health 110 chapter 2 psychological and spiritual well-being

Juvenal

"A sound mind in a sound body" was, according to the ancient Roman poet ______, something all should strive for.

rather than spend money on lottery tickets, try these ways to put a smile on your face:

*Make time for yourself. It's impossible to meet the needs of others without recognizing and fulfilling your own. *Up your appreciation quotient. *Regularly take stock of all the things for which you are grateful. To deepen the impact, write a letter of gratitude to someone who's helped you along the way. *String beads. Think of every positive experience during the day as a bead on a necklace. This simple exercise focuses you on positive experiences, such as a cheery greeting from a cashier or a funny e-mail from a friend, and encourages you to act more kindly toward others. *Create a virtual DVD. Visualize several of your happiest memories in as much detail as possible. Smell the air. Feel the sun. Hear the sea. Play this video in your mind when your spirits slump. *Fortify optimism. Whenever possible, see the glass as half-full. Keep track of what's going right in your life. Imagine and write down your vision for your best possible future and track your progress toward it. *Immerse yourself. Find activities that delight and engage you so much that you lose track of time. *Experiment with creative outlets. Look for ways to build these passions into your life. *Seize the moment. Rather than wait to celebrate big birthday-cake moments, savor a bite of cupcake every day. *Delight in a child's cuddle, a glorious sunset, a lively conversation. Cry at the movies. Cheer at football games. This life is your gift to yourself. Open it!

three major factors that contribute to a sense of well-being:

1. Your happiness set point—a genetic component that contributes about 50 percent to individual differences in contentment 2. Life circumstances such as income or marital status, which account for about 10 percent 3. Thoughts, behaviors, beliefs, and goal-based activities, which may account for up to 40 percent of individual variationsFootnote

spirituality and physical health

A growing body of scientific evidence indicates that faith and spirituality can enhance health—and perhaps even extend life. Individuals who pray and report greater spiritual well-being consistently describe themselves as enjoying greater psychological and overall well-being. Volunteering to help others, like these students serving meals to homeless people, can contribute to your sense of life satisfaction. Among the positive traits that correlate with a lower risk for heart disease, stroke, brain deterioration, or premature death is a strong sense of purpose, defined as "a sense of meaning and direction in one's life, which gives the feeling that life is worth living." In older adults, a strong purpose in life lowers the risk of brain damage, dementia, and stroke. Church attendance may account for an additional two to three years of life (by comparison, exercise may add three to five extra years), according to researchers' calculations. According to data on nearly 95,000 participants in the landmark Women's Health Initiative, attending a weekly church service, regardless of an individual's faith, lowers the risk of death by 20 percent, compared with those who don't attend at all. Attending less frequently also reduces the risk, but by a smaller percentage. How does going to church add years to a life? Researchers speculate that the reason may be the sense of community or support or that people feel less depressed when they join in religious services. Prayer and other religious experiences, including meditation, may actually change the brain—for the better. Using neuro-imaging techniques, scientists have documented alterations in various parts of the brain that are associated with stress and anxiety. This effect may slow down the aging process, reduce psychological symptoms, and increase feelings of security, compassion, and love. In a recent study, undergraduates with higher levels of spirituality coped with challenges by "turning to religion" along with other practical problem-solving strategies, such as positive reframing, acceptance, and humor. This implies that students who are already religious use their spirituality to bolster resources to focus on the problem at hand. Those who did not score high in spirituality but turned to religion in a crisis were more likely to do so as a way of avoiding or denying the problem, along with such maladaptive strategies as trying to distract themselves from it.

Self-compassion

A healthy form of self-acceptance in the face of perceived inadequacy or failure. being kind to yourself reciprocal golden rule

boos emotional intelligence

A person's "IQ"—or intelligence quotient—was once considered the leading predictor of achievement. However, psychologists have determined that another "way of knowing," dubbed emotional intelligence, makes an even greater difference in personal and professional success. "EQ" (for emotional quotient) is the ability to monitor and use emotions to guide thinking and actions. Neuroscientists have mapped the brain regions involved in emotional intelligence, which overlap significantly with those involved in general intelligence. Among the emotional competencies that most benefit students are focusing on clear, manageable goals and identifying and understanding emotions rather than relying on "gut" feelings. People with high EQ are more likely to enjoy good mental and physical health and are more productive at work and happier at home. They're also less prone to stress, depression, and anxiety, and they bounce back more quickly from serious illnesses.

Extraversion

A personality dimension describing someone who is sociable, gregarious, and assertive

self-actualization

A state of wellness and fulfillment that can be achieved once certain human needs are satisfied; living to one's full potential.

mood

A sustained emotional state that colors one's view of the world for hours or days. bad____ descend upon us- every 3 out of 10 days

sleeplessness on campus

According to the Centers for Disease Control and Prevention (CDC), Only one-third of Americans say they get enough sleep. An estimated 50 to 70 million American adults suffer from sleep and wakefulness disorders. Women are more likely than men to report not getting enough sleep. African Americans reported getting less sleep compared with all other ethnic groups. Alcohol compounds many students' sleep problems. Poor-quality sleepers report drinking more alcohol than good sleepers and are twice as likely to use alcohol to induce sleep as are better sleepers. Students who drink more alcohol go to bed later, sleep less, and show greater differences between weekday and weekend sleep timing and duration. In general, students who do not adhere to a regular bedtime and rising schedule are more likely to be poor sleepers. Female students generally have poorer sleep patterns than males and suffer more consequences as a result. Women report more sleep disturbances than men and are at greater risk for poor academic performance and more physical, social, and emotional problems. Men sleep better at the beginning of the academic year, but their sleep quality decreases. Women's sleep quality worsens only slightly over the school year. Students reporting poor quality sleep feel more tense, irritable, anxious, depressed, angry, and confused than others. On average, college students go to bed 1 to 2 hours later and sleep 1 to 1.6 hours less than students of a generation ago. In comparisons of exhaustion levels reported by workers in various occupations, college students consistently score high. Figure 2.2 shows a campus campaign to encourage students to get more sleep.

