Rates of adolescent anxiety keep climbing, and parents heading into the new school year are asking how to spot it early. Experts point to academic pressure, social media and worries about the future as key drivers.

What are the warning signs of anxiety in a teenager?

The seven signs experts flag most often are physical symptoms, difficulty concentrating, social withdrawal, negative self-talk, slipping academic performance, appearing distracted or tense and mood swings. Physical clues can show up as sweating, body aches, stomachaches, muscle tension, headaches, insomnia, loss of appetite or fatigue. A teen may also have angry outbursts or crying spells, pull back from friends and activities they once enjoyed, or describe their mind going blank at school. Grades often start to drop as focus fades and self-critical thinking takes hold. Any one of these signs on its own may not mean much. A pattern of several, especially ones that persist for weeks, is worth paying attention to.

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How common is anxiety among American teens?

Anxiety is now one of the most common mental health issues teens report. Seventy percent of U.S. teens ages 13 to 17 identify anxiety or depression as major issues among their peers, according to the Pew Research Center. The American Psychological Association has highlighted the high levels of stress many teens experience. In an APA survey, 75% of high school students reported experiencing emotions such as boredom, anger, sadness, fear or stress at school, and teens rated their stress levels at 5.8 out of 10 during the school year.

What causes anxiety in teens?

Perfectionism, social scrutiny and physical development are among the biggest drivers, according to Jerry Bubrick, PhD, a clinical psychologist who has treated many children with anxiety and OCD at the Child Mind Institute. “We see a lot of fear of not doing well,” Bubrick said. “A lot of anxiety is geared towards perfectionism, or needing to do their absolute best in school, beyond an intense work ethic.” Social anxiety is also common. Bubrick said some teens worry excessively about being seen as incompetent or stupid, or about doing something embarrassing. Physical changes matter too. Girls who develop early and boys who develop late often feel it most acutely, which can affect self-esteem and confidence for years.

How should parents talk to a teen about getting help?

Lead with concern and curiosity rather than judgment, experts advise. Describe specific behaviors you have noticed and invite your teen to share what’s behind them, without loading the question with worry. Jacqueline Sperling, PhD, a clinical psychologist and assistant professor of psychology in the Department of Psychiatry at Harvard Medical School, offered a script through the Anxiety and Depression Association of America. She suggested saying something like, “I have noticed that you have stopped seeing your friends lately and asked us to make calls for you. I am wondering if these activities have been making you anxious.” After the teen responds, Sperling recommended following up when appropriate with, “Anxiety is very normal, and it also can worsen and get in the way of things we want to do. I am here if you want to talk, and we also can take you to see someone to help you with this.”

Should an anxious teen still go to school?

Yes. Pediatricians say pushing through anxiety, rather than staying home, helps teens build resilience over time. Dr. Molly O’Shea, a pediatrician and spokesperson for the American Academy of Pediatrics, told KOAT7 that even partial attendance beats staying home. “Any attendance is better than no attendance when it comes to school anxiety. And it’s so tempting as a parent to say, OK, we’ll take a mental health day today. And you’ll kind of gather your strength and be able to go again, go tomorrow, when actually that reinforces the anxiety and makes it even harder to go the next day,” O’Shea said.

What can parents do at home to help an anxious teen?

Acknowledge feelings, connect daily and support healthy routines. Clinicians at Johns Hopkins advise parents to take teen emotions seriously and resist the urge to dismiss worries with lines like, “You have a good life. You shouldn’t worry about that.” Practical steps from Johns Hopkins and other clinicians include the following:

• Let your teen talk and sit with the silence rather than firing off questions
• Help them face anxiety-triggering situations in small, manageable steps
• Avoid labels like “shy” or “anxious” that can become part of how they see themselves
• Protect sleep, nutritious meals and regular physical activity
• Set aside distraction-free time each day to connect

If your teen keeps struggling, contact your pediatrician, a psychologist, counselor or your school’s counseling services. If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org.

Anxiety disorders are the most common mental health condition among adolescents, according to the World Health Organization, which estimates that 4.1% of 10- to 14-year-olds and 5.3% of 15- to 19-year-olds experience one. Traditional therapy helps many teens, but not all. That gap is why researchers are now testing whether a video game can teach anxious teens to steady their attention and quiet their worries.

The game is called Eco-Rescue, and FIU’s Center for Children and Families is the first site in the United States running a clinical trial to see if it works.

How the Eco-Rescue video game works

Players take on the role of pilots working to restore damaged environments. The gameplay asks them to track moving objects, adapt to unexpected changes and juggle several tasks at once. Difficulty ramps up as players advance, giving them repeated practice at attention control and emotional regulation inside a setting that feels more like entertainment than therapy.

Unlike therapeutic games built for challenges such as ADHD, Eco-Rescue was designed to target the specific cognitive processes tied to anxiety rather than deliver general brain-training exercises. The game was developed alongside researchers at the University of Geneva, who bring cognitive training and game design expertise to the collaboration.

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“The University of Geneva team brings expertise in cognitive training and game design, while FIU contributes its experience running clinical trials and studying anxiety in young people,” said Jeremy Pettit, psychology professor and executive director of FIU’s Center for Children and Families. “Together, this partnership combines the science behind the game with the clinical rigor to test how well it works.”

Why attention control matters for anxious teens

Therapists often teach young people to reconnect with the present by focusing on their surroundings instead of getting stuck in anxious thoughts. When teenagers struggle to redirect that focus, worry tends to feel more persistent and harder to shake.

