There are a number of simple things that anyone can do to lift their mood. You may already be doing some, and you certainly don’t need to be doing them all. Just try the ones that you feel most comfortable with, or that are easiest for you. As your mood begins to lift—and sooner or later it will—you can make more and bigger changes to your routine. And if you can hold on to these good habits once your mood has lifted, you will continue to feel better.

1. Spend more time with sympathetic friends and relatives.
Talking to others about our feelings helps us to process them, put them into perspective, and obtain advice and support. Don’t be afraid to tell people that you need their help, and don't feel guilty for accepting it. If you feel uncomfortable talking to friends and relatives, or are unable to, you can phone a helpline. Perhaps you prefer not to talk about your feelings at all. Even so, spending time with sympathetic people and doing things together should help to lift your mood.

2. Don’t bite off more than you can chew.
Break down large tasks into smaller ones, and set realistic deadlines for completing them. Try to reduce your levels of stress. Don’t blame yourself for "doing nothing"; you are merely giving yourself the time and space that you need to get better. Just think of it as taking a step back to jump further.

3. Do more of the things you normally enjoy, even if they no longer seem appealing.
Read your favorite childhood book, go shopping or to the cinema, prepare a meal, spend time with an old friend—anything that gets you out and takes your mind off negative thoughts is likely to make things better.

4. Get out of the house, even if only to buy milk or walk in the park.
Bright daylight, fresh air, and the hustle bustle of everyday life can all be very helpful, as can the sights, sounds, and smells of nature. If you can, try to take some mild exercise, such as 20 minutes of brisk walking.

5. Fight off negative thoughts.
Make a list of all the positive things about yourself and your situation (you may need help with this), keep it with you, and read it several times a day. However bad you may be feeling, remember that you have not always felt this way, and will not always feel this way.

6. Be realistic about your progress.
Improvements in mood are likely to be gradual rather than sudden, and you may even get worse before you start getting better. Once you are on the right track, there are going to be bad days as well as good days. Bad days that come after one or several good days may seem all the worse for it. Don’t blame yourself for the bad days, and don’t despair.

7. Avoid making or acting upon important decisions.
This would include leaving your job, getting divorced, or spending a large amount of money. While in the throes of depression, thinking errors are likely to impair your judgment.

 

8. Get as much sleep as you can.
A single good night’s sleep, or even a nice nap, can make a world of difference to your mood. To sleep better and longer, follow some of the advice in this related article.

9. Make an appointment with a health professional.
Enlist the advice and support of your family doctor or a psychiatrist. Maybe ask for counseling and take things from there.

10. Decide whom to call in an emergency should you feel overwhelmed by negative or suicidal thoughts.
This may be a relative or friend, your doctor, or a helpline. Think of a backup in case you can’t reach your primary support. Carry the appropriate telephone numbers on your person at all times, on your phone or in your wallet.
 

The world is so much bigger and more interesting than we can see with our naked eyes. If we could, we could watch cells grow, morph, and split again over and over again on the backs of our own wrists—or the billions of foreign cells living in and among our own, forming what scientists are beginning to call our “second brain.”[1]
As researchers turn their microscopes to these hidden environments, they have discovered something remarkable: There’s an entire ecosystem of bacteria and a vast neural network operating in our guts. This ecosystem is our second brain, and comprises some 100 million neurons, more than the spinal cord. This is not a thinking brain—it does not reason, write poetry, or solve multi-linear regressions—but mounting evidence suggests that your gut’s health strongly influences your mood.
It’s not just that a stomach ache can sour your day. It’s more than that. The enteric nervous system is a mesh-like network of neurons that lines the entire digestive track. It causes the sensation of nervous butterflies or a pit in your stomach that are innate parts of our psychological stress responses. Up to 90 percent of the cells involved in these responses carry information to the brain rather than receiving messages from it, making your gut as influential to your mood as your head is. Maybe even more.
Even crazier is that our second brain is actually only half of us. Inside the digestive system, the enteric nervous system mainly communicates with bacteria. These are completely separate creatures that make up our microbiome, and there are just as many of them inside of us as our own human cells.[2]


Don’t panic: This is not an alien takeover. Our gut bacteria have evolved with us since birth. They help digest our food and fight off unfriendly outsiders like viruses and molds. To keep us healthy they need to be healthy and plentiful as well.[3] When they’re not, we feel it: This biomass of bacteria communicates with important neurotransmitters embedded throughout our enteric nervous system to send messages that influence the way we feel.
This could herald good news for those who suffer from anxiety or depression. Studies indicate that those with healthy and diverse gut microbes are less likely to suffer from either malady.[4] And many of us who grew up in too—clean environments, frequently took antibiotics, and ate junk food have a decidedly unhealthy microbiome. So changing one’s diet could well benefit far more than your waistline.


If you’ve seen the term “probiotics” recently, this is why. Probiotics are foods that nourish and promote your biome. They’re foods cultured with the strains of healthy bacteria. Yogurt is a perfect example of a cultured food.[5] Unfortunately, many grocery store yogurts are little more than a thickened, sweetened milk product. But yogurt that lists strains such as Lactobacillus acidophilus and Bifidobacterium lactis actually contain the healthy bacteria your gut needs. “Prebiotic” foods, meanwhile, support a healthy gut ecosystem in which your bacteria can thrive. Together, prebiotic and probiotic food help keep your second brain full of the vibrant bacterial community it needs to function.


How exactly these gut-healthy foods help manage depression is not yet totally clear. The science on the gut-brain connection is still young, especially as it relates to our mood. But studies continue to find promising correlations. There is evidence that a healthy gut can curb inflammation and cortisol levels, lower your reaction to stress, improve memory, and even reduce neuroticism and social anxiety.[6][7][8][9] Many of these preliminary studies were conducted on mice, but there’s little risk to conducting your own human test at home. Incorporate more gut-healthy foods into your diet like yogurt, sauerkraut, and dark chocolate, and see how you feel.