Feeling in Control

Although no one has absolute control over destiny, we can do a great deal to control how we think, feel, and behave. By assessing our life situations realistically, we can make plans and preparations that allow us to make the most of our circumstances. By doing so, we gain a sense of mastery. In nationwide surveys, Americans who feel in control of their lives report greater psychological well-being than those who do not, as well as extraordinarily positive feelings of happiness. One way to boost self-control is with a short bout of moderately intense exercise. In an analysis of two dozen studies, a workout, such as a half-hour run or bike ride, improved "executive" brain functions, such as self-control, in people under age 35.

pursue happiness

As a meta-analysis of long-term studies has shown, happiness even reduces the risk of dying—both in healthy people and in those with diagnosed diseases. But even if just about everyone might benefit from smiling more and scowling less, can almost anyone learn to live on the brighter side of life? Skeptics who dismiss "happichondria" as the latest feel-good fad are dubious. However, happiness researchers, backed by thousands of scientific studies, cite mounting evidence suggesting that happiness is, to a significant degree, a learned behavior. (See Health on a Budget, .)

Individuals high in self-compassion tend to

Be understanding toward themselves when they make mistake Recognize that all humans are imperfect Not ruminate about their errors in judgment or behavior When feeling inadequate engage in soothing and positive self-talk Recognize that failure is an unavoidable part of the human experience so, they feel a greater sense of connection to others, even in the face of disappointment Not exaggerate the significance of painful thoughts (though they're mindful of them) Manage frustration by quelling self-pity and melodrama

forgive

Being angry, harboring resentments, or reliving hurts over and over again is bad for your health in general and your heart in particular. The word forgive comes from the Greek for "letting go," and that's what happens when you forgive: You let go of all the anger and pain that have been demanding your time and draining your energy.

assert yourself

Being assertive means recognizing your feelings and making your needs and desires clear to others. Unlike aggression, a far less healthy means of expression, assertiveness usually works. You can change a situation you don't like by communicating your feelings and thoughts in nonprovocative words, by focusing on specifics, and by making sure you're talking with the person who is directly responsible. Becoming assertive isn't always easy. Many people have learned to cope by being passive and not communicating their feelings or opinions. Sooner or later they become so irritated, frustrated, or overwhelmed that they explode in an outburst—which they think of as being assertive. However, such behavior is so distasteful to them that they'd rather be passive. But assertiveness doesn't mean screaming or telling someone off. You can communicate your wishes calmly and clearly. Assertiveness is a behavior that respects your rights and the rights of other people even when you disagree. Even at its mildest, assertiveness can make you feel better about yourself and your life. The reason: When you speak up or take action, you're in the driver's seat. And that's always much less stressful than taking a backseat and trying to hang on for dear life.

sleeping pill precautions

Chances are you've taken some form of sleep medication. After aspirin, they are the most widely used drugs in the United States. If sleeping pills seem the best option at a certain time in your life, use them with caution. Facts to Know Sleeping pills are not a long-term solution to a sleep problem, but they can be helpful if travel, injury, or illness interfere with your nightly rest. Prescription and over-the-counter sleep aidscan interact with other medications or a medical condition, so always check with your doctor before taking them. If taken too often or for more than several nights, some sleeping pills may cause rebound insomnia—sleeplessness that returns in full force when you stop taking the medication. Steps to Take Read carefully. Take time to read through the informational materials and warnings on pill containers. Make sure you understand the potential risks and the behaviors to avoid. If you are a woman, take half the standard dose. The FDA has found that women metabolize sleeping medications much more slowly than men so their effects linger longer. Avoid alcohol. Never mix alcohol and sleeping pills. Alcohol increases the sedative effects of the pills. Even a small amount of alcohol combined with sleeping pills can make you feel dizzy, confused, or faint. Quit carefully. When you're ready to stop taking sleeping pills, follow your doctor's instructions or the directions on the label. Some medications must be stopped gradually. Watch for side effects.If you feel sleepy or dizzy during the day, talk to your doctor about changing the dosage or discontinuing the pills.

accentuate the positive

DO Smile. Putting on a happy face makes for a happy spirit. Focus. By being fully present in the moment, you'll experience it more intensely. Share your joy. Talking about and celebrating good experiences extends positive feelings over and above the positive event. Travel through time.Vividly remembering or anticipating positive events—a technique psychologists call "positive mental time travel"—boosts levels of happiness and life satisfaction. Don't Don't hide your feelings. Suppressing positive feelings—because of shyness or a sense of modesty, for instance—diminishes them and may have physiological consequences on your health. Don't get distracted.Unrelated worries and thoughts detract from the here-and-now of a positive experience. Don't find fault. Paying attention to negative aspects of otherwise positive experiences sabotages levels of happiness, optimism, self-esteem, and life satisfaction. Don't go there."Negative mental time travel"—reflecting on what went wrong or what may go wrong—can lower self-esteem and foster depressive symptoms.