Pettit’s earlier research suggests that strengthening attention control can ease anxiety symptoms, including for some teens who have not responded to traditional treatment. Eco-Rescue is built around that same principle, turning practice into gameplay.

“Adolescents are already spending a lot of time engaging with digital media,” Pettit said. “This project allows us to meet them where they are while delivering an intervention grounded in science.”

Inside the FIU clinical trial for the Eco-Rescue game

FIU is recruiting 50 adolescents between the ages of 11 and 15, part of a broader study expected to enroll about 150 participants across all research sites. The age range is deliberate. Anxiety disorders often emerge in early adolescence, a period of significant brain development when targeted interventions may have the most effect.

Participants will be split into three groups. One will play Eco-Rescue at home. Another will play a different video game that lacks attention-training features. A third group will not use any game during the six-week study.

Teens assigned to Eco-Rescue will play about 30 minutes a day, four days a week, adding up to roughly 12 hours over the course of the trial. Researchers will then measure changes in attention control, emotional regulation and anxiety symptoms across the groups.

What this study could mean for families

The World Health Organization notes that anxiety and depressive disorders can profoundly affect school attendance and schoolwork, and that social withdrawal can deepen isolation and loneliness. Access to care remains uneven, and many families face barriers to reaching traditional treatment.

If Eco-Rescue shows results, it could add a low-friction option to the toolbox, one that meets teens on devices they already use.

“This study is testing a new generation of attention-based treatment,” Pettit said. “If it proves effective, it could offer adolescents another option for managing anxiety in their daily lives.”

Major depressive disorder has been making headlines recently, but many of us don’t actually know much about the condition. And that’s not surprising. According to the American Psychological Association, 84 percent of Americans believe there’s still a stigma surrounding mental illness. 

One thing that helps shrink that stigma is having more open conversations, and politician Tom Kean, Jr. recently started one. According to the New York Times, the New Jersey representative was absent from Congress beginning in March without explanation until Tuesday, June 30, when he revealed that he was hospitalized for treatment of major depressive disorder (MDD). While Kean didn’t specify what treatment he received, one therapy that’s making waves in new research is vagus nerve stimulation. Here we break down everything you need to know about MDD, a condition that’s more common in women than men, and how researchers are exploring new treatment options that can help. 

What is major depressive disorder?

“Major depressive disorder is a medical illness that affects mood, thinking, sleep, energy,

appetite, motivation and the ability to experience pleasure,” says Dave Rabin, MD, PhD, author of A Simple Guide To Being Alive. “To meet diagnostic criteria, symptoms must persist for at least two weeks, represent a change from a person’s usual functioning and significantly interfere with daily life. MDD is one of the leading causes of disability worldwide.”

If you don’t live with major depressive disorder, you might think it’s simply another word for sadness, but the two are very different. “Sadness is a normal human emotion that usually has a clear cause and improves with time or support,” adds Dr. Rabin. “Major depressive disorder is different because it persists beyond expected emotional recovery, often without improving when circumstances change. It affects the entire nervous system including sleep, appetite, concentration, energy and physical health—not just mood.”

During a major depressive episode (a period of at least two weeks), the Cleveland Clinic reports that you may experience symptoms such as:

• A depressed mood
• Loss of interest in activities
• Fatigue
• Appetite changes
• Sleep problems

Important: If you’re experiencing thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, which is open 24/7.

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Top Doc: Vagus Nerve Exercises Reverse Stress — And Taking *This* Many Breaths a Minute Is the Easiest Fix

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How vagus nerve stimulation may help with depression 

In many cases, depression can be treated with medication, lifestyle changes and/or psychotherapy, explains Dr. Rabin. That said, researchers are continually exploring new ways to help manage the mood disorder, and one promising treatment is what’s known as vagus nerve stimulation (VNS). 

“Vagus nerve stimulation is an intervention that involves sending low-level electrical impulses to the vagus nerve,” explains Amy Fitzpatrick, MD, chief medical officer at Bedrock Recovery and assistant professor of medicine at Boston University. “The vagus nerve is one of the major nerves that allows for communication between the brain and other parts of the body. During surgical VNS, a very small device is implanted just below the surface of the skin on the upper part of the chest. The device is connected by a thin, insulated wire directly into the left vagus nerve located within the neck.”

Once implanted, the device regularly sends tiny signals to the vagus nerve to stimulate it. Why is that important? The vagus nerve plays a role in many bodily functions, including regulating your heart rate, breathing, digestion and the body’s release of stress hormones like cortisol.

What new research shows

In a new study published in the International Journal of Neuropsychopharmacology, researchers followed 214 participants with major depressive disorder that had not responded to multiple antidepressant treatments, such as medications and psychotherapy. After one year of treatment with a surgically implanted vagus nerve stimulation device, 43.6 percent of participants experienced meaningful improvements in their depression on a clinician-rated depression scale, while 61.3 percent experienced meaningful improvements on a self-reported depression scale. Among those participants who experienced improvements in their depression symptoms, about 80 percent maintained those improvements for another year.

So why might vagus nerve stimulation work when other treatments have fallen short? Dr. Rabin says it comes down to how the therapy works in the brain and body. “Unlike antidepressants, which primarily target specific neurotransmitters and decrease meaningfulness around negative (and positive) emotional states, VNS activates a natural broad brain-body communication network that already exists in the body,” explains Dr. Rabin. “Signals carried through the vagus nerve reach the brainstem and influence regions involved in mood regulation, increasing perception of safety and decreasing perception of threat.”

