University of California at San Francisco, says that one of the most important predictors of how an adolescent uses screens is their parents' behavior. This means that parents need to respect whatever boundaries they've set for the household, including no texting at dinner, or putting phones away an hour before bedtime.

"If you're telling your kid one thing, and you're breaking those rules, they're not going to listen to you, or they're just going to emulate what they see," says Nagata, whose research in the Adolescent Brain Cognitive Development (ABCD) study has found links between screen use and binge-eating and disruptive behavior disorders in youth and teens.

Make sure screens aren't displacing healthy, enjoyable activities. Nagata says that screen time shouldn't lead to reduced in-person socializing, offline hobbies, physical activity, and sleep. Turning off notifications and taking social media breaks when screen time becomes stressful helps preserve time for other important activities, which creates a buffer against the negative messages girls may encounter online.

Talk about different challenging scenarios. Parents should have conversations with their children about how to handle various kinds of negative online experiences, like bullying and being targeted with weight-loss ads. Helping a teen problem-solve in advance can give girls an advantage in the future. Parents also shouldn't underestimate the role that peers and influencers play in girls' online lives, especially when it comes to body image.

Nagata often treats teen girls hospitalized with eating disorders, many of whom struggle to stop scanning their favorite social media accounts for weight-loss tips, even as they're receiving care. He also sees girls who develop an association between screen use and binge-eating disorders, which are more common than anorexia and restrictive food intake disorders. (Eating disorders occur in boys as well, and sometimes go undetected because of gendered stereotypes about who's most affected by such conditions.)

Nagata says that while there are some benefits for teens who use social media, like staying in touch with family and friends, others struggle in concerning ways.

"[I] think there are also teens who get stuck in some of these eating disorder or body image traps where they're constantly comparing themselves to others, and it can detrimentally affect their mental health," he says.

Helping girls cope with screen time and social media

In her book, Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media, science journalist Donna Jackson Nakazawa reiterates well-known advice about girls and screen use, but it's her focus on empowering girls in all areas of their lives that parents will find refreshingly helpful. These strategies include:

1. Protecting a girl's "in-between years."

From ages 7 to 13, between childhood and adolescence, girls are in a period known as the "in-between years." Nakazawa says that during this unique time, a girl's brain is still developing the ability to handle stress. Yet girls often face heightened pressure from parents (and other adults) to do well in school and extracurricular activities. If they're using social media a lot during this time, they're also invited to constantly compare themselves to others, take in peer feedback on social media posts, see advertisements related to body image, and watch young female peers present themselves in more mature or sexualized ways. And if a girl goes through puberty at a younger age while also experiencing high stress levels, this dynamic can be harmful.

"[W]hen puberty comes in early, the parts of the brain that help put social and emotional distress in proper context haven't yet wired and fired up," says Nakazawa.

She urges parents to thoughtfully guide girls through this developmental stage. This includes understanding how and when girls are exposed to stressful messaging. A smartwatch, for example, might seem like a good compromise instead of getting a phone, but Nakazawa points out that girls can often access the same apps and messaging platforms available on a smartphone. Instead of forbidding access to internet-enabled devices, Nakazawa recommends being aware of what a girl is seeing or doing on them, how that could exacerbate the normal challenges of the in-between years, and finding welcome ways to protect their well-being. Dedicated time for rest, physical activity, socializing, and intellectual exploration, with less emphasis on competition and performance, can provide a much-needed counterweight to online pressures.

2. Being someone a girl can talk to about hard things.

Teens may be notoriously fickle when it comes to confiding in their parents, but Nakazawa says it's worth the effort of consistently positioning themselves as an empathetic, nonjudgmental listener, including where online conflict is concerned. If a girl discovers she's the only person from her friend circle not to get a party invite, or if she becomes a victim of dogpiling for a comment she made online, she should be able to process such experiences with a calm parent or caregiver.

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"These are the kinds of discussions that happen during puberty and adolescence and childhood that really shape our child's sense of belonging and mattering," says Nakazawa. "You need to know how your child is feeling in today's world, in this onslaught, so that you can turn that into a conversation of connection and follow up on it."

Parents should do their best to make all hard conversations a positive experience for their daughter. An important element of this is ensuring her psychological safety during these chats, which Nakazawa describes in her book as an ability for a girl to "be insecure, imperfect, angry, confused, needy, anxious, or unhappy (or all of the above), and still be loved." Countless people online may insist that the opposite is true, but it can make a profound difference for a girl's mental health if her caregivers regularly offer to listen with unconditional support.

3. Noticing and praising a girl's positive behaviors and qualities.

Nakazawa says that noticing a girl's positive qualities — unrelated to her appearance or performance — is a powerful antidote against harsh peer criticism and self-judgment that can become common during adolescence. In fact, Nakazawa cites research showing that teens who face intense pressure to excel, and whose parents make it clear that their children have fallen short of high standards for grades, activities, and accomplishments, are at higher risk for depression and anxiety. When this dynamic collides with algorithms that encourage peer comparison, girls can feel like they're never good enough.

Parents can still set reasonable limits and expectations, but Nakazawa says they should be focused on helping their children cultivate resilience and feel connected to family and community. Instead of critically evaluating their child's performance, Nakazawa encourages parents to praise their positive character traits and virtues. Her examples include phrases like, "One of the things I love about you is that you are so thoughtful to your friends," or "I notice the way you always follow through on things. That takes a lot of effort, and it's a wonderful quality."

4. Helping girls create their own in-person community.

Supporting a girl as she builds her own community is one of the most important things a parent can do, says Nakazawa. She refers to this as the "community effect," wherein girls develop meaningful relationships with adults like grandparents, coaches, teachers, mentors, and even a therapist or healing professional. Nakazawa says these relationships give girls the sense that they're safe, and have a place, in a larger community. They also help girls feel like they matter. Belonging is a key protective factor against psychological distress, including suicidal thinking, and it may help lessen the pain related to negative online experiences.

Parents should also help a girl explore her interests in the context of her community. Whether that's gardening, science, running, or spirituality, it's important for girls to develop a sense of purpose and joy during the in-between years. It helps when girls can do this in relationship with their friends and peers. Moderate screen time can certainly make this process more exciting by introducing girls to online resources and communities, but parents can help focus their child's passion on confidence-building in-person activities.

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Encouraging girls to make their offline community more engaging than their online world may create a buffer against excessive screen time, and help them put upsetting online experiences into perspective.

"There are so many ways to [help a girl build community] if we just put the phones down as adults and go looking for all of those different invitations by noticing what really gets our daughter excited, and following that spark with real people, in real time, in our real communities," says Nakazawa.

If your child is feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources. If you'd like to talk to someone about your child's eating behavior, call the National Eating Disorder Association’s helpline at 800-931-2237.

This story, originally published in September 2022, was updated in May 2023.

YouTube announced Tuesday that it's updating the video platform's approach to eating disorder content.

YouTube, which is owned by Google, said in a statement that its community guidelines will now prohibit material that features imitable behavior. The move is designed to limit viewers' exposure to videos that show or describe certain disordered eating behaviors, like severe calorie restriction or purging.

YouTube worked with experts at the National Eating Disorders Association (NEDA) and other organizations to identify behaviors most likely to influence at-risk viewers. The new policies expand on existing guidelines that remove content that glorifies or promotes eating disorders.

The updated guidelines also implement age restrictions for content that discusses disordered eating in the context of recovery. While this content may appear in an educational, documentary, scientific, or artistic format, it will not be viewable for those under 18, or to users who are signed out. Additionally, such videos embedded on another website will not play.

YouTube said it sought to "strike the right balance" between protecting younger viewers from behaviors they may try to imitate and making it possible for creators to document their experiences with eating disorder recovery.

"YouTube is an important platform for raising awareness and understanding of mental health issues like eating disorders, and we want to continue empowering creators to share their stories," Dr. Garth Graham, director of health partnerships at YouTube, said in a statement. "We believe this approach, informed by third-party experts, creates space for community and recovery while protecting viewers."

While crisis resource panels, which contain referral information for people seeking help or treatment, currently appear in search results, YouTube's new approach will now include placing the same information under videos related to eating disorders in several countries, including the United States, United Kingdom, Mexico, and France.

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YouTube said the new policies will take time to implement and may not be immediately noticeable.

NEDA applauded YouTube's announcement, noting in a statement that the video platform notched over 1.4 billion views related to mental health content in the U.S., in 2021.

In collaboration with YouTube, the nonprofit organization recently launched a year-long series on its own YouTube channel that focuses on eating disorder information and lived experience. The earlier a person with an eating disorder seeks and receives treatment, the likelihood that they'll have a physical and emotional recovery increases, according to NEDA.

"Video content is a compelling way to reach people online, and so we’re heartened by the further concrete actions being taken by YouTube to mitigate harm and help counteract content that can lead to an eating disorder," said Sarah Chase, vice president of communication for NEDA.

If you feel like you'd like to talk to someone about your eating behavior, call the National Eating Disorder Association's helpline at 800-931-2237. You can also text "NEDA" to 741-741 to be connected with a trained volunteer at the Crisis Text Line or visit the nonprofit's website for more information.

The toughest part of a project, for me, is sorting through overwhelming chaos in my mind to take the very first step. I'm not a firbolg cleric, I'm a person with Attention Deficit Hyperactivity Disorder (ADHD) aspiring to role-play in Dungeons & Dragons as one, and before I called on OpenAI's ChatGPT for help I was frozen, staring at a blank character sheet and unsure where to begin.

ADHD, a condition estimated to affect 4.4 percent of U.S. adults, typically is characterized by a cluster of issues: inattention, impulsive behaviors, and hyperactivity. I was diagnosed earlier this year, in my late 30s, with the inattentive type, and I'm constantly fighting with myself to avoid side quests.

My diagnosis was made just as generative AI tools like the ChatGPT chatbot became accessible to the public and the world clambered to explore their uses. While browsing the r/ADHD subreddit for ideas on how to work with my brain a little bit better, I saw a few people praising the chatbot's potential as a tool to improve executive function — using ChatGPT to sort through email backlogs and generate professional-sounding responses, organizing prioritized to-do lists, and overcoming ADHD paralysis, a common symptom of ADHD marked by an inability to function effectively.

To test this out for myself, I prompted ChatGPT to help me complete a task I've been putting off: creating an original playable character for a tabletop role-playing game.

Rolling with a ChatGPT advantage

While I knew I wanted to create a firbolg cleric and had given thought to themes and motivations, I was overwhelmed by the prospect of producing a comprehensive character sheet that tracks everything from the character's name, to the items they carry, their individual attribute scores, and other important details that make the game come alive. I've had trouble concentrating on this undertaking even while using online character builders like D&D Beyond. Although this is a task I have done before, I found myself preferring to retreat back into the comfortable zone of vaguely imagining the outline of this character, rather than actually doing the work of making them playable in a specific campaign.

ChatGPT was most helpful when I asked it to help me organize my thoughts and stay focused while brainstorming my character's basic outline, taking each field one at a time. When I asked the chatbot to detail relevant domains for my cleric (vital characteristics related to abilities, spells, and areas of influence) with pros and cons for each choice, the result was a basic but accurate list that more or less aligned with my own previous research. ChatGPT asked me good, if generic, questions that served as writing prompts for this character, which allowed me to give focused thought to how I might represent them within the mechanics of the game.

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The end result was a perfectly serviceable sketch of a firbolg nature cleric who was struggling to understand the conflicting values of two beloved mentors. ChatGPT was even able to conduct a short but cogent dialogue role-play with me, with the AI serving as a Game Master (GM), so that I could try out a couple personality choices and dialogue styles.

At this point, I felt better prepared to complete creating the character, ideally in conversation with a real human GM, having made some key decisions and given some thought to how those choices might translate into the game itself. But when I asked ChatGPT to help me deepen my research on firbolgs, a fictional race of giant-like creatures with a culture that draws substantially from Celtic folklore, the chatbot briefly lost its "mind."

A disappointing history check

After talking through my character with ChatGPT, I asked, "I'd like to research the real-life inspiration for the firbolg character. Can you give me some sources I could read or contact about the role of Celtic culture in Dungeons & Dragons?"

For its first attempt, ChatGPT provided me with a list of five suggestions, including articles that appeared to be misidentified or inaccessible online. The first suggestion pointed to a scholarly publication I could not track down, which, upon further prompting, ChatGPT clarified was a book, not a journal — but I could not find any published work matching the citation provided. When I asked ChatGPT for links to the resources it recommended, including an Atlas Obscura article and a piece from the official Dungeons & Dragons site, I was provided with a series of dead ends, including broken links and titles of out-of-print materials.

When I repeated my initial question, regenerating responses several times, the results were somewhat better. Not every recommendation appeared to be fully accurate information, but the chatbot did point me to a few readily available reference books on Celtic folklore, and listed some relevant scholars. However, in one manual Google search, I was able to find a collection of much more helpful, pertinent articles and resources.

Generative AI generates. When you struggle to overcome the terror of a blank sheet, tools like ChatGPT can be enormously helpful in opening the gates to creative work. But as many others have noted, tools like ChatGPT have not demonstrated that they deserve your trust.

Getting to the encounter

Generative AI-powered chatbots like ChatGPT and Google's Bard are the center of conversations these days about the future of tech, ranging from professional applications, to the arts, to travel, accessibility, and more. Said conversations are evolving as fast as the technology itself, with evangelists promoting hype about how generative AI is about to revolutionize and dominate everything from education to creative expression to software development, and others warning against rushing to give these brand new tools critical responsibilities.

Indeed, many of the central problems of the current tech landscape (including bias and exploitation) appear to be simply replicated in this newest generation of technology. And, there are huge privacy issues with using a bot — designed to absorb and share data it's provided — to handle sensitive medical information. Still, experts see some potential in these tools for people with ADHD, so long as there's an understanding of what they can and cannot do.

"Probably the most powerful aspect of it related to ADHD is going to be in overcoming procrastination," said Lara Honos-Webb, a clinical psychologist who specializes in Attention Deficit Disorder (ADD) and ADHD and is the co-founder of a startup aimed at helping those managing ADHD. Honos-Webb said that she'd been playing around with ChatGPT herself, and believes that it could have beneficial applications for some with the disorder, particularly with the inattentive subtype. 

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In addition to organizing thoughts, Honos-Webb said, ChatGPT might also come in handy as a memory device, since the tool can log past conversations and generate a topical label for them. So you could, for instance, brainstorm in a chat with ChatGPT as if you were talking to a friend or a peer in your industry. The chat itself would then become your conversation notes.

Using it might also help reduce distractions, Honos-Webb added. As someone whose tab count on my phone's browser has long read "99+" I can see the appeal of having one single interface for looking things up. The problem is, that information isn't always going to be correct, relevant, or complete.

For Brayden Motion, a 23-year-old software developer with ADHD who dabbles in music and creative writing, ChatGPT has been a helpful assistant for generating ideas and how-to guides. People with ADHD can struggle to stick to new activities, Motion noted, especially when excellence at a hobby or career choice takes planning and work — as most do. 

"You can ask ChatGPT how to accomplish something such as writing a novel or creating a successful company and get an outline of the entire process," Motion said. "I have also used ChatGPT to find what jobs or careers would best suit me based on my individual needs and ADHD symptoms."

He's found ChatGPT to be really useful, but only as a guide. "When I realized I could use ChatGPT to break down tasks for me, I expected a huge shift in my life," he said. "But it turns out you still need to put in the work in your daily life! Who would've thought?"

Clearing the way for my own spellcasting

There is another, particular risk for people with ADHD leaning too hard on tools like this — the temptation to push procrastination even further. Before getting to step one of my firbolg design process, I was distracted time and time again: I was thirsty, so I grabbed a glass of water. On the way back to my seat, I noticed that the stairs needed to be vacuumed. As I cleaned, I began to think of all the other things I needed to do: plant flowers outside, update my insurance information at the pharmacy... Where did I put my water glass?

As Honos-Webb noted to me, many people with ADHD like to test limits — how long can I delay starting on this task and get away with it? ChatGPT may provide the illusion of a solution here, by producing outlines, direction, and even full essays for, say, that term paper due in 12 hours. While the ChatGPT answer might sound good, these tools repeatedly have been caught in the act of making up academic sources and confidently stating nonsense as fact. And that's not even getting into the chatbot's potential for facilitating plagiarism.

That said, when I leaned on ChatGPT for a prioritized to-do list to organize the tasks cluttering my brain, it was extremely helpful in breaking through the chaos to allow me to take action on each of these items. But the most important limitation was one I kept asking myself about while endlessly searching for ADHD "hacks" and hoping for a nice, focused day after one conversation with an AI bot: Just what is ChatGPT "improving" about someone with ADHD anyway?

Honos-Webb's research has focused on the strengths of the condition, the flip sides of struggling with emotional regulation, factual memorization, and attention to detail, to name a few common symptoms of ADHD. Tools like ChatGPT might help a person struggling with related tasks to stay on track, save time, and work within the systems that govern many workplace and interpersonal interactions, but that leaves it far from being a cure-all. 

"When you think about AI, it's going to help patch up the weaknesses of people in the realms of inattention, lack of focus and organization, and procrastination," she said. That could go a long way in clearing a path that allows a person with ADHD's gifts to shine.

Honos-Webb emphasized the connection between people with ADHD and creativity, emotional intensity, and sensitivity as one that can be embraced as benefits that balance the struggles with executive function. AI, she noted, cannot really replicate any of these things.

As tempting as it is to think of ChatGPT as a path for self-actualizing a chaotic brain, that framework assumes that the most valuable human skills are the ones that AI can augment through structure and lists. But humans are so much more than a tool to be optimized.

In addition to medication, I use a growing arsenal of technologies and tactics to manage my ADHD: a Kobo reader for taking and organizing notes, project management tools, and synced calendars to try to stay on track, among others. I could see ChatGPT, or tools like it, becoming a part of that mix, to help people like me complete routine tasks that can become burdensome or overwhelming, and to overcome paralysis by generating starting points for creative thought.

However, its middling attempts at replicating some of the things I'm good at, like idea generation and in-depth research, are clumsy at best and problematically inaccurate at worst. Instead, the most helpful thing ChatGPT could do for me is to clear the fog of ADHD paralysis, then step aside and let the human creativity flow.

Sometimes the best way a teen can share their feelings, or acknowledge their mental health, is through a favorite song.

This maxim of adolescence is the basis for "Sound It Out: When You Can't Say It, Play It," a new campaign partnership between the Ad Council and Amazon that aims to help parents and caregivers find a common language — music — with their teens.

Debuting Thursday, the campaign leverages Amazon's vast music library of over 100 million songs and a new interactive tool that pairs key emotions with corresponding tracks, many of them recognizable hits like Coldplay's "Fix You," Billie Eilish's "Lovely," and Selena Gomez's "Me and My Mind."

Parents who notice that their child is struggling but can't quite break through typical teen resistance to exploring their feelings through conversation might use the interactive tool to search for and share an appropriate song, with a simple prompt like, "Talk later?" or "Everyone can feel sad sometimes."

The tool is available in both English and Spanish. A two-minute film that accompanies the campaign features a Spanish-speaking mother and daughter navigating tough emotions and using the interactive tool.

"Our goal is to help parents and caregivers support their kids' emotional well-being, especially through those turbulent preteen and teen years. This new tool from Amazon will open up the conversation for families through one of the most powerful emotional associations we have: music," Heidi Arthur, chief campaign development officer of the Ad Council, told Mashable in a statement. "We know this digital experience will help spark some powerful and important talks."

The interactive tool is the latest effort by the Ad Council's Sound It Out campaign to help parents and caregivers talk to teens about their feelings and mental health. Additionally, the Seize the Awkward campaign, which launched in 2018, is designed to help teens and young adults learn how to ask friends about their well-being.

