We know the importance of a good night’s sleep cannot be understated, as prioritizing your sleep affects everything from your stress response to appetite regulation to mood. What’s more, every minute really does count: A new study published in Sleep Health (Journal of the National Sleep Foundation) revealed that losing just 16 minutes of sleep can detrimentally affect your productivity, which isn’t exactly the best news for those trying to conquer the workweek while skimping on their slumber.

Soomi Lee, a sleep researcher and aging studies professor at the University of South Florida, and her colleagues surveyed and interviewed 130 healthy employees working in IT and parenting at least one school-aged child. They measured sleep timing, duration, quality, and latency as well as “cognitive interference,” including the ability to control your thoughts and suppress intrusive or avoidant thinking. (An example of one of these questions would be “How often did you think about personal worries today?” or “How often did you have trouble concentrating today?”)

Researchers found that when participants slept just 16 fewer minutes than usual and reported unsatisfactory sleep quality, they experienced a heightened amount of cognitive issues the next day—that is, they were more distracted and couldn’t think as clearly. Because of this, their stress levels increased, especially concerning the maintenance of work-life balance. According to the researchers, heightened stress and lack of clearheadedness may have directly resulted in poorer work performance and poorer socially interactive decisions—and also further continued to mess with their sleep, with the more stressed and distracted workers tending to go to bed and wake up earlier because of their exhaustion. The researchers also compared workdays to weekends and found the consequences of less sleep were absent when someone had the next day off from work.

“These cyclical associations reflect that employees’ sleep is vulnerable to daily cognitive stress and also a contributor to cognitively stressful experiences,” Lee explained in a news release. “Findings from this study provide empirical evidence for why workplaces need to make more efforts to promote their employees’ sleep. Good sleepers may be better performers at work due to greater ability to stay focused and on task with fewer errors and interpersonal conflicts.” (Indeed, research shows people are more hostile when they’re sleepy—just saying.)

The science clearly demonstrates getting enough sleep is not, well, enough: That sleep also needs to be consistent and regular. People with more irregular bedtimes tend to have worse cardiovascular health and a slower metabolism, and people who wake up at the same time each morning tend to be more satisfied with their work-life balance.

That means it’s worth getting strategic about your sleep schedule. Sleeping soundly each night is by no means the easiest task out there, but there are actionable measures you can take on your own in order to improve your sleep schedule, boost your productivity, and, in turn, improve your health altogether. If you’re having trouble staying away from the snooze button in the morning or shutting off the lights at night, consider booking a.m. workout classes to hold you accountable or scheduling short meditations in the evening to help you wind down. Strategizing your sleep in this way can help you avoid skimping on precious minutes of shut-eye and subsequently create a more solid, uninterrupted sleep experience.

Source: https://www.mindbodygreen.com/articles/how-losing-just-16-minutes-of-sleep-affects-your-productivity-research-shows?otm_medium=onespot&otm_source=inbox&otm_campaign=Daily+Mailer&otm_content=daily_20190425&otm_click_id=e3e436e456c14465227f43b6b7e42f2b&os_ehash=4366f4a34c67ce527584ae17c656bb4bd17ce861

Constantly feeling overwhelmed is a telltale sign—but you can overcome that feeling.

We all know what it feels like to be overwhelmed. But if it feels like you can never catch a break—a frank conversation with your boss on Friday has you in tears all weekend, then you turn around to go to work on Monday and want to scream at every bad driver on the road—it might be something more. You may be what experts call a highly sensitive person.

The term “highly sensitive” has been used to describe several different personality types—people who overreact, for instance, or people who get upset easily. But the true, research-backed definition of a “highly sensitive person” is an individual who “has a sensitive nervous system, is aware of subtleties in his or her surroundings, and is more easily overwhelmed when in a highly stimulating environment,” according to Elaine Aron, PhD, a psychologist who has studied high sensitivity since 1991.