Characteristics of emotionally healthy persons include the following:

Determination and effort to be healthy Flexibility and adaptability to a variety of circumstances Development of a sense of meaning and affirmation of life An understanding that the self is not the center of the universe Compassion for others The ability to be unselfish in serving or relating to others Increased depth and satisfaction-in intimate relationships A sense of control over the mind and body that enables the person to make health-enhancing choices and decisions

boost self-esteem

Each of us wants and needs to feel significant as a human being, with unique talents, abilities, and roles in life. A sense of self-esteem, of belief or pride in ourselves, gives us confidence to dare to attempt to achieve at school or work and to reach out to others to form friendships and close relationships. Self-esteem is the little voice that whispers, "You're worth it. You can do it. You're okay." Self-esteem is based not on external factors like wealth or beauty but on what you believe about yourself. It's not something you're born with; self-esteem develops over time. It's also not something anyone else can give to you, although those around you can either help boost or diminish your self-esteem. The seeds of self-esteem are planted in childhood when parents provide the assurance and appreciation youngsters need to push themselves toward new accomplishments: crawling, walking, forming words and sentences, learning control over their bladder and bowels. Adults, too, must consider themselves worthy of love, friendship, and success if they are to be loved, to make friends, and to achieve their goals. Low self-esteem is more common in people who have been abused as children and in those with psychiatric disorders, including depression, anxiety, alcoholism, and drug dependence. One of the most useful techniques for bolstering self-esteem and achieving your goals is developing the habit of positive thinking and talking. While negative observations—such as constant criticisms or reminders of the most minor faults—can undermine self-image, positive affirmations—compliments, kudos, encouragements—have proved effective in enhancing self-esteem and psychological well-being. Individuals who fight off negative thoughts fare better psychologically than those who collapse when a setback occurs or who rely on others to make them feel better.

EQ

Emotional Quotient-the ability to monitor and use emotions to guide thinking and actions.

manage your moods

Feelings come and go within minutes. A mood is a more sustained emotional state that colors our view of the world for hours or days. According to surveys by psychologist Randy Larsen of the University of Michigan, bad moods descend upon us an average of 3 out of every 10 days. "A few people—about 2 percent—are happy just about every day," he says. "About 5 percent report bad moods four out of every five days." There are gender differences in mood management: Men typically try to distract themselves (a partially successful strategy) or use alcohol or drugs (an ineffective tactic). Women are more likely to talk to someone (which can help) or to ruminate on why they feel bad (which doesn't help). Learning effective mood-boosting, mood-regulating strategies can help both men and women pull themselves up and out of an emotional slump. The most effective way to banish a sad or bad mood is by changing what caused it in the first place—if you can figure out what made you upset and why. "Most bad moods are caused by loss or failure in work or intimate relationships," says Larsen. "The questions to ask are: What can I do to fix the failure? What can I do to remedy the loss? Is there anything under my control that I can change? If there is, take action and solve it." Rewrite the report. Ask to take a makeup exam. Apologize to the friend whose feelings you hurt. Tell your parents you feel bad about the argument you had. If there's nothing you can do, accept what happened and focus on doing things differently next time. "In our studies, resolving to try harder actually was as effective in improving mood as taking action in the present," says Larsen. You also can try to think about what happened in a different way and put a positive spin on it. This technique, known as cognitive reappraisal, or reframing, helps you look at a setback in a new light: What lessons did it teach you? What would you have done differently? Could there be a silver lining or hidden benefit?

how to forgive

How to Forgive Compose an apology letter. Address it to yourself and write it from someone who's hurt you. This simple task enables you to get a new perspective on a painful experience. Leap forward in time.In a visualization exercise, imagine that you are very old, meet a person who hurt you long ago, and sit down together on a park bench on a beautiful spring day. You both talk until everything that needs to be said finally is said. This allows you to benefit from the perspective time brings without having to wait years to achieve it. Talk with "safe" people. Vent your anger or disappointment with a trusted friend or a counselor, without the danger of saying or doing anything you'll regret later. And if you can laugh about what happened with a friend, the laughter helps dissolve the rage. Forgive the person, not the deed. In themselves, abuse, rape, murder, and betrayal are beyond forgiveness. But you can forgive people who couldn't manage to handle their own suffering, misery, confusion, and desperation. People may feel more in control, more powerful, when they're filled with anger, but forgiving instills a much greater sense of power. Forgiving a friend or family member may be more difficult than forgiving a stranger because the hurt occurs in a context in which people deliberately make themselves vulnerable. Forgiving yourself may be even harder. When you forgive, you reclaim your power to choose. It doesn't matter whether someone deserves to be forgiven; you deserve to be free. However, forgiveness isn't easy. It's not a one-time thing but a process that takes a lot of time and work and involves both the conscious mind and the unconscious mind. Forgiveness-based interventions for individuals, couples, and groups and for specific conditions such as bereavement and alcohol abuse have resulted in greater self-esteem and hopefulness, positive emotions toward others, less depression and anxiety, and improved resistance to drug use. I in college students, such interventions have helped relieve symptoms of depression and reduce suicidal thoughts and behavior.

to nap or not to nap

In a recent study, a late-afternoon nap proved to undo the negative impact on hormones and immunity of a lost night of sleep. However, napping can disrupt the sleep-wake cycle, which can lead to negative health consequences such as depression, metabolic abnormalities, and hormonal disruptions. Longer naps are associated with poorer overall sleep quality than shorter ones and can cause "sleep inertia," a lethargy that can last for several hours. In a study of college students, quantity and quality sleep as well as GPA and class attendance suffered in those who did the following: Napped more than three times a week Napped for more than two hours Napped between 6:00 and 9:00 p.m.

student night life

In various studies, 25 to 50 percent of undergraduates have reported significant daytime sleepiness, which may affect academic performance as well as daily tasks such as driving. In the National College Health Assessment, about one in five college students said that sleep difficulties have affected their academic performance, ranking behind stress and anxiety.