Surgical vs. non-invasive vagus nerve stimulation 

While the new research focused on surgically implanted vagus nerve stimulation, there are also noninvasive vagus nerve stimulator devices. These small devices, which often cost $200 or more, claim to activate the vagus nerve without surgery. (Check out a Woman’s World editor’s personal review of two popular vagus nerve stimulation devices.) But do they actually work?

Dr. Rabin says yes, but more research is still needed. “There is significant evidence that noninvasive vagus nerve stimulation can influence autonomic function, reduce physiological stress and improve symptoms in selected neurological and psychiatric conditions,” he explains. “For depression, early clinical trials are encouraging, but the evidence remains considerably smaller than for implanted VNS.”

“Implanting a vagus nerve stimulation device is an option for individuals experiencing severe and chronic depression that has been unresponsive to other evidence-based treatments,” adds Bonnie Lambert, PMHNP-BC, LPC, board-certified psychiatric mental health nurse practitioner and licensed professional counselor at Crestview Recovery Center. “A non-invasive device could be a good option for individuals seeking to try a lower-risk approach, or those who are not able to have surgery due to a medical condition.”

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10 Fast, Free Ways to Improve Vagus Nerve Function Naturally

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How to get started with vagus nerve stimulation

If you’ve been living with major depressive disorder and are interested in giving vagus nerve stimulation a try, Dr. Rabin shares a three-step guide:  

Try an OTC vagus nerve stimulator

While surgically implanting a vagus nerve stimulator has proven effective for some people with treatment-resistant depression, Dr. Rabin says it is not considered a first-line treatment.

He adds that while the Food and Drug Administration (FDA) has approved surgically implanted vagus nerve stimulation for depression that is treatment resistant, insurance approval can be inconsistent. “Without insurance, total costs, including surgery, the implanted device and follow-up care, can exceed $30,000 to $50,000,” says Dr. Rabin. 

Dr. Rabin recommends first trying an over-the-counter, noninvasive vagus nerve stimulator for 12 weeks to see if your symptoms improve. He says that if it helps, the OTC option may be all you need.

Get evaluated by a professional

If an over-the-counter, noninvasive vagus nerve stimulator isn’t helping to curb your depression symptoms, Dr. Rabin says to schedule an evaluation with a board-certified psychiatrist who specializes in treating depression that is treatment resistant. He or she can confirm your diagnosis and review other possible treatment options, such as lifestyle interventions, medications or even ketamine therapy, to make sure they have been used adequately.

Do your homework on surgical VNS

If you’ve noticed some improvement with an over-the-counter vagus nerve stimulator but your symptoms are still affecting your daily life, or if other treatment options haven’t provided enough relief, get a referral to a neurosurgeon or interventional psychiatrist to discuss whether surgical vagus nerve stimulation is a good fit for you, says Dr. Rabin. The provider can go over the risks, benefits, insurance coverage and recovery to help you make an informed decision, he adds.

The bottom line on major depressive disorder 

Living with depression can make you feel like you’ve lost yourself, but with emerging treatments like vagus nerve stimulation offering new hope, there are more options for healing than ever before. Talk to your doctor about whether VNS might be right for you.

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You may not be able to remove stress from your life, but new research finds you can change how your body responds to it. And that goes a long way toward reducing the risk of health conditions tied to chronic stress, such as high blood pressure, a weakened immune system, insomnia and digestive system upset. Fortunately, rewiring your stress response doesn’t have to be hard. We’re breaking down the best ways to shift out of the sympathetic nervous system’s “fight or flight” response and into the parasympathetic nervous system’s “rest and digest” mode, so you feel calm, cool and collected, whatever the day throws your way.

How to rewire your stress response naturally

The next time you feel stuck in overdrive or notice your blood pressure increasing from lingering tension, give these smart tricks a try to help reset your acute stress response:

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How To Regulate Your Nervous System and Feel Calmer in Minutes

If you wake up wired but exhausted, snap at small annoyances or struggle to wind down at night, your nervous system may be stuck in overdrive. The good news? Learning how to regulate your nervous system doesn’t require an expensive retreat or a prescription. A handful of simple, science-backed habits can shift your body out […]

Sneak in power-walks

Take a brisk, seven-minute walk three times a day and you may help lower your body’s baseline of the stress hormone cortisol. A year-long randomized trial in the Journal of Sport and Health Science found those who packed in 150 total minutes per week of aerobic activity had measurably lower cortisol. The research suggests that being consistent in how participants got movement may have helped dial down their long-term stress response.

Tip: Worried about breaking a sweat on your stroll? Use a portable fan, like the JisuLife Pro 1 Mini Handheld Fan, to keep your cool on the go.

Give a ‘physiological sigh’ 

Take a full, deep inhale through your nose, sip in a second quick inhale, then exhale slowly through your mouth. The breath trick, sometimes called a “physiological sigh,” quickly calms your stress response. A Stanford University study found performing the technique for just five minutes a day improved mood, reduced anxiety and lowered a key physical marker of physiological stress. Not only did participants show benefits from the very first session, many of the mood-boosting effects grew stronger over the month-long study.