This personality type is actually pretty common. In fact, about 20 percent of the population identifies with it, says Aron, which is why it isn’t classified as a disorder. And oddly enough, about 30 percent of people who are highly sensitive are alsoclassified as extroverts, so it can be difficult to discern if high sensitivity is something you live with, says Aron.

So, how can you tell if you are a highly sensitive person? Here’s how to spot the most common qualities of the personality type—and what you can do to live better as one.

What are the common traits of a highly sensitive person?

Being highly sensitive isn’t a bad thing. In fact, it’s a personality that’s entirely innate. But in order to be classified as highly sensitive, you need to have four specific characteristics. “If you don’t have all four, you’re probably not what we’re defining as highly sensitive,” says Aron. These characteristics, known as DOES, include:

Depth of processing

This simply means that you process things more deeply and observe more carefully before you act. The result? You tend to react more cleverly to situations, says Aron. “This is the most important one,” she says. “This is a survival strategy found in at least 100 species.” And although we don’t know exactly what the purpose of this characteristic is in highly sensitive people, we do know that it has some kind of advantage to survival.

For example, if you’re packing for a trip, you may think, plan, and imagine everything that you might need while you’re away—so you end up being the person who comes equipped with the items others forgot about.


Thinking about things so deeply means you tend to notice every single detail, which can tire you out more easily. “That is the only downside of the personality,” says Aron. “We’ve done studies in which we find that sensitive people are noticing subtleties and their brains are processing things at a higher level in the sense that it’s not just their eyes and ears and noses that are so sensitive, but it’s noticing subtle aspects of a complex situation.” And that keen observance is ultimately what leads to overstimulation, causing a highly sensitive person to sometimes feel frazzled, rushed, or drained.

Emotional response and empathy

Highly sensitive people have strong emotional responses in order to deeply process the things and situations they’re experiencing, says Aron. They also tend to be more empathetic than average, both to people they know and to strangers.

For example, you may be preparing for a job interview and start worrying about all the questions you have to prepare for, causing you to slow down—but then your empathy kicks in when you think of your family, who is depending on you to succeed, so your brain tells you to keep going.

Sensitivity to subtleties

This characteristic is ultimately what breeds overstimulation, says Aron: being sensitive to all the small things that may be occurring at any given time that other people don’t tend to notice.

But picking up on subtle details has quite a few upsides that could help you both personally and professionally. According to Ryne Sherman, PhD, a psychologist and chief science officer at Hogan Assessments which runs personality tests, these positive traits include:

  • Being able to find problems and spot issues easily
  • Being dissatisfied with things, leading to progress and change
  • Trying to improve the way things are

How to tell if you’re a highly sensitive person

The easiest way to find out if you’re a highly sensitive person is to take Aron’s self-test, which includes research-backed questions to find out where you land in terms of the above characteristics. But there are some key indicators that could help you determine if you’re highly sensitive, including if you identify with any of the following:

  • You think deeply about things and life has to be meaningful.
  • You’re easily overstimulated and avoid noisy places.
  • If you’ve had a full day, you’d rather stay home than go out.
  • People say you have a lot of empathy for others.
  • You cry easily.
  • You notice things other people miss.

The trouble is, most of us have a hard time recognizing our own tendencies and reactions to things, because “we tend to think other people see us just the way we see ourselves,” says Sherman.

This is where getting some outside perspective to determine if you’re highly sensitive could be helpful. Try to think about yourself and your reactions to things from other people’s perspectives, and think about how they’d react in a given situation. If it feels like you react more strongly than those in your inner circle or you notice more than those you surround yourself with do, that could provide some insight.

How to adapt to your emotions if you’re highly sensitive

If you’ve found that you identify with being highly sensitive and have been looking for an excuse for a lazy Saturday, here it is: The key to coping with your high sensitivity is getting plenty of down time. “Everyone talks about down time these days, but it’s important for highly sensitive people that it be really quiet,” says Aron. “You need quiet down time to allow that overstimulation and depth of processing to overstimulation to wind down.”