Cultivate Gratitude

Is defined as attending more to the good things that have happened to us A grateful spirit brightens mood, boosts energy, and infuses daily living with a sense of glad abundance. Although giving thanks is an ancient virtue, only recently have researchers focused on the "trait" of gratitude—appreciation not just for a special gift but for everything that makes life a bit better. Feelings of gratitude are associated with better mood, improved sleep, less fatigue, less inflammation, and lower risk of heart failure. Here are some of its psychological effects: More frequent and intense positive emotions More positive views of the social environment More productive coping strategies Greater appreciation of life and possessions College students who keep gratitude journals report higher levels of happiness, feel better about their lives as a whole, are more likely to have made progress toward important personal goals, exercise more regularly, and report fewer negative health symptoms. Among the most effective "gratitude interventions"—proven techniques for increasing appreciation—is keeping a diary and recording three things you are grateful for every day. In clinical studies, this approach has proven as effective as the rigorously developed and tested techniques used in psychotherapy. In experiments with students, expressions and displays of gratitude not only increased the helpers' sense of self-worth by making them feel valued but also spurred them to do more to help others.

sleep impact on health

Learning and memory.When you sleep, your brain helps "consolidate" new information, so you are more likely to retain it in your memory. Metabolism and weight.The less you sleep, the more weight you may gain. Chronic sleep deprivation may cause weight gain by altering metabolism (for example, changing the way individuals process and store carbohydrates) and by stimulating excess stress hormones. Loss of sleep also reduces levels of the hormones that regulate appetite, which may be why, in one study, young normal-weight men ate larger portions of high-calorie junk foods than they did after a normal night of sleep. Safety. People who don't get adequate nighttime sleep are more likely to fall asleep during the daytime. Daytime sleepiness can cause falls, medical errors, air traffic mishaps, and road accidents. Mood/quality of life. Too little sleep—whether just for a night or two or for longer periods—can cause psychological symptoms, such as irritability, impatience, inability to concentrate, lack of motivation, moodiness, and lowered long-term life satisfaction. Immunity. Sleep deprivation alters immune function, including the activity of the body's killer cells. If you get less than seven hours of sleep a night, you're three times more likely to catch a cold. And if you sleep poorly, you're five times more susceptible. Mental disorders.Disturbed sleep can be an early sign of mental illness; sleep loss may trigger or may be an early sign of a manic episode (see the discussion of bipolar disorder on ).Too much (10 or more hours a night) or too little (5 or fewer hours) sleep, according to recent research, can increase the risk of depression. Major diseases and death.Serious sleep disorders such as insomnia and sleep apnea have been linked to hypertension, increased stress hormone levels, irregular heartbeats, and increased inflammation (which, as discussed in Chapter 15, may play a role in heart attacks). Inadequate sleep also has been linked to higher overall death rates. Sexuality. In a study of college women, those who slept longer were more likely to engage in sexual activity the following day. On average the women slept 7 hours, 22 minutes, with each hour of sleep increasing the women's sexual desire and likelihood of sexual activity.

happiness on a budget

Make time for yourself. It's impossible to meet the needs of others without recognizing and fulfilling your own. Up your appreciation quotient. Regularly take stock of all the things for which you are grateful. To deepen the impact, write a letter of gratitude to someone who's helped you along the way. String beads. Think of every positive experience during the day as a bead on a necklace. This simple exercise focuses you on positive experiences, such as a cheery greeting from a cashier or a funny e-mail from a friend, and encourages you to act more kindly toward others. Create a virtual DVD.Visualize several of your happiest memories in as much detail as possible. Smell the air. Feel the sun. Hear the sea. Play this video in your mind when your spirits slump. Fortify optimism.Whenever possible, see the glass as half-full. Keep track of what's going right in your life. Imagine and write down your vision for your best possible future and track your progress toward it. Immerse yourself. Find activities that delight and engage you so much that you lose track of time. Experiment with creative outlets. Look for ways to build these passions into your life. Seize the moment.Rather than wait to celebrate big birthday-cake moments, savor a bite of cupcake every day. Delight in a child's cuddle, a glorious sunset, a lively conversation. Cry at the movies. Cheer at football games. This life is your gift to yourself. Open it! Among 5,000 students in 280 countries who completed a massive online open course (MOOC) on happiness, positive feelings kept going up as the course progressed. The students registered progressively less sadness, anger, and increasing fear and more amusement, enthusiasm, and affection.

Become optimistic

Mental health professionals define optimism as the "extent to which individuals expect favorable outcomes to occur." Studies have established "significant relationships" between optimism and cardiovascular health, stroke risk, immune function, cancer prognoses, physical symptoms, pain, and mortality rates. For various reasons—because they believe in themselves, because they trust in a higher power, because they feel lucky—optimists expect positive experiences from life. When bad things happen, they tend to see setbacks or losses as specific, temporary incidents. In their eyes, a disappointment is "one of those things" that happens every once in a while rather than the latest in a long string of disasters. In terms of health, optimists not only expect good outcomes—for instance, that a surgery will be successful—but take steps to increase this likelihood. Pessimists, expecting the worst, are more likely to deny or avoid a problem, sometimes through drinking or other destructive behaviors. Individuals aren't born optimistic or pessimistic. Researchers have documented changes over time in the ways that individuals view the world and what they expect to experience in the future. Cognitive-behavioral techniques (discussed in Chapter 3) have proven effective in helping pessimists become more optimistic. In research on college students, learning to decrease automatic negative thoughts and increase more constructive ones reduced episodes of moderate depression.