Do a ‘brain dump’ before bed

For many of us, stress shows up at night, when unfinished tasks and other worries make it hard to fall asleep. Jotting them down just before bed can help. A study in the Journal of Experimental Psychology: General found that those who spent 5 minutes writing a detailed to-do list offloaded their cognitive load, tamping down nighttime rumination and improving their sleep. That’s important in light of a British review, which found that good sleep is part of your stress-regulation system, helping direct how and when stress hormones are released. 

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A Vagus Nerve Reset Can Ease Chronic Stress in as Little as 60 Seconds

If you feel simultaneously on-edge and burned out—wired but exhausted, foggy by 3 p.m. and still tossing at midnight—your vagus nerve could use a tune-up. The good news? A vagus nerve reset doesn’t require pricey gadgets, hours of free time or anything you don’t already have at home. Here’s why this remarkable nerve matters so […]

Ready for more inspiration? Subscribe to our YouTube channel for video podcasts, health tips and uplifting stories designed for women 40, 50, 60 and beyond.

You’ve tried everything to feel like yourself again. You’ve done talk therapy, made time to get outside every day, listened to your granddaughter’s advice to spend less time on Facebook and surrounded yourself with a community of people who love you. But you still wake up every morning with a racing heart and a sense of dread about the day ahead. You think an SSRI might help, but want to know what side effects you should expect and how long they’ll last. We spoke with two experts to find out. 

What are SSRIs?

Selective serotonin reuptake inhibitors (SRRIs) are medications often considered antidepressants but are used to treat many different psychiatric conditions, says Guy Maytal, MD, chief medical officer at Forge Health and assistant clinical professor of psychiatry at Weill Cornell Medicine.

Dr. Maytal says the FDA-approved uses for SSRIs include:

• Anxiety disorders (generalized anxiety disorder, social anxiety disorder and panic disorder)
• Post-traumatic stress disorder (PTSD)
• Eating disorders (bulimia nervosa)
• Obsessive-compulsive disorder (OCD)
• Major depressive disorder 

Dr. Maytal adds that menopausal symptoms such as hot flashes and night sweats can also be treated with SSRIs. However, low-dose paroxetine (Paxil) is currently the only FDA-approved SSRI for these symptoms, while use of other SSRIs for hot flashes and night sweats would be considered off-label. Other off-label uses of SSRIs include irritable bowel syndrome (IBS) and premature ejaculation. 

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SSRI side effects to watch for 

SSRIs are effective for many people, but some still avoid them for fear of side effects. Here’s are some of the more common potential side effects to be aware of: 

Nausea and GI upset

Nearly 90 percent of the serotonin in our bodies is found in cells along the GI tract. Because SSRIs affect the GI tract, they raise serotonin levels there, which can trigger nausea and vomiting, explains Dr. Maytal.

Sleep changes 

Dr. Maytal says SSRIs can cause excessive sleepiness or insomnia because they affect serotonin receptors involved in the body’s sleep-wake cycle. “Whether a patient experiences insomnia or [excessive sleeping] depends partly on the specific SSRI and individual’s receptor sensitivity.”

Weight gain 

The relationship between SSRIs and weight gain is still being understood by doctors. If patients do experience weight gain on an SSRI, Dr. Maytal says it may be due to serotonin’s role in impacting appetite and changes in carb craving and metabolism after starting them.

Sexual dysfunction

Changes in sexual functioning due to SSRIs can take different forms including inability to orgasm, low libido and erectile dysfunction, says Dr. Maytal. He explains that increased serotonin activity due to SSRIs can suppress the activity of neurotransmitters in the brain, including dopamine and norepinephrine, which can then impact sexual desire.

Note: Not everyone will experience side effects from SSRIs, and Dr. Maytal says differences in genetic makeup can help explain why. Factors such as how a person’s body metabolizes medications, baseline serotonin activity and differences in serotonin transporters and receptors can all influence how someone responds to SSRIs and whether they experience side effects.

How long do SSRI side effects last?

“Some SSRI side effects, especially nausea, mild headache, jitteriness and early sleep changes, often improve within the first one to four weeks as the body adjusts,” says Rab Nawaz, MD, a board-certified neurologist. “Weight gain and sexual dysfunction are different because they may persist, appear later or last as long as the medication is continued in some patients. I always tell patients not to stop an SSRI suddenly, but to speak with their prescriber if side effects are affecting sleep, intimacy, weight or quality of life.” 

And if you find the weight is sticking while you’re on an SSRI, Dr. Nawaz recommends tracking your weight, focusing on fiber and protein, walking and strength training. He adds that you can also speak to your doctor about whether dose adjustment or switching to another SSRI make sense. 

Note: If you ever experience rare side effects such as suicidal thoughts, seek immediate medical care.

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What to remember about SSRI side effects

We get it. After reading these side effects, you may be tempted to cancel your CVS pickup appointment. But new research provides some encouraging news. 

An animal study published in Molecular Psychiatry found that the SSRI fluoxetine increases serotonin signaling in the brain, which temporarily causes serotonin neurons to not fire properly as the brain adjusts to the medication. But after 22 days of treatment, the mice showed widespread changes in serotonin signaling and brain-cell pathways, suggesting the brain had adapted to the medication over time. 

“This research reinforces what clinicians and clinical researchers have long observed: An adjustment period of several weeks is expected and normal when starting an SSRI,” says Dr. Maytal. “The brain must undergo a series of neurochemical adaptations before the full therapeutic benefit of the medication is experienced.”