Make time for rest

Whatever your version of self-care is, prioritize that. This might mean that when you go on vacation, it’s more important for you to catch up on sleep and rest rather than participating in a full day of activities, says Aron. Or, it might mean that instead of going out and playing tennis with friends or going to a party after work on a Friday, you go home and have some time to yourself. The important thing here is making sure you get quiet time to let yourself reset.

Try meditation

Meditation is a great way to soak in the quiet. “I think meditation is really important, and I think transcendental meditation is the best because it’s the most restful,” says Aron. “Mindfulness involves observing your breathing or your body or your thoughts, and transcendental meditation doesn’t include any of that.”

Try doing transcendental meditation—which simply includes focusing on a mantra or sound and letting your mind fall to silence—for about 15 to 20 minutes per day.

Consider seeing a therapist

It’s important to remember that being highly sensitive isn’t a bad thing. “People shouldn’t feel hopeless,” says Aron. If it’s something you’re struggling with, start attending sessions of psychotherapy, which sensitive people are naturally more responsive to. “We think that sensitive people do better than others in intervention like psychotherapy because they’re paying more attention,” says Aron. “If they’re seeing a good therapist, they’re paying more attention to the therapist’s feedback and feelings about them and should get more from that.”

Source: https://www.prevention.com/health/mental-health/a27019841/highly-sensitive-person/

I’m perhaps the biggest evangelist for a green smoothie breakfast. Smoothies take less than five minutes to make and they’re the best way to eat more vegetables before noon than most people eat all week. Because of my fervent passion for my morning green shake, I often find myself in the position of solving people’s smoothie-based hangups—the most frequent of which I hear is, “I’m always still hungry after eating a smoothie!”

Yes, smoothies can you leave you feeling hungry, but no—they absolutely don’t have to. The secret is filling your smoothie with a heaping amount of greens, a good amount of healthy fat, and enough protein to turn off your hunger hormones and keep your blood sugar super stable well past noon. For protein, I tend to eschew protein powders and reach for more whole-food smoothie add-ins. Here are my five favorites.

1. Hulled hemp hearts

Hulled hemp hearts are top of my protein list—each tablespoons packs 9 grams of complete protein in plant-based form. Hemp hearts are also rich in healthy omega-3 fats, which help your body fight inflammation and further encourage satiety. From a culinary perspective, I love adding hemp to smoothies because they become super creamy—if you blend hemp hearts and water, you get hemp milk, so when you add hemp hearts and water to your smoothie, the effect is as if you’d blended in milk. Beyond the creamy texture, the flavor is fairly neutral, making hemp hearts an ideal addition to almost any smoothie.

2. Nut butter

A smoothie bar staple, nut butters also make my list, although because they’re more expensive, I reach for them less often. I like to keep an almond, cashew, and peanut on hand—beyond making a smoothie super creamy and thick, they also add a rich, almost-dessert like flavor that makes them taste extra decadent. Because of the more pronounced flavor, I reserve nut butters for smoothies that highlight the nut butter, like Chocolate Peanut Butter or a Cardamom Strawberry Cashew.

3. Chia

Like hemp hearts, chia seeds offer a one-two punch of protein (4 grams per one ounce serving) healthy fat in the form of omega-3s (5 grams per one ounce serving). Their real power, though, is in their fiber content—a whopping 11 grams per serving. It’s no wonder that famed doctor Terry Wahls, M.D. named them as one of her favorite constipation-busting foods! Chia thickens smoothies quite a bit (think chia pudding), so when I use it, I avoid or go light on other thickening ingredients like banana, cauliflower, and avocado.

4. Pepitas

Shelled pumpkin seeds, or pepitas, have 7 grams of protein per one-ounce serving, alongside a whole host of other nutrients, including 30 percent of the RDI of manganese and magnesium. Magnesium is a powerful mineral that many of us are deficient in, and adding more of it to your diet is a great way to help manage stress and anxiety. Like hemp seeds, pepitas offer a lovely creamy quality to smoothies, although they have a slightly more toasty, nutty flavor. I like to pair them with cacao-based, chocolatey smoothies and some spices (a pepita-spiked Mexican Hot Chocolate smoothie is my favorite blend).