deepend your spiritual intelligence

Mental health professionals have recognized the power of spiritual intelligence, which some define as "the capacity to sense, understand, and tap into the highest parts of ourselves, others, and the world around us." Spiritual intelligence, unlike spirituality, does not center on the worship of a God above, but on the discovery of a wisdom within. All of us are born with the potential to develop spiritual intelligence, but most of us aren't even aware of it—and do little or nothing to nurture it. Part of the reason is that we confuse spiritual intelligence with religion, dogma, or old-fashioned morality. "You don't have to go to church to be spiritually intelligent; you don't even have to believe in God," says Reverend Paul Edwards, a retired Episcopalian priest and therapist in Fullerton, California. "It is a scientific fact that when you are feeling secure, at peace, loved, and happy, you see, hear, and act differently than when you're feeling insecure, unhappy, and unloved. Spiritual intelligence allows you to use the wisdom you have when you're in a state of inner peace. And you get there by changing the way you think, basically by listening less to what's in your head and more to what's in your heart."

meet your needs

Newborns are unable to survive on their own. They depend on others for the satisfaction of their physical needs for food, shelter, warmth, and protection, as well as their less tangible emotional needs. In growing to maturity, children take on more responsibility and become more independent. No one, however, becomes totally self-sufficient. As adults, we easily recognize our basic physical needs, but we often fail to acknowledge our emotional needs. Yet they, too, must be met if we are to be as fulfilled as possible. The humanist theorist Abraham Maslow believed that human needs are the motivating factors in personality development. First, we must satisfy basic physiological needs, such as those for food, shelter, and sleep. Only then can we pursue fulfillment of our higher needs—for safety and security, love and affection, and self-esteem. Few individuals reach the state of self-actualization, in which one functions at the highest possible level and derives the greatest possible satisfaction from life (Figure 2.1)

develop autonomy

One goal that many people strive for is autonomy, or independence. Both family and society influence our ability to grow toward independence. Autonomous individuals are true to themselves. As they weigh the pros and cons of any decision, whether it's using or refusing drugs or choosing a major or career, they base their judgment on their own values, not those of others. Their ability to draw on internal resources and cope with challenges has a positive impact on both their psychological well-being and their physical health, including recovery from illness. Those who've achieved autonomy may seek the opinions of others, but they do not allow their decisions to be dictated by external influences. For autonomous individuals, their locus of control—that is, where they view control as originating—is internal (from within themselves) rather than external (from others). (See Chapter 1.) Autonomy also contributes to a sense of personal mastery, the tendency to feel that life circumstances are under one's control. A sense of mastery reflects general expectations about an individual's coping resources rather than confidence in performing specific behaviors. Closely rated to self-efficacy and an internal locus of control, mastery is associated with better cardiometabolic health and reduced risk for disease or death.

how much sleep do you need?

Over the last century, we have cut our average nightly sleep time by 20 percent. More than half of us try to get by with less than seven hours of shut-eye a night. College students are no exception, with an average sleep time slightly less than seven hours, with little difference between men and women. No formula can say how long a good night's sleep should be. Normal sleep times range from five to ten hours; the average is seven and a half. About one or two people in a hundred can get by with just five hours; another small minority needs twice that amount. Each of us seems to have an innate sleep appetitethat is as much a part of our genetic programming as hair color and skin tone. According to researchers, that depends on the nature of the exam. If it's a test of facts—Civil War battles, for instance—cramming all night works. However, if you will have to write analytical essays in which you compare, contrast, and make connections, you need to sleep to make the most of your reasoning abilities.

positive mental health lessons

Positive psychology (the scientific study of ordinary human strengths and virtues) and positive psychiatry (which promotes positive psychosocial development in those with or at high risk of mental or physical illness) focus on the aspects of human experience that lead to happiness and fulfillment—in other words, on what makes life worthwhile. This perspective has expanded the definition of psychological well-being. According to psychologist Martin Seligman, Ph.D., who popularized the positive psychology movement, everyone, regardless of genes or fate, can achieve a happy, gratifying, meaningful life. The goal is not simply to feel good momentarily or to avoid bad experiences but to build positive strengths and virtues that enable us to find meaning and purpose in life. The core philosophy is to add a "build what's strong" approach to the "fix what's wrong" focus of traditional psychotherapy. Among the positive psychology interventions that have proven effective in enhancing =emotional, cognitive, and physical well-being, easing depression, lessening disease and disability, and even increasing longevity are Counting one's blessings Savoring experiences Practicing kindness Pursuing meaning Setting personal goals Expressing gratitude Building compassion for one's self and others Identifying and using one's strengths (which may include traits such as kindness or perseverance) Visualizing and writing about one's best possible self at a time in the future Neuroscientists, using sophisticated imaging techniques, have been able to identify specific areas in the brain associated with positive emotions, such as love, hope, and enthusiasm. As people change, the processing of emotions in the brain appears to change, with older adults responding more to positive information and filtering out irrelevant negative stimuli.

consider the power of prayer

Prayer, a spiritual practice of millions, is the most commonly used form of complementary and alternative medicine. However, only in recent years has science launched rigorous investigations of the healing power of prayer. Petitionary prayer—praying directly to a higher power—affects both the quality and quantity of life, says Dr. Harold Koenig, director of Duke University's Center for Spirituality, Theology and Health. "It boosts morale; lowers agitation, loneliness, and life dissatisfaction; and enhances ability to cope in men, women, the elderly, the young, the healthy, and the sick." People who pray regularly have significantly lower blood pressure and stronger immune systems than those who are less religious. They're also hospitalized less often, less prone to alcoholism, and less likely to smoke heavily. Prayer may foster a state of peace and calm that could lead to beneficial changes in the cardiovascular and immune systems. Sophisticated brain imaging techniques have shown that prayer and meditation cause changes in blood flow in particular regions of the brain that may lead to lower blood pressure, slower heart rate, decreased anxiety, and an enhanced sense of well-being. However, praying for others, regardless of the type of prayer or religion, has not been shown to improve either symptoms or recovery of patients undergoing various medical procedures. Helping or giving to others enhances self-esteem, relieves stress, and protects psychological well-being.