The bottom line on SSRI side effects 

Just as your body adjusts to new exercise routines, dietary changes or other health plans, it needs time to adjust to an SSRI. Those first few weeks of side effects don’t mean the medication isn’t working or that it never will. Your brain is recalibrating and finding its new balance. If side effects feel overwhelming or last beyond the adjustment period, that’s valuable information to share with your doctor. Together, you can adjust your treatment plan to figure out what’s best for you.

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Feeling wound tight at the end of the day? Science says the right playlist may do more than lift your mood—it could actually calm your nervous system. A growing body of research suggests that music tuned to a specific frequency can lower anxiety, slow your heart rate and leave you feeling noticeably more peaceful. The best part? You don’t need a meditation app or a fancy subscription. Here we reveal the most relaxing music for stress.

Tiny frequency shift, big difference 

Most music you hear on the radio, in stores or through your favorite streaming app is tuned to 440 hertz (Hz)—the modern standard orchestras and producers have used for decades. But a review published in PLOS One found that music tuned just slightly lower to 432 Hz was linked to less anxiety, reduced heart rate and improved feelings of calm compared to the more common 440 Hz tuning in several small studies.

The difference between 440 Hz and 432 Hz is so subtle that you probably wouldn’t notice it on a casual listen. But your body, it seems, notices the shift right away. In fact, it’s even been dubbed a “healing” frequency.

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How relaxing music for stress works on your body

When study participants listened to 432 Hz music, researchers observed what’s sometimes called the “pink noise” effect—a soothing, balanced sound quality the body appears to respond to physically. Listeners’ heart rates dropped by about 4.79 beats per minute on average. That may sound small, but a slower heart rate is one of the clearest signs your nervous system is shifting out of “fight or flight” mode and into a calmer, more restorative state.

Researchers say the lower tuning frequency may influence relaxation and stress responses in listeners. In other words, the gentle drop from 440 Hz to 432 Hz appears to nudge your body toward rest without you having to do anything except press play.

The best relaxing music for stress: 4 songs to try

The wonderful news is that you don’t have to give up the music you already love. Many fan-made versions of popular songs have been re-tuned to 432 Hz and uploaded to platforms like YouTube and Spotify. A quick search pairs the song title with “432 Hz,” and you’re set.

Researchers and listeners have pointed to a handful of beloved tracks that feel especially soothing at this lower frequency. Try searching for fan-made 432 Hz versions of:

• “Hallelujah” by Jeff Buckley
• “Someone Like You” by Adele
• “In the Air Tonight” by Phil Collins
• “Viva la Vida” by Coldplay

Each of these songs is already known for its emotional depth and slower pacing. Tuned to 432 Hz, they take on an even more grounded, gentle quality—perfect for unwinding after a long day, easing into sleep or pressing pause during a stressful afternoon.

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How to add stress-relieving music to your day

Try playing a 432 Hz track during your morning coffee, in the car during the school pickup line, or while you’re getting ready for bed. Some women find it helpful to create a short playlist of three or four favorite re-tuned songs and use it as a built-in “reset button” during stressful moments.

It’s a tiny act of self-care that requires no effort, no equipment and no extra time—just a softer note, played at the right frequency, working with your body instead of against it. In a world that rarely slows down, that’s music to anyone’s ears.

Ready for more inspiration? Subscribe to our YouTube channel for video podcasts, health tips and uplifting stories designed for women 40, 50, 60 and beyond.

Feeling wired but tired? Gaining weight around your middle no matter what you do? Lying awake at 3 a.m. with your mind racing through tomorrow’s to-do list? If any of that sounds familiar, your stress hormone may be working overtime. Fortunately, learning how to lower your cortisol levels doesn’t require a complete life overhaul. Small, science-backed tweaks can bring this powerful hormone back into balance and curb the risk of health problems in the process.

What is cortisol?

Cortisol is a hormone produced by your adrenal glands that helps regulate how the body handles stress, among other key functions, explains Eve Elizabeth K. Pennie, MD.

In an ideal rhythm, cortisol rises in the morning to help you wake up and dips at night so your body can rest. “In healthy amounts, cortisol regulates blood sugar levels, blood pressure, metabolism, immune function and even memory,” says resilience expert Eva Selhub, MD, founder of Resilience Experts. The trouble starts when cortisol stays high around the clock.

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What causes high cortisol levels?

Several everyday factors can keep your levels elevated, Dr. Pennie says, including chronic stress that keeps the body in “fight or flight” mode, poor sleep or overnight shift work, long-term use of corticosteroid medications, hormone conditions like Cushing syndrome and obesity or poorly controlled diabetes.

Women over 50 are especially vulnerable. As estrogen and progesterone decline during menopause, “the HPA axis, the brain’s stress command center, becomes more reactive and slower to reset,” Dr. Selhub notes. That’s why mild stressors can suddenly leave you wired or wiped out.

High cortisol symptoms you need to know

When cortisol stays high, the consequences pile up. “Chronic elevation increases the risk of hypertension [high blood pressure], type 2 diabetes, cardiovascular disease, osteoporosis and depression,” Dr. Pennie warns. 