The new tool comes in the wake of heightened emotional and mental health distress amongst teens. A recent report from the Centers for Disease Control and Prevention (CDC) revealed that, in 2021, teen girls experienced record levels of sexual violence and sadness, and that three quarters of LGBQ+ teens expressed persistent feelings of sadness or hopelessness, with nearly one in four LGBQ+ teens reporting a suicide attempt.

When parents use Sound It Out's interactive tool, they can search for emotions like afraid, confused, inspired, heartbroken, and happy. Those emotions will yield song matches like "Breathin" by Ariana Grande, "Ordinary People" by John Legend, "Girl on Fire" by Alicia Keys, "Call Out My Name" by The Weeknd, and "Good Feeling" by Flo Rida.

Once parents know which song they'd like to send, they can ask Alexa through an Echo device or the free Alexa app to share it with their teen, who will receive a notification within the app. The teen can listen to the song at their convenience, and the song can then be played on any Alexa-enabled device on Amazon Music's free, Prime, or Unlimited plans. Alexa must be enabled to use the tool. Amazon is not collecting personal user data on the campaign's landing page, which includes the interactive tool.

In addition to the interactive tool, the campaign has a website dedicated to helping parents and caregivers start meaningful conversations about emotional well-being with their teens. A "conversation starter pack" offers prompts to help parents and teens talk about subjects like their favorite musical artist, who they consider their closest friends and family members, and what's been making them sad or happy lately. A separate guide to emotions offers basic information for topics including sadness, sexuality, racism, and grief, and offers suggestions for starting related conversations with a teen.

"The Ad Council’s initiative to create open, accepting, and proactive discussions around mental health resonates with our goals to do better and be better for our customers, employees, and communities," Alan Moss, vice president of Global Advertising Sales at Amazon, said in a statement. "Music has always been a vehicle for connection, and 'Sound It Out: When You Can't Say It, Play It' provides parents and caregivers with another tool to check in with their teens."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

When Sam Norpel became ill with COVID in December 2021, she worked through the infection to meet a deadline. The former chief digital officer had a product to launch and no time to waste.

Norpel met the deadline by working from bed, but her life became unrecognizable.

A few months later, now debilitated and bedridden by long COVID, the 48-year-old mother of three and family breadwinner confronted an unfamiliar foe: suicidal thoughts. First, a malicious idea crossed her mind. Why hadn't COVID just killed her, she wondered, as financial concerns mounted and chronic pain persisted. That thought faded as her health improved.

But months later, following worsened neurological symptoms that preceded a diagnosis of mild cognitive impairment, she experienced specific suicidal thoughts that felt far more insidious.

"It was that my whole identity was fractured," says Norpel.

A loving text from her teenage son, sent unwittingly at precisely the right time, helped alleviate the intensity of Norpel's thoughts. So did an exchange with another long COVID survivor who reached out to her online, and who also felt suicidal. For the first time in a while, Norpel felt useful as she offered empathy. She had missed feeling like her life had meaning.

Norpel's experience isn't anomalous. On Facebook, Twitter, and in other online groups and communities built by long COVID survivors, the topic often comes up, either in public conversations or direct messages. As pandemic emergency declarations expire, long COVID patients say it feels like they're being left behind, without the financial, medical, and mental health resources to navigate their chronic illness — and the despair that can accompany it. But survivors interviewed by Mashable say that the empathetic connections found in their online communities offer a refuge from suicidal feelings, give them elusive hope, and help restore their sense of purpose.

Long COVID, suicide, and online communities

Though suicide is complex and caused by multiple factors, the possibility that long COVID increases risk is concerning given that an estimated 11 percent of the U.S. adult population currently has long COVID, broadly defined as signs, symptoms, and conditions that continue or develop after the initial phase of COVID infection.

Serious illness, including chronic disease, is a risk factor for suicide. But so are other experiences that commonly occur in long COVID's wake, including unemployment, relationship troubles, financial strain, and social isolation. Some survivors lose health insurance, or never had it, and can't access mental or physical healthcare, which is another risk factor for suicide.

Research also suggests that brain inflammation, which COVID can cause, may increase a person's risk for depression and suicidal thinking. Indeed, one preliminary study found that long COVID may be associated with suicide risk and concluded that "psychiatric disorders and suicide risk should be systematically assessed in patients with long COVID."

While there are long COVID patients who don't contemplate suicide, many with severe or debilitating long COVID describe how the illness suddenly destroys their carefully built lives. Some have no prior experience with mental illness, much less with suicidal thoughts, and feel afraid as they struggle to process these feelings. When they confide in each other, the effect can be lifesaving.

The prominent suicide death of former television writer Heidi Ferrer, who had experienced long COVID, drew attention to the possibility of heightened risk when it became public in June 2021. In the public Survivor Corps Facebook group, where Ferrer was a member, people routinely respond with kindness and understanding to posters who, plagued by debilitating symptoms, feel they can't go on. Dozens of replies effectively say, in unison, "We've been there, too — just hold on." Some post contact information for the 988 Suicide and Crisis Lifeline, or other crisis lines. The group currently escalates explicitly suicidal posts to Facebook's moderation team, which reviews them and may reach out to the poster with resources.

Survivor Corps founder Diana Güthe calls the group of nearly 200,000 people the "epicenter of hope" for long COVID patients. But as Survivor Corps, the nonprofit organization, winds down its official activities for lack of funding, it will also stop paying moderators to manage the Facebook group, leaving uncertainty about how it will continue given that each post is personally pre-approved.

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A separate, much smaller and private Facebook group run on behalf of the federal Disaster Distress Helpline also offers a peer support community for long COVID patients, as do several other private Facebook groups. Many long COVID survivors find support groups like these by luck, either seeking them out online or by receiving treatment at long COVID clinics, which typically have lengthy waiting lists.

The Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center at Vanderbilt University Medical Center effectively became a long COVID clinic during the pandemic and hosts several weekly video support groups. Current members live across the U.S., and receiving care at CIBS isn't a requirement to join, but the waitlist is currently 50 people long.

"When you look over the long COVID landscape it can feel very hopeless," says Dr. James C. Jackson, a neuropsychologist at Vanderbilt University Medical Center who runs the support groups and notes that members talk about positive developments like improved symptoms or becoming more resilient. "So to be in a community with people where you're hearing stories of overcoming...it really adds a lot of hope."

Finding support from other long COVID survivors

Jackson says that in addition to chronic health issues, survivors grapple with day-to-day uncertainty about their well-being, livelihood, and future; medical professionals who may not believe, or cannot say, that there's anything wrong; social isolation because they're housebound or fear getting infected again; and, overall, a total dismantling of their identity.

"Part of the dynamic is life gets turned on its head pretty quickly for these folks and they don't know how to make sense of it," says Jackson, author of the forthcoming book Clearing the Fog: From Surviving to Thriving with Long Covid—A Practical Guide.

Three of the CIBS support group's members interviewed by Mashable, who requested anonymity to protect their privacy, say participating is vital for their mental health.

Marie, 57, lived with depression and anxiety that were treated with medication and therapy, but she never experienced suicidal thoughts prior to being hospitalized with COVID in March 2020. Among other medical conditions, she now has cognitive impairment, constant fatigue, and postural orthostatic tachycardia syndrome (POTS), a blood circulation disorder that can cause lightheadedness, fainting, and rapid heartbeat.

"I had a life that died, and I was like born again with this long COVID," she says.

While long COVID exacerbated Marie's depression and anxiety, the arrival of suicidal thoughts still came as a "scary" shock. But when she told the group she was spiraling, others provided a "lifeline" through their understanding and compassion, Marie says. When she came close to acting on her suicidal thoughts last fall, Marie sought Jackson's help and checked into a weeklong inpatient psychiatric program at Vanderbilt University Medical Center, a decision she describes as the "hardest but best thing in my life."

Suzanne, 46, says that every long COVID survivor should have access to a support group like the one offered through CIBS. Suzanne, whose husband of 20 years died of his COVID infection, experiences POTS, migraines, cognitive impairment, fatigue, and joint and muscle pain, among other health issues. For the past year and a half, she's brought her concerns to meetings and has never felt gaslit or dismissed. She also finds it rewarding to support others.

Alex, a 23-year-old former competitive runner who surrendered his dreams of a career in the sport after contracting long COVID, experiences unpredictable flares in his symptoms, which also come with intense waves of depression, anxiety, and, sometimes, suicidal thinking. He says that the group rallies around members "going through the ringer," which makes him feel less alone.

"This community kind of rises together to hold this person up when they can no longer hold themselves up," says Alex.

Seeking solutions for long COVID and suicide

For Sam Norpel, the second bout of suicidal thoughts, about a year after her COVID infection, convinced her to share those feelings with her medical care team. She also told close family members how badly she was struggling, despite improvements to her physical health.

Though she experiences speech issues, migraines, chronic fatigue and pain, and dysautonomia, a term used to describe problems with the body's autonomic nervous system, Norpel has joined the board of the nonprofit organization Pandemic Patients, in a limited capacity. She says this work, along with continuing to communicate online with other survivors, gives her a long-missing sense of purpose.

Dr. Doreen Marshall, vice president of mission engagement for the American Foundation for Suicide Prevention, says that hearing survivors' stories is critical to understanding how best to support them. She emphasizes that experiencing suicidal thoughts for the first time can be confusing and frightening. People may feel ashamed of having those thoughts. But she encourages survivors to think of suicidal feelings, which involve the brain, like any other health indicator that suggests something isn't functioning optimally, such as high blood pressure.

While Marshall says there's not enough research to demonstrate a link between long COVID and heightened suicide risk, she says it's important that survivors do not suffer alone, and that employers and policymakers meaningfully address and support patients' mental health. Friends and family can also play a crucial role by checking in with loved ones who have long COVID, including asking if they're having thoughts about suicide if they notice talk of hopelessness, feeling like a burden, or sudden changes in mood or behavior.

"These kinds of illnesses are often invisible to other people...most people look at someone and do not realize they may be struggling with long COVID symptoms, and particularly mental health symptoms as a result," she says.

Marshall recommends that survivors experiencing intense suicidal thoughts contact a crisis line. While some survivors express skepticism about hotlines, partly fearing that those on the other end won't believe long COVID is real, Crisis Text Line and the 988 Suicide and Crisis Lifeline told Mashable that their staff are ready to offer support. Crisis Text Line provides its volunteers with separate tip sheets about chronic pain and the long-lasting effects of COVID. The 988 Suicide and Crisis Lifeline has resources related to COVID's impact on families, mental health, and managing relationships.

Dr. Jessi Gold, a psychiatrist and an assistant professor in the department of psychiatry at Washington University School of Medicine whose patients include those experiencing long COVID, says healthcare professionals should act with more sensitivity and compassion toward survivors. While mental healthcare can be very helpful for patients, Gold says physicians should resist the impulse to send them to a therapist solely because medical tests haven't pointed to a conclusive physical diagnosis. Gold says simply telling patients, "I don't know what this is, but I believe you," would be far better than indicating that their physical symptoms are essentially "all in their head."

"A lot of people turn to the internet and peer support communities because they want to know they're not alone," she says. "They want to know that people see them and believe them. A lot of times that comes from peers, and doesn't come from medicine."

At Vanderbilt University Medical Center, Jackson, who is also a research professor of medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine, works with patients and support group members to identify what aspects of their condition they can live with, even if they'd rather not. Using treatment known as Acceptance and Commitment Therapy, the aim is to lessen their emotional reactivity and find a way to "co-exist" with a certain level of discomfort or pain.

Support group member Suzanne has found this strategy helpful: "COVID and the devastation it leaves behind is definitely unmeasurable. But just trying to practice acceptance is not the same as giving up, or giving in, either."

Jackson also teaches a strategy called "unhooking" wherein patients note thoughts that steal their focus and sap their hope, like the thought that things will never get better. Instead of becoming swept up in their implications, patients learn to simply observe them. And Jackson urges survivors to find and embrace the parts of themselves, from before the infection, that still exist.

Marie knows she doesn't want to end her life, but the side of her brain "that isn't quite working right" can insist otherwise in her darkest moments, which is why support from other long COVID survivors has been so critical to her survival.

"You're just at the end of your rope," she says, "and you need someone to help you at the end of that rope."

UPDATE: Apr. 1, 2023, 11:23 a.m. EDT This story has been updated to correct an error in Dr. Jessi Gold's quote. Her statement was about the role of peer support communities, not patient-supported communities.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Dese’Rae L. Stage keeps a list of things that make her happy. It includes going to the movies alone, walking around with a giant cup of coffee, and regular Zoom chats with her best friends who live too far away to meet up with in person. She learned a long time ago, after attempting suicide, that gratifying distractions and reminders of life's small pleasures might save her in a moment of crisis.

Stage knows that even if a person once attempted or contemplated suicide, it doesn't mean that's how their life will end. She knows this because she's a living example. She's also the creator of Live Through This, an initiative that documents the portraits and stories of suicide attempt survivors. Stage has interviewed 188 people in 37 cities across the U.S. who once tried to end their lives but didn't.

The popular perception of suicide — that it's unstoppable once the idea takes root — doesn't reflect the reality that Stage and so many other survivors know. Indeed, nine out of 10 people who attempt to take their own lives and survive do not ultimately die by suicide, according to research.

"I don’t think I’ll ever be cured of my suicidal thoughts, but I also don’t think I’ll take my life," Stage says. "There's a lot of room for growth and movement past the suicidality even if it’s something that occurs several times over a lifetime."

Stage says that coping with suicidal thoughts can get easier with time, particularly once a person develops a set of skills to help manage negative or volatile emotions. Safety planning and creating a support network make a critical difference.

It's also important to remember that not everyone who becomes suicidal has an obvious or diagnosed mental illness, says Stage. The Centers for Disease Control and Prevention found that more than half of those who died by suicide between 1999 and 2016 didn't have a known mental health condition. (Those without a known mental health condition were more likely to be men and died by firearm.)

Stage says we tend to associate suicide strictly with mental illness and overlook other known factors related to trauma and adversity, including relationship problems, substance use, financial struggles, health issues, and sudden crises.

"This is just life, not mental illness," she says. "[T]he truth is that any of us could end up in that place."

Stage hopes that Live Through This will change the stories we tell each other and ourselves about why people attempt and die by suicide. It's also a community of survivors who support each other privately, often in a Facebook group designated only for those who've participated in Live Through This.

Mashable asked Stage if members of the Live Through This Facebook group would share their reasons for living.

You can read their hopeful answers here:

1. I stay because I discovered I’m not ready to go. — Lex Tobin

2. I stay because living and loving are not possible if I am gone. I would miss all of this senseless beauty. Making the world a better place for my granddaughters is worth any pain. — Cheryl Sharp

3. I stay because I'm now in a unique position to educate, advocate, offer hope, and save lives. [Two] specifically that I know of. — Liz Mitchell

4. A dear friend’s brother died by suicide several years ago. The memory of his funeral — of the intense singular suffering that comes with losing a loved one to suicide — has kept me from ever attempting suicide again. No matter how bad my depression gets, I know that there are people who would be devastated if they lost me, and when it’s too hard for me to live for myself, when every cell in my body wants to give up, I tell myself that I will keep living for them, and I do. And bonus: Eventually the depression lifts, because with time it always lifts, and I’m able to start living for myself again as well. — Melody Moezzi

5. I feel like overcoming a lot has put me in a position where I'm able to help people. At this point, I feel like one of my purposes in life is to educate people on suicide via a lived experience perspective — something I feel we don't see enough of. That keeps me going if I have bad days. —Caitlin Coleman

6. I stay for my dog, I stay for my family, I stay to see what I’ll create next. — Logan

7. I stayed for my sisters, my grandparents, and I eventually came to accept, I stayed for me. — N.P.

8. I stayed for myself and for my kids who accepted me as their mom with all my flaws and my talent! — Nancy Nettles

9. I stay because my students deserve an adult who always puts them first and fights for their well-being. — Marie

10. I stay because if I leave, what is my story going to tell? I want to be stronger than that. I want to be more vulnerable with the precious friends and family around me. I want those people that are feeling the way I have felt, to know that things can get better. To know it’s OK to ask for help even if it seems stupid. To realize that maybe one day you’ll find what you are looking for, but even if you don’t, things will be OK. You can take a few wrong turns and find out that life still turns out OK. I want to have a story. Not one cut short by frustration. — Cayla

11. I stay because that's the natural course I'd rather follow. When I feel differently, I get help from the people who know the struggle. — MSB

12. I stay because there are so many more adventures to be had and so many fires of hope in people's souls to ignite. — Rhianna Brand

13. I don't have one big reason. Instead, I have thousands of little reasons, ranging from family and friends to the episodes of Bob's Burgers I won't get to see. Each reason, no matter how small, is an act of resistance that my suicidal thoughts would have to knock down. It's sort of a way of passing time to ride it through. — Alyse Ruriani

14. I stay because I finally found long-term happiness. While it was terrifying to realize that I now had to relearn how to function as a happy person, it was worth it all. I stay because I want people to know of all the things I live with, and have lived through, and see that I am not only still here, but I am truly happy. I stayed to be a source of hope to those facing situations like mine; for those who feel forgotten and alone. — Cecelia Markow

15. I was given a second chance at life so I stay because 1) I want to honor the people who saved my life and 2) I'm stubborn. — Tina Aspegren

16. I stay because life is full of beautiful surprises that I can't even fathom yet. I know there will be pain too, but I've learned to cope so much better. I think of all I would've missed out on if my attempt was successful, the most important that I never would've been an aunt and watch my nieces grow. I stay so they will have me to support them. — Melanie Demoree

17. I stay with the help of my service dog, Hero. Medicines don't work and I was going to give up until he came along. — Megan Alldredge

18. I chose to stay so that I could have the opportunity to help others choose life over suicide. — Teagan Kempe

19. I stay for the loves of my life (boyfriend and dog) and for the adventure of writing. And [because] when I stay, I can help others to stay as well. — Jen Karner

20. I choose to stay for my two cats, the people I love and hold dear, the next gorgeous sunrise and epic thunderstorm, and the next good book or awesome cup of tea. The biggest reason I choose to stay is because I'm not ready to choose to go. — Ashley Shoemaker

21. I'm not who I thought I was. I want to stick around and find out who I become. — Paul Currington

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Stage includes the following additional information about crisis and warmlines on Live Through This: "Many of these resources utilize restrictive interventions, like active rescues (wellness or welfare checks) involving law enforcement or emergency services. If this is a concern for you, you can ask if this is a possibility at any point in your conversation. Trans Lifeline does not implement restrictive interventions for suicidal people without express consent. A warmline is also less likely to do this, but you may want to double-check their policies."

UPDATE: Mar. 20, 2023, 4:31 p.m. EDT This story was originally published on Sept. 10, 2018, in recognition of World Suicide Prevention Day and was updated in March 2023.

At one San Francisco hospital, it's not uncommon for teens hospitalized with an eating disorder to surreptitiously use their phones to find weight-loss tips on social media. A psychologist who treats children in an Ohio primary care office hears from anxious or depressed patients who go online for fun only to encounter harmful content, like racial slurs in the public chat of the video game they play with friends. Suicidal teens receiving outpatient treatment at a Dallas hospital say their time spent on screens has included experiences like feeling left out or bullied, or being exposed to violence and self-harming behaviors. 

Interviewed by Mashable, these doctors on the frontlines of the teen mental health crisis are quick to say that social media and screen use aren't universally bad for their patients. Indeed, they can connect teens to friends and fulfilling activities. 

But even if the research on screen time and youth mental health is inconsistent, the worst-case scenarios illustrate how digital technology can help push teens into a downward spiral. Excessive or harmful screen time may act like an accelerant when combined with other risk factors for anxiety, depression, and suicide, which include chronic stress and trauma, drug or alcohol use, bullying violence, discrimination, and economic insecurity.