circadian rhythm sleep disorder

Problems involving the timing of sleep are called circadian rhythm disorders because they affect the basic circadian ("about a day") rhythm that influences many biological processes. The most common causes are jet lag and shift work. Jet lag generally improves on its own within two to seven days, depending on the length of the trip and the individual's response. Avoiding caffeine and alcohol and immediately switching to the new time zone's schedule can help in overcoming jet lag. A "shift work" circadian rhythm disorder consists of any inability to sleep when one wants or to stay alert when needed because of frequently changing work shifts. Behavioral strategies and good sleep habits can help. In addition, phototherapy—exposure to bright light for periods ranging from 30 minutes to two hours—has shown promise as an experimental treatment to help shift workers adjust to their changing schedules.

roots of happiness

Psychological research has identified three major factors that contribute to a sense of well-being: Your happiness set point—a genetic component that contributes about 50 percent to individual differences in contentment Life circumstances such as income or marital status, which account for about 10 percent Thoughts, behaviors, beliefs, and goal-based activities, which may account for up to 40 percent of individual variations Education may protect against mental disorders, but it doesn't guarantee happiness. Asked if they were "feeling good and functioning well," people with varying levels of education had similar odds of high levels of emotional well-being. Intelligence, gender, and race do not matter much for happiness. Health has a greater impact on happiness than does income, but pain and anxiety take an even greater toll. People seem to be less able to adapt to the unpredictability of certain health conditions than they are to others. The well-being of individuals who can no longer walk after an accident, for example, typically returns to its pre-accident levels, while many diagnosed with epilepsy face a lifetime of uncertainty about the occurrence of seizures. What Does and Doesn't Make Us Happy Many people assume that they can't be happy unless they get into a certain school, earn a certain grade, win a certain job, make a certain income, find a perfect mate, or look a certain way. But according to psychologist Sonja Lyubomirsky, author of The Myths of Happiness, such notions are false. "People find a way to be happy in spite of unwanted life circumstances," she notes, "and many people who are blessed by wealth and good fortune aren't any happier than those who lack these fortunes." Unfortunately, most of us look for happiness in the wrong places. We assume that external things—a bigger house, a better job, a winning lottery ticket—will gladden our lives. While they do bring temporary delight, the thrill invariably fades. The joy we feel when we get something we desire—whether it's a new car or a sports trophy—doesn't last because of "hedonic habituation," the capacity to become accustomed to life changes and take them for granted. The bliss of acquiring a new cell phone or flat-screen TV generally fades in 6 to 12 weeks; the bliss of making a new friend, which is more dynamic and engaging, lasts longer. Children, despite all the challenges they bring, yield more joy than many possessions, according to studies of parents. Positive activities also boost positive emotions like happiness. One of the most effective is performing small acts of kindness. While there is no set formula for their variety and frequency, Lyubomirsky advises a minimum of once a week, which provides as much a boost as a thrice-weekly activity. She also recommends variety—taking out the trash when it's your roommate's turn one time, for instance, and buying a hot chocolate for a homeless person the next—because simple repetitions lose their ability to boost happiness. In surveys of college students, the happiest generally shared one distinctive characteristic: a rich and fulfilling social life. Almost all were involved in a romantic relationship as well as in rewarding friendships. The happiest students spent the least time alone, and their friends rated them as highest on good relationships. Even people we don't know may make us happy. By analyzing 20 years of data on the social ties of almost 5,000 participants in the Framingham Heart Study, researchers found that happy people spread happiness to others. Spouses, neighbors, relatives, and friends benefit most, but so did more distant contacts. The more happy people you surround yourself with, the happier you—and your social network—are likely to be in the future. This may also be true online—at least to a certain extent. According to a recent study of college students, their feelings of well-being increase along with the number of their Facebook friends—perhaps because seeing friends' photos reminds them of their social connections and enhances their feelings of self-worth. (See Chapter 5 for more on social media.)

4 fundamental behaviors are less likely to become depressed, be overwhelmed by stress, or suffer poor mental health:

Regular exercise A healthful diet Moderate alcohol use No tobacco

movement disorders

Restless legs syndrome, which may affect 12 million Americans, is a movement disorder characterized by symptoms that patients describe as pulling, burning, tingling, creepy-crawly, grabbing, buzzing, jitteriness, or gnawing. Many people with these symptoms have difficulty falling or staying asleep but do not realize that the cause is a medical disorder that can be treated with regular physical activity. Medications also are available.

self compassion development

Self-compassion is a healthy form of self-acceptance and a way of conceptualizing our favorable and unfavorable attitudes about ourselves and others. Some psychologists describe it as being kind to yourself in the face of suffering and practicing a "reciprocal golden rule," in which you treat yourself with the kindness usually reserved for others. This includes accepting your flaws; letting go of regrets, illusions, and disappointments; and taking responsibility for actions that may have harmed others without feeling a need to punish yourself. Individuals high in self-compassion tend to Be understanding toward themselves when they make mistake Recognize that all humans are imperfect Not ruminate about their errors in judgment or behavior When feeling inadequate engage in soothing and positive self-talk Recognize that failure is an unavoidable part of the human experience so, they feel a greater sense of connection to others, even in the face of disappointment Not exaggerate the significance of painful thoughts (though they're mindful of them) Manage frustration by quelling self-pity and melodrama In contrast, individuals low in self-compassion are extremely critical of themselves, believe they are unique in their imperfection, and obsessively fixate on their mistakes. After a traumatic life event, self-compassion may help individuals recognize the need to care for themselves, reach out for social support, engage in less self-blame and self-criticism, and look back on the time as an emotionally difficult event rather than an experience that defines or changes them. Therapists have developed specific cognitive treatments that can increase the attributes of compassion for self and others and alleviate feelings of anxiety and depression.