Yes, it’s unlikely that simply taking a sip of kombucha the next time you feel anxious will calm you much. And you can’t expect to replace your SSRIs with prebiotic pickles. As with most of medicine, the gut-brain connection is a complex, varied, and ever-changing system for which no one definition of “healthy” will do. Your gut is, after all, as unique as you are. But these emerging insights about our gut-brain connection make us reframe the way we think about—and treat[10]—our bodies and minds. If a cupful of yogurt for breakfast can make the workplace more bearable, then it’s time to go grocery shopping.
                                                

The bizarre death of six-year-old JonBenet Ramsey back in 1996 remains a major unsolved mystery today. How might forensic psychology possibly contribute to finally resolving this now totally "cold" case? Let us take a careful look back at what happened on that frosty and fateful Christmas night in the Ramsey household, attempting to more clearly discern why little JonBenet was seemingly brutally murdered and who might have been motivated to commit such an evil deed. Over the course of the next several postings, we will together closely examine the detailed history of this case from the perspective of forensic criminal psychology.


Before proceeding, it must, in fairness, be explicitly stated that no charges have ever been formally filed against the Ramseys. John, Patsy, and Burke Ramsey have always adamantly professed their innocence and denied any involvement in JonBenet's death. In fact, in 2008, based on the results of the most recent "touch" DNA testing, the Ramsey family was publicly and officially exonerated by then Boulder District Attorney Mary Lacy of any complicity or wrongdoing in the death of JonBenet, based mainly on the discovery, according to Lacy, of the DNA of an "unknown male" on key articles of JonBenet's bedclothing. (See Lacy's official letter to John Ramsey here.) However, some investigators still vehemently dispute these scientific findings as inconclusive, and deem her apologetic letter of exoneration inappropriate and "not legally binding." And there are apparently still no alternative suspects at this point, some 200 having already reportedly been investigated and cleared. (There is in this regard some similarity to another infamous case, the bloody murders of Nicole Brown Simpson and Ron Goldman in 1989, for which O.J. Simpson was exonerated by the criminal trial but still believed by many, including a jury in the subsequent civil case, to be responsible. See my prior post.) The JonBenet Ramsey case is stone cold. Seemingly the perfect crime. So what do we know, twenty years down the line, regarding the possible identity and motivation of the perpetrator(s) of this gruesome evil deed?


The first thing we want to do is to put away any assumptions, preconceptions or biases, to approach the case by consciously assuming a phenomenological stance, which means simply to re-examine it without presupposition, presumption or prejudice. Taking a deliberately naive, new, and dispassionate look at it with fresh, unfettered eyes. This is something I always tried to do when conducting forensic evaluations of  defendants for the criminal courts in California. It means placing what we know, or at least what we think we know, about a defendant or, for instance, this particular high-profile criminal case, temporarily aside, and looking at what actually took place in light of the currently available facts.


All we really know for certain is that an adorable little blonde girl, who had become a local celebrity because she occasionally competed enthusiastically in beauty pageants for children, was found dead in the basement of her luxurious family home. She had apparently been sadistically tortured by the perpetrator(s), possibly sexually assaulted, and, ultimately, killed. The exact time of her death is not clear; nor are the causes of the injuries from which she died, which included a massive eight-inch skull fracture and a tightened noose around her neck causing strangulation and asphyxiation, the official cause of death. In addition, and still not explained, there were two small, distinct dark spots on her body that some investigators believe to have been caused by a stun gun. The seemingly hastily made ligature fastened tightly around her neck was comprised of a woven white piece of cord, looking similar to a sneaker shoelace, attached to a perhaps six-inch fragment of fashioned wood, which, when turned or twisted, tightened the noose with which she was strangled. JonBenet's hands were tightly bound together behind her head, and a piece of black duct tape covered her mouth, according to her father.

Indeed, JonBenet's cold and lifeless body, reportedly already stiff with rigor mortis—suggesting she had been dead for at least 4 hours or more—was reportedly discovered by her father in the spacious home's hidden basement wine cellar during the late morning/early afternoon of December 26th. John Ramsey states that he immediately, upon searching the house a second time and finding her body lying on the basement floor covered up by a blanket, removed the duct tape from her mouth and tried unsuccessfully to unbind her hands before carrying her upstairs in his arms. According to the police laboratory, the DNA of an unknown male was found on two different articles of JonBenet's clothing. Moreover, there was, according to news reports, some physiological evidence discovered during the autopsy that suggested to examiners the presence of sexual abuse: specifically, evidence of vaginal trauma and having been possibly sodomized with a foreign object, though these findings are subject to interpretation. One thing is certain and incontrovertible: JonBenet did not die of natural causes. Whether she was deliberately tortured and murdered or was the tragic victim of an accidental death and subsequent cover up, as the Boulder police long suspected, is still hotly debated. How did she die, who killed her, and why?


Earlier that morning, prior to her body being found by John, JonBenet's mother, Patsy, herself a former beauty queen, reported having stumbled upon a three-page ransom note on the stairs leading down from her second floor bedroom. The oddly worded, roughly handwritten note makes reference to wanting precisely $118,000.00 for JonBenet's return, lest she be "beheaded." According to police, it was written on pages torn from Patsy"s own personal note pad, where they found physical impressions of what they believed to be a practice note or perhaps one that was started and stopped, and the writing—especially when compared side-by-side to one sample done in her non-dominant left hand—reportedly bore some resemblance to Patsy's. In addition, the garotte-like ligature was fashioned, say the police, with a length of cord and a piece of broken wooden paint brush handle apparently taken from Patsy's art supplies, very close to where the body was found. Certainly, if there was an intruder, as the Ramseys have consistently claimed, he or she could have made use of Patsy's pad and art supplies during the night while the family slept. But, for that matter, so could have another family member.