5. Collagen

The only non-plant-based protein option on this list, collagen earns its spot through its mega quantity of protein and myriad other health benefits. One 20 gram serving contains a whopping 18 grams of protein, the vast majority of which is comprised from various amino acids that play a role in aiding joint health, helping skin elasticity, and contributing to a healthy digestive system. Because collagen is an animal product, it’s important to be particular about sourcing, and only purchase from suppliers whose products are grass-fed and third-party certified. A good quality collagen will taste completely neutral, and won’t change the flavor or texture of your smoothie in any noticeable way.

Half of all pregnant women who experience depression do not get any treatment, and some may turn to alcohol, marijuana, and opioids to self-medicate, a study of national data found.

The research, which was published this month in Psychiatric Services in Advance, involved responses from 12,360 women to the National Survey on Drug Use and Health between 2011 and 2016. Researchers compared responses for pregnant and nonpregnant women between the ages of 18 and 44, all of whom had an episode of major depression.

They found 51 percent of pregnant women and 43 percent of nonpregnant women did not get any treatment for depression.

“In general, treatment rates are very, very low,” said Maria X. Sanmartin, a coauthor of the study and assistant professor of health professions at Hofstra University.

But pregnant women seem to be particularly underserved. Even among those who did get some treatment, pregnant women were significantly more likely to say it was not enough to meet their needs.

“What we would expect is that pregnant women are visiting the ob-gyn more and they should have more opportunities to see a psychologist or psychiatrist,” Sanmartin said. “But that is not what we found.”

Guidelines from both the U.S. Preventive Services Task Force and the American College of Obstetricians and Gynecologists recommend doctors screen all pregnant women for depression and refer those at risk to counseling.

The study didn’t ask women if they were screened, but maternal-health experts say depression in pregnant and postpartum women is consistently underdiagnosed. Many women are not asked about depression symptoms, and even those who are may feel too ashamed to answer truthfully.

For women of color, an added fear of child welfare services deeming them unfit can keep women from admitting symptoms and seeking care.

When mental illnesses go untreated, there can be serious consequences, research shows — from deteriorating physical health for the mother to developmental delays for the baby. People with untreated mental illness are also at higher risk for substance use.

The study found that in the month before women took the survey, 23 percent of pregnant women reported using alcohol, 17 percent used marijuana, and 6 percent used opioids. That indicates a significant health concern for mother and child, Sanmartin said.

In Pennsylvania, more than 3,000 drug-exposed newborns were born in 2017 — a number that has soared over the last decade as the opioid crisis grows. Experts suggest getting women proper mental-health and substance-use treatment could lower these numbers.

But what should treatment look like?

Maternal mental-health guidelines suggest therapy and consultations with a psychiatrist should be the first option. Yet the study found prescription medication was the most prevalent form of treatment among pregnant women.

“The easiest way to cope with these things is to just give medication,” Sanmartin said. “But medication alone might not be what would help the patient.”

The American Psychiatric Association says there is growing evidence that it’s safe for pregnant women to use antidepressants, and they can be helpful for some. But combining medication with therapy helps people address environmental and social factors that influence their mental health too.

Often, cost gets in the way, Sanmartin said.

The study found both pregnant and nonpregnant women cited financial concerns as the main barrier that kept them from getting treatment. More than three-quarters of the women in the study had insurance, but some had high deductibles or could not afford the copay.

Under the Affordable Care Act, all insurance plans are required to cover mental health and substance use treatment. But that doesn’t necessarily make accessing care easy or affordable.

Studies have shown many insurance plans have few in-network mental-health providers, forcing people to pay high fees for an out-of-network provider or skip treatment altogether. Add to that the shortage of psychiatrists across the nation and wait times for appointments that can stretch weeks, and the obstacles can be insurmountable for some.

Sanmartin said it would help to have doctors work in teams — an ob-gyn with a psychiatrist, for example — to detect depression in pregnant women and improve treatment rates.