autonomy

The ability to draw on internal resources; independence from familial and societal influences. contributes to a sense of personal mastery, the tendency to feel that life circumstances are under one's control

enrich your spiritual life (steps)

Sit quietly. The process of cultivating spiritual intelligence begins in solitude and silence. "There is an inner wisdom," says Dr. Dean Ornish, the pioneering cardiologist who incorporates spiritual health into his mind-body therapies, "but it speaks very, very softly." To tune into its whisper, turn down the volume in your busy, noisy, complicated life and force yourself to do nothing at all. This may sound easy; it's anything but. Start small. Create islands of silence in your day. Don't reach for the radio dial as soon as you get in the car. Leave your ear buds on as you walk across campus but turn off the music. Shut the door to your room, take a few huge deep breaths, and let them out very, very slowly. Don't worry if you're too busy to carve out half an hour for quiet contemplation. Even 10 minutes every day can make a difference. Step outside. For many people, nature sets their spirit free. Being outdoors, walking by the ocean, or looking at the hills puts the little hassles of daily living into perspective. As you wait for the bus or for a traffic light to change, let your gaze linger on silvery ice glazing a branch or an azalea bush in wild bloom. Follow the flight of a bird; watch clouds float overhead. Gaze into the night sky and think of the stars as holes in the darkness, letting the light of heaven shine through. Use activity to tune into your spirit. Spirituality exists in every cell of the body, not just in the brain. As a student, you devote much of your day to mental labor. To tap into your spirit, try a less cerebral activity, such as singing, chanting, dancing, or drumming. Alternative ways of quieting your mind and tuning into your spirit include gardening, walking, arranging flowers, listening to music that touches your soul, or immersing yourself in a simple process like preparing a meal. Ask questions of yourself.Some people use their contemplative time to focus on a line of scripture or poetry. Others ask open-ended questions, such as What am I feeling? What are my choices? Where am I heading? Trust your spirit. While most of us rely on gut feelings to alert us to danger, our inner spirits usually nudge us not away from but toward some action that will somehow lead to a greater good—even if we can't see it at the time. You may suddenly feel the urge to call or e-mail a friend you've lost touch with—only to discover that he just lost a loved one and was grateful for the comfort of your caring. Develop a spiritual practice: If you are religious:Deepen your spiritual commitment through prayer, more frequent church attendance, or participation in a prayer group. If you are not religious: Keep an open mind about the value of religion or spirituality. Consider visiting a church or synagogue. Read the writings of inspired people of deep faith, such as Rabbi Harold Kushner and Rev. Martin Luther King, Jr. If you are not ready to consider religion:Try nonreligious meditation or relaxation training. Research has shown that focusing the mind on a single sound or image can slow heart rate, respiration, and brain waves; relax muscles; and lower stress-related hormones—responses similar to those induced by prayer. Simply taking a few moments to stop and enjoy the day can help quiet your mind and soothe your spirit.

Sleep Disorders

Sleep Disorders Three of four Americans struggle to get a good night's sleep at least a few nights a week. According to the National Commission on Sleep Disorders Research, 40 million adults suffer from a specific sleep disorder, such as chronic insomnia or sleep apnea; an additional 20 to 30 million have occasional sleep difficulties. The estimated economic cost of sleeplessness may be higher than $300 million a year. Insomnia Individuals with insomnia—a lack of sleep so severe that it interferes with functioning during the day—may toss and turn for an hour or more when they get into bed, wake frequently in the night, wake up too early, or not be able to sleep long enough to feel alert and energetic the next day. Most often insomnia is transient, typically occurring before or after a major life event (such as a job interview) and lasting for three or four nights. During periods of prolonged stress (such as a marriage breakup), short-term insomnia may continue for several weeks. Chronic or long-term insomnia, which can begin at any age, may persist for long periods. About three-fourths of insomniacs struggle to sleep more for at least a year; almost half, for three years. For about a third of those with chronic insomnia, the underlying problem is a mental disorder, most often depression or an anxiety disorder. Many substances, including alcohol, medications, and drugs of abuse, often disrupt sleep. About 15 percent of those seeking help for chronic insomnia suffer from "learned" or "behavioral" insomnia. While a life crisis may trigger their initial sleep problems, each night they try harder and harder to get to sleep, but they cannot—although they often doze off while reading or watching a movie. Sleeping pills may be used for a specific, time-limited problem—always with a physician's supervision. (See Consumer Alert.) In the long term, behavioral approaches, including the following, have proved more effective: Relaxation therapy, which may involve progressive muscle relaxation, diaphragmatic breathing, hypnosis, or meditation Cognitive therapy, which challenges misconceptions about sleep and helps shift a poor sleeper's mind away from anxiety-inducing thoughts Stimulus control therapy, in which individuals who do not fall asleep quickly must get up and leave their beds until they are very sleepy Sleep restriction therapy, in which sleep times are sharply curtailed in order to improve the quality of sleep

The characteristics of mental health include:

The ability to function and carry out responsibilities The ability to form relationships Realistic perceptions of the motivations of others Rational, logical thought processes The ability to adapt to change and to cope with adversity --doesn't try to avoid conflicts and distress but can cope with life's transitions, traumas, and losses in a way that allows for emotional stability and growth. The

emotional intelligence

The ability to monitor and use emotions to guide thinking and actions.