According to unconfirmed sources, a neighbor reported having heard a high-pitched scream in the vicinity of the Ramsey home around midnight that night. Such a scream from within the Ramsey household and audible from outside would almost certainly have woken and alerted the family. But if JonBenet was killed some time between midnight, after allegedly being put to bed by her parents on Christmas night, and the next morning by the supposed kidnapper(s), what was the point of them taking the time and trouble to compose a detailed ransom note and leaving it for someone to discover on the stairs? In the rambling letter, the author(s), identifying themselves as a "foreign faction,"

demanded ransom money and warned against notifying authorities if the parents hoped to ever see their beloved daughter again, concluding with the cryptic signature: VICTORY! SBTC
The strange ransom note and signature, as well as some other aspects of the Ramsey case, are reminiscent of another sensational kidnapping case occurring in 1932, in which the 18-month-old son of celebrated cross-Atlantic flyer Charles Lindbergh was abducted from the home during the night. A poorly handwritten and very cryptically signed ransom note was left for the family. (See the details of this infamous case here.) The ransom money was delivered as demanded, but the baby was never seen alive again. His battered body was discovered in a wooded area of a nearby town two months later, having suffered from a massive skull fracture. Subsequent to an extensive investigation, a suspect, Richard Hauptman, was arrested, prosecuted, convicted of the heinous crime, and eventually executed, though he always proclaimed his innocence. Some continue to speculate on who truly committed this kidnapping and killing to this day.


Did the original plan of kidnapping JonBenet, the daughter of a wealthy businessman, for ransom money go awry for some reason, resulting in her murder instead? Could the alleged kidnapper(s), who said they would call the Ramseys by 10:00 AM that morning after Christmas but never did, have somehow believed that her body would not be found there in the basement? Or was there never any serious intention of extorting ransom money from the Ramseys at all? Could the unusually long ransom note have been merely another means of cruelly tormenting and torturing them as JonBenet had been cruelly tortured? Was this evil deed the work of a sadistic psychopathic pedophile? Was the motivation merely to inflict the greatest possible pain and suffering upon the Ramsey family? And, if so, why the Ramseys? Or was the note deliberately designed to deflect suspicion away from the actual perpetrator?


This single concrete piece of evidence, the ransom note, seems absolutely key to solving the case. But it is so enigmatic. Was it, as Boulder police long suspected, penned by Patsy Ramsey herself? If so, why? And if not, who did write and leave it to be found? Probably not nine-year-old Burke, though that possibility cannot necessarily be ruled out in my opinion. (Whether Burke was ever considered by investigators as being the possible author is not clear to me.) And certainly not JonBenet herself. Nor, according to police investigators, was John Ramsey the likely author. (Was it dusted for fingerprints?) Whether the contents and style of this letter have previously been subjected to psychological analysis is not known to me, but it would seem to potentially provide a wealth of information about the psychology of its author(s), something we will seriously consider in Part 2 of this series.


If we rule out the family members as writing the rambling ransom note, which has officially already occurred in effect by dint of their formal and controversial exoneration, it becomes clear that if John, Patsy, or Burke did not create the note, someone else (or possibly more than one person) was inside the home that night, opportunistically lurking in the darkness, and responsible for both the ransom note and the grotesque killing of JonBenet. Someone sufficiently cruel, hateful, violent and sadistic to have committed such an atrocious crime. Someone powerfully motivated to brazenly take the risk of doing so and of possibly being caught. Which begs the following questions: What type of person would most likely perpetrate such a crime? Were they motivated by money? Sex? Rage? Jealousy? Or resentment toward the very affluent and influential Ramsey family? Or animosity toward JonBenet in particular? Did John or Patsy Ramsey have enemies? If someone wanted to hurt John and Patsy, this would surely be one extreme way to do so. If JonBenet Ramsey was deliberately and brutally murdered by an intruder(s), the perpetrator(s) must have been driven or compelled to commit this evil deed by something very powerful indeed. Could the killing have happened, counter to the original plan, due to fear of being discovered when JonBenet cried out around midnight? Though the Boulder police department reportedly investigated and cleared hundreds of potential suspects in this case, either the perpetrator was somehow mistakenly eliminated as a suspect by investigators or never identified and investigated at all.


Or, could the killer's true intention all along have been simply to permanently silence the child, a motive perhaps symbolized and suggested by the duct tape allegedly found over her mouth by her father, John, whom some speculated may have been sexually abusing his daughter, conjecture both he and JonBenet's pediatrician dismiss unequivocally. Could JonBenet, these theorists wondered, have been killed to keep this sordid secret from ever being exposed? Curiously, this evidentiary detail of the case is eerily reminiscent of the duct tape found on the badly decomposed corpse of Casey Anthony's 4-year-old daughter, Caylee. According to her prosecutors during the trial, Casey Anthony (now found not guilty, but still believed responsible by some for Caylee's death) presumably killed her daughter partly because she wanted to be free to live a different, freer lifestyle or possibly covered up her accidental death. Casey told investigators that her daughter had been kidnapped by a mysterious nanny who evidently never existed. (See my prior posts.)

 In the case of Susan Smith (now convicted), the then twenty-three-year-old mother drowned her two young children (both about JonBenet and Caylee's same age) by driving her car into a lake with the children restrained by their seat belts from escaping, presumably so that she could be with her new boyfriend. Prior to eventually confessing, Smith blamed the murders on a phantom carjacker. Smith had reportedly been severely emotionally damaged during childhood, sexually abused, was suicidally depressed, and may have suffered from some sort of personality disorder. Extremely immature, narcissistic individuals (see my prior post) can have great difficulty placing their own selfish needs secondary to those of their children. Yet another murderous mother, Andrea Yates (now found not guilty by reason of insanity and diagnosed as suffering from postpartum depression and psychosis), drowned her five children one-by-one in a bathtub, claiming she did this evil deed to keep them from being damned and tormented by Satan as she felt she had been. (See my prior post.)
Statistically speaking, the likeliest culprits when a child dies in the home would be one or both parents, which is the main reason why the authorities focused so intensively on the Ramseys from day one. Filicide—defined as the killing of a child by his or her parent—is a deeply disturbing but very real phenomenon. According to Department of Justice statistics, between 1976 and 1997, which includes the year of JonBenet's death, nearly 11,000 children like her were killed by their parents or step-parents. The motives for filicide vary, from so-called "altruistic" filicide or supposedly well-intentioned mercy-killing of sick and suffering offspring, to "accidental" filicide during severe child abuse or neglect, to angry retribution against an offending spouse as in the ancient Greek tragedy Medea, to the overwhelmed or self-serving solution of killing unwanted, demanding, cumbersome, socially inconvenient children, to the murderous acting out of the paranoid delusions and command hallucinations of madness.