It’s also crucial to improve patient education, she said. Doctors need to let women know about the possibility of experiencing depression during pregnancy and that there are treatment options. “Otherwise women might not know it’s not normal what they’re feeling,” she said.

Source: https://www.philly.com/health/pregnant-women-depression-treatment-mental-health-addiction-20190417.html

A human embryo seen under a microscope.

esearchers at Columbia University in New York have created embryos containing genetic material from three people and are ready to use them to start pregnancies. But they’re at a legal impasse.

At a public forum at Harvard Law School on Wednesday, Dietrich Egli, assistant professor of developmental cell biology at Columbia, said his team has used a controversial technique called mitochondrial replacement therapy to make embryos for four female patients. The women are all carriers of genetic disorders that are passed down through maternal mitochondria, the energy-generating organelles inside cells.

The embryos cannot be transferred into a woman’s uterus because of a 2015 congressional amendment that forbids the Food and Drug Administration from considering human research applications “in which a human embryo is intentionally created or modified to include a heritable genetic modification.”

For now, Egli said, the embryos have been frozen. “They would be ready for transfer if a legal path could be found,” he said.

Wednesday’s event at Harvard was the first in a series of meetings meant to draft policy recommendations with the goal of persuading U.S. lawmakers to lift the prohibition on mitochondrial replacement therapy. In the U.K., the procedure is allowed but is strictly regulated.

The technique involves taking the nucleus from the mother’s egg and transferring it into a donor egg that has had its nucleus removed. In human cells, the nucleus is where the majority of DNA is located. But a tiny amount of DNA is also located in the mitochondria, which float around in the cytoplasm outside the nucleus. Mutations in mitochondrial DNA can cause serious genetic diseases. When the nucleus of the donor egg is taken out, it retains its healthy mitochondria. The donor egg with the mother’s nucleus is fertilized with the father’s sperm. Because a tiny amount of DNA comes from the donor, the resulting baby ends up with DNA from three people.

The 1996 Dickey-Wicker Amendment prohibits the use of federal funds for the creation of human embryos for research purposes, so Egli said that his group at Columbia, which includes neurologist Dr. Michio Hirano, is using philanthropic funds for their study.

Because of these restrictions, New York-based fertility specialist John Zhang went to Mexico in 2015 to skirt U.S. law. There, he transferred an embryo created with mitochondrial replacement therapy into a woman who’s a carrier of Leigh syndrome. She delivered a seemingly healthy baby in April 2016.

Egli and his colleagues previously studied the use of mitochondrial replacement in stem cells, but they have moved forward with creating viable embryos in hopes of being able to transfer them into women in the near future. “We want them to realize their dreams,” Egli said.

Shouhkrat Mitalipov, an embryologist at Oregon Health and Science University who was at the Harvard event, has also used mitochondrial replacement in human embryos but, according to a university spokesperson, those embryos were never intended to be transferred to establish a pregnancy, like Columbia is doing.

Marcy Darnovsky, executive director of the Center for Genetics and Society, in Berkeley, Calif., worries that allowing this kind of heritable alteration could open the door to genome editing in eggs, sperm or embryos. “I think it’s clearly a warmup to germline editing,” she said.

In separate experiments for research purposes only, Egli is using the genome-editing tool CRISPR in embryos in an effort to repair certain disease-causing genetic mutations.

Because of lingering safety concerns that a mismatch in mitochondria from the donor and intended mother could cause complications for a fetus or resulting baby, Egli said his group is using donor eggs with mitochondrial DNA from the same haplotype — essentially the same family of mitochondrial DNA — as the mother’s.

The women are a part of a study looking at female carriers of mitochondrial diseases. Out of 45 women of childbearing age, 78%, or 35 women, had thought about not having children because of the risk of transmitting mitochondrial disease to them, according to Egli’s presentation.