Common symptoms of high cortisol include:

• Weight gain around the midsection (the dreaded “cortisol belly”)
• Facial fullness, often dubbed “moon face” 
• Fatigue
• Anxiety
• Thinning skin
• Memory issues
• Sugar cravings 
• Frequent infections

The benefits of getting cortisol back in balance? Better sleep, steadier mood, easier weight management, sharper focus, stronger immunity and a lower risk of chronic disease. In other words, more of the calm, capable you.

How to lower cortisol: 7 simple strategies

Ready to start feeling less stress and more joy? Here’s how to lower high cortisol levels naturally:

Prioritize sleep

Aim for seven to nine hours nightly to restore your body’s natural cortisol rhythm, Dr. Pennie advises. Struggling to drift off? A JAMA Internal Medicine study found that jotting down tomorrow’s to-do list for five minutes before bed helped stressed adults fall asleep faster.

Take micro breaks

You don’t need to splurge on a week at the beach (as lovely as that sounds). “Take micro breaks. Stand up and get some fresh air, because we know sitting all day is horrible for us,” says registered dietitian Dawn Jackson Blatner. Even 60 seconds outside listening to birds can reset your nervous system.

Move your body 

Regular physical activity like brisk walking, cycling and other moderate exercise help regulate stress hormones and reduce cortisol. Bonus: a study in Appetite found that a 15-minute walk curbs cravings for sugary treats. Skip daily intense HIIT sessions, which can backfire and spike cortisol further.

Try mindfulness or tapping

Research in Frontiers in Psychology shows meditation, yoga and deep breathing significantly reduce stress. Don’t love sitting still? Try a tapping technique to help lower cortisol. “You go through a short series of movements, tapping on yourself on the acupuncture points, which can alleviate anxiety and high cortisol quickly,” says Wynne Brown, MD, medical director of integrative medicine at Atrium Health Wake Forest Baptist.

Eat blood-sugar-friendly meals

A balanced diet rich in fiber, protein and healthy fats prevents the crashes that trigger cortisol spikes. And here’s permission to indulge: British researchers found that eating 25 grams of dark chocolate daily for four weeks dropped cortisol by 29 percent. One tasty way to get your mood-boosting protein fix: Pure Protein Ammmaze Blackout Cake Protein Bars.

Get outside

A Japanese study showed spending time in nature lowers cortisol in as little as 15 minutes. And enjoying three nature breaks of about 20 to 30 minutes weekly produced significant drops within eight weeks.

Stay connected

Loneliness is one of our biggest health crises, Blatner says. “You want to do fun things with friends, family, it could even be a pet. The bottom line is that social connection” keeps cortisol levels in check, she reveals.

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How to lower cortisol with natural supplements

Certain supplements can support your cortisol-lowering efforts, too. Dr. Selhub recommends:

• Magnesium (200 to 400 mg of glycinate or citrate nightly)
• L-theanine (200 to 400 mg daily)
• Omega-3s (1 to 2 grams of EPA + DHA)
• Vitamin C (500 to 1,000 mg) 
• Ashwagandha (300 to 600 mg for short-term use, about 8 to 12 weeks)

Always check with your doctor first, and if symptoms persist, ask about a saliva, blood or 24-hour urine test to pinpoint your cortisol pattern. With small daily shifts, calmer days—and a happier, healthier you—are well within reach.

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For people living with treatment-resistant PTSD, the search for relief can feel endless. A recent study suggests a tiny implant that stimulates the vagus nerve — paired with talk therapy — may deliver something rare in this field: lasting improvement that holds up six months after treatment ends.

Every participant in the small first-in-human trial lost their PTSD diagnosis. The findings, while early, are now pushing researchers to design a larger, controlled trial.

How vagus nerve stimulation works for PTSD

The 2025 study, published in Brain Stimulation, followed nine people with moderate to severe treatment-resistant PTSD. Each received a standard 12-session course of prolonged exposure (PE) therapy combined with vagus nerve stimulation, or VNS.

Researchers used a next-generation miniaturized device. An implantable pulse generator was placed inside a silicone cuff on the left cervical vagus nerve. During therapy sessions, an external power and communication module sat over the implant inside a soft cloth collar, wirelessly powering the device — which meant no implanted battery was required. A smartphone controlled the stimulation and recorded audio for at-home exercises.

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Unlike medications that continuously alter brain chemistry, the stimulation was delivered only at key moments. Brief bursts were timed to coincide with imaginal exposure exercises, when participants revisited traumatic memories, and in vivo exercises, when they confronted real-world situations tied to trauma-related fear.

Scientists believe the approach works by engaging neuromodulatory systems in the brain — particularly pathways involving norepinephrine and acetylcholine, neurotransmitters tied to attention, memory consolidation and neuroplasticity. Activating those pathways may reinforce the learning that happens during exposure therapy, helping patients form new emotional associations with traumatic memories instead of reliving them as immediate threats.

What the PTSD study found

The results were striking for a trial of this size.

“VNS therapy resulted in significant, clinically-meaningful improvements in multiple metrics of PTSD symptoms and severity compared to baseline (CAPS-5, PCL-5, and HADS all p < 0.001 after therapy). These benefits persisted at 6 months after the cessation of therapy, suggesting lasting improvements. All participants showed loss of PTSD diagnosis after completing treatment. No serious or unexpected device-related adverse events were observed,” the study said.

Assessments were performed before therapy, one week after, and at one, three and six months following the final session.

Researchers also pointed to a broader track record for the technology. VNS has been FDA approved for major depressive disorder since 2005, and thousands of people have already received conventional VNS implants for MDD. That history, the authors noted, “highlights the appetite for implanted neuromodulation approaches for serious psychiatric disorders.”