Could someone like Patsy Ramsey, who succumbed to ovarian cancer in 2006, have, as some still insist, intentionally or unintentionally killed her daughter? Perhaps. But, as in other infamous cases of filicide, there would need to have been some overwhelmingly compelling motivation or compulsion to do so in order to overcome the innate maternal instinct to protect and defend her offspring from any and all harm. From all reports, Patsy was a very loving, caring and devoted mother to JonBenet. What could possibly drive a loving mother like this to commit such a reprehensible crime? Police hypothesized early on that she may have that night flown into a fit of rage regarding JonBenet's chronic bedwetting, fatally injuring her daughter accidentally, and then, in a total panic, desperately covering it up by concocting the far-fetched kidnapping story, composing the ransom note, and staging the gruesome murder. Presumably, this would have had to happen with her husband's knowledge and full complicity, motivated perhaps by his strong desire to protect his wife, their marriage, and their reputation. (Though it may hypothetically be possible for this all to have taken place during the night when both John and Burke were deeply asleep and unaware, that scenario seems rather improbable.)


The most likely explanation for deliberate infanticide or filicide being committed by a mother like Patsy Ramsey, in my view, would be the presence of severe postpartum depression, but there is no publicly known psychiatric history of this (or at least none known to me). Nor is there any information suggesting the presence of profound depression after JonBenet's brother, Burke, was born nine years prior. And it had been six years since she gave birth to JonBenet, which, if she had been suffering from prolonged depression and possible psychosis, it would likely have been diagnosed and treated at some point. Whether either Patsy or John have any previous history of mental health treatment whatsoever is not known to me. However, there apparently were several psychiatric interviews of Patsy Ramsey subsequent to JonBenet's death which, according to then District Attorney Mary Lacy, revealed no signs of psychopathy, pathological jealousy or envy of her daughter, or violent tendencies in general. Absent any prior psychiatric history of psychopathy, major depressive disorder, postpartum depression, psychosis or any other significant mental disorder, other possible diagnoses I would, as a forensic psychologist, want to rule out in evaluating a defendant in such a case would include substance intoxication, acute psychotic or manic episode, borderline personality disorder, severe obsessive compulsive disorder, and dissociative identity disorder (formerly called multiple personality disorder), in which one repressed shadowy part of the personality temporarily takes over, not unlike what tragically occurs in Robert Louis Stevenson's famous fictional tale of Dr. Jekyll and Mr. Hyde (see my prior posts).


Despite having been officially eliminated (but not legally tried and acquitted) as a suspect, since the early days and as recently as last year, in a CBS documentary on the JonBenet Ramsey case, there are those, including famed forensic pathologist Werner Spitz, who hypothesize, despite his being long ago officially ruled out as a suspect, that Burke, now 29, killed his sister. There are unconfirmed reports, for example, of a "family friend," who claims that Burke as a boy had a terrible temper, and physically struck his sister, JonBenet, in the head with a golf club about eighteen months prior to her death. Promoters of this theory believe that Burke may have been jealous of JonBenet, perhaps suffering from sibling rivalry, that he became enraged with her that night for some minor reason, and either intentionally or accidentally killed her. Appalled, horrified, in shock and terrified of losing Burke too, the Ramseys, these individuals suggest, deliberately and hastily created an elaborate (and effective) cover up to protect Burke from suspicion and prosecution. This theory requires that we accept two premises: first, that Burke was capable of committing the killing; and second, that his parents could have concocted the ransom note, and, as part of their story, further hideously mutilated and defiled their own daughter's now dead body in order to save their son from prosecution for homicide. And that they did all this on the spur of the moment, without hesitation or time for planning, while grieving the shattering loss of their daughter.


Regarding the second premise, I find it strains credulity that these two parents would react in such a spontaneous, calculating, coordinated and criminal fashion. Could a nine-year-old boy hypothetically commit a vicious evil deed like this? To paraphrase Sigmund Freud, the innocence of children is due largely to weakness of limb. Children, from infancy on, are subject to passionate feelings not only of sexuality, but of jealousy, rage, resentment, and murderous impulses toward siblings, and even parents. And children often have difficulty controlling these emotions, sometimes leading to a destructive acting out of these violent impulses. A child with psychopathic proclivities, one who might be diagnosed as manifesting symptoms of Conduct Disorder, for instance, would, I believe, be capable of committing a crime such as this—including the crushing blow to the head, the possible use of a stun gun (was a such a stun gun ever found in the home?),

the slow and torturous strangulation by garrote, and the obscene sexual violation. Indeed, by definition, according to the American Psychiatric Association, the diagnosis of Antisocial Personality Disorder (see my prior post) in adults requires a history of Conduct Disorder starting prior to the age of 15, and the presence of a "pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence." These antisocial behaviors commonly include "aggressive conduct that causes or threatens physical harm to other people or animals." This cruelty can take the form of torturing insects or animals for pleasure. Such children or adolescents "often initiate aggressive behavior and react aggressively to others. They may display bullying, threatening, or intimidating behavior, start fights, exhibit physical cruelty, and use potentially deadly weapons (e.g., a bat, brick, broken bottle, knife, or gun)." But that degree of aberration in a boy of nine would, fortunately for us all, be relatively rare, though studies suggest that the incidence of Conduct Disorder is on the rise, occurring in anywhere from 1-10 percent of the general population, mainly in males. (See my prior post.) And there would likely be some significant history of serious behavioral problems at both school and home, prior and subsequent to the crime. Whether this can be said of Burke is questionable based on the available information. Much less unusual would be a scenario in which one sibling becomes enraged with the other over some seemingly trivial event, suddenly lashing out angrily and violently (though not necessarily murderously): for example, impulsively striking the victim forcefully over the head with some handy heavy object, occasionally resulting in his or her serious injury or death.