A recent report from the Centers for Disease Control and Prevention (CDC) revealed that, in 2021, teen girls experienced record levels of sexual violence and sadness, and that three quarters of LGBQ+ teens expressed persistent feelings of sadness or hopelessness, with nearly one in four LGBQ+ teens reporting a suicide attempt. Some argued that these trends, particularly amongst girls, could be partly traced back to the advent of smartphones and the sophistication of social media algorithms.

As political and consumer pressure mounts on social media companies like TikTok, YouTube, and Instagram to better protect youth from negative online experiences, parents are desperately searching for ways to let their teens enjoy the internet without becoming ensnared in the dark side of digital life. This week, TikTok announced that it would begin rolling out a 60-minute daily screen time limit for accounts belonging to users younger than 18. Once they reach that limit, they must enter a passcode to continue, a loophole that teens could easily exploit.  

While the policy change was welcomed by the doctors Mashable interviewed, they also emphasized that parents can't count solely on these measures and trust that their children will be OK online. Instead, they need to better understand what content is being recommended to their teens by social media algorithms, what potentially unhealthy "norms" they're being exposed to online, and what they can do to boost their own family's connectedness as a bulwark against negative online experiences.   

Dr. Ariana Hoet, a pediatric psychologist at Nationwide Children’s Hospital in Columbus, Ohio, knows that parents come to this challenge with their own strengths, whether that's clear values, deep ties to their community, or strong family relationships. But she also understands the tremendous pressure they're under to meet their kids' basic needs and deal with other problems. Sometimes, it's easier to let a teen have free rein of their screens in the midst of that chaos, but Hoet cautions against that approach. 

"Adults have a hard time" managing their own screen time, she points out. "Kids with a developing frontal lobe going against these machines and algorithms that are meant to hook you in, they're going to lose." 

"You're always on, you're being watched" 

Hoet, clinical director for On Our Sleeves, a national movement for children's mental health, typically sees Latino and Somali youth in her primary care clinic. Though youth mental health had declined nationwide prior to the pandemic, like other psychologists Hoet saw an increase in mood disorders amongst children 8 and older, beginning in 2020. 

During the pandemic, screen time surged for youth. One study found that 12- to 13-year-old youth spent twice the amount of minutes on non-school-related screen time, or 7.7 hours per day, than prior to the pandemic, with Black, Latino, and low-income youth reporting higher usage than their white, wealthier peers. 

For many of Hoet's patients, digital connectivity is like a metronome in their heads. Even if their screen time is often positive, they've developed hyper-awareness of how they're perceived online. 

"You are always on, you're being watched," says Hoet, describing how patients talk about their online lives. "A lot of kids view themselves as a brand, and they focus on that brand and how they're presenting themselves to others. That's a lot of pressure. That's a lot of stress 24/7."

This pressure may not be obvious to parents, who see their children texting with friends, posting funny TikToks, and exploring their interests on YouTube. But feeling like they can never turn off could be eroding their teens' confidence or overwhelming their developing brain. These same teens might also be dealing with violence in their community or economic insecurity at home, and relying on their phones to provide an escape — a coping strategy that can become problematic. 

Once teens start to feel something is amiss with their mental health, they might search the internet for symptoms and a diagnosis, which only leads to more stress and anxiety. Hoet says she frequently talks to patients who've decided they have bipolar disorder or obsessive-compulsive disorder based on information they found online. Hoet can help debunk misinformation or clarify their diagnosis, but she knows there are plenty of teens who are convinced they have severe mental illness but never talk to a therapist or mental health professional. 

Hoet says that parents can help relieve some of these pressures for teens by looking for ways to strengthen their child's relationship with peers as well as their own family bonds, particularly by doing offline activities together. Positive and fulfilling relationships are protective against a number of harmful experiences, including bullying and trauma. But Hoet knows that parents may encounter challenges as they try to boost their children's connectedness, like being unavailable after school because they work long, demanding hours. 

Parents shouldn't blame themselves, says Hoet, but instead hold technology companies accountable and also look to policymakers who could address pressing social and economic issues that burden caregivers. 

"We cannot expect parents to be at their best if they're battling the systems around them," she says. 

The effects of social media 

Dr. Jason Nagata, a pediatrician who cares for teens hospitalized with an eating disorder at UCSF Benioff Children's Hospital in San Francisco, sees perhaps the most extreme examples of how digital technology can erode youth mental health. 

His patients require medical care because of the negative physical health effects associated with an eating disorder, which can include heart and kidney complications. From their hospital beds, some secretly try to consult social media for tips on how to continue disordered eating behaviors despite receiving in-patient medical treatment for them. 

"To a certain extent, it's not something within their own control," says Nagata. "We do see people who are so entrenched in their illness, and how social media really enables that." 

Nagata says the rise in eating disorders, particularly during the pandemic, partly reflects the changing dynamics of social media. While media and peer influences have long been risk factors for disordered eating, teens are no longer in "read-only mode," picking up ideals about body shape and size from movies, magazines, and commercials. Instead, they can create their own content, using their bodies as an example. This pressure can really "drive them over the edge," says Nagata. 

Teens in heavier bodies are especially at risk of self-shaming and bullying related to social media content depicting idealized, often unhealthy, body aesthetics, and developing an eating disorder as a result, Nagata says. And while eating disorders are typically considered conditions that affect girls and women, he notes that boys and men are at risk, too. Instead of pursuing thinness, they're more likely to attempt to increase their muscle mass or tone in potentially dangerous ways. Yet Nagata says that social media companies haven't put as much emphasis on flagging and removing harmful content for boys as they have for girls. 

Nagata says that social media use is just one risk factor for developing an eating disorder. Others include genetics, childhood trauma, and food insecurity. But he also studies the effect of screen time on children, and has consistently found a negative association with certain types of screen use and youth mental health. A recent study that he co-authored analyzed screen time data from more than 11,000 children between 9 and 11 years old and found that excessive use was associated with increased suicidal behaviors two years later. 

Nagata can't say whether the screen use actually caused suicidal feelings amongst the children, but he emphasizes that the relationship between the two things should be better understood. 

"These exposures are very complex," says Nagata, "...but [screen time] is an exposure we should pay attention to because it is modifiable." 

What's happening on your teen's TikTik For You Page? 

Dr. Betsy Kennard, a pediatric psychologist at Children’s Health in Dallas, Texas, treats teens who've been experiencing suicidal thoughts or have made a suicide attempt.

Most patients in the outpatient Suicide Prevention and Resilience at Children’s Program (SPARC) report some form of social media use that is known to be problematic, whether that's being on their phones well past bedtime, experiencing bullying, practicing extreme social comparison, or discovering content that promotes disordered eating. 

In each case, the staff psychologists work with the patient to understand all the factors that went into suicidal feelings or an attempt. Then they develop a safety plan to address those specific issues, which vary from teen to teen. Among other skills, the program emphasizes media literacy, helping patients better understand what to share, how to compare themselves to others, and how to remember that their peers may not be posting the full truth about their lives. 

But Kennard thinks the most powerful component of the program is helping teens realize that they're not alone, and that they can help each other recover. 

Like Hoet, she strongly believes that tech companies need to create safer environments for teens, but also sees an opportunity for parents to protect their children using connection-based strategies. 

"We find that a lot of times some of these behaviors we consider to be resilience-building have dropped out," says Kennard, noting how families may have prioritized extracurricular activities or honors-level classes for their children instead of one-on-one or family time. Parents can also talk openly about mental health with their children and model healthy screen use. 

Dr. Lisa Damour, a psychologist in private practice, in Ohio, says that parents should learn as much as possible about the "norms in the digital environments" where their children spend time. They can make ideas like unhealthy thinness, bullying, and white supremacy seem conventional, and Damour says that teens are "very vulnerable to the norms" in spaces they seek out. (It's important to remember that their FYP or Instagram feed one week might look much different a month later depending on their viewing habits.)   

If their TikTok For You Page is filled with goofy dance videos, that'd be less cause for worry. But if it's dominated by "dark and despairing content," that would concern Damour, author of the new book The Emotional Lives of Teenagers: Raising Connected, Capable, and Compassionate Adolescents. 

In general, Damour believes that young people are trying to metabolize a lot of content from the internet while also being constantly aware of what their friends and peers are doing. 

"It's a lot to ask of a developing brain," says Damour. "Teenagers deserve time away from the swirl of their broader social network."

If you feel like you’d like to talk to someone about your eating behavior, call the National Eating Disorder Association’s helpline at 800-931-2237. You can also text "NEDA" to 741-741 to be connected with a trained volunteer at the Crisis Text Line or visit the nonprofit’s website for more information. If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Freddie Chipres couldn't shake the melancholy that lurked at the edges of his otherwise "blessed" life. He occasionally felt lonely, particularly when working from home. The married 31-year-old mortgage broker wondered if something was wrong: Could he be depressed?

Chipres knew friends who'd had positive experiences seeing a therapist. He was more open to the idea than ever before, but it would also mean finding someone and scheduling an appointment. Really, he just wanted a little feedback about his mental health.

That's when Chipres turned to ChatGPT, a chatbot powered by artificial intelligence that responds in a surprisingly conversational manner. After the latest iteration of the chatbot launched in December, he watched a few YouTube videos suggesting that ChatGPT could be useful not just for things like writing professional letters and researching various subjects, but also for working through mental health concerns.

ChatGPT wasn't designed for this purpose, which raises questions about what happens when people turn it into an ad hoc therapist. While the chatbot is knowledgeable about mental health, and may respond with empathy, it can't diagnose users with a specific mental health condition, nor can it reliably and accurately provide treatment details. Indeed, some mental health experts are concerned that people seeking help from ChatGPT may be disappointed or misled, or may compromise their privacy by confiding in the chatbot.

OpenAI, the company that hosts ChatGPT, declined to respond to specific questions from Mashable about these concerns. A spokesperson noted that ChatGPT has been trained to refuse inappropriate requests and block certain types of unsafe and sensitive content.

In Chipres' experience, the chatbot never offered unseemly responses to his messages. Instead, he found ChatGPT to be refreshingly helpful. To start, Chipres googled different styles of therapy and decided he'd benefit most from cognitive behavioral therapy (CBT), which typically focuses on identifying and reframing negative thought patterns. He prompted ChatGPT to respond to his queries like a CBT therapist would. The chatbot obliged, though with a reminder to seek professional help.

Chipres was stunned by how swiftly the chatbot offered what he described as good and practical advice, like taking a walk to boost his mood, practicing gratitude, doing an activity he enjoyed, and finding calm through meditation and slow, deep breathing. The advice amounted to reminders of things he'd let fall by the wayside; ChatGPT helped Chipres restart his dormant meditation practice.

He appreciated that ChatGPT didn't bombard him with ads and affiliate links, like many of the mental health webpages he encountered. Chipres also liked that it was convenient, and that it simulated talking to another human being, which set it notably apart from perusing the internet for mental health advice.

"It's like if I'm having a conversation with someone. We're going back and forth," he says, momentarily and inadvertently calling ChatGPT a person. "This thing is listening, it's paying attention to what I'm saying...and giving me answers based off of that."

Chipres' experience may sound appealing to people who can't or don't want to access professional counseling or therapy, but mental health experts say they should consult ChatGPT with caution. Here are three things you should know before attempting to use the chatbot to discuss mental health.

1. ChatGPT wasn't designed to function as a therapist and can't diagnose you.

While ChatGPT can produce a lot of text, it doesn't yet approximate the art of engaging with a therapist. Dr. Adam S. Miner, a clinical psychologist and epidemiologist who studies conversational artificial intelligence, says therapists may frequently acknowledge when they don't know the answer to a client's question, in contrast to a seemingly all-knowing chatbot.

This therapeutic practice is meant to help the client reflect on their circumstances to develop their own insights. A chatbot that's not designed for therapy, however, won't necessarily have this capacity, says Miner, a clinical assistant professor in Psychiatry and Behavioral Sciences at Stanford University.

Importantly, Miner notes that while therapists are prohibited by law from sharing client information, people who use ChatGPT as a sounding board do not have the same privacy protections.

"We kind of have to be realistic in our expectations where these are amazingly powerful and impressive language machines, but they're still software programs that are imperfect, and trained on data that is not going to be appropriate for every situation," he says. "That's especially true for sensitive conversations around mental health or experiences of distress."

Dr. Elena Mikalsen, chief of pediatric psychology at The Children's Hospital of San Antonio, recently tried querying ChatGPT with the same questions she receives from patients each week. Each time Mikalsen tried to elicit a diagnosis from the chatbot, it rebuffed her and recommended professional care instead.

This is, arguably, good news. After all, a diagnosis ideally comes from an expert who can make that call based on a person's specific medical history and experiences. At the same time, Mikalsen says people hoping for a diagnosis may not realize that numerous clinically-validated screening tools are available online.

For example, a Google mobile search for "clinical depression" immediately points to a screener known as the PHQ-9, which can help determine a person's level of depression. A healthcare professional can review those results and help the person decide what to do next. ChatGPT will provide contact information for the 988 Suicide and Crisis Lifeline and Crisis Text Line when suicidal thinking is referenced directly, language that the chatbot says may violate its content policy.

2. ChatGPT may be knowledgeable about mental health, but it's not always comprehensive or right.

When Mikalsen used ChatGPT, she was struck by how the chatbot sometimes supplied inaccurate information. (Others have criticized ChatGPT's responses as presented with disarming confidence.) It focused on medication when Mikalsen asked about treating childhood obsessive compulsive disorder, but clinical guidelines clearly state that a type of cognitive behavioral therapy is the gold standard.

Mikalsen also noticed that a response about postpartum depression didn't reference more severe forms of the condition, like postpartum anxiety and psychosis. By comparison, a MayoClinic explainer on the subject included that information and gave links to mental health hotlines.

It's unclear whether ChatGPT has been trained on clinical information and official treatment guidelines, but Mikalsen likened much of its conversation as similar to browsing Wikipedia. The generic, brief paragraphs of information left Mikalsen feeling like it shouldn't be a trusted source for mental health information.

"That's overall my criticism," she says. "It provides even less information than Google."

3. There are alternatives to using ChatGPT for mental health help.

Dr. Elizabeth A. Carpenter-Song, a medical anthropologist who studies mental health, said in an email that it's completely understandable why people are turning to a technology like ChatGPT. Her research has found that people are especially interested in the constant availability of digital mental health tools, which they feel is akin to having a therapist in their pocket.

"Technology, including things like ChatGPT, appears to offer a low-barrier way to access answers and potentially support for mental health." wrote Carpenter-Song, a research associate professor in the Department of Anthropology at Dartmouth College. "But we must remain cautious about any approach to complex issues that seems to be a 'silver bullet.'"

Carpenter-Song noted that research suggests digital mental health tools are best used as part of a "spectrum of care."

Those seeking more digital support, in a conversational context similar to ChatGPT, might consider chatbots designed specifically for mental health, like Woebot and Wysa, which offer AI-guided therapy for a fee.

Digital peer support services also are available to people looking for encouragement online, connecting them with listeners who are ideally prepared to offer that sensitively and without judgment. Some, like Wisdo and Circles, require a fee, while others, like TalkLife and Koko, are free. (People can also access Wisdo free through a participating employer or insurer.) However, these apps and platforms range widely and also aren't meant to treat mental health conditions.

In general, Carpenter-Song believes that digital tools should be coupled with other forms of support, like mental healthcare, housing, and employment, "to ensure that people have opportunities for meaningful recovery."

"We need to understand more about how these tools can be useful, under what circumstances, for whom, and to remain vigilant in surfacing their limitations and potential harms," wrote Carpenter-Song.

UPDATE: Jan. 30, 2023, 12:59 p.m. PST This story has been updated to include that people can access Wisdo for free through a participating employer or insurer.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

As the video of the brutal police beating of Tyre Nichols by Memphis police continues to circulate online, many are feeling a range of emotions, from anger and sadness to frustration and fear. The tragic incident has sparked widespread outrage and calls for justice, with protests breaking out in major cities across America in the aftermath of bodycam and surveillance footage being released to the public by the Memphis Police Department.

While it is important to stay informed, and engage with issues of police brutality and racial injustice, it is also crucial to take steps to protect yourself and your loved ones from the emotional stress that can come from consuming too much news and social media.

Nichols, 29, was brutally beaten by five Memphis police officers during a traffic stop on Jan. 7, just minutes away from his home where he stayed with his mother and step-father. Nichols would pass away three days later after succumbing to his injuries. The officers responsible for Nichols' death have been fired and indicted on charges that include second-degree murder, kidnapping, and assault.

Video from the bodycam footage taken by Memphis police on Jan. 29 may seem unavoidable online, and the surrounding discussion both justifying and condemning the actions of the police officers may be ubiquitous as well. While some may feel duty-bound to be updated about the protests and discourse online revolving around Nichols' death, psychologists say that the best approach for one's mental health might involve setting limits and possibly just...not watching the video at all.

Social media limits

To be quite honest, the discussion about Nichols' death is enough to make one physically sick. Whether due to gut-wrenching testimonials by those closest to Nichols, a loving father of a 4-year-old boy, or hot takes from conservative news pundits victim-blaming a dead man for his own murder, this story is making Twitter and other social media apps really toxic right now.

In an article for Healthline, E. Alison Holman, a professor at the Sue and Bill Gross School of Nursing at the University of California, Irvine, says that "being too wrapped up in bad news can be problematic because it’s associated with a greater chance of reporting acute stress symptoms."

To keep balance in one's social media scrolling, Holman recommends limiting news consumption to once or twice a day from reputable sources or turning off the news altogether. Consider setting a specific time each day to check for updates, rather than constantly scrolling through your feeds. Sites like Twitter and Instagram allow users to mute or unfollow accounts that are causing them stress. Better yet, you can mute posts by keywords so nothing can slip past the filter.

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Tonya C. Hansel, a doctorate of social work program director at Tulane University agrees with Holman in the Healthline article, suggesting that one should avoid consuming news before bed as it can cause anxiety, thus giving rise to sleep problems that will make your stress and anxiety even worse. Hansel also recommends avoiding news with sensational headlines and being diligent with headlines to find news that's important to read rather than just consuming any and everything you can find.

Avoiding racial trauma

For Black Americans, the killing of Nichols is a tragic reminder of a systemic police brutality problem in the country. As the footage continues to circulate online, experts urge Black Americans to take care of their emotional well-being in the wake of the tragedy and the ongoing protests around the nation. More specifically that it's OK to not watch the video at all.

Dr. Monnica Williams, a clinical psychologist and expert on racial trauma, law enforcement, and community trauma, spoke with CNN stating that the Black community is outraged enough without having to sear graphic images into their minds.

“We can read a description of the events. We live in a violent culture, and serving around these clips as entertainment only really makes us more violent," Williams told CNN. “You have to think about the toll that this takes on your humanity. I really discourage it, because I don’t think that this really gives dignity to the person who is deceased.”

Yolo Akili Robinson, founder and executive director of the nonprofit Black Emotional And Mental Health Collective, spoke with Mashable in 2021 in the aftermath of the Daunte Wright police killing, of the restless nights and anger he observed in his friends and colleagues. "Police killings create a culture of shame, trauma and anxiety," Robinson said.

He added that "murals and memorials dedicated to those victims become an everyday reminder that those deaths 'were never deemed worthy of justice.'"

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The American Psychological Association states that the "experiences of racism against people of color build on each other and over time, can chip away at one’s emotional, physical, and spiritual resources." As Mashable's Rebecca Ruiz writes, "The concept of racial trauma, or race-based stress, is decades old but has emerged as a mainstream idea [...] since George Floyd's death." Symptoms are similar to post-traumatic stress disorder, causing many to suffer from hyper-vigilance, increased heart rate, higher levels of the stress hormone cortisol, disrupted sleep, and irritable bowel syndrome.

It's important to note, that Black Americans (myself included) have the right to feel the full range of emotions in response to racial trauma and police brutality, and you should not be made to feel guilty or ashamed for feeling the way you do.