Why the findings come with caveats

The authors were direct about the limits of the trial.

“Two major limitations of this study merit consideration: the single arm design and open-label implementation of VNS therapy,” the study reads. With no sham-stimulation control group, and with outcomes drawn largely from self- and clinician-administered surveys, the design leaves room for bias. Prolonged exposure therapy alone is also known to help some patients, and the authors said they “cannot conclusively ascribe benefits to the addition of VNS.”

They argue the results “should be evaluated in a more rigorous double-blinded, placebo-controlled crossover study design that directly compares active and sham stimulation with PE.”

Future work, the team wrote, should expand the sample size and explore biomarkers that could help tailor stimulation to individual patients.

What this means for PTSD treatment going forward

The trial is part of a wider push to develop therapies that target the body’s stress-response systems. A separate clinical study of 63 veterans with a history of PTSD examined the Apollo Wearable System, a device that delivers gentle vibroacoustic stimulation and was studied for its effect on heart rate variability, a marker of autonomic nervous system function.

That wearable operates differently from an implanted vagus nerve stimulator and was not designed to treat PTSD symptoms directly. But together, the research reflects growing recognition that PTSD affects not just psychological processes but the biological systems behind stress, arousal and emotional regulation — and that targeting those systems may open new doors for patients who have run out of options.

Feeling stressed, anxious or overwhelmed? Have you tried turning to ghosts, zombies and aliens for help? Yes, a surprising solution may be watching a scary movie! It sounds counterintuitive, but experts reveal that horror films (like Backrooms and Obsession), thriller novels and even roller coasters can powerfully reset your nervous system and melt away tension, making you more resilient in the future. Here, the science and startling health benefits of getting scared.

How safe scares reset your nervous system

Here’s what happens: First, the brain simulates a danger, and then the body responds. “After the original danger is over, we’ve now created an experience of relief,” explains Sam Zand, DO, a certified psychiatrist and the CEO at Anywhere Clinic. Why this matters: “This contrast can be very regulating for some people and can also be seen as a form of a controlled-stress type of workout for your nervous system.” In short: A quick scare can reset our nervous system back into the preferred “rest and digest” setting. This happens anytime we move through the activation-and-recovery cycle.

“Horror movies are a means through which the brain gets to experience a ‘safe threat,’” adds Carolina Estevez, PsyD, at Soba treatment center. It’s often called “recreational fear” or a “safe-threat workout.” She explains, “Many individuals find this to be a healthy way for them to develop skills to regulate their emotions.”

What happens when you get scared

What really happens in the brain and body during a horror movie or while walking through a haunted house, for example? Follow this step-by-step process to understand the biology at play:

Step 1: Jump scare

“The initial shock from a jump scare causes an instant reaction of fear in the viewer’s brain,” explains psychiatrist Lauren Grawert, MD, clinical advisor of The Garden Recovery & Wellness. “The ‘fight or flight’ response is triggered almost immediately through the rapid detection of a perceived threat by the brain’s amygdala.”

Step 2: Hormone release

This leads to the release of stress hormones like adrenaline and norepinephrine into the bloodstream.

Step 3: Recognition

“In a matter of seconds, these hormone releases increase the viewer’s heart rate, blood pressure and state of alertness,” Dr. Grawert explains. “Their pre-frontal cortex—the area of the brain responsible for decision-making—recognizes there is no real danger. The viewer’s body is physiologically aroused but intellectually knows it is safe.”

Step 4: Reward of relaxation

The reward system in the brain kicks in, “leading to increased levels of dopamine, which can lead to positive emotions including feelings of excitement and relief,” says Dr. Grawert.

Yes, the benefits of getting scared are real

“Horror movies are one of my favorite examples of the brain doing something completely counterintuitive,” says Jessica Meers, PhD, a licensed clinical psychologist and founder of Houston-based Rhythm Wellness. “People are always surprised by the science behind something they assumed was just a guilty pleasure.” But research shows experiencing fear in a controlled way can lead to improved mood.

How? It’s a tug of war between the reflex and the rational parts of your brain. “That tension between ‘my body thinks I’m in danger’ and ‘my brain knows I’m not’ is where the magic happens. You get the full experience of fear, then the immediate relief of safety,” explains Meers. A good scare is essentially a workout for your threat response system with all the benefits, none of the actual danger. Some instant health benefits you can expect:

• Energy boost
• Sharper alertness and focus
• Deep relaxation and calm
• Increased vitality

And when you routinely practice safe-threat workouts, you build resilience to stress and master your fears. The same can be said about cold plunging, visiting saunas or intermittent fasting—activities researchers call “eustress” or healthy stress on the body that makes it stronger.

Who can benefit from safe scares?

“For a lot of people who struggle with anxiety, this is a good way to experience and release excess tension,” says Dr. Zand. “When we’ve been able to control how we’ve interacted with a scary situation, we’ve shown ourselves our ability to deal with fear.”

And while streaming a movie alone at home works great, there’s an added bonus in a theater. “The social aspect of watching horror movies may enhance both bonding and shared regulation of emotion,” Dr. Zand adds.