Clinics in Greece and Ukraine are currently using mitochondrial replacement therapy not to avoid serious genetic disease in babies but as an infertility treatment for women who haven’t been able to get pregnant with standard IVF. Egli said he and his team do not plan on transferring the embryos outside the U.S. though.

“We have no plans to move them abroad. We would like to advance the regulatory framework here,” he said.

Source: https://www.statnews.com/2019/04/18/new-york-researcher-ready-to-start-pregnancies-with-three-parent-embryos/

Studies show increase in cancer that evades Pap, confirm lethality of non-HPV disease

A type of cervical cancer often missed by Pap testing was seen at increasing rates over the past 15 years in the U.S., whereas rates of the most common histology decreased, a review of a cancer database showed.

The incidence of adenocarcinoma rose by 1.3% annually from 2002-2015 among non-Hispanic whites, including steeper rises among women ages 40 and older during some years. Rates of adenocarcinoma declined or did not change in other racial/ethnic subgroups, reported Farhad Islami, MD, PhD, of the American Cancer Society, and coauthors.

Meanwhile, diagnosis of squamous cell carcinoma (SCC) of the cervix decreased or remained stable across all subgroups. More women had advanced-stage disease at diagnosis, regardless of histology, they wrote in Preventive Medicine.

The findings underscored the importance of preventing human papillomavirus (HPV) infection, which causes most cervical cancer, and using HPV testing for diagnosis, Islami and colleagues concluded.

“Increasing or stabilized incidence trends for [adenocarcinoma] and attenuation of earlier declines for SCC in several subpopulations underscore the importance of intensifying efforts to reverse the increasing tends and further reduce the burden of cervical cancer in the U.S.,” the authors said.

An unrelated study from Spain confirmed previous evidence showing that non-HPV cervical cancer has a more aggressive clinical course and worse prognosis, including a 50% lower survival, as compared with women who have HPV-positive cervical cancer.

Over the past decade, multiple studies documented a decline in cervical cancer incidence in the U.S. Studies dating back to the 1970s showed an increased incidence of cervical adenocarcinoma, but those studies did not adequately account for hysterectomy, which introduced bias to comparisons across different subgroups, Islami and coauthors noted.

To examine contemporary trends in cervical cancer incidence, investigators queried the CDC’s U.S. Cancer Statistics Incidence Analytic Database to determine cervical cancer incidence during 1999-2015. They compared incidence by age, race/ethnicity, histology, and stage at diagnosis.

The analysis revealed 218,244 cases of cervical cancer for the period reviewed (67% SCC, 21% adenocarcinoma, 3.3% adenosquamous carcinoma, and 6.3% unknown or unspecified). For all histologies combined, cervical cancer incidence among white women declined by 4.1% a year from 1999-2003 and 1.1% a year from 2003-2013, then stabilized from 2013-2015. Among blacks and Asian/Pacific Islanders, rates declined in almost all age groups from 1999-2015. Rates also declined in Hispanics but stabilized in recent years.

Analysis by histology showed a steady rise in adenocarcinoma incidence among white women since 2002, driven by steeper increases in women ages 40 to 49 (4.4% per year since 2004) and 50-59 (5.5% per year since 2011). Rates declined or stabilized in other racial/ethnic groups. The incidence of SCC cervical cancer decreased in all racial/ethnic groups, except whites, wherein rates decreased until the current decade and then stabilized.

Of particular concern, the frequency of distant-stage cervical cancer — SCC and adenocarcinoma — increased in several age groups among whites. In general, rates remained stable in other racial/ethnic groups.

The increasing incidence of adenocarcinoma warrants attention, given that Pap testing has a lower sensitivity for detecting cervical adenocarcinoma, Islami noted. Adherence to guidelines for HPV vaccination and cervical cancer screening (with testing for HPV) affords the best assurance against continued increases.

Investigators at the Spanish Institute for Global Health (ISGlobal) in Barcelona investigated clinical and prognostic features associated with HPV-negative cervical cancer, which accounts for a small minority of all cases worldwide. Several small studies showed that HPV-negative cervical cancer suggested the disease had a more aggressive clinical course and worse prognosis, but the rarity of the cancer and the small sample sizes made the findings less than definitive, according to Jaume Ordi, MD, PhD, and colleagues at ISGlobal, writing in Modern Pathology.