"To learn about and name racial trauma at this moment in American history is to understand that countless people of color have long been denied their basic dignity and human rights and have paid, at the very least, with their mental health," Ruiz writes.

And while the solution to combatting racial trauma is a complex and arduous task, there are things we can do in the here and now, to protect ourselves as we deal with the fallout of the death of another innocent Black man. It can start in small ways in your own personal life by limiting social media and news consumption as stated earlier or by reaching out for support from a loved one or a licensed professional.

It's important that we take the time to process our emotions, support our own emotional health, and come together as a community to support each other. The family of Tyre Nichols has created a GoFundMe to raise funds for his memorial services. Additionally, the funds provide mental health assistance to the Nichols family as they deal with the aftermath of losing their loved one. As of this writing, the fundraiser has surpassed its original $500,000 goal, and donations continue to pour in.

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If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Sandy Bruno, youth and family coordinator at Comfort Zone Camp, a national nonprofit bereavement camp for grieving families, experienced compassion fatigue in the aftermath of her husband's death. She had devoted her full emotional capacity to her children, while synchronously trying to control whatever she could in her life.

"When your partner in life dies unexpectedly, at the prime of their life, controlling things becomes more of a priority," she tells Mashable. "In theory, that works. In real life, all it did was make me exhausted and wiped out emotionally."

For those whose roles, whether professional or personal, are inextricably linked with empathy, compassion fatigue is a real and persisting possibility.

What is compassion fatigue?

Compassion fatigue is an occurrence that gained exposure during the pandemic, a time when all sorts of caregivers — from nurses and healthcare workers to parents — faced heightened responsibility, reduced boundaries, exhaustion, and recurring trauma. Renowned trauma expert Charles Figley described compassion fatigue as "the deep physical, emotional, and spiritual exhaustion that can result from working day to day in an intense caregiving environment" — or more simply, "the cost of caring."

The term compassion fatigue covers the psychological and physical impact of helping others, as licensed psychologist and mental health counselor Phylice Kessler explains the various symptoms.

"The main symptoms of compassion fatigue are feeling helpless and powerless in the face of patient suffering, reduced feelings of empathy and sensitivity, and feeling overwhelmed and exhausted by work demands," says Kessler. People with compassion fatigue are also likely to experience "irritability, feelings of detachment, [and] decreased pleasure in work," psychiatrist Dr. Julian Lagoy tells Mashable. Other effects include numbness, hopelessness, insomnia, anger, and a sense of isolation.

What's the difference between compassion fatigue and burnout?

These symptoms notably mirror those associated with burnout, an "occupational phenomenon" which is often closely linked to compassion fatigue. Burnout, another commonplace term in the larger conversation about mental health, refers to the intense emotional turmoil associated with one's occupation, leading to chronic stress and dissatisfaction in the workplace. According to the World Health Organization, burnout's three key symptoms are "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."

Dr. Lauren Cook, licensed psychologist, outlines the similar effects of burnout and compassion fatigue, saying, "We can start to lack empathy for others, feel impatient when people reach out, and we'll want to block off everything on our calendar." Still, they're different. Compassion fatigue is a more specific experience, and is often secondary, especially linked to secondary traumatic stress or vicarious trauma, which result from empathetic engagement with the circumstances of others.

How does compassion fatigue affect people in their work?

The nature of compassion fatigue means that many working in traditional caregiving roles are likely to experience its symptoms. This includes first responders, medical professionals, social workers, journalists, and lawyers specializing in family law or criminal law.

Kelli Collins, a licensed marriage and family therapist, describes compassion fatigue as "a shutdown."

"Think about muscle fatigue — if you work out too hard, your muscles might simply give out," she tells Mashable. "In the same way, compassion fatigue means your ability to offer compassion to others is dramatically impacted."

Collins herself experienced compassion fatigue as a young therapist working in a community mental health setting, where she "had the strong desire to help" but quickly realized some things were out of her "sphere of influence". She felt herself becoming irritable with loved ones, sleeping very little, and fantasizing about pivoting careers. It was an overwhelming time, during which she felt she was failing her clients.

"I thought that by giving endless compassion to my clients, I was 'leaving it all on the field'. In fact, bearing the responsibility for my clients' pain without consideration for my own needs and limits meant that I wasn’t a particularly effective therapist," she says.

Bruno, too, says she didn't take the time to attend to her own emotional needs while undergoing grief. Now, through her work at the Comfort Zone Camp, where she "listens to people's stories of loss, trauma, and grief" every day, she has learned to take the time for herself, while fostering connections with children and families.

Lynne Hughes, who founded Comfort Zone in 1999 and is now serves as CEO, lost both her parents as a child, experiencing first-hand the lack of resources and support for grieving children. Hughes expresses similar sentiments about the challenge of compassion fatigue, stressing the importance of looking inward.

"Suffering from compassion fatigue does not mean you’re bad at helping or caring, it only means the scale between caring for others and caring for yourself is no longer balanced," she says. "When you're in a role where you're nurturing and caring for others – it's imperative to extend that nurture and care to yourself so that your 'well' does not run dry."

But both Hughes and Collins emphasize that it's not only traditional caregivers who experience compassion fatigue. "It is applicable to anyone in a caring role," says Hughes, while Collins believes it is a uniquely human condition, occupational or not.

"When you see someone on the street who lacks basic resources, when you get an alert that your local animal shelter has become overcrowded, when you read a news article about war and suffering in another country, you feel the pain of others, and whether you mean to or not, whether you can help or not, you have the strong desire to act."

Our capacity for empathy means the probability of experiencing some sort of compassion fatigue — even from absorbing the daily news cycle — is high for many. A constant barrage of ominous headlines and doomscrolling has contributed to this effect. Feelings of anxiety and uncertainty at the state of the world, such as attacks on reproductive rights, racial justice, and the effects of climate change are real concerns for anyone consuming media or simply existing today, highlighting the importance of recognizing compassion fatigue for what it is — and knowing how to find support. And while some may choose to channel their concern into empowerment and activism, it's crucial support your own wellbeing throughout the process to avoid exacerbating compassion fatigue.

What kind of support is there for people with compassion fatigue?

The commonality of potentially developing compassion fatigue means many people, from all walks of life, require foundational tools and support to manage it. Resources like Figley's study on compassion fatigue may provide necessary insight, while organizations like the Compassion Fatigue Awareness Project, Caregiver Action Network, and The Rosalynn Carter Institute for Caregivers host information, firsthand accounts, and programs for individuals in specific roles. There also are online support groups and forums, like The Caregiver Space and The Psychological PPE Community on Facebook, which facilitates open conversations on "the impact of empathic strain, burnout, and secondary trauma."

Battling compassion fatigue requires replenishing your own supply of compassion, as Collins says, as it's a "valuable resource," one that requires "accepting and honoring limits." The therapist recommends asking for help to personalise your experience and support strategy: turning to support groups and resources online, or requesting the support of a mental health professional.

Meanwhile, the act of setting personal and professional boundaries was overwhelmingly suggested by the caregivers and therapists we talked to, including Kessler, who deems this practice vital to preventing or recovering from compassion fatigue. "Take some time for yourself where you can find some quiet. Even if it's cutting back on sound of all kinds, allow yourself space to simply be," agrees Cook. Hughes suggests practicing routes of self-care: journaling, meditating, or adopting a non-related work hobby.

"It’s the same way the flight attendant tells us to put the oxygen mask on ourselves before assisting others during takeoff," Hughes says. "Put the oxygen mask on yourself first."

People on social media have so much to say about mental health. Throughout 2022, online commentary about subjects like trauma, eco-anxiety, social-emotional learning, anti-LGBTQ legislation, mass shootings, cyberbullying, and dangerous TikTok challenges have given rise to complex conversations about our individual and collective well-being. In fact, this year marked a span of time in which the internet and mental health arguably became more entwined than ever, with people turning to TikTok for diagnoses and others pointing out the possible ways screen time can harm kids and teens.

Some of this discourse is truly informative, especially when it comes from widely respected mental health experts and people who thoughtfully share their lived experiences with mental illness. But many of the exchanges lack important context — like insights from scientific research — and overlook or exclude marginalized voices. If we're being completely honest, a frightening number of influencers who share content related to mental health and wellness are looking to turn their followers into a source of income, regardless of whether the advice they share is trustworthy.

All of this is why Mashable has assembled this list of the 11 best mental health books, in alphabetical order, from 2022. As a reporter who's covered mental health for a decade, my definition of mental health and well-being is expansive. These books cover a lot of ground, exploring ideas like rest as a radical act of resistance, loving someone who experiences suicidal thoughts, fixing a mental health system that fails so many people in the U.S., and mindfully spending time in nature.

The list incorporates my own favorite titles, as well as recommendations from experts I know and trust. The books don't universally touch on the way the internet intersects with our mental health, but even if you pick just one of them, you'll gain valuable insight into ways to understand and talk about emotional and psychological well-being — and perhaps bring a more informed perspective to the online conversations you have in 2023.

Here are 11 of the best books on mental health published in 2022:

1. Bittersweet: How Sorrow and Longing Make Us Whole by Susan Cain

Selected by Dr. Jessica Gold, assistant professor in the Department of Psychiatry at Washington University in St. Louis School of Medicine

It seems almost symbolic that the book I recommend is the book my own therapist recommended to me. Even as a psychiatrist I struggle to understand the role of big feelings in my life, particularly the ones that feel "negative," like sadness. I feel like they "get in the way" or "I just want them to stop.” In the middle of yet another conversation about this, my therapist stopped me and said, “Have you read Susan Cain's new book?" The rest was history.

Like her book Quiet: The Power of Introverts in a World that Can't Stop Talking, which helped people who were introverted feel seen, Bittersweet helped me see that sadness has power and importance for all of us. It also normalized a lot of my, and my patient's, experiences. I am grateful to my therapist for the recommendation and hope it helps some of you, too.

2. Forest Walking: Discovering the Trees and Woodlands of North America by Peter Wohllenben and Jane Billinghurst

Selected by Chanel Tsang, creator and host of the Peace Out podcast

The chapters in Forest Walking: Discovering the Trees and Woodlands of North America are short and sweet, and authors Peter Wohllenben and Jane Billinghurst provide a gentle guide on how to engage your senses while walking in the woods, with interesting facts and stories about forest life lining the way (banana slugs are fascinating!). The book also includes fun activities you can try, such as "forest telephone" (tapping one end of a fallen tree trunk with a rock while someone else listens at the other) or looking for signs and stories of wildlife.

Of course, I especially loved the chapters dedicated to exploring nature with children. There are so many amazing health benefits to walking in nature, including lower stress and anxiety, improved sense of well-being, and relaxation. Forest walking has inspired me to be more intentional and mindful during my walks, reigniting my curiosity and interest in exploring the outdoors. Or, in the authors' words, to simply "go out and enjoy."

Editor's note: Tsang also recommended the children's book Being a Dog: A Tail of Mindfulness, written by Maria Gianferrari and illustrated by Pete Oswald. Tsang wrote: Looking for a book for kids? Maria Gianferrari’s Being a Dog: A Tail of Mindfulness is a sweet and funny picture book that does a lovely job of explaining mindfulness to kids and includes some fun and easy mindfulness activities to try together.

3. Generation Dread: Finding Purpose in an Age of Climate Crisis by Britt Wray

Selected by Rebecca Ruiz, senior reporter, Mashable

Eco-anxiety is one word used to describe the difficult and sometimes intense emotions that arise when contemplating the disastrous effects of climate change. Taking this all in can become overwhelming, thereby shutting down the ability to believe that our bleak future might ultimately look different with the right policies in place.

The researcher Britt Wray, who studies the mental health effects of living through the planetary crisis caused by climate change, has spent years sensitively and rigorously looking for ways to respond to this dread. In this book, she proposes developing critical skills, like reframing eco-anxiety as "super fuel" to learn how to cope and find one's purpose; turning to resilience-building practices such as mindfulness, meditation, and gratitude journaling to alleviate despair and burnout; and prioritizing social connections, which can help tremendously during times of crisis.

As I wrote earlier this year, "Wray's approach is holistic, weaving together various strands of thought from psychology and public health to help readers cultivate the resilience and emotional intelligence they'll need to fight for the planet — and to survive the calamities that might come."

4. Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media by Donna Jackson Nakazawa

Selected by Rebecca Ruiz, senior reporter, Mashable

Plenty of books have been written about the crises adolescent and teen girls face today. What sets Girls on the Brink apart is science journalist Donna Jackson Nakazawa's ability to weave together her own compelling reporting and well-explained scientific research on child development. We hear moving stories from girls and their parents about their experiences, but Nakazawa matches those anecdotes with science-based insights whenever possible.

The resulting text gives readers expert guidance for how to help girls thrive amidst intense pressures, including the siren song of social media. When I spoke to Nakazawa earlier this year, we talked about the importance of protecting a girl's "in-between years," from age seven to 13; being someone a girl can talk to about hard things; noticing and praising a girl's positive behaviors and qualities; and helping girls create their own in-person community. You can read all about these and other strategies in Girls on the Brink.

5. Healing: Our Path from Mental Illness to Mental Health by Dr. Thomas Insel

Selected by Juan Acosta, influencer, on behalf of the Seize the Awkward campaign

This year, I was highly moved by the book Healing, written by psychiatrist and neuroscientist Dr. Thomas Insel, which addresses our current mental health care system. He acknowledges that what has worked in the system has benefited only a few people, leaving many others unsupported and lacking access.

As I read this, I was struck by how much it really resonated with my lived experience with mental health. Dr. Insel proposes a path forward, a path toward healing that must include addressing people’s social support using what he identifies as the "three P's": people, place, and purpose. These are often overlooked, he says, which I found to be powerful, as I have — in my darkest moments — been most supported by my family and friends.

His spotlight on the need to address people's social support gave me hope for the future of mental health care, and it reaffirmed how important it is for us to connect with those around us. In a time of rising mental health crises around the nation, Healing is a reminder that our social support system can play a huge role in our collective mental health.

6. Loving Someone with Suicidal Thoughts: What Family, Friends, and Partners Can Say and Do by Stacey Freedenthal, Ph.D.

Selected by Rebecca Ruiz, senior reporter, Mashable

Dr. Stacey Freedenthal, Ph.D., comes at her book with unique expertise. She treats patients who experience suicidal thoughts, once attempted suicide herself, and supported her son when he experienced a suicide crises as a teen. In this thorough guide, she compassionately walks readers through feelings and scenarios they might be terrified to handle.

Freedenthal skillfully points out distinctions between certain types of suicidal thinking — fleeting versus obsessive, vague versus specific — and dispels myths about suicide, like the notion that everyone who contemplates suicide experiences mental illness. She offers tips and scripts for talking to a loved one who is suicidal. In many ways, the book is a public service in a culture that still judges suicide harshly.

By offering practical information, shared through the lens of professional expertise and personal experience, Freedenthal empowers readers to lovingly support someone who's suicidal. (Note: The publication date of Loving Someone with Suicidal Thoughts is technically January 2023, but the book was made available for purchase and delivery in late 2022.)

7. Rest Is Resistance: A Manifesto by Tricia Hersey

Selected by Thérèse Cator, founder of Embodied Black Girl, leadership coach, and somatic experiencing practitioner

Tricia Hersey, also known as The Nap Bishop and founder of The Nap Ministry, invites us to snatch our pillows, find a couch, a bed, a hammock, or a patch of earth, and rest our worn bodies, not as a productivity hack but as a way back to our humanity, which has been stolen by capitalism and white supremacy. 

Through vivid storytelling and soul sermons, we travel to the Black churches of Hersey’s youth and find our roots in womanism and Black Liberation theology. Her words become a healing balm and a portal that invites us to surrender to the DreamSpace. In the DreamSpace, we move beyond the death grip of grind culture and embrace our humanity and divinity. This manifesto is not only for those of us who are weary and exhausted, it's for everyone. Ms. Hersey has handed us a map for dreaming worlds that liberate us all, and it all begins with creating space to rest.

8. Stolen Focus: Why You Can't Pay Attention — and How to Think Deeply Again by Johann Hari

Selected by Rebecca Ruiz, senior reporter, Mashable

Earlier this year, I set out on a quest to use only one browser window at a time versus juggling dozens of open tabs. It only made sense to call author and journalist Johann Hari, whose book Stolen Focus smartly explains the many ways that technology hijacks our attention. Whether your particular Achilles heel is TikTok's engrossing algorithm or responding to fruitless political debates on Facebook, Stolen Focus will help you understand how major technology companies design products that exploit features of human psychology.

Importantly, Hari provides a lot of context at the outset. He recognizes that we live in a culture that's increasingly hostile, or inhospitable, to acts like resting and daydreaming, which makes us more prone to the perfectly-designed temptations we find in our digital worlds. We're constantly invited to interrupt ourselves by checking social media, for example, and often rewarded for doing so in the form of a "like" or positive comment on something we've posted. Soon, we're consumed by the checking and posting, with less time to sleep or let the mind wonder, both of which are essential for well-being. As Hari charts how we've gotten to this point, he talks to scientists who study attention, among other related subjects, and explores his own relationship with technology.

But Hari is clear that he hasn't written a self-help book. He can offer no single solution to the problem at hand. What he does instead is explain how we arrived here, share his own insights, and envision a radically different future.

9. The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture by Dr. Gabor Maté

Selected by Rebecca Ruiz, senior reporter, Mashable

So much of the online discourse about mental health revolves around the rise of so-called "trauma talk." I've previously written that trauma, including sexual trauma and childhood trauma, is actually more widespread than people understand. If you see commentary that people overuse the word "trauma" to describe their experiences and thus render the term meaningless, you can point to this book as a compelling counterargument.

Dr. Maté, a physician and addiction expert, makes an ambitious effort in The Myth of Normal to marshal scientific research and evidence suggesting that stress and trauma are pervasive, harmful forces in people's lives. He helps draw and emphasize connections between stress and trauma and people's physical and mental health, convincingly arguing that we live in a toxic social and economic culture that "generates chronic stressors that undermine well-being in the most serious of ways."

While Maté is more comfortable outlining the challenges we face, he also attempts to chart a path toward healing. For this, he sketches a blueprint based on a combination of ideas, including what he describes as the "four A's" (authenticity, agency, anger, acceptance), that can guide people toward wholeness. Maté isn't sure how to fix our broken society, but he does call for "visioning a saner society." At nearly 500 pages long, The Myth of Normal is one of the most comprehensive accounts of trauma, illness, and healing you could pick up right now.

10. What My Bones Know: A Memoir of Healing from Complex Trauma by Stephanie Foo

Selected by Dr. Stacey Freedenthal, Ph.D., author of Loving Someone with Suicidal Thoughts: What Family, Friends, and Partners Can Say and Do, psychotherapist, and associate professor of social work at the University of Denver

The Diagnostic and Statistical Manual of Mental Disorders, a publication that classifies mental illnesses, is notorious for pathologizing common experiences ranging from grief (persistent complex bereavement disorder) to profound shyness (social anxiety disorder), but it misses the opportunity to recognize a condition recognized by many others: complex post-traumatic stress disorder, aka, C-PTSD. You've no doubt heard many times of PTSD, but not everyone with PTSD has the "C," which is the result of prolonged, repetitive trauma, not a single traumatic event.

Stephanie Foo's book casts much-needed light on the painful challenges of C-PTSD. Foo's telling of her own story of how childhood trauma led to C-PTSD is captivating. Using her talents as a journalist and radio producer, she also synthesizes research, theory, and expert commentary. The book goes into inherited trauma, dissociation, epigenetics, and other heavy topics, but she does so in a down-to-earth (read: not boring) way. And Foo also illuminates abundant possibilities for healing. The book will give solace to those who suffer, feel alone, and don’t have a name for their constellation of symptoms that the DSM doesn’t recognize.