In addition to the controversial DNA evidence, currently there are at least two seemingly significant clues that seem to lend support to the intruder theory. The suitcase that was found sitting below the unlocked and open basement window in the room where JonBenet's body was discovered was said to not belong there by John Ramsey. Its position suggests the possibility that it was purposely placed below the window and used to step up on in order to exit the room through the window. And, according to ex-Boulder DA Mary Lacy, who has officially ruled out any member of the Ramsey family as suspects and was taken through the home a few days after JonBenet's body was found, there was an obvious and unmistakable impression in the carpet outside of JonBenet's bedroom, a so-called "butt print," which she concludes was left by the intruder: "Whoever did this sat outside of her room and waited until everyone was asleep to kill her." Who could that have been? Or might that impression in the carpeting have a more innocent explanation?

I have tried here in Part 1 of this series of posts to succinctly and accurately gather and summarize some of the publicly known facts to date gleaned from a review of various media and news sources, as well as prior and current speculative theories about this case, to provide readers who may be unfamiliar with it an overview for further exploration and discussion. There are numerous other theories and details not noted here, some of which will be explored later. Clearly, there are still, twenty years since the crime was committed, more questions than answers, some of which we will be further examining. Let me know your own thoughts, theories, speculations and responses to mine regarding this tragic and very mysterious unsolved case in your comments and questions. I will do my best to include, consider, and address them in Part 2.

In Jennifer Yu's debut novel, Four Weeks, Five People, teenagers Clarisa, Stella, Mason, Andrew and Ben meet at summer camp. But this is no ordinary summer camp. It's a camp for teens with mental-health challenges. The protagonists didn't choose the camp as a fun way to spend a month – they're there because the camp was mandated to treat issues like OCD, anorexia, and depression. Their four weeks at Camp Ugunduzi is a chance for them to become "normal" in the eyes of their parents and teachers.
"It wasn't like I was trying to write a book. I wrote two pages and didn't realize it was going to get longer," Yu says. "The voice of Stella just came to me so strong. She's returning to camp for her second summer and talks about how stupid it is – the idea of 'getting better' and what does that even mean? But at the end, it's hard for her not to hope that it will help."

While at camp, the characters voice opinions and talk through challenges that Yu has faced in her own life. And, like life, there are no easy cures and no easy answers.
"In school, I would read these stories of people with mental health challenges and it was like they realize they have a problem, they commit to something, and...they did it! But that's not how it really works. I think it's important for young people to see that change doesn't always happen. I hope this book shows that for people with depression or other issues, it's okay and they can be less hard on themselves. I hope that reading about characters who struggle will help people see that it's okay to struggle," Yu says.


At its heart, Four Weeks, Five People is about the struggle to connect. The adults in this story hope that camp will help their teens act like everyone else and learn to connect with the mainstream world. But what happens is much different. As relationships and conflicts evolve, the book shows the power of connecting with others who understand what it's like to not be "normal," and, ultimately, the power of connecting with a self that, outside camp, has been systematically devalued.
"I used to think, if only I could be a different person! I wanted to cut out part of myself – cut out the part that felt totally inadequate at school," Yu says. "But now I see you have to look that part of yourself in the eye. The most you can learn is to be okay with the person you are."


Yu's gorgeous exploration of herself, distributed across five characters, will resonate not only with teens in therapy but with every teen reader who feels at odds with the world – namely almost every teen. Teens will see in these pages and in this author a voice that's been there. Sometimes it's enough for now just to feel understood.

A diverse range of recent studies concur that excessive nighttime use of digital devices is a growing international epidemic that is leading to sleep disturbances and a broad spectrum of psychological and performance-related consequences. The most hazardous aspects of late-night screen time appear to be a type of daytime somnambulism marked by chronic drowsiness as if someone is sleepwalking his or her way through the day.

What Is Sleep Hygiene?

Sleep hygiene is defined as, "habits and practices that are conducive to sleeping well on a regular basis and having full daytime alertness." Historically, poor sleep hygiene has been associated with disrupted circadian rhythms, depression, anxiety, and subpar levels of performance at work and school due to reduced cognitive function and physical coordination caused by sleep debt.  
Regardless of your age, if you sleep with your smartphone next to your bed without turning off the ringer, odds are that your phone probably wakes you up during the night. Obviously, being woken up randomly by the dings and rings of your mobile phone can make you groggy and somewhat somnambulistic the next day.

On average, Americans use smartphones for about 4.7 hours within a 24-hour period according to a 2015 study by Informate Mobile Intelligence in Seattle. Hopefully, the extensive compilation of empirical findings presented here will educate and motivate people of all ages and walks of life to remain cognizant of your late-night smartphone use.
For this blog post, I’ve compiled a comprehensive review that includes a summary of 8 recent studies by various international researchers who investigated the link between late-night smartphone use, sleep disturbances, and the various consequences of poor sleep hygiene being caused by nighttime use of digital devices and social media.
The research below presents a broad swath of science-based findings from multidisciplinary experts who all seem to agree: Unplugging from your digital devices and limiting smartphone use during the hours you set aside for sleeping is of paramount psychological and chronobiological importance.

"I Reported to Work In the Morning, After an Hour or Two's Sleep, Looking Like a Somnambulist"

While I was researching and writing about the impact of nighttime digital technology use on our daytime state-of-mind this afternoon, I was constantly reminded of the world-renowned American writer, Henry Miller, and his fascination with somnambulism.
Before diving into the abundance of potentially dry scientific data below, I wanted to breathe some storytelling life into this blog post on somnambulism by mentioning the vivacious lifestyle and writings of Henry Miller who inspired the concept of this post's title. As the antithesis of daytime somnambulism, Miller was a role model.

As a novelist who frequently made social commentary, Henry Miller wrote metaphorically about somnambulists of the modern work-a-day world sleepwalking through life. He used the word somnambulist to describe dispirited characters who were going through life in a half awake, zombie-like daze.
For example, in A Devil in Paradise Miller writes, “Often I took a seat on a public bench, closed my eyes for a few moments to sink below the surface, then suddenly opened them to look at the world with the vacant stare of a somnambulist.” In the semi-autobiographical novel Sexus, Miller writes, “I reported to work in the morning, after an hour or two’s sleep, looking like a somnambulist. The day passed like a dream.”
However, in his personal day-to-day life, Henry Miller was notorious for his passion for bicycle racing and pushing against his limits as summed up in his mantra “Life is 440 horsepower in a 2-cylinder engine.” This approach to life echoes a similar type of moxie Maya Angelou expressed when she wrote, "Life likes to be taken by the lapel and told, 'I'm with you kid. Let's go!'"
Miller aspired to live a zestful life by keeping all of his senses fully engaged and encouraged others to do the same. His joie de vivre is summed up in many of his famous quotations about living life to the fullest—with your eyes, ears, mind, and body wide open to the sense of wonder and awe that can be found in the digital-free world around you.