To improve understanding about HPV-negative cervical cancer, investigators analyzed data for 214 patients with cervical cancers diagnosed from 2012-2015 and followed for 5 years. They found that 21 (10%) of the cancers were HPV negative.

As compared with the HPV-positive majority, HPV-negative cervical cancers were significantly more likely to be non-SCC (43% vs 19%, P<0.01), advanced stage at diagnosis (91% vs 57%, P<0.01), and have spread to lymph nodes (67% vs 36%, P<0.01). Patients with HPV-negative tumors had a median progression-free survival of 59.8 months versus 132.2 months (P<0.01) and median overall survival of 77 months versus 153.8 months (P=0.01).

“The new study confirms that HPV-negative tumors represent a more aggressive type of cancer with worse prognosis, which must be considered for the clinical management of these patients,” Ordi said in a statement.

Source: https://www.medpagetoday.com/hematologyoncology/cervicalcancer/79341

Calming activities include: making to-do lists, cleaning, organizing, and taking deep breaths.

Anxiety isn’t just a temporary feeling that happens when you’re working against a tight deadline, or trying something new for the first time. It’s a constant presence that can pop up even when there’s nothing to be anxious about. Here are some things that only those who struggle with anxiety know all too well.

1. How annoying it is when people tell you to “stop worrying about it.”

Trust me, if I could stop worrying about how I’m going to get all my work done and if I’m going to be late for dinner, I’d stop. You telling me to stop worrying just makes me worry about it even more.

2. “Maybe” is the worst word in the English language.

Uncertainty triggers the worst anxiety. Especially these days, with everyone making such loose plans. Let’s just make our plans now and be done with it, thank you very much.

3. How loosely people use the word “panic attack.”

No, a panic attack is not simply freaking out. It’s like when you’re crying and you cannot breathe and everything will not be OK and it never has been OK and you feel like you’re going to die.

4. Waking up in the middle of the night and not falling back asleep because your brain is a spinning wheel of anxiety.

You have so much to do tomorrow and now you’re going to be so tired and you basically ruined everything and oh my god, I accidentally said that weird thing to my boss the other day and now she totally hates me and…

5. You feel anxiety about the tiniest things.

Your phone is going to run out of battery, even if it’s at 53 percent. And why didn’t you get invited to that neighborhood get-together? Oh my god, you missed the train to work, and now you’re going to be late and it’s all your fault.

6. You can’t stand being late or early.

You freak out about being early — Will it be weird? What will I do while I’m waiting? — but if you’re late, you freak out about keeping someone waiting or or having your boss get mad at you or…

7. If you ever have to cancel plans, you’re afraid everyone will hate you.

Sometimes you just need a night off. Then, of course, you get anxious about it. Because you’re anxious about everything. Because anxiety sucks.

8. When your anxiety is in full-throttle and you just shut down.

Fetal position, please.

9. You have anxious tics you don’t even notice.

For me, it’s slapping my leg and overusing the word “honestly.”

10. When too many people are trying to communicate with you at once, your brain feels like it’s about to explode.

How do you respond to everyone at once? How do you resist the urge to throw your phone across the room?

11. On the flip side, when no one’s texting you back, it’s definitely because they all hate you.

It’s all because of that thing you said three years ago. Or they never liked you to begin with and they’re done pretending. Yep, it’s definitely that.

12. That sporadic anxiety crying.

Please, pay no attention to me, I barely even know what I’m crying about. I’m just so overwhelmed.

13. Those terrible anxiety stomachaches.

No, it definitely wasn’t something you ate.

14. You freak out if there’s no order in your life.

Calming activities include: making to-do lists, cleaning, organizing, and taking deep breaths.

Source: https://www.prevention.com/health/a27155521/struggles-of-having-anxiety-1/