11. You Are Not Alone: The NAMI Guide by Dr. Ken Duckworth

Selected by Rebecca Ruiz, senior reporter, Mashable

Dr. Ken Duckworth is a psychiatrist and chief medical officer of the National Alliance on Mental Illness (NAMI), a nonprofit organization dedicated to advocating for and supporting people with mental illness and their loved ones. You Are Not Alone is an impressive, exhaustive guide based on Duckworth's own expertise and interviews with 130 people from diverse backgrounds who live with mental illness or love someone who does.

The book covers the basics of mental illness, including details about common conditions, best practices, and how to find help. It also addresses more challenging issues, like what recovery can look like, how to become an advocate for one's self in different spheres (personal, public, or legal) to aid recovery, and how to make meaning of suicide loss. Duckworth watched his own father grapple with bipolar disorder, and his knowing, empathetic voice is exactly the one you want as your guide.

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Parents and caregivers worried about their children's screen time can gain valuable insight from two new studies on the topic, both published this week.

In one study, which appears in JAMA Pediatrics, researchers evaluated what happened when parents reported giving kids ages three to five a mobile device to calm them during a stressful moment. The strategy will sound familiar to plenty of harried parents desperate to calm their toddler's tantrum in the supermarket checkout line. The researchers found that while the tactic may work in the short-term, it can backfire for certain children who end up becoming more emotionally reactive, not less, over time.

Another study, published in the Journal of Adolescent Health, tracked several thousand children ages nine and 10 over the course of two years. They discovered that increased time spent playing video games and watching YouTube videos, separately, was associated with heightened risk of developing obsessive compulsive disorder, a condition that involves uncontrollable thoughts and/or behaviors. They found no such link with texting, TV, social media, and other forms of media use. The researchers suspect that aspects of video game playing and YouTube viewing may promote types of thinking associated with OCD, including perfectionism, overestimated fears about violence, and negative biases in how youth see themselves.

OCD is a treatable condition that affects half a million youth in the U.S. Risk factors for OCD may include genetic predisposition and childhood trauma. Research indicates some children's symptoms worsened during the pandemic, when anxiety related to avoiding COVID-19 was high.

Neither study can prove that exposure to mobile devices and screens led to negative outcomes for kids, because that would require randomly assigning the participants to different styles of media use which they may not like or be interested in. Instead, the researchers studied the children over time, which helps minimize the possibility that the studies will just show an association between kids who are most vulnerable to the negative effects of screen time as being more prone to using devices a lot in the first place. The researchers also controlled for different factors that could similarly influence their mental health, like age, sex, parental education, income, and more. Their findings persisted despite accounting for these factors.

The studies aren't cause for alarm, but instead informed caution, particularly if a child's temperament makes them prone to mood swings and explosive emotional reactions, or if they have risk factors that could predispose them to obsessive compulsive behavior. Expert tips and strategies, like strategic mobile device use and creating a family media plan, can also help caregivers navigate their concerns about both issues.

Calming kids down with mobile devices

Dr. Jenny Radesky, a developmental behavioral pediatrician and lead author of the JAMA Pediatrics study, said that when she first set out to evaluate parents' use of mobile devices to calm upset children, she wanted to know if it was an effective, benign strategy, or if it had negative consequences for kids. The study of 422 parents and their individual children suggested the latter outcome, specifically for boys, and toddlers and preschoolers whose temperament is more intense, persistent, and inflexible.

These children tend to exhibit more demanding or difficult behavior and, in turn, are given mobile devices more frequently by their parents during challenging moments. Over time, their parents told the researchers that their kids increasingly struggled to positively manage their emotions, instead experiencing worse tantrums, defiance, and impulsivity. The researchers believe the same wasn't true for girls, possibly because they are often raised to express their emotions in ways that boys aren't. Kids with a more flexible temperament weren't given devices as frequently, and their parents didn't report worse emotion-regulation for them over time.

"Not every child is going to have the same relationship with media," says Radesky, emphasizing the importance of understanding a child's individual strengths and challenges in the context of screen time.

Radesky, who authored the American Academy of Pediatrics' screen-time guidelines for children ages zero to five, says parents worried about using mobile devices to soothe their kids shouldn't abandon screen time altogether out of guilt or fear. Rather, they should use moments of difficult behavior as an opportunity to help children communicate their feelings in healthier ways, because often the presence of a screen will make it easier for them to ignore or suppress their emotions.

If a parent notices their child has "bigger behavior," like aggression or tantrums, they could develop coping strategies or tools for preventing that and for helping them to calm down, instead of reaching for their phone.

Those tactics include basic language to help young kids name their emotions; noticing, for example, that they may be sad, frustrated, or angry that a friend took their toy away. Radesky also says that young kids often need sensory strategies for dealing with feelings. That's when swinging, bouncing, dancing, and cuddles can help them channel strong emotions. A calm-down zone, outfitted with a comfortable place to sit, makes a good alternative to mobile devices. And referencing how their favorite book or TV characters would handle a situation can help, too. Knowing the words to that Daniel Tiger song about feeling angry can come in handy mid-tantrum.

Still, Radesky is realistic about how difficult it can be to forgo the phone at times.

"Occasionally you're going to have to pull out that mobile device waiting in line at a store," says Radesky, noting that it may feel like a mobile device is the only way to calm down a child in certain circumstances. The key is "not making it the primary way for managing those emotional moments."

Video games, YouTube, and OCD

Like Radesky, Dr. Jason Nagata is a pediatrician who studies the effects of screen time on children. Nagata draws on data from the Adolescent Brain Cognitive Development (ABCD) study, an ambitious government-funded effort to follow children over a number of years to better understand the links between childhood experiences and well-being. His past research found associations between screen use and binge-eating and disruptive behavior disorders in youth and teens.

Nagata is the lead author of the study that suggests playing video games and viewing YouTube can increase the risk of developing OCD. The study analyzed self-reported media use habits of 9,208 children between the ages of nine and 10, asked their parents to provide information about their children's obsessive and compulsive behaviors over time, and looked for changes suggesting they'd developed OCD during the two-year study period. (Parents filled out a diagnostic screening about observed mental health symptoms, which the researchers used to make conclusions about new onset OCD.)

Importantly, the risk of developing OCD was a modest 15 percent for video games and 11 percent for YouTube viewing, but it increased for each additional hour of usage beyond the average of 3.9 hours per day, which amounts to more than 27 hours of use each week. The researchers also evaluated TV viewing, texting, video chatting, and social networking and found no association between those forms of media and the development of OCD. 

Nagata and his fellow researchers accounted for a number of factors, including race and ethnicity, household income, and parental education and history of mental illness. They also excluded participants who already had OCD at the study's outset.

While the researchers didn't look specifically at how video games and YouTube viewing could potentially lead to OCD, they argue that the addictive nature of both forms of media could be problematic for some children. 

Video games, which have become social in nature thanks to multiplayer platforms and voice and video chat functions, may be hard to stop playing. They can become similarly absorbing when kids are eager to achieve or maintain a perfect score, which could lead to repetitive or ritualistic behaviors. Certain video games may also expose children to violence, perhaps increasing their vulnerability to imagery and scenes that make them overestimate the possibility of scary scenarios coming true. 

Nagata and his fellow researchers didn't know what YouTube videos participants watched, but they suspect that the immersiveness of the platform's algorithm makes it possible for children to develop obsessive viewing habits. At the same time, if a child is watching an influencer and develops an intense fascination or admiration for that person, they could develop negative thinking patterns about their own abilities or worth in comparison, which may drive more obsessive, compulsive thoughts. 

Though Nagata is concerned by the findings, he's not encouraging parents to entirely restrict video games and YouTube for kids. 

"Screens are not something that are going to go away," says Nagata, who is also an assistant professor of pediatrics in the division of adolescent and young adult medicine at the University of California at San Francisco. "Part of it is really helping our kids, and especially teens as they transition to becoming older teens or young adults, to be able to navigate this complex world on their own." 

Nagata recommends that parents and their children develop a family media plan. The American Academy of Pediatrics offers a template that can be customized for each family. It includes sections on adopting healthy screen-use strategies, choosing good content, and creating screen-free zones. Nagata also says that if youth develop repetitive and intrusive thoughts that affect their ability to function every day, it's time to seek professional help. 

Nagata notes that not every child who excessively plays video games or watches YouTube is going to develop OCD. "There's maybe a slightly elevated risk, and parents and pediatricians should be aware of it," he says. 

If you're a parent struggling with your mental health, or you're concerned about your child's mental health, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.

When someone embarks on a psychedelic trip, they have little control over what they'll experience. A person could find themselves floating through the universe, or face-to-face with terrors that haunt them — or some wild combination of both.

What happens at the end, though, is often less intense. The consciousness-altering drug begins to wear off, but the visceral effects of the trip haven't completely faded. This is actually a critical period, particularly for those undergoing psychedelic-assisted psychotherapy. It's during these liminal minutes or hours that the profound insights and emotions a person experienced on their trip can start to slip away. Sometimes what they feel deeply in their heart or bones can't be expressed in words. For some, the ineffable nature of a trip makes it difficult to use the experience as a catalyst for transformational change. Integration, or the therapeutic process by which people make meaning of their trip, is typically designed to help patients recall and interpret their insights, but their recollections aren't always as intuitive the farther they get from dosing.

A few years ago, Dr. Prash Puspanathan, a psychiatrist who's studied psychedelics extensively, and scientist Agnieszka Sekula recognized this challenge, and cofounded Enosis Therapeutics, an Australian startup developing virtual reality scenarios to facilitate psychedelic psychotherapy. They not only created a protocol for delivering psychedelic therapy with VR but also a proprietary software called AnchoringVR, which creates an immersive scenario that patients explore once they begin emerging from their trip.

Using any commercially available VR set, a patient starts the AnchoringVR scenario at the tail end of their psychedelic session, which can be four to five hours following psilocybin treatment or shortly after an intravenous infusion of ketamine.

The patient can then construct their own VR world, using audio and visual elements. They might chose to sit seaside, then virtually interact with a large rock, label it with an emotional burden, like a specific trauma, and throw it into the waves. A star can be plucked from the sky, then paired with an audio recording of a memory or feeling that emerged during the trip. That object then becomes a symbolic representation of a key insight and is symbolically turned into the patient's North Star. The handful of patients who've tried AnchoringVR did so for 45 minutes at the end of their psychedelic experience, then replayed those recordings in the company of their therapist during each integration session.

"Patients feel emboldened to speak freely and comfortably when they're encased within a cocoon which is a manifestation of their own mind," says Puspanathan, who is the company's sole funder. (Prior to founding Enosis Therapeutics, Puspanathan was the CEO of a successful boutique cryptocurrency brokerage.)

Amid the billion-dollar rush to identify effective psychedelic compounds, Enosis has carved out an unexpected niche. While VR is used to achieve or enhance consciousness-altering states, pairing the technology with psychedelic-assisted psychotherapy is uncharted territory. Enosis hopes to harness the wonder and awe produced by VR to fine-tune integration. While this treatment phase doesn't capture the popular imagination in the same way as the hunt for new psychedelic drugs or the wonder of a psychedelic trip itself, experts say it's fundamental to successful treatment. In trying to build technology that aids integration, Puspanathan and Sekula are raising important questions about why that aspect of the psychedelic experience matters so much — and how VR could play a pivotal role in improving it.

What is psychedelic integration?

Once Dr. Sergio Pérez Rosal, CEO, cofounder, and medical director of OVID Clinic in Germany, personally tested AnchoringVR, he says it was a "no brainer" to bring Enosis into the psychiatric and psychotherapeutic clinic. Pérez Rosal says that the two patients who've undergone four integration sessions using AnchoringVR have been immersed in the experience. They've interacted with and labeled stars, using them to record insights. Some stars were converted into plants for tending. Others were turned into stones, or brought to a fire for burning. They've also created their own meaningful symbols, which have included drawings of hearts, partners, pets, and birds. (Enosis and OVID declined to make patients available to speak with media, but Mashable did see a demo of AnchoringVR.)

This style of engagement aligns with OVID's approach to psychedelic-assisted psychotherapy, which combines pharmacological and psychotherapeutic treatment with a well-integrated psychedelic experience.

"We shift the focus away from this idea that [the psychedelic] substance is going to make the change," says Pérez Rosal.

While some scientific research suggests that psychedelics may have a powerful effect on neurons in the brain, possibly creating new pathways or repairing damaged or dysfunctional ones, high-quality integration is key to helping patients draw conclusions from their insights and make new or different choices in their lives. At OVID Clinic, patients are treated with ketamine, an anesthetic that induces a psychedelic experience. Patients undergo both preparatory and integration sessions with the aim of making their treatment as effective as possible.

Dr. Margaret Ross, a senior clinical psychologist at St. Vincent's Hospital in Melbourne, Australia, and the chief principal investigator for the country's first psilocybin-assisted psychotherapy study, knew Puspanathan for years prior to joining Enosis' clinical advisory board. One of her primary concerns as a psychologist who treats end-of-life patients is ensuring that their integration process is as successful as possible. In this regard, she believes Enosis' technology is "quite extraordinary."

Ross describes its design as nonverbal and symbolic, which can help patients "bridge the conceptual and real without making it too concrete or reducing it all to words." Ross says she often hears from patients desperate for psychedelic-assisted therapy to cure their severe anxiety or treatment-resistant depression, who assume that the substance will seamlessly lead to a life-changing transformation. What they don't understand is how much emotional work it takes to make those changes long after a psychedelic has worn off.

In one clinical trial sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS), which is unrelated to Enosis' research, investigators are researching the efficacy of methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of PTSD. Following each dose, participants have three integration sessions with a therapist, says Sara Gael, a psychedelic therapist and one of the trial investigators. Participants may meditate, journal, create art, or use movement or other activities to support the integration process. Importantly, analyzing insights with language isn't always necessary or possible.

Gael, harm reduction officer for MAPS, says that when a client concludes psychedelic-assisted therapy, it's as if they're walking away with a handful of seeds that may be new insights, awareness, changes to their self-concept, or even mystical spiritual experiences, which can contribute to healing and growth. If planted in nurtured soil, under the right conditions, those seeds will eventually blossom. Integration can similarly create the right environment for change, says Gael.

"If proper integration doesn't happen, the best-case scenario is those seeds just never get planted and change doesn't really stick," she says of her experience working with private practice clients. In the worst cases, people are further "destabilized" and may feel lost or confused after treatment.

Avoiding an over-the-top VR experience

While Gael is unfamiliar with Enosis, she said its technology could hold promise if used in "client-centered" ways. This means avoiding overstimulation. VR has the potential to flood a person with stimuli like light, noise, color, and movement, which can undermine a patient's natural ability to interpret the sensations of their trip. An over-the-top VR experience could also trigger cybersickness, or worsen anxiety and trauma for those with a history of both conditions, particularly if their psychedelic journey brought up difficult or painful emotions and memories.

Sekula says AnchoringVR has been designed with these risks in mind, even if some might expect the software to come with every bell and whistle.

"Everyone has an idea based on their own private, probably single experience [with psychedelics] at one time..." says Sekula. "They want angels, or someone wants tarot cards, or someone wants to have little humans they can play with."

But while one person might find an angel comforting, for example, the next person might find it terrifying, which is why Enosis has built nature-based environments with imagery that mimics the traditional setting for psychedelic use, before human beings started using those substances in medical clinics.

"We really need to systematically test and check how does that work, when does it not work, how risky is it," says Sekula of design elements that could be more overwhelming than helpful for most patients.

Earlier this year, Sekula and Puspanathan laid out these considerations, among others, in a paper published in Frontiers in Psychology. They also tested AnchoringVR on four volunteers at a psychedelic retreat in the Netherlands. The participants received therapeutic doses of truffles that contained psilocybin.

While their findings haven't been published in a peer-reviewed journal, Sekula and Puspanathan found that AnchoringVR helped recreate similar emotions to those the participants experienced while on psychedelics while also increasing their ability to remember insights during an integration session. The same results weren't true for participants who were only exposed to an "awe-evoking" VR scenario, not Enosis' proprietary technology. Enosis plans to launch a large clinical trial early next year.

The future of VR and psychedelics

Sekula and Puspanathan are both concerned that VR companies will try to tap the psychedelics market with experiences optimized for gaming and entertainment. While a recreational psychedelics user might seek spiritual or psychological growth by tripping while using VR, Puspanathan says commercial, off-the-shelf VR scenarios haven't been designed with this purpose in mind.

"We do maintain our stance that an evidence-based, science-first approach is very important because of the risks that are involved," he says. "The deeper worry for us is that while uptake is good but then the wrong scenarios start to be used, then the entire industry starts to be tarred with that brush, which isn't actually reflective of the science that's behind what will be the optimal approach..."

So far, Pérez Rosal has been impressed by Enosis' technical support and pace of innovation. When he personally tried AnchoringVR prior to bringing it to OVID Clinic, Pérez Rosal found it created a calm environment that allowed the user to follow their own thoughts, without immersing them in a stereotypical '60s-style version of a psychedelic trip. Enosis' team trained his clinic's staff to use the technology. The implementation was easy, with no software or hardware failures to slow it down.

Still, Enosis has a monumental challenge ahead. Its clinical trial must show convincing evidence that AnchoringVR is equivalent or superior to standard integration practices like meditation and journaling. Then there's the question of who pays for VR sets and licenses. Puspanathan and Sekula say that AnchoringVR is intended for clinics and research institutions, which will need to purchase licenses. Any VR headset is compatible with AnchoringVR, and Enosis' licenses can be used for an unlimited number of patients.

Puspanathan acknowledges that developing a business model for what Enosis is doing won't be easy, but he and Sekula are driven by their belief that psychedelic-assisted psychotherapy patients who use their VR technology will benefit in unique ways.

"Being in control gives you a sense of empowerment," says Sekula, "and also means you're far more likely to continue with the therapy and stick to the therapy, and come up with solutions that are personally relevant to you."

Breathwork seems like one of those self-help techniques that you could easily learn on social media. After all, there are countless tutorials on YouTube and TikTok, along with numerous testimonials on Reddit. And anyway, could it really be that difficult to consciously change your breathing pattern to promote stress relief and relaxation, which breathwork practices promise to do?

As it turns out, experts say learning breathwork as a beginner is harder than most understand. That's partly because many people are accustomed to drawing short breaths from their chest, rather than inhaling deeply from their abdomen. Altering this pattern can be challenging, as it requires an awareness that many people don't possess, through no fault of their own. The body's reflexes are powerful; it's easy to take breathing for granted.

But there are also dangers to practicing breathwork without proper guidance and support. For those who've experienced severe anxiety or trauma, focusing on the breath can trigger intense discomfort and distress. Some people find that the stillness of breathwork can surface painful memories, or rapidly put them in touch with emotions or physical sensations they've suppressed.

Social media breathwork tutorials frequently leave out these details. On TikTok, the search term "breathwork" has more than 170 million views, with some videos notching millions of views. A successful breathwork video can win a creator clout and followers. Viewers eager to discover a seemingly quick self-help technique while scrolling through social media might be inclined to overlook any drawbacks.

Somatic healing practitioner Thérèse Cator doesn't share breathwork content on social media. In her experience, when people attempt the practice on their own using online instruction that doesn't provide appropriate context and framing, it can become an unexpectedly high-pressure or negative experience.

"[A] lot of times that hustle or grind culture mentality comes in even when we're doing practices that are going to help us," says Cator, who is also a leadership coach and founder of Embodied Black Girl. "We're like, 'I have to finish this breathwork, or if I don't...I'm a failure, or I'm not good enough, or all of those things."

Instead of looking to online breathwork tutorials, Cator and other experts say curious beginners should seek out a trained, trauma-informed practitioner in their local community. Specifically, she recommends looking for practitioners whose trauma-informed approach is connected to an understanding of social justice issues. This is particularly important given that the wellness world has not been immune to the spread of disinformation and conspiracy theories. While this can negatively affect anyone regardless of their identity, Cator says that women, people of color, people who identify as LGBTQ, and people with disabilities may be disproportionately affected by political and social trauma, and may need more complex or even outside support.