Three Quotations by Henry Miller that Reiterate the Importance of Avoiding Daytime Somnambulism

Source: Vaclav Volrab/Shutterstock

“The moment one gives close attention to any thing, even a blade of grass, it becomes a mysterious, awesome, indescribably magnificent world in itself.”
“The aim of life is to live, and to live means to be aware, joyously, drunkenly, serenely, divinely aware.”
“Develop interest in life as you see it; in people, things, literature, music—the world is so rich, simply throbbing with rich treasures, beautiful souls and interesting people. Forget yourself.”

Hopefully, something you read in one of the eight studies listed numerically below will motivate you to modify your nighttime smartphone habits and help you become more invigorated and tuned-in to the world around you during the day.

1. Global Media Study Challenged College Students to Go Without Using a Smartphone for 24 Hours

Recently, the International Center for Media & the Public Agenda (ICMPA) in partnership with the Salzburg Academy on Media & Global Change conducted a survey of college students around the world to identify how ‘addicted’ they were to smartphone use. The researchers assessed this 'addiction' by asking the students to ‘unplug’ and go for 24 hours without the use of their mobile phones or other digital devices.
The study concluded, “Students around the world reported that being tethered to digital technology 24/7 is not just a habit, it is essential to the way they construct and manage their friendships and social lives.”
Although most students around the world saw multiple benefits of going unplugged, their negative reactions to being unplugged from their digital devices for a full day was overwhelming. That being said, there was a sliver of students the researchers referred to as ‘Transcendentalists-in-the-making’ because they were able to revert to ‘simple pleasures’ and found peace of mind when they gave up all media for 24 hours.

2. Higher Daily Averages of Smartphone Use Are Associated with Lower Sleep Quality

A November 2016 study by Matthew Christensen from the University of California, San Francisco (UCSF) and colleagues reported that nighttime exposure to smartphone screens is associated with lower sleep quality. The research team found that smartphone use within 60 minutes of bedtime had the greatest impact on sleep disturbances. The findings were published in the open-access journal PLOS ONE.

Christensen and his team analyzed smartphone data use from 653 adult individuals across the United States who were participating in the Health eHeart Study. They also recorded participants number of sleeping hours and sleep quality.
On average, the researchers found that each participant activated his or her smartphone for a total of about 4 minutes every 60 minutes within a 24-hour period. Across the board, longer quantities of daily screen-time use was associated with poor sleep quality and less sleep overall—particularly when smartphones were used near or after participants' bedtime.

3. Nighttime Smartphone Use Drains Workers' Daytime Energy

Using a smartphone to cram in more work late at night can backfire by resulting in significantly less work productivity the next day, according to business scholars from Michigan State University (MSU). The researchers state, "Our findings suggest that late night use of smartphones for work may interfere with sleep, thus leaving employees depleted in the morning and less engaged during the workday.”
This 2014 study, “Beginning the Workday Yet Already Depleted? Consequences of Late-Night Smartphone Use and Sleep," was published in the journal Organizational Behavior and Human Decision Processes.
This research consisted of two studies in which Russell Johnson and colleagues at MSU surveyed a broad spectrum of U.S. workers including people who closely monitor their smartphones for business purposes after 9 p.m. Not surprisingly, these workers were more tired and less engaged the following day on the job than their peers who unplugged for the night.
In a statement to MSU, Johnson said, "Smartphones are almost perfectly designed to disrupt sleep. Because they keep us mentally engaged late into the evening, they make it hard to detach from work so we can relax and fall asleep."
The first arm of the study found that nighttime smartphone usage for business purposes cuts into sleep and sapped workers' energy the next day in the office. Interestingly, the second study compared smartphone usage to other electronic devices and found that smartphones had a larger negative effect than watching television and using laptop and tablet computers at night.
In addition to keeping people mentally engaged at night, smartphones emit "blue light" that seems to be the most disruptive color of light for our circadian rhythms. Blue light is known to hinder melatonin, a chemical in the body that promotes sleep. Based on these dual findings, Johnson concluded,

"So it can be a double-edged sword. The nighttime use of smartphones appears to have both psychological and physiological effects on people's ability to sleep and on sleep's essential recovery functions."

4. One in Five Teenagers Wake Up During the Night to Check Social Media

A January 2017 study by researchers in the UK found that approximately one in five young people wake up during the night to send or check messages on their social media accounts. This study, “Sleepless in school? The Social Dimensions of Young People’s Bedtime Rest and Routines,” was published online in the Journal of Youth Studies.
The researchers found that late-night social media engagement is making about 20 percent of teenagers three times more likely to feel constantly tired at school. This type of daytime somnambulism could be affecting these students’ academic performance, happiness, and well-being, according to the researchers.
Notably, students who woke up to use social media almost every night of the week said they were always tired at school and were significantly less happy on average than young people with better sleep hygiene who did not feel sleep deprived at school.

5. Social Media Use by Young Adults Is Associated With Sleep Disturbance

A January 2016 study from the University of Pittsburgh School of Health Sciences also found that young adults who spend a lot of time on social media during the day or check their social media accounts throughout the night are more likely to suffer sleep disturbances than their peers who use social media less. These findings were published in the journal Preventive Medicine.
For this study, the researchers sampled 1,788 U.S. adults ages 19 through 32, using questionnaires to determine social media use and a previously established measurement to assess sleep disturbances.
The questionnaires asked each individual about his or her use of the 11 most popular social media platforms at the time: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn. On average, the participants used social media for a total of 61 minutes per day and visited various social media accounts 30 times per week. The assessment showed that nearly 30 percent of the participants had high levels of sleep disturbance.
In a finding that corroborates the UK study above, the respondents who reported most frequently checking social media throughout the week also had three times the likelihood of sleep disturbances, compared with those who checked social media least frequently.
The researchers point out that people who have difficulty sleeping may oftentimes use smartphones and social media as an entertaining way to pass the time when they can't fall asleep or fall back to sleep. Again, due to the impact of "blue light" and other types of stimulation using a smartphone as an insomnia aid often backfires.
The Pitt researchers concluded that their findings (along with the findings of other researchers in the field) should galvanize primary care physicians to consider asking patients about social media habits when assessing sleep issues.