Why women especially benefit from horror movies

The payoff may be especially big for some. “For women, I think this matters in a way that doesn’t get enough attention,” says Meers. “So many women I work with carry a constant hum of anxiety, the mental load, the hypervigilance, the sense of never fully being off duty.” She adds, “That post-scare glow is real. Dopamine, endorphins and, if you’re watching with someone else, oxytocin too,” adds Meers. “Your nervous system just sprinted and cooled down in ninety minutes. That’s not nothing.”

And Dr. Grawert says, “Horror movies can provide women with a sense of control over their fears, enhance their perception of self-efficacy and provide them with an opportunity for social catharsis.”

Smart tips for maximizing your scare benefits

For best results, consider these details:

Find your “optimal scare zone.” Research in the journal Psychological Science found that the best scares hit a sweet spot—thrilling enough to get your heart racing, but not so intense they leave you traumatized. Find the level that feels good-scary to you.

Scares should be voluntary. The benefits only come if you are open to feeling scared. If you feel forced to watch a scary movie by other people, it could backfire.

It’s worth noting: “The experience of watching scary movies is not the same for everyone,” says Dr. Zand. “For people with a history of trauma, it may actually create more activation rather than relief.”

The bottom line on the benefits of getting scared

“Horror films are like roller coasters. Our heart races, our senses focus. They give us a safe experience where we expect an adrenaline jolt,” says Susan Hatters Friedman, MD, a forensic psychiatrist. “And can lead to relaxation when we get to the end!”

Reaching for your phone before your feet hit the floor feels harmless. A quick check of email, a scroll through headlines, a glance at overnight messages. But mental health experts say those first waking minutes shape your mood, focus and stress levels for the rest of the day—and that the cumulative toll of starting every morning on a screen can quietly reshape how your brain handles attention, comparison and decision-making.

Here’s what to know about why morning phone use matters and what experts suggest doing instead.

How morning phone use affects your brain and mood

The first 10 to 30 minutes after waking are a uniquely quiet window—a stretch of time when your thoughts are still self-directed and your nervous system hasn’t yet been pulled into the day’s demands. Picking up your phone collapses that window almost instantly, replacing internal grounding with external input. Mental health experts describe this as a lost “identity moment,” a missed chance to check in with how you actually feel before the world tells you how to feel.

Katherine Brownlowe, MD, an associate clinical professor of psychiatry and behavioral health, told Real Simple that small shifts in this routine can have outsized effects.

“Decreasing smartphone use, especially first thing in the morning, helps make us more mindful and intentional,” Brownlowe said. “It decreases impulsivity and helps us feel motivated to persist in making healthy choices.”

Anxiety and “borrowed stress” before you’re fully awake

Phones introduce urgency before your mind has the context to sort it. Emails, Slack messages and news alerts all arrive with the same insistent ping, and your nervous system doesn’t distinguish between what’s important and what’s merely loud. The result is what some clinicians call “borrowed stress”—your body reacting to other people’s priorities before you’ve had a chance to set your own.

That early jolt of cortisol can color the entire morning, making it harder to feel settled even hours later. Over time, the brain begins to associate waking up with a low-grade sense of alarm.

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Fragmented attention and decision fatigue

Moving straight from sleep into a stream of apps, texts and feeds trains the brain into a reactive, scattered state. Attention is shaped by the first patterns you expose it to each day, and starting with rapid task-switching makes deep focus harder later—not as a matter of willpower, but of conditioning.

Every scroll, tap and swipe is also a micro-decision: what to read, what to ignore, what to respond to. By the time meaningful work begins, cognitive energy has already been spent. You start the day slightly depleted without realizing why.

Social comparison kicks in just as early. Social media surfaces other people’s productivity, appearance and success before your own sense of self is anchored, subtly shifting how you measure your own day.

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If bedtime at your house involves a nightly negotiation over phones, you’re far from alone. A survey from the American Academy of Sleep Medicine found that 87% of Americans sleep with their phone in their bedroom — parents included. So before this turns into another lecture aimed at your teenager, think of it as a […]

The cumulative cost of a daily habit

A single morning of scrolling isn’t the problem. The concern is what happens when it becomes the default, repeated across months and years.

Maris Loeffler, MA, a family and marriage therapist, explained the long arc in an article from Stanford Lifestyle Medicine.

“The negative effects of screen time are insidious because you can’t see what’s happening in your brain as you’re staring at the screen,” Loeffler said. “If you scrolled on your phone in bed for an hour just one morning, the negative impacts would be minimal. But if it becomes a habit, day after day, month after month, this behavior can take a toll.”

How to break the morning phone habit

Experts emphasize that the goal isn’t simply removing the phone—it’s replacing the habit with something that actually serves you. Light exposure, hydration, journaling or a “brain dump,” gentle movement or stretching, and making coffee or tea without screens are all common substitutions that give the brain a calmer on-ramp into the day.

In an article for Verywell Health, Mark Gurarie outlined practical strategies for cutting back.

“Try no-phone zones: If your habit is to scroll in bed, keep your phone in another room or out of arm’s reach,” Gurarie wrote. “Get an alarm clock: Using a phone as an alarm increases your chances of checking it or scrolling mindlessly after you hit ‘snooze.’ Track your use: Check your smartphone for your usage statistics to track your progress. Take it step by step: Start small and work gradually until you change habits. You might start by stopping phone use in bed, then gradually add activities like showering, exercise, or breakfast before checking it.”

The through line from clinicians and therapists is consistent: the first hour belongs to you, and protecting it—even imperfectly—can change how the rest of the day feels.