Cator says that virtual group sessions often begin at $25, and private sessions can range from $90 to upwards of $300. In-person training may be more expensive than virtual classes. Since the beginning of the pandemic, many practitioners have moved their trainings online. Instructors working in-person may choose outdoor and well-ventilated spaces. Beginners can search online for practitioners, ask for recommendations from friends who've done breathwork, or see if their local yoga studio offers breathwork instruction. If you have any health concerns, contact a trusted health care professional before starting breathwork.

If you're curious about pursuing breathwork, here's what you should know about how it works, the benefits, and when to stop:

What is breathwork?

Cator defines breathwork as "the conscious shifting of your breath pattern."

This means that yoga and meditation practices that involve shifting your natural rhythm of inhaling and exhaling count as breathwork. Pranayama, an ancient yogic breathwork technique, takes different forms depending on the intended outcome. This can include alternate nostril breathing and bhastrika, also known as bellows breath.

Mindfulness methods like Tai-Chi, Qi-Gong, and mindfulness-based stress reduction promote slow and deep rhythmic breathing. The Wim Hof Method, which features breath-holding and forceful inhalation and exhalation, has become popular in recent years. Breathwork can also be based on various numbered patterns, like inhaling for four counts, pausing for seven, and exhaling for eight, a popular, Pranayama-style method developed by Dr. Andrew Weil and known as 4-7-8. Longer, meditative styles of breathwork that can last as long as an hour are typically designed to elicit profound or spiritual revelations and insights. This is true of the holotropic breathwork practice, which is done in a specific setting with music to produce a "non-ordinary state of consciousness."

Cator says that breathwork has been practiced around the world by many different cultures. The way a certain technique is packaged may be about maximizing consumer appeal. Cator uses different patterns, including three-part breathwork, which means the breath is drawn from the abdomen, passes into the heart, and is exhaled through the mouth.

Dr. Selda Yildiz, Ph.D., a researcher studying the effect of breathwork on the brain's health and sleep, says that beginners can prioritize finding an experienced teacher and become familiar with a number of practices to choose the ones that work best for them.

"What works for me is maybe not going to work for somebody else," says Yildiz, an assistant professor in the department of neurology at the Oregon Health & Science University School of Medicine, and a certified yoga and meditation teacher.

The benefits of breathwork

Breathwork is thought to influence the vagus nerve, which stretches from the brain to the gut and makes up the majority of what's known as the parasympathetic nervous system. This web of nerves promotes a relaxed state, shifting the body away from a "fight or flight" stress response and into a state of "rest and digest."

Yildiz says the vagus nerve is moderated by respiration — or inhaling and exhaling. Slow and deep breathing can improve the strength or "tone" of the vagus nerve. The higher the tone, the faster the body recovers from a stressful event, says Yildiz.

She is currently researching how different yogic breathing patterns, practiced over a period of eight weeks, impact cerebrospinal fluid (CSF) movement and circulation. This clear, colorless fluid effectively bathes the brain and spine and helps play a critical role in removing waste products from the brain. So far, data from Yildiz's study showed an immediate increase in CSF movement during initial slow and deep breathing practices compared to natural breathing.

The research team's next step is to investigate whether the yogic breathwork interventions improve sleep quality. In the future, Yildiz hopes to determine whether sustained yogic breathing could be a potential tool or therapy for neurodegenerative diseases including Alzheimer's.

For Tori Gordon, a personal coach with a TikTok following of more than 800,000 people, breathwork was transformative. After a period of immense personal loss, Gordon attended a meditative breathwork session at a retreat designed to get participants out of their head and into their body. There, Gordon discovered the power of her own breath.

"It was the first time I felt really connected to my body and heart in a way that was compassionate, not judgmental," she says.

Gordon returned home and soon completed a months-long breathwork certification course. While she has posted brief TikToks demonstrating how she relaxes with breathwork, Gordon doesn't include detailed instructional information. Like Cator, she believes that people should attempt breathwork with a trauma-informed practitioner who can guide them through the process and help them integrate their experiences afterward.

However someone chooses to practice breathwork, Gordon says they shouldn't be focused on performance. Instead, their experience should revolve around being with the sensation of the breath, cultivating an awareness of it, observing how that feels, and noticing where that takes you.

"It's really about learning how to experience yourself and be with what is in a state of acceptance and openness and curiosity, instead of [saying], 'I have to be efficient. I have to get this done. I have to check this off and get it under my belt so that I can feel accomplished or good about what I did today,'" says Gordon.

When to stop breathwork

When Thérèse Cator instructs someone in breathwork, she aims to keep them in what's known as a "window of tolerance." Since breathwork can be challenging for various reasons, that means making sure a person's level of discomfort is manageable for them. For example, counted pauses between inhaling and exhaling can feel stressful but ultimately tolerable for some. Others may need to stop and take a sip of water or end the session.

Cator frequently begins breathwork instruction with somatic exercises that ease people into feeling their bodies. That includes gentle movement practices that help calm the sympathetic nervous system. For people who feel negatively activated during breathwork, pausing for a moment to orient themselves in the room can feel reassuring. Such preparation can help someone begin to sense more safety in their body.

"Depending on the body you're in, we have a spectrum of violence many of us have experienced, or our ancestors experienced, that is lodged in our bodies," says Cator.

For someone who's dissociated from their body as a way of coping with stress or trauma, breathwork can quickly bring them into contact with a feeling, sensation, or emotion they've been avoiding, which may overwhelm their nervous system. If someone feels overwhelmed, or experiences anxiety or hyperventilating, Cator says they should immediately stop.

In Yildiz's study, people who'd experienced trauma were excluded to avoid this possibility. While pausing between inhaling and exhaling can be an important part of certain yogic breathwork practices, Yildiz and her fellow researchers also avoided breath-holding in their training for a variety of reasons, including that it can create tension for beginners.

The 18 study participants in the randomized controlled trial received eight weeks of training to practice 20 minutes daily at home, with a weekly 60-minute on-site session guided by a certified yoga teacher. Depending on which intervention the participants were part of, they learned breathing practices that included slow and/or deep patterns in various positions, and more sophisticated breathwork techniques. They could also choose from different counts, like separately inhaling and exhaling for counts of three, four, five, or more.

If this sounds basic, consider that Yildiz found most participants had chest-breathing patterns and had to work at developing breathing from their abdomen and diaphragm.

Yildiz says trying different practices is key to understanding what's effective for a person, noting that their body will let them know when it doesn't feel right. Still, beginners might be tempted to push themselves to perfection at first, and insist on sticking with an ambitious practice. They should resist that urge.

"It's like giving somebody a 100-pound dumbbell on their first weightlifting session," Yildiz says.

Similarly, Cator advises her clients to proceed slowly with breathwork: "You can't bypass your nervous system in healing."

There is a moment in Selena Gomez: My Mind & Me in which it feels like the star's world has cracked wide open, and she's bravely invited viewers to witness what comes next.

Both of these things are somewhat true of the Apple TV+ documentary, made about a six-year period in Gomez's life, which focuses on her mental health. But the hour-and-a-half-long film does something curious 20 minutes in, when the singer and actress receives a bipolar disorder diagnosis in 2019, following hospitalization for a psychotic break.

Gomez, now 30, tells the viewer that when she first got out, she didn't know how she'd cope with the diagnosis.

"I needed to keep learning about it," she says. "I needed to take it day by day."

Then she tenderly recalls a childhood fear of thunderstorms, which could precede a tornado in her native Texas. Recognizing her daughter's terror, Gomez's mother provided her with books about storms, lightning, and thunder. This is paired with touching home video footage of a young Gomez being held in her mother's arms and playing innocently outside as thunder rumbles in the background.

"[She] basically said, 'The more you learn about it, the less you're going to be afraid of it,'" Gomez remembers. "And it really helped."

For a moment, it seems like Gomez is poised to let her recovery journey unfold before our eyes, but this is not the film we're given. The intimate documentary shows Gomez in crisis, and yes, her revival, but not much of what happens in between. Though Gomez courageously allows the camera to linger as she weeps over anxious thoughts and stares blankly out the window, perhaps overcome by numbing depression, we never learn what bipolar disorder is, or how it affects her.

Bipolar disorder can be a severe mental illness, typically characterized by intense shifts in mood, energy, and activity. Some people experience manic episodes accompanied by symptoms of psychosis like hallucinations and delusions. We also never learn that people with lupus, the autoimmune disease that affects Gomez, commonly experience depression.

Given the complexity of Gomez's illness, it's surprising that no psychologists, psychiatrists, or other healing professionals appear onscreen. Gomez has spoken to the media about how a type of treatment known as dialectical behavioral therapy has been instrumental to her recovery, but she never mentions it in the film.

This is not a criticism of Gomez or the filmmakers inasmuch as it's an attempt to imagine how else a project like this could address mental health in ways that help others, something that Gomez suggests is vitally important to her. What Gomez offers to viewers instead is profound reassurance that they're not alone with their pain. The genuine compassion she shows two young women who've attempted or contemplated suicide are standout scenes, not only because she recognizes their suffering, but also because she embraces them without judgment or shame. If only a fraction of viewers model the empathy she displays, Gomez may indeed fulfill her hope of saving lives.

Yet just as people need to hear that others, including a celebrity like Gomez, struggle with their mental health, they also deserve to feel less alone in their recovery journey. It is one thing to receive a diagnosis — which is often dependent on access to high-quality health care — but an entirely different experience to piece together a recovery plan. Treatment for bipolar disorder can include mood-stabilizing medications and various forms of psychotherapy.

It's easy to imagine why none of this is included in the film. Gomez may understandably have privacy concerns. Identifying members of her health care team may feel like too big a risk. Providing details about the severity of her bipolar disorder, or how it manifests, may open Gomez up to questions from insurers of tour and film productions. Executives could wonder if Gomez's mental health makes her a liability. She may have feared that including details about her treatment would seem dangerously prescriptive to her fans. (I've asked Apple TV+ representatives about the film's approach to these questions and will update the review if provided with a response.)

Such aspects of Gomez's recovery could've also felt less compelling to director Alek Keshishian, who is famous for his unvarnished portrait of Madonna at the height of her fame in the 1991 documentary Truth or Dare. In this film, the catalyst for Gomez's recovery is a visually and emotionally evocative trip to Maasai Mara, Kenya, where she visits schools built partly because of her fundraising efforts.

At times, these scenes risk becoming a cliché. When an emotionally unmoored, far-from-home Gomez finds comfort in the wisdom and resilience of the community members and schoolgirls she meets, a cynical viewer could be forgiven for questioning the motives behind her visit. There is a delicate line between the perspective-shift such a trip offers, particularly for someone prone to ruminating on negative emotions, and seeking salvation from people with fewer resources who seem to live simpler but more rewarding lives.

What saves these scenes is Gomez's emphasis on human connection and service. These are balms for psychic pain, a point later underscored by Surgeon General Vivek Murthy, with whom Gomez makes a virtual appearance in a discussion about loneliness during the COVID-19 epidemic. The trip to Kenya fuels Gomez's recovery, giving her a newfound sense of purpose, and the desire to pursue change in the U.S. by creating a universal mental health curriculum for schools.

Soon after Gomez returns home, she experiences a lupus flare and requires intensive treatment to reduce joint pain. The ease with which this is filmed, along with other lupus-related scenes, provides a striking contrast to the absence of footage detailing treatment of her bipolar disorder. It may unintentionally reinforce the notion that it's more acceptable to publicly document physical health conditions compared to mental illness.

For all of its omissions, the film is a moving portrait of what it's like to live with mental illness, and more specifically, Gomez's determination to make meaning out of her diagnoses. She is a committed mental health advocate, as her recent trip to the White House demonstrates, and society is arguably better for the attention and fundraising she brings to the cause. No doubt her fans, along with interested viewers, will feel seen and understood by the film. Importantly, it powerfully counters the cruelty of those who insist that mental illness is weakness, undeserving of kindness or empathy.

"When you're struggling with your mental health, the essential part of it is knowing what to do and recognizing that," Gomez says at the end of the film. "I had to relearn things that completely fell out of my mind. It was like, hey, 'You're not a bad person. You're not a gross person. You're not crazy. You're not any of this. But you're going to have to deal with this. I know it's a lot, but this is the reality.' I found having a relationship with bipolar and myself — it's going to be there. I'm just making it my friend now."

Seeing Gomez endure so much pain, then find her way to this conclusion, makes the film worth watching, even if we never see up close how she built this unique relationship with her illness. In that sense, Selena Gomez: My Mind & Me raises more questions than its makers probably realize. Namely, once we reassure others that they're not alone, what do we say next about the journey that's to come?

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

Could it really be that difficult to consciously change your breathing pattern to promote stress relief and relaxation, which breathwork practices promise to do? As it turns out, experts say learning breathwork as a beginner is harder than most understand. That's partly because many people are accustomed to drawing short breaths from their chest, rather than inhaling deeply from their abdomen. Altering this pattern can be challenging, as it requires an awareness that many people don't possess, through no fault of their own. The body's reflexes are powerful; it's easy to take breathing for granted. But there are also dangers to practicing breathwork without proper guidance and support. If you're curious about pursuing breathwork, here's what you should know about how it works, the benefits, and when to stop.

If you have any health concerns, contact a trusted health care professional before starting breathwork.

Once upon a time, self-care was about striving to be the best version of yourself, because ultimately, how can you look after others if you aren’t looking after yourself?

The history of self-care goes way back — all the way back to Socrates. Self-care also has roots in Black history. As Black feminist writer and civil rights activist Audre Lorde wrote in her 1988 essay collection A Burst of Light: "Caring for myself is not self-indulgence. It is self-preservation, and that is an act of political warfare." Lorde defines self-care as a radical act of resistance and a means of survival. Self-care is also all about compassion and community, and as Mashable journalist Chris Taylor puts it, "Self-care isn't performative self-coddling. It's doing the hard work of examining and improving yourself in order to better serve the world."

The problem is, wellness and internet culture have essentially stolen the term, which has led to the original definition of self-care to become co-opted. Thanks to Twitter discourse, the creator economy, and wellness culture colliding, this nonsensical version of "self-care" has grown a life of its own, and from there has amassed a self-indulgent cult of devoted followers.

Google Trends data shows that in the last five years, searches for "self-care" have almost tripled, while over 66 million Instagram posts include the #selfcare hashtag. Meanwhile, the #SelfCare tag on TikTok has racked up a cumulative 30 billion views, as the app encourages users to "show us how you prioritise yourself." Prioritising yourself is important, but should this come at the expense of others?

Like a lot of scams, this co-opted version of self-care preys on vulnerable people. In my case, I was experiencing a particularly bad patch with my OCD and was angry at the world. The version of self-care that I'd learned about from social media felt like a golden ticket to do all the destructive things I wanted to do — neglecting staying in touch with my family, blocking people whenever they mildly irritating me, and trauma-dumping on my friends for hours on end but then refusing to let them lean on me for support because their burdens were detrimental to my mental health. 

Integrative psychotherapist Caroline Plumer, who runs her own therapy and coaching practice CPCC London, told Mashable that "self care is a crucial part of preserving our mental health and building resilience. But like most things in life, the term can be misused, or taken as an excuse to refuse to compromise even where perhaps we should."

Online spaces have co-opted the meaning of 'self care'

The language of self-care — which aims to give words to coping strategies, boundary setting techniques and non-violent communication styles — has entered mainstream internet discourse. The only problem is: these words are often used incorrectly. Phrases like "toxic," "love-bombing," "narcissist," and "trauma-dumping" are thrown around far too liberally and applied inaccurately. In online spaces, where our hot takes are largely limited to 280 characters, these deeply important and complex psychological terms and definitions are stripped of all their nuance and turned into trendy buzzwords. A friend disagreeing with you about where to meet becomes "toxic." A roommate who asks you to wash your dishes becomes a "narcissist." A person on a dating app opening with a cheesy pick-up line becomes a "love-bomber." 

All of these terms exist for a reason — they help people understand and recognise when they’re being mistreated — to put a name to often-traumatic experiences and feelings they’ve had — but in our pursuit to look holier-than-thou 24/7 online, these terms have become an extremely diluted version of their original meaning. 

As Plumer explains: "Whilst self care done right can often lead to us having more patience and emotional generosity towards others, there are some that see self care as the practice of consistently prioritising their own wants and needs above everyone else's, including the greater good." She adds: "While getting our needs met is important, we do need to do this with respect for others and a willingness to meet in the middle where appropriate."

When self-care is just a euphemism for selfish 

In the aftermath of George Floyd’s murder, white activists spoke about how they were suffering with "allyship fatigue" — lamenting about how posting a black square and attending a march or two had wreaked havoc on their mental health, and how for the sake of their wellbeing, they could no longer show their solidarity with Black people.

Earlier this year, amid the onslaught of news about the war in Ukraine, people began sharing infographics and articles about how we can practise "self-care" in the wake of distressing news. Of course, for some people with existing mental health issues and those who have lived in active war zones,, this kind of news cycle can obviously be deeply upsetting, triggering, and traumatising — and in those cases, self-care is important. But when it comes  people were centring themselves and taking attention/focus away from the people experiencing systemic racism and losing family members in a war — but because it was underpinned in this idea of "self-care," we were meant to think it was ok. 

Even earlier, in 2019, a Twitter thread focussed on a text conversation between friends, which included a copy and paste template for how you can tell someone via text that you don’t have the capacity listen to them vent, went viral. In the thread, the OP discussed how they used this interaction with their friend to "set boundaries" in terms of venting, but was subsequently meme’d because, like other clinical terms under social media’s version of self-care’s umbrella, its meaning had become co-opted. The user’s text message, which she offered up as a template for others wishing to "set boundaries," read: "Hey! I'm so glad you reached out! I'm actually at capacity right now and I don't think I can hold appropriate space for you. Could we connect [later date] instead? Do you have someone else you can reach out to?" Of course, setting valid boundaries is not the problem here, but as many responses to this thread pointed out, this type of self-involved mindset was "exhausting."

"Friendships shouldn't be transactional," one user wrote. "This is weird." Another described the thread as a "fundamental misunderstanding of what it means to be human," adding that "being of service to others is what relives us from the bondage of hyper individualistic "self" under capitalism." Underpinning both these examples is a very-online attempt at mental gymnastics, as people strive to justify the lack of reciprocity inherent in this version of self-care as a spiritual journey as opposed to plain old selfishness. 

Trauma, sex, and relationship therapist Sally Baker tells Mashable that "wellness culture has debased real self-care," describing it as a "narcissistic call to arms." In trying to differentiate self-care from selfishness, she explained, "when it’s all about what an individual needs there’s no context; no responsibility and little or no opportunity for personal growth." Meanwhile, Sally defines "real" self-care as "intuitive," and insists that at its core, it's centred around "establishing healthy boundaries as well as respecting what is your stuff versus what is other people’s responsibility."

Villain era? Or just setting boundaries? 

What’s especially interesting about the tail-end of the self-care movement is the directly-opposing counter-culture that seems to have arisen due to it. All over Twitter, we’re seeing people declare that they’re in their Fleabag and villain era, when all they’re actually doing is setting healthy boundaries with people, like not getting back with an abusive ex or refusing to let someone with sinister intentions take advantage of their good nature. 

You might think the rise of the villain era further supports the need for a self-care culture: with the fact that people are struggling to even communicate their most basic needs to others being a surefire sign that more of an emphasis on self-care is the very thing we need right now.

But that’s not the truth. The problem is, people are recognising that when it comes to self-care, a lot of us are really taking that term and running with it. They're using it to excuse all kinds of actions and behaviour which, as I’ve explained, are objectively shitty things to do. This means that, contrary to promoting actions that are good for our mental health, self-care has become a dirty word, as people have learned to see the phrase as synonymous with not just selfishness, but even villainy. 