6. Teenagers Who Own Smartphones Spend More Time Online 

Another 2015 study from the University of Basel also reported that teenagers' smartphone use during the night is associated with an increased risk of sleep problems and depressive symptoms. The researchers found that only 17 percent of smartphone owners turned their devices off—or put their devices on silent mode—when they were in bed.
The researchers found that teenagers who own smartphones spend more time online during the night, which can dramatically affect their sleep. Lots of teenagers with smartphones also watch videos, surf the internet, and text with friends late at night.
From a public health perspective, the worst news from this study was that teenagers who used smartphones at night had an increased risk for poor sleep hygiene and depressive symptoms.
Therefore, sleep experts recommend that teenagers—who suffer from sleep disturbances and subsequent daytime drowsiness—should be encouraged by parents, coaches, or other influencers to turn off all of their digital media devices and discontinue use at least one hour before bedtime.

7. Texting After Bedtime Impacts School Performance in Adolescents

A January 2016 study, from Rutgers University, found that texting at night affects both teens' sleep and their academic performance. In fact, students who turned off their digital devices or text messaged for less than 30 minutes after lights out, performed significantly better in school than those who messaged for more than 30 minutes after lights out.
This 2016 Rutgers study was the first of its kind to link nighttime texting habits of American teenagers with sleep hygiene and academic performance.
The researchers found that students who texted longer in the dark slept fewer hours and were more tired during the day than those who stopped messaging and turned off their phones when they went to bed. This is common sense, but it's nice to have empirical evidence to back up something most of us have probably realized from our own life experience.
In a statement to Rutgers, study author Xue Ming, professor of neuroscience and neurology at Rutgers New Jersey Medical School, said,

"During the last few years I have noticed an increased use of smartphones by my patients with sleep problems. I wanted to isolate how messaging alone—especially after the lights are out—contributes to sleep-related problems and academic performance.
When we turn the lights off, it should be to make a gradual transition from wakefulness to sleep. If a person keeps getting text messages with alerts and light emission, that also can disrupt his circadian rhythm. Rapid Eye Movement (REM) sleep is the period during sleep most important to learning, memory consolidation and social adjustment in adolescents. When falling asleep is delayed but rising time is not, REM sleep will be cut short, which can affect learning and memory.
We need to be aware that teenagers are using electronic devices excessively and have a unique physiology. They tend to go to sleep late and get up late. When we go against that natural rhythm, students become less efficient."

Ming suggests that educators recognize the sleep needs of teenagers and incorporate sleep education into their curriculum. Ming said, "Sleep is not a luxury; it's a biological necessity. Adolescents are not receiving the optimal amount of sleep; they should be getting 8-and-a-half hours a night."  Adding, "Sleep deprivation is a strong argument in favor of later start times for high schools—like 9 a.m."

8. Feeling Pressure to Be available 24/7 on Social Media Is Linked to Teenage Sleep Disturbances, Anxiety, and Depression

The need to be available 24/7 on social media can be a prime driving force that reduces sleep quality and often leads to depression and free-floating anxiety according to recent research conducted by Heather Cleland Woods and Holly Scott from the University of Glasgow.


For this study, the researchers created a questionnaire for 467 teenagers regarding their overall and night-time specific use of social media. Another set of tests were designed to measure sleep quality, self-esteem, anxiety, and depression. They also measured emotional investment in social media which can increase the feeling of obligation to respond immediately to texts and social media posts around the clock.
Both daytime and nighttime specific social media use—along with the emotional investment in staying plugged into their digital devices—was correlated with poorer sleep quality, lower self-esteem as well as higher anxiety and depression levels, the researchers concluded.
In a statement to the British Psychological Association, Cleland Woods explained:

"Adolescence can be a period of increased vulnerability for the onset of depression and anxiety, and poor sleep quality may contribute to this. It is important that we understand how social media use relates to these. Evidence is increasingly supporting a link between social media use and wellbeing, particularly during adolescence, but the causes of this are unclear.
While overall social media use impacts on sleep quality, those who log on at night appear to be particularly affected. This may be mostly true of individuals who are highly emotionally invested. This means we have to think about how our kids use social media, in relation to time for switching off."

The need to be constantly available and respond 24/7 on social media can cause depression, anxiety, and reduce sleep quality for teenagers and people of all ages, according to this study and other research.

Smartphones Are Disrupting Circadian Rhythms Around the World: Experts Recommend Turning Off Your Smartphone One Hour Before Going to Bed

The data from these studies reaffirms that whether or not you're a teenager, excessive nighttime texting or smartphone use may be to blame for reduced cognitive performance and feeling lethargic during the day.
In the decade since its invention in 2007, smartphones are rapidly disrupting sleep patterns that evolved over millennia for people around the globe. Experts strongly recommend that teenagers (and adults) who suffer from any type of sleep disorders or severe daytime tiredness should turn off all of their digital media devices at least one hour before bedtime.
Humans have evolved to spend roughly one-third of our lifetime sleeping. Ideally, you should sleep about 8 hours for every 16 hours of wakefulness, which adds up to 122 days of sleep per year.
Your mind, body, and brain will function optimally at a basic two-to-one ratio of wake-to-sleep. Based on this equation, by the time you're sixty years old, this would add up to twenty years spent sleeping, and about five solid years in REM sleep.


Circadian rhythms are the prime driver of our wake-sleep chronobiological cycles. Even with the advent of artificial light and the modern day 9-to-5 work schedules, our circadian rhythms appear hardwired to stay in tune with Earth's rotation and the rising and setting of the sun.
Everybody has an internal biological clock that dictates the circadian rhythms and the fluctuations within your body based on our planet's 24-hour day. Circadian rhythms are controlled by a grain-of-rice-sized cluster of 20,000 neurons behind the eyes called the Suprachiasmatic nucleus (SCN). The SCN is regulated by how much light, particularly natural sunlight, is taken in by specific cells in the retina.