Mental health

The ability to perceive reality as it is, respond to its challenges, and develop rational strategies for living.

optimism

The tendency to seek out, remember, and expect pleasurable experiences. significant relationship with cardiovascular health, stroke risk, immune funtcion, cancer prognosis, physical symptoms, pain and mortality rates

sleeping pills

The use of prescription sleeping pills has more than doubled in the last decade, and increasing numbers of teenagers and young adults use these medications either occasionally or regularly. An even greater number buy nonprescription or over-the-counter (OTC) sleep inducers. Others rely on herbal remedies, antihistamines, and other medications to get to sleep. In the long run, good sleep habits, regular exercise, and a tranquil sleep environment are the cornerstones of high-quality sleep. But if circumstances, travel, injury, or illness have disrupted your sleep, you may consider sleep medications. Here is what you need to know about them. (See Consumer Alert.) Over-the-counter medications. Various over-the-counter sleeping pills, sold in any pharmacy or supermarket, contain antihistamines, which induce drowsiness by working against the central nervous system chemical histamine. They may help for an occasional sleepless night, but the more often you take them, the less effective they become. Dietary supplements. The most widely publicized dietary supplement is the hormone melatonin, which may help control your body's internal clock. The melatonin supplements most often found in health food stores and pharmacies are synthetic versions of the natural hormone. Although these supplements may help some people fall asleep or stay asleep and may sometimes help prevent jet lag, there are many unanswered questions about melatonin. Reported side effects include drowsiness, headaches, stomach discomfort, confusion, decreased body temperature, seizures, and drug interactions. The optimal dose isn't certain, and the long-term effects are unknown. Other supplements—such as valerian, chamomile, and kava—have yet to be fully studied for safety or effectiveness in relieving insomnia. Prescription medications.The newest sleep drugs—nonbenzodiazepine hypnotic medications such as Lunesta (eszopiclone), Ambien/Ambien CR (zolpidem), and Sonata (zaleplon)—quiet the nervous system, which helps induce sleep. They're metabolized quickly, which helps reduce the risk of side effects the next day. These medications, which can interact with other medications, are mainly intended for short-term or intermittent use.

cognitive reappraisal

a form of emotion regulation in which an individual changes her emotional response to a situation by altering her interpretation of that situation

psychologically healthy men and women generally share certain characteristics:

They value themselves and strive toward happiness and fulfillment. They establish and maintain close relationships with others. They accept the limitations as well as the possibilities that life has to offer. They feel a sense of meaning and purpose that makes the gestures of living worth the effort required.

characteristics of psychologically healthy men and women

They value themselves and strive toward happiness and fulfillment. They establish and maintain close relationships with others. They accept the limitations as well as the possibilities that life has to offer. They feel a sense of meaning and purpose that makes the gestures of living worth the effort required.

Know Yourself

Two personality traits in particular—conscientiousness (striving for competence and achievement, self-discipline, orderliness, reliability, deliberativeness) and extraversion (being active, talkative, assertive, social, stimulation-seeking)—correlate with very different health behaviors. College students who rate high in conscientiousness tend to wear seat belts, get enough sleep, drive safely, use safer sex practices, exercise, not smoke, drink less, and eat fruits and vegetables. The reason may be that they carefully weigh the risks and benefits of their behavior. They also can delay immediate gratification for the sake of long-term benefits, such as preventing cardiovascular disease or sexually transmitted infections. Although they're more likely to participate in vigorous exercise, students who score high in extraversion are more likely to put their health at risk. They often drink more alcohol, binge-drink, smoke, engage in risky sexual behaviors, and don't get enough sleep. The reasons may involve brain chemistry. Individuals with low levels of neurochemical arousal may pursue highly stimulating (though risky) behaviors to feel more alert and excited.

spiritual health in life

Whatever your faith, whether or not you belong to any formal religion, you are more than a body of a certain height and weight occupying space on the planet. You have a mind that equips you to learn and question. And you have a spirit that animates everything you say and do. Spiritual healthrefers to this breath of life and to our ability to identify our basic purpose in life and experience the fulfillment of achieving our full potential. Spiritual readings or practices can increase calmness, inner strength, and meaning; improve self-awareness; and enhance your sense of well-being. Religious support has also been shown to help lower depression and increase life satisfaction beyond the benefits of social support from friends and family. Giving support and getting it from others are fundamental to good psychological health and emotional well-being. Spirituality is a belief in what some call a higher power, in someone or something that transcends the boundaries of self. It gives rise to a strong sense of purpose, values, morals, and ethics. Throughout life you make choices and decide to behave in one way rather than another because your spirituality serves as both a compass and a guide. The terms religiosity and religiousness refer to various spiritual practices. That definition may seem vague, but one thing is clear. According to thousands of studies on the relationship between religious beliefs and practices and health, religious individuals are less depressed, less anxious, and better able to cope with crises such as illness or divorce than are nonreligious ones. The more that a believer incorporates spiritual practices—such as prayer, meditation, or attending services—into daily life, the greater his or her sense of satisfaction with life. In a ten-year study of young adults (average age 29), those who considered religion or spirituality "highly important" were 76 percent less likely to experience an episode of major depression—regardless of their religious denomination or whether they attended religious services. Other research has found that religiosity affects patterns of alcohol use and vulnerability to eating disorders.

Clarify your values

Your values are the criteria by which you evaluate things, people, events, and yourself; they represent what's most important to you. In a world of almost dizzying complexity, values can provide guidelines for making decisions that are right for you. If understood and applied, they help give life meaning and structure. When you confront a situation in which you must choose different paths or behaviors, follow these steps: Carefully consider the consequences of each choice. Choose freely from among all the options. Publicly affirm your values by sharing them with others. Act out your values. Values clarification is not a once-in-a-lifetime task but an ongoing process of sorting out what matters most to you. Values are more than ideals we'd like to attain; they should be reflected in the way we live day by day.

most effective way to banish a sad mood is to

change what caused it in the first place

self-esteem

confidence and satisfaction in oneself develops over time others around you can help boost or diminish it seeds of ___ ____ are planted in