So, that leaves us with this Catch-22 where people who really do need to practise self-care are anxious about doing so because they don’t want to be seen as a "villain," while those who arguably need to practise less ‘self-care’ and more care toward others feel emboldened to continue toxic patterns of behaviour.

Perhaps at the root of all of this is a need for better emotional education so that we are all able to communicate our boundaries and needs in a healthy way, but the question is, at what point does self-care become selfishness? When do we know where to draw the line? 

Of course, after a tough couple of years, looking after ourselves is going to be more important than ever. The key is making sure that we don’t fall into the scam of narcissism packaged up in a pretty Instagram infographic. Maybe we can all agree on one principle: Don’t be a dick. 

Sometimes it's hard to know how to talk about mental health, or whether it's safe to share feelings of distress with friends and family.

A new public service announcement depicts this reality vividly. In the minute-long spot, teens and young adults hear from loved ones that they shouldn't be struggling. When scrolling through social media, they are bombarded with messages that sound a lot like toxic positivity. Slogans like "harden up," "good vibes only," and "manifest your happiness" leave no room for sadness, anxiety, and depression.

The PSA specifically features teens and young adults of color, who were among those at higher risk for mental health challenges during the pandemic. That heightened risk could reflect the toll of experiences like discrimination and racism, exposure to community violence, and living in under-resourced or racially segregated neighborhoods.

In the video, well-intentioned loved ones reinforce some of the misconceptions that youth often hear when discussing mental health. A father tells his daughter she shouldn't be sad with a roof over her head. One friend tells another that he needs to stop the "depression stuff." A father declares to his son that "men don't cry."

The ad is the latest effort from the Seize the Awkward campaign to help young people feel less alone, and to remind people that a caring friend can help someone who's suffering get through tough periods.

Seize the Awkward launched in 2018 as an initiative of the American Foundation for Suicide Prevention and The Jed Foundation, in collaboration with the Ad Council. The campaign encourages young people to be there for each other, even if it might feel temporarily awkward. That's why the campaign's website includes tips about how to start a conversation about mental health.

Dr. Christine Yu Moutier, chief medical officer of the American Foundation for Suicide Prevention, told Mashable that the PSA is one way of letting young people know that adults care and that "we're listening to you." She said that concerning trends related to mental health for youth of color, including increased psychological distress and suicidal thinking, prompted the campaign to focus on that population, but that themes of the PSA are universal.

She also noted that an empathetic friend might need their own support from a loved one.

"We can be struggling at times and we can be helping others at times," she said. "And sometimes it's even [doing both] at the same time."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

"I’ve never said this to anybody," a bisexual person who requested anonymity confessed in my Twitter DMs. "I’m so sorry if it sounds like a drama."

It didn't sound like a drama at all — not to me, at least. This person, who reached out to me after a call-out I tweeted for this story, said it was difficult to accept her bisexuality. She began questioning whether she liked women at age 11, but went to great lengths to hide this attraction from her parents. That's when her anxiety began; it only heightened as she matured, which led to weight loss.

She continued to suppress her attraction to women, even undergoing plastic surgery to appear more desirable to men. "Proving I didn’t like women was something that really hurt me," she said. She tried to deny her own bisexuality because she was never in love with a woman, "but then when I fell for one I knew — as always — I wasn't straight… In my heart I always knew I was bisexual."

This inner tug of war is one I know personally, and one some of the other bisexual people I spoke to experienced as well. The anxiety and other mental health impacts bisexuals face is evident in data, too.

According to a 2011 report from the San Francisco Human Rights Commission (HRC), bisexual people have a greater likelihood of depression, anxiety, and other mood disorders. More recent data supports these figures, as well. The Journal of Affective Disorders published a paper that concluded that "Bisexual individuals are at greater risk of poor mental health than lesbians and gay men" in Jan. 2020.

In a factsheet on mental health of bisexual populations released at the beginning of this year, the American Psychiatric Association explained that bisexuals report increased experience of depression or suicide in comparison to monosexuals (hetero or homosexual). Substance use rates are also higher. In August, the University of Manchester released a study that claimed bisexual people are six times more likely to self-harm than people of other orientations.

Multiple bisexual people I spoke to mentioned anxiety and depression, and two mentioned suicidal ideation. "I've contemplated death before because I truly felt like I was broken," one said. What is it about being bisexual that impacts mental health — and what can we do about it?

The data doesn't always capture the true picture

These statistics are alarming, but could be at least partially explained by the way research is conducted on bisexual people. It comes down to the difficulty researchers have correctly identifying the population they're trying to study, and with an indeterminate group like bisexuals, that's easier said than done.

Dr. Geoffrey Ream, an associate professor at Adelphi University’s School of Social Work who has conducted research on suicide rates of LGBTQ youth populations, explained to Mashable that researchers decide to code subjects as bisexual using various methods. The HRC data, for example, deals with people who self-identified as bisexual. But other studies code people based on how they answer questions about behavior and attraction — say, whether they've had sex with members of their or other genders.

Dr. Sarah Noble, author of the APA's factsheet, told Mashable that research on bisexuality is difficult to capture in general. "The thing about sexuality is that there is fantasy and attraction, there's sexual behavior, and there's sexual identity," said Dr. Noble. "Demarcating those different aspects of sexuality is often complicated and not necessarily perfectly identified for every study." Thus, each study isn't comparable, according to Noble.

So while the coding issues can certainly lead to self-identified bisexual people and "coded" bisexual people being lumped together, this is ultimately okay. "You're always working with imperfect data," Ream said. He quoted his PhD advisor Ritch Savin-Williams, who specializes in LGBTQ research: "Something Ritch always told me is that you can never get a representative sample of a stigmatized and invisible population." Therefore, you combine different sources. Ream continued, "So you take a bunch of different data sources and triangulate. Or quadrangulate. Quintangulate, even."

bisexuality mental illness Credit: bob al-greene / mashable

Recruiting can also be a roadblock

Sarah Jen, assistant professor in the school of social welfare at the University of Kansas, agreed with Ream about the imperfect nature of the data. Jen, who worked on the Aging With Pride study, the largest study of LGBTQ midlife and older adults in the U.S., told Mashable it's why we need more bisexual-specific research. "Recruitment methods that we use for LGBTQ communities broadly aren't as generalizable and aren't as reflective of the full diversity of the bisexual population," she said.

Jen also pointed out that non-monosexual people are more likely to use multiple terms to identify themselves, such as queer, pansexual, and omnisexual. This further impacts bisexual representation in research.

Another factor is that many studies on queer people use LGBTQ community organizations to help with recruitment. "Bisexual people have historically and continue to say that they don't feel as welcome and they don't feel as much of a sense of belonging in those spaces," said Jen, "because they've faced bi negativity or biphobia…and they don't feel like that space is for them."

The result, Jen argued, is that researchers are missing a large swath of people who not only identify as various non-monosexual terms, but also those people who don't identify as any of those but still exhibit "bisexual behaviors" (i.e., having sex or dating people of both their and other genders), histories, and romantic relationships throughout their lives.

"It's really hard to recruit people that way," Jen said. "How do you write a recruitment statement that says, 'Have you ever done all of these things?'"

While bisexual people are the largest self-identified group within the LGBTQ community, the proportion of bisexual-focused research is small. Ream said this conglomeration of bisexual data results in skewed mental health research. Jen argued that, if anything, we're not getting the full picture.

Although bisexual data is imperfect, as Ream reiterated, researchers are always working with imperfect data when it comes to sexual orientation. This doesn't invalidate the studies done on the bisexual population; if anything, it's proof that more bisexual-focused research needs to be done. For now, the data and resulting statistics — worrisome ones at that — are all we have.

The unique, but shared, mental health experiences of being bi

Regardless of how complicated it is to gather "true" data on the bisexual population, it's clear that bisexual mental health is distinct from that of monosexuals.

Minority stress theory, developed by Ilan H. Meyer, can contribute to this. The theory states that instances of social stigmatization don't directly lead to mental health problems. Rather, these instances result in stress for the minority, and this stress accumulates over time. This accumulation can lead to long-term mental health concerns. (As one can imagine, this theory extends to other minority groups as well.)

Minority stress stems out into external stress (distal) and internal stress (proximal). An example of distal stress is a bisexual person being told they're lying, or that their sexuality doesn't exist. An example of proximal stress is internalized biphobia, or not even coming out at all for fear of backlash.

"Minority stress falls very hard on bisexual folks," said Noble. Tricia, a bisexual grad student I spoke to for this piece, said she's felt weighed down by internalized biphobia, and biphobia in general.

Biphobia, bi-erasure, and monosexism — the belief that people can only be straight or gay — exist in both the straight and LGBTQ communities. As I discussed in my piece on feeling "queer enough" earlier this year, bisexuals may not feel at home in either because of these factors. "Part of identity development is finding your people, and that's particularly difficult for bisexuals," said Ream.

Tricia said she feels like an invalid member of the LGBTQ community. Recognizing her privilege as someone white, cis, and in her words "extremely straight passing," she's been reluctant to make space for herself. "I’ve found that in my efforts to make space for and pass the mic to members of the LGBTQ community whose sexualities overlap less with heterosexuality than mine does, I don’t make any space for myself at all," she said. "And that constant self-invalidation really takes a toll on me."

Another bisexual woman, Julia, feels similarly. "Because I’m femme, I’ve been lucky to not stand out and get bullied or harassed," she said. "But I feel like I don’t deserve to be in queer spaces or even call myself bi." Some members of her family have also accused her of "faking" her bisexuality.

Our culture struggles with things that don't fit into neat boxes, according to Noble. "We as a culture have come to accept homosexuality," she said, as it is a "box" that is the opposite of heterosexuality. Bisexual people — as well as those who don't fit into the gender binary like nonbinary and trans people — don't fit into these boxes society has constructed.

Society's black-and-white thinking impacts stigma against bisexuals, who occupy the gray area, Jen said, and also people's ability to understand the bisexual experience.

"It leads to some sense of othering," she said. "We can't understand an identity [so we think] we shouldn't adhere [to] it…when it doesn't fit into our cleanly-cut categories, we don't know how to make sense of it."

Jordyn, another bisexual I spoke to, said that people told her her sexuality was "wrong" and "didn't work like that." When Jordyn confided in some straight female friends, they stopped talking to her. "They were scared I would try to hook up with them," Jordyn told me. "Some even started spreading rumors about me trying to kiss them or claiming I confessed my feelings to them (which never happened)."

Jordyn fell into a depression and had anxiety attacks whenever someone questioned her sexuality or tried to discuss it with her.

When Jen herself came out as bi in college and started to find a queer community, she remembers being told that bisexuals were "doing fine" due to factors like passing privilege, the ability for some bisexuals to "pass" as straight in everyday life and thus avoid discrimination people who "look queer" face. "What we end up finding through Aging With Pride was just the opposite," she said. "Some of our bisexual participants reported more mental health concerns than the lesbian-identified and gay-identified participants we were talking to."

It doesn't help matters that there's been a debate about whether bisexuality exists within the scientific community itself. Until recently, according to Ream, medical sexologists couldn't observe bisexual arousal in a lab and thus argued it doesn't exist. That is, until last month when scientific journal PNAS published "Robust evidence for bisexual orientation among men" which shows — surprise! — that bisexual arousal, particularly in men in this study's case, does exist.

"Took you long enough," Ream joked.

Unfortunately, however, scientific proof doesn't erase the stigma against bisexual people. Jen pointed out that bisexual people experience both invisibility and hypervisibility, which she defined as negative depictions of bisexuality like hypersexualization.

Jordyn experienced hypersexualization by way of her ex-boyfriend, who called her a slut when she tried to explain her bisexuality. "[He] said I only enjoyed being with women because I am trying to impress more men," she said.

Ashley, another bisexual woman I spoke to, also experienced this. "I felt fetishized by my cishet ex who I began dating during a depressive episode sophomore year of college," she told me. This came after her first bout of depression her freshman year, when her former abuser threatened to out her. Because of experiences like this as well as her biphobic/homophobic family, Ashley kept her bisexuality a secret until this January; she's still not out to her family.

The need for bi spaces and positive framing

"I believe it’s important to note that my depression exists outside of my sexuality," Ashley said. "However, it is at times worsened by the difficulty I’ve had navigating life as a bisexual person and as part of a greater community at large."

Despite it being 2020 — and despite bisexuals being a large portion of the LGBTQ population — biphobia exists even in the "woke" corners of the internet. Last month, for instance, a now-deleted viral tweet stated, "I understand the argument against biphobia, but I also understand the argument for lesbians not wanting to date bisexual women. Man Residue™ is a real thing that affects the relationships of all women who deal with men romantically."

man residue tweet Credit: thotscholar on twitter

In addition to biphobia, this tweet displays transphobia (some trans men identify as lesbians); trans misogyny (the specific hatred of trans women) if "Man Residue™" refers to sperm and a woman has a dick; and ignorance of compulsory heterosexuality, the assumption that women are attracted to men due to society's push of heterosexuality (so some lesbians may have sex with men before figuring out they're lesbians). The user acknowledged their biphobia and continued to be biphobic. This tweet encapsulates some of the othering bisexuals experience in the queer community, as if bisexual women are somehow tainted by their experiences with cismen.

"I hate the idea of being considered a queer tragedy because my life has been full of joy that I’m lucky to have experienced," Ashley said. "I don’t think my sexuality makes me tragic, but I do think it’s tragic that I'm not alone in struggling with how it impacts my mental health, or lack thereof, and how I simultaneously don’t receive the care or support I deserve in order to healthily cope."

Resources for handling bisexual minority stress

So how can bisexual people cope with minority stress, with either external or internal cries that their sexuality is wrong, or that it doesn't even exist?

For Bisexual Awareness Week 2020, The Trevor Project released a guide on How to Support Bisexual Youth. The guide not only breaks down bisexuality and biphobia, but also offers ways to support and celebrate one's bisexuality — which, in my opinion, is useful for anyone, young or not.

All my expert sources recommended that bi people find their own community, their own space, their own people. During the pandemic, making friends online can arguably be smoother than ever. If you don't know where to start, VICE made a helpful guide on how to make more LGBTQ friends.

While this may run the risk of being a negative experience — as seen above, biphobia does exist within the online queer community — you can focus on, say, the "#bisexual" TikTok tag, or peruse through Twitter trends like #beautifullybisexual that highlight bisexual people specifically.

What's more is that bisexual people can have a meaningful role in the broader queer community, according to Jen. Focusing on our commonalities with other queer people, regardless of orientation or expression, can lead to community building. Further, those who have access to passing privilege can act as allies and advocates to queer people who don't, Jen said.

The knowledge that you're not alone anecdotally — in my and others' experiences, that is — can be not only reassuring, but freeing as well. An anonymous bisexual said it was a cathartic experience when they spoke to queer friends they made through the Doctor Who fandom on Tumblr.

Jordyn told me that before she graduated college, she met a girl who was struggling in the same way she was. "It was in that moment I realized I was not alone," she said. "We helped each other find our way and understand that there's a whole world of people out there struggling to understand and find acceptance for their sexuality."

While Jordyn hasn't fully come out yet, she's no longer ashamed of who she is. She said, "I've surrounded myself with people who love and accept me for me, and I'm so grateful for that, and I hope everyone in the world struggling to find themselves understands they're not alone."

Jen advises building a network for yourself, as one fellow bisexual may relate to certain parts of your experience but not all, and that's okay. As we were chatting on the phone, for instance, Jen said we both can relate and talk about passing privilege — but as she's married and I'm single, we don't relate on that level.

Jen also said there are ways bisexual people can positively internally process their identity. When she performed a study on older bisexual women in 2018, she observed that they described their identities negatively. Their bisexuality created a division; it made their lives more challenging, especially relating to lesbians — it was like a political and emotional divide they couldn't cross.

But when they perceived bisexuality as a life, as a way of living — not just an identity — it was seen positively. "It allowed for capacity, openness, fluidity," Jen said. The word that came up most often was freedom.

Internalized biphobia (or queerphobia or homophobia), like any ingrained belief, takes time to unlearn — but that doesn't mean it can't be done. Jen suggests positive reframing, as these subjects reframed their bisexuality. You can do this yourself, or seek guidance of a queer-affirming therapist if you have access to one.

"It allowed for the freedom of a non-traditional life," Jen said. "And I think whenever we come against identities where there isn't a script for how to be, there isn't a way laid out for us, that actually gives us a lot of potential to lay our own path."

This isn't to say positive reframing is a sudden cure-all for anxiety and depression, or that bisexual people going through mental health struggles shouldn't seek help. But, like community building, reframing is a step bisexual people can take to affirm themselves, to see their sexuality as something other than an affliction."

"Folks could see [bisexuality] as a freedom, as a capacity that they have," said Jen. "One woman actually described it as a superpower that most people didn't have, but that she had, to see the world in a more open way."

If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.

Depending on which student you talk to, back-to-school season may be a welcome shift back into a familiar routine with friends, an anxiety-provoking transition that raises fears about classwork, bullies, and school violence, or a complex combination of both. While back-to-school jitters are normal, intense fear or refusal to return are signals that your child needs additional emotional support. 

One unexpected sign of this struggle could be offhand remarks about a "back-to-school necklace," or internet searches and social media posts related to the term. In some cases, a teen might be referencing despair or suicidal feelings about returning to school, similar to a meme that pairs the phrase "back-to-school necklace" with suicidal behavior. (Mashable isn't sharing more details about this term to avoid spreading suicide contagion to vulnerable readers. If you're a student who found this story via that search term, please consider talking to a trusted friend or adult about your feelings, or consider contacting the 988 Suicide & Crisis Lifeline.) 

Whether teens are using this term as slang to offhandedly indicate they're not thrilled to go back or they're actively feeling suicidal about returning, it's clear that parents are worried about what their kids will experience this school year. A recent survey of 532 parents by On Our Sleeves, a national movement for children's mental health, found that 79 percent of respondents are worried about issues like bullying, racism and discrimination, school safety and violence, and ongoing challenges related to the pandemic.

Ariana Hoet, Ph.D., clinical director of On Our Sleeves and a pediatric psychologist at Nationwide Children’s Hospital, says that when children make references to phrases like "back-to-school necklace," it's possible they're trying to express frustration but have no intention of harming themselves and do not feel suicidal.

"Whereas some children truly are feeling that hopelessness, feelings of worthlessness, feeling like things won't get better, and those are the kids I worry about," she says.

Either way, it's critical that parents take such references seriously so they can determine the extent of their child's anxiety. This can feel daunting for parents, particularly those unaccustomed to discussing mental health with their children. But by watching for certain warning signs, engaging in nonjudgmental conversations, and acting swiftly if their child is severely distressed, parents can intervene before the situation becomes a crisis.

Warning signs of suicide risk you should know

Hoet says that children who are anxious about returning to school may develop physical symptoms like stomachaches or headaches. They may withdraw from social or family activities. If they're experiencing an anxiety disorder, they may have a panic attack or refuse to attend school.

Doreen Marshall, Ph.D., a psychologist and vice president of mission engagement for the American Foundation for Suicide Prevention, says that warning signs of suicide risk typically show up in three ways: talk, behavior, and mood.

Learning the warning signs for suicide risk can help parents intervene before a crisis. Credit: American Foundation for Suicide Prevention

A teen might overtly say they want to end their life, but they could also be less direct by lamenting that life is pointless or that they have nothing to which they can look forward. Their behavior might include sudden isolation, substance use, and searching online for ways to end their life. If their mood shifts quickly and they become sad, angry, or agitated often, it could indicate they're not coping well.

"These are warning signs that tell us that this is a time to lean in a little bit more, to find out what's happening," says Marshall. "It may also be a time to ask directly about suicide."