In 2013, researchers at MIT reported that when circadian rhythm are thrown off—health problems including obesity and metabolic disorders such as diabetes can arise.
However, digital technologies—along with light pollution caused by global trends of urbanization—are playing an even bigger role in disrupting our natural sleep patterns in the smartphone era than most experts anticipated. In fact, researchers reported in June 2016 that due to artificial lights, one-third of humanity (and 80 percent of Americans) can no longer see the Milky Way at night.
In a perfect world, the consensus of most experts is to turn off your smartphone (and all other digital devices) one hour before bedtime to minimize the "blue light" exposure to your SCN which disrupts circadian rhythms and sleep patterns. Sleep experts also recommend using a traditional alarm clock and charging your phone overnight outside of the bedroom.
Although unplugging from our smartphones takes some willpower for most of us, any effort you make to minimize screen exposure before and during bedtime hours will help reduce sleep disturbances and subsequent consequences of poor sleep hygiene such as daytime somnambulism.

The suicide of a young mother is an unspeakable tragedy:

Thirty-two-year-old Florence Leung went missing without an explanation in late October, causing New Westminster police to launch a massive search. It was revealed she was suffering from postpartum depression and her family was concerned about her well-being.
On Nov. 16, Leung’s body was found in the waters near Bowen Island. No foul play was suspected.

Her husband believes that breastfeeding pressure contributed to her suicidality:

Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes. Apparently the hospitals are designated “baby-friendly” only if they promote exclusive-breastfeeding. I still remember reading a handout upon Flo’s discharge from hospital with the line “Breast Milk Should Be the Exclusive Food For the Baby for the First Six Months” , I also remember posters on the maternity unit “Breast is Best”. While agreeing to the benefits of breast milk, there NEED to be an understanding that it is OK to supplement with formula …

Postpartum depression, like all clinical depression, is a multifactorial problem. No one can say for certain what causes it. But we can say for certain that bullying makes it worse. And contemporary lactivism, breastfeeding activism, is plagued by bullying.

I finished my medical training before breastmilk became “the elixir of life” and before colostrum became “liquid gold.” What scientific evidence came to light in the last 35 years to elevate breastfeeding from one of two excellent forms of infant nutrition, the other being infant formula? No evidence. Indeed most of the scientific evidence around the purported benefits of breastfeeding is weak, conflicting and riddled with confounding variables. To the extent that there is definitive scientific evidence about the benefits of breastfeeding in first world countries, it appears to be limited to 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of term infants in the first year. In other words, the vast majority of term infants will experience no obvious benefit from breastfeeding.


So if the scientific evidence hasn’t changed, what happened? Two things: the monetization of breastfeeding and the adoption of pressure and guilt as marketing tactics.
Organized breastfeeding support originated with La Leche League, started by a group of seven traditionalist Catholic women whose goal was to keep mothers of young children out of the workforce. They reasoned that Mary, mother of Jesus, would not have worked because she was breastfeeding. Therefore all mothers should breastfeed so they wouldn’t be able to work either.
La Leche League was originally a volunteer organization that shared breastfeeding information and offered free support. It had to be a volunteer organization because the whole point was to prevent mothers of young children from working. But by the early 1980’s, mores had changed and the folks at LLL reasoned that they could charge for information that they had been giving away for free. They spun off the organization that created the lactation consultant credential and began campaigning vigorously for the employment of lactation consultants in hospitals, doctors’ offices and private practices

 

Initially they met the existing demand for breastfeeding support. But like any industry, they wanted to grow and that meant expanding the market for their services beyond those women who wanted to breastfeed to those women who didn’t. They hit upon the perfect tactic: exaggerating the benefits of breastfeeding, fabricating “risks” of infant formula, and, above all else, pressuring new mothers.
Make no mistake, bullying is not an unfortunate side effect of contemporary lactivism. It is a deliberate tactic designed to increase market share. It is meant to create a sense of fear, obligation and guilt.
The foundational document of marketing breastfeeding through bullying is Diane Weissinger’s Watch Your Language.

All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances …(my emphasis)

In contrast, all of us within the medical profession want HEALTHY BABIES and HEALTHY MOTHERS to be the biological reference point. We are concerned with outcome; the breastfeeding industry is concerned with process, specifically the only process by which it can profit. And profit depends on pressuring ever more women into breastfeeding.
The breastfeeding industry induces fear by lying about the benefits of breastfeeding and ignoring the risks (dehydration, starvation and death); it induces obligation withcatch phrases like “breast is best,” and “Baby Friendly Hospital Initiative,” and it induces guilt by insisting that “even one bottle of formula” is the mark of a mother who doesn’t truly love her baby.


Lactivists have perfected a particularly vicious form of bullying, gaslighting. This is a specialized form of invalidation that involves denying reality. A mother says her baby is hungry? Tell her all babies scream like that. A mother worries that she is not producing enough breastmilk? Lie and say that all women produce enough milk. A mother needs medication incompatible with breastfeeding? Tell her she doesn’t really need it. A mother says that breastfeeding is harming her baby’s physical health and her mental health? Tell her that she is a failure at mothering before she’s really even started and imply that her baby deserves a better mother than her.
 

 

Is it any wonder then that some women will commit suicide as a result and a far greater number will experience significant postpartum depression?
We must put an end to the bullying of new mothers by breastfeeding advocates.

• Take down the “breast is best” posters and acknowledge that fed is best.
• Stop exaggerating the benefits and denying the risks of breastfeeding.
• End the Baby Friendly Hospital Initiative immediately.
• Stop pretending that “even one bottle” of formula harms breastfeeding or babies.

Breastfeeding advocates like to cite the theoretical “cost savings” from increasing breastfeeding rates. But what does it cost to hospitalize a mother for postpartum depression? What is the cost of the lost earnings of a mother who commits suicide? And what is the cost to a child of losing his or her mother? Incalculable.
How much suffering will it take before we repudiate the pressure tactics of breastfeeding advocates?