Though specific descriptions of methods can contribute to contagion, asking if an adolescent feels suicidal doesn't increase their risk of an attempt. Marshall says that parents can calmly note to their child that with everything going on, sometimes people feel hopeless and may want to end their life, and then ask, "I'm wondering if you've ever had those kinds of thoughts."

How to talk about back-to-school anxiety

While parents tend to focus on the positive aspects of school when talking to a nervous child, that could inadvertently minimize their fears. Drawing on perspective, parents might emphasize that things kids insist will last forever, like the pain of a breakup or drama between friends, will ebb and flow. But teens have yet to gain distance from these challenges, so the intensity of their pain can feel permanent.

Marshall says that open-ended, nonjudgmental conversations that validate how a child feels are key to helping them cope. She urges parents to focus on listening, and avoid making their child's concern smaller. Instead, they should try to genuinely hear what their child is saying and not jump to fix problems for them.

Hoet says that some parents don't want their children to feel uncomfortable emotions, so they might avoid those feelings instead. Indeed, nearly all parents polled in a recent On Our Sleeves survey said they felt it was important to talk about mental health issues, but the majority of respondents said they needed help starting those conversations, and that they didn't have those discussions with their own parents growing up. The campaign's list of conversation starters for children include questions like, "When you feel sad, what do you think about to make yourself happy again?"

For adolescents and teens, Marshall recommends asking them what might help with back-to-school anxiety. Parents can also speak candidly about the risks of certain online experiences, like bullying or exposure to suicide contagion in online forums, and help kids set limits as needed. By framing suicide as a health issue instead of something to be kept secret, parents can lessen the stigma that surrounds thoughts of wanting to die. That can empower a teen to talk about how they or a friend are affected by those feelings.

How to help your child with back-to-school anxiety

Lydia McNeiley, a middle-school counselor from Hammond, Indiana, says that parents who are worried about their child's well-being should contact school staff, including a counselor or psychologist if one is available. Parents can confidentially raise concerns about issues like bullying and discrimination, but ask that their student's name be kept private. McNeiley, who serves as the school counselor district coordinator, says counselors can take this information and bring students in to discuss what's happening, both to help resolve a conflict and offer the affected teen additional support. Parents can also encourage their kids to talk to a counselor or trusted teacher about their challenges.

McNeiley says that adolescents can't always identify what exactly is bothering them. For example, if they're being harassed or discriminated against but the attacks are more like microaggressions than blatant homophobia or racism, the student may have difficulty pinpointing why they feel uncomfortable. That's why it's critical for adults to validate the student's emotions, particularly if the student belongs to a group historically targeted by discrimination.

If a parent feels overwhelmed by what their child is experiencing or expressing, Marshall recommends trusting that instinct and seeking help without delay. That could mean contacting their teen's doctor to ask for a referral or reaching out to a local mental health professional or organization for resources and peer support. She says parents don't need a detailed plan before talking to their child about getting them help. Instead, a parent can let the child know that help is available, and that they'll figure next steps out together. Of course, it's critical that the parent follows through.

And while parents might be inclined to dismiss internet slang related to mental health as benign, McNeiley says to take it seriously.

"They might not realize that tomorrow could be better," she says of kids experiencing school-related stress or anxiety. "It could be like a little internet trend, but this is their life, and we don't know what their mind state is, so we want to be cautious and address everything."

If you’re feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text “START” to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don’t like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

The day that Americans knew was coming is finally here. Roe v. Wade, the Supreme Court decision that created a constitutional right to abortion, is gone.

In many ways, we know what this means. More than half of American women live in states that are hostile to abortion rights. They will lose access to abortion in the coming weeks and months. The majority of those seeking abortion care live below the poverty line and will find it difficult to travel to where the procedure is legal. Reproductive justice activists are scrambling to meet those urgent needs by organizing support for abortion funds and coordinating travel to other states.

Yet there's a little-discussed aspect of abortion access that can have enduring consequences: its impact on mental health. Research tells us that being denied an abortion leads to worse short-term mental health and that it raises the likelihood of living in poverty and being tethered to an abusive partner, neither of which are good for well-being.

Beyond those facts, the decision should prompt us to wonder — and research — what happens when women and people who can become pregnant live in a state where abortion care is no longer just hard to get, as it is currently in many states, but banned with rare exceptions.

Will the Supreme Court's decision and subsequent state bans lead to low-level dread for people who can become pregnant but know they don't have the resources to travel elsewhere should they need an abortion? Will it intensify anxiety for women of color, trans men, and nonbinary people who know they may be targeted and criminalized if they self-manage an abortion? Such questions will be hard to answer without rigorous research designed to disentangle the complex factors that affect a person's mental health, but we urgently need to better understand what this decision means for people's well-being.

Dr. M. Antonia Biggs, Ph.D., an associate professor and senior researcher at the University of California at San Francisco who's studied what happens to women's mental health when they can't access abortion, suspects the decision will lead to worse emotional and psychological experiences.

"This is fundamentally a loss of bodily autonomy, which is not good for people's mental health," says Biggs, who is a social psychologist.

Her research found that when women were denied an abortion, they initially had higher levels of anxiety and lower self-esteem than those who had the procedure. While those disparities faded between six and 12 months later, the women forced to give birth subsequently experienced more long-term physical health problems and financial insecurity. They were more likely to live in poverty, experience financial hardship, and be with a violent partner. These are troubling cascading effects that heighten the risk of experiencing anxiety, depression, and post-traumatic stress disorder.

It makes no sense to look at the data and suggest that abortion is what harms people's mental health, which is what its opponents insist. When I wrote about this subject in 2017, a number of experts told me this idea was based on debunked and flawed research. One even told me of anti-abortion researchers: "They are making wrong conclusions and really bad science, if you can even call it science."

Those who've fought to overturn Roe for years or decades may feel personal relief or even joy now, but this is a perverse justification to offer anyone who fears remaining pregnant and being forced to give birth.

Biggs' research also found women who received an abortion were more likely to perceive stigma and more likely to experience psychological distress years later. She believes that pregnant people may internalize new state bans as stigmatizing, increasing the odds that they'll feel worse about themselves in the future. A preliminary finding from the study, which needs further exploration, revealed that those who had to make disclosures about seeking or receiving abortion care, typically because they needed help paying for it and related travel costs, experienced negative mental health symptoms, too.

"There's so many compounding effects of being denied abortion that impacts so many aspects of your life," says Biggs. "It's overwhelming and incredibly sad to think about that."

Imagine, too, the reality that many pregnant people living in a state where abortion is banned may be alone with their struggles, worried that discussing the possibility of seeking care elsewhere could be used against them. We know that emotional isolation is painful, but the Supreme Court decision all but guarantees countless pregnant people will feel more alone than they ever have. We shouldn't forget them, because they deserved so much better than this.

If you want to talk to someone, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.

Trying to parent a kid with an internet-connected device can feel like a game of whack-a-mole. Just as quickly as you've set boundaries around their smartphone or tablet use, they present an urgent request to play a popular game or message with friends on a new app.

Of course, the companies trying to win young customers design their digital products to be as engaging as possible, with experiences and algorithms that pull users in for as long as possible. That means you're left trying to determine how your child's internet use competes with — or complements — aspects of their well-being like sleep, physical activity, and socialization.

Parents know the horror stories told about children with unfettered or unsupervised access to the internet. They encountered bullies, spent sleepless nights playing video games, or lost themselves in anonymous message boards riddled with hate speech and conspiracy theories. More commonly, they make social comparisons about perfectly curated images that play into their feelings of insecurity — and that can be terrible for their mental health.

Desperate for a quick, effective solution, caregivers might delay getting their tween or teen a smartphone, make use of parental controls on devices and apps, severely limit how and when their child can go online, or try all of those things. But a new report published by the Wheatley Institution at Brigham Young University found that parents might be overlooking a critical factor in this complex equation: their own parenting style.

The report's co-authors conducted a survey of 1,231 adolescents and their parents from across the U.S. (While not nationally representative, the survey used a national sample.) The researchers found that parenting style and parents' personal technology use appears to significantly influence their child's mental health and well-being.

That parenting style matters for a child's mental health is no surprise. Research has long suggested that a responsive and supportive yet firm approach, known as authoritative parenting, is positively associated with a child's self-esteem, optimism, and resilience, among other qualities. (Other styles include authoritarian and permissive parenting.)

In this study, the researchers indeed found that "warm, responsive, and engaged parenting" was strongly protective for teen mental health. For teens who reported the "warmest" parenting, only 13 percent reported high levels of depression. Those teens also described parental supportiveness that would, in theory, help them feel more confident about their choices. "They listen and treat me as an equal instead of assuming I’m up to no good," said one participant.

Of the young survey respondents in the least warm group, whose parents were less responsive and loving, 88 percent were high on depression.

But parenting style also showed up in relation to how adults used technology and its potential consequences for their children.

Depression was higher among adolescents whose parents reported greater levels of their own social media use. Of the respondents whose parents engaged with social media for more than seven hours a day, more than a third said they were depressed. The researchers found that the more parents used social media, the more likely they were to exhibit lower levels of warm parenting.

More than half of respondents said their parents demonstrated high levels of responsiveness, comfort, and understanding, and reported experiencing fond time together. But 15 percent of adolescents in the survey rarely or never experienced such behavior from their parents.

Dr. Sarah Coyne, the study's lead researcher and associate director of BYU's School of Family Life, said that while parents' social media use isn't yet causally linked to child mental health, the findings point to the possibility that some kids feel their caregivers ignore them and their needs when a device is present.

The researchers also found that when parents become overly controlling about digital media use, perhaps thanks to battles over screen time or fears over unrestricted access, it can backfire. Children whose parents imposed the most rules and restrictions reported the highest rates of depression compared to those with a less rigid approach. This, too, may reflect what research tells us about authoritarian parenting, a style that stresses obedience and punishment and has been linked to outcomes like aggression and anxiety.

The researchers' statistical analysis controlled for variables, including gender, family structure, and age. Coyne and her fellow researchers decided to publish their findings now for the public prior to submitting them to an academic journal because of the furor surrounding teen mental health and social media following the release of the Facebook Papers. Those internal documents, shared by a former Facebook employee last fall, exposed the social media company's internal research on the negative mental health effects experienced by some young users on the platform.

Coyne said her team's research persuaded her to adjust her own approach to social and digital media use with her five children, who range from ages five to 18. Instead of imposing restrictions out of fear, she's tried to emphasize talking to her children about what they're seeing, and encouraging them to practice compassion for themselves and others when they start to make negative social comparisons. Coyne also tries to spend her screen time actively using social media in positive ways, like congratulating someone instead of passively scrolling or getting involved in heated exchanges.

"I'd be very thoughtful about the types of interactions that you model for your own kids," says Coyne.

If you're a parent struggling with your mental health, or you're concerned about your child's mental health, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is a list of international resources.

It was the second winter of the pandemic when Alexis Grams, 28, a project manager from Minnesota, decided to make a drastic change. 

The atmosphere on TikTok "had become too toxic and negative. No amount of likes or popularity was worth the endless barrage of criticism left by internet trolls."

Despite noticing how social media negatively impacted her mental health, Grams felt trapped in an endless cycle of FOMO and misery. As someone with ADHD, her smartphone was a huge distraction that took away from activities she enjoyed like reading, her mental energy too depleted to finish a book.

"The thought of my life quickly passing by while my face was constantly fixated on whatever mindless videos I was watching was a grim, uncomfortable thought," she says. "After hours of scrolling, I’d look down at my dogs and feel terrible for choosing my phone over them."

Then in December 2021, she switched from her iPhone to a "dumb" Nokia phone. 

The instant relief brought on by the absence of notifications constantly bombarding her was powerful. "I did feel a bit empty and bored a week in. You start to realize how much time there actually is in the day when your face isn’t glued to your screen."

Grams had inadvertently peeked behind the curtain of the social media machine and discovered its true cost: time.

It's a modern-day proverb: “If you’re not paying for the product, then you are the product." Even if you didn't see The Social Dilemma, you've likely heard this aphorism first spoken by Tristan Harris, a former Google employee and co-founder of the Center for Humane Technology. And when it comes to social media, we are all definitely the product. 

The addictive and dangerous effect of platforms likeTikTok, Facebook, and Instagram is pretty evident these days. But it's not just social media, it's the pings and pop-ups of notifications on our phones, the auto-play on streaming platforms, and the ubiquitous screens screaming for our attention. We know this, yet we feel powerless to stop it.

Enter digital minimalism. 

The concept, popularized in 2019 by Cal Newport's book Digital Minimalism: Choosing a Focused Life in a Noisy World, isn't new. But in today's world of virtual everything, blurred work/life boundaries, and alarming choices made by eccentric billionaires, digital minimalism has a growing following and has become even more relevant. 

What is digital minimalism?

Essentially, digital minimalism is whittling down the technology you use to tools that only help or enrich your life in some way. Rather than the occasional digital detox or hacks like turning off notifications, Newport argues that an entire philosophy is needed to make lasting changes. And that philosophy stems from identifying which technologies serve you and which don't. 

The beauty of this philosophy is that it's completely up to the individual to identify which technologies they value— it's not a stringent set of rules. It's an adaptable approach because it puts the "rulebook" in the hands of the individual.

Digital minimalism says technology isn't inherently good or bad, it's how we use it that gets us into trouble. "Digital minimalism definitively does not reject the innovations of the internet age, but instead rejects the way so many people currently engage with these tools," Newport writes. 

So it's not just for aging hippies who never switched to smartphones?

Last year, Ella Jones, was in her final year at the University of Leeds when she ditched her smartphone. It started when she and her boyfriend were talking about the purpose that smartphones serve and whether they were actually useful or a waste of time. 

Jones, who is now 21, had been interested in minimalism in general, so she and her boyfriend decided to take on the challenge of switching to dumbphones. It was such a success that she documented her experience on YouTube.

Jones ended up using the flip phone for nine months until she switched to an old iPhone 5S because she missed having a high-quality camera, but through the digital minimalism subreddit, she's found ways to make her iPhone less distracting like deleting the app store or making the screen grayscale. "These little things that phones have that are designed to grab your attention, if you remove those, the phone itself isn't really any more engaging than any other kind of device or thing you have in your house."

Jerzy Rajkow, is a father of two daughters and chief of support staff at a law firm in Warsaw, Poland. An early tech adopter, when his first daughter was born seven years ago, he started thinking about how he would teach technology to his children.

"I was thinking that of course, she should be a digital native, she should use those devices from early on, and then I started to research this in order to verify whether I am wrong or right in this attitude," said Rajkow. What he learned was profound. "Basically, I concluded that I will probably never give a smart device to my children before they're 18."

Rajkow wanted to be a role model for his daughters and for them to be "well-oriented in the world, be able to think for themselves, and to draw conclusions without being influenced." He discovered a version of the problems Frances Haugen would eventually blow the whistle on Facebook and Instagram’s reported effects on mental health among teens.

As an IT worker, he intimately understood the dangers of some of these new technologies. "I saw more and more how tech was invading people's lives, people's privacy. How it became more difficult to maintain work-life balance and focus on complex problem-solving."

Rajkow also noticed how sessions on Facebook — whether promoting his coaching business or interacting with friends — made him feel bad about himself. He ended up deleting social media altogether. 

How does it work? 

There is no one-size-fits-all approach to digital minimalism. The key is to evaluate which technologies add meaningful value to your life and limit or eliminate the rest. To get started, Newport recommends a clean slate approach by cutting off all "optional technologies" for 30 days. "During this thirty-day break, explore and rediscover activities and behaviors that you find satisfying and meaningful," he writes. 

"At the end of the break, reintroduce optional technologies into your life, starting from a blank slate. For each technology you reintroduce, determine what value it serves in your life and how specifically you will use it so as to maximize this value.”

Jones uses an old iPhone 5S with Facebook Messenger installed for keeping up with friends. She only uses Facebook and Instagram on her laptop. She doesn't have GPS and generally tries not to rely on her phone for directions. 

"I think social media apps are the main issue," says Jones. "You click on it, and it's loads of information all at once, whereas, if you go on the banking app, it's just static and to the point."

Grams used a Light Phone for a while: a minimalist phone that only has simple functions. Now she is back to an iPhone with only WhatsApp and Snapchat installed "for messaging friends and family and getting adorable pictures of my nieces." She also has other social media accounts and set a rule for herself to check them on her computer for two minutes a few times a week. 

Rajkow does not have any social media accounts except for YouTube where he vlogs about digital minimalism and Reddit where he occasionally posts about the topic. "I have no problem using YouTube, because making videos on YouTube is, is something I like to do. I feel better after publishing a video," he said. "I'm not against social media at its core, but I am against social media that is not serving you."

During the pandemic, he and his wife both switched to dumbphones. Rajkow sometimes travels for work, and now that things have started to open up more, the use of QR codes and digital COVID passes presented new challenges. 

But Rajkow found a workaround by using his iPad instead, which still aligns with his goal to only use tech that serves him and his family. "It's not convenient enough to put in my back pocket, but if I need the QR code, I just have to take it from my backpack."

If this sounds extreme, r/DigitalMinimalism offers a detailed guide with varying levels of extremity for those who aren't willing to go cold turkey or are simply "digital minimalism curious." The subreddit also offers a wealth of resources and tips including blocking software, simplified versions of sites and browsers, a mega list of offline activities, and books/videos from digital minimalist experts. 

What about work? FOMO? Staying in touch with people? 

Remarkably, Jones, Grams, and Rajkow all work in professions that require regular tech use. After ditching her old smartphone ways, Jones graduated and got a job in social media. But she keeps up her digital minimalist habits by having a second phone with all of the social media apps that she keeps in a drawer when she's not working. She uses her dumbed-down iPhone for everything else. 

So far, it's been working well. "I find that now I see my phone in a different way to how I use smartphones, pre-flip phone era," she says. "My perception of how I use a phone has changed. So it's less of like, the phone rules me and it's more of like, I use the phone for X purposes."

Grams, too, feels like her relationship with her smartphone has fundamentally changed, even though her job as a project manager at an advertising firm keeps her constantly surrounded by social media, websites, and TV. "I’m able to compartmentalize my work life and my personal life. Creating content for businesses is not the same as adding the latest adorable picture of my two Australian shepherds to my Instagram story."

As for FOMO, Jones makes a good point: you can't have FOMO if you don't know what you're missing out on. "If you're on Instagram you can see that your friend is at the cafe, but if you don't have access to that, you don't know, and then you have no FOMO to feel. So it kind of eliminated FOMO in a lot of ways.

Like everyone else, Rajkow and his family used video calls on his desktop to keep in touch with loved ones during the pandemic. But he avoided getting overwhelmed by the constant screens and distractions. He was able to be more intentional about these conversations and would set up a microphone and a DSLR camera, "so it's a better experience with the other party." 

Grams says her mental health has greatly improved, and that she has used her newfound time in fulfilling ways."I joined a local book club and didn’t have to use SparkNotes since I actually had the mental stamina and attention span to read the books cover-to-cover. 

For many of us, our relationship to our body is a complicated one. Not least because of the existence of the patriarchy.

Here with some words of wisdom is none other than Emma Thompson, who has a nude scene in her upcoming film Good Luck to You, Leo Grande. In the scene, she looks at her unclothed body in a mirror with a look of neutrality. Speaking to Stephen Colbert about the significance of that scene, Thompson talked about her own relationship to her body.

"I think that I started hating my body when I was about 14," she said. "I think those neural pathways are kind of well carved into my soul. I know we laugh, but you think of all those eight-year-olds out there going 'I don't like my thighs.'"

Colbert asked Thompson if she had a message for 14-year-olds who are experiencing poor body image.

"Don't waste your time, don't waste your life's purpose worrying about your body. This is your vessel, it's your house, it's where you live, there's no point in judging it, absolutely no point, but it's very hard to do," she said.

Want more?

• How to practice body neutrality

• What to do when body image is affecting your sex life

• It's time to rethink how you speak to young people about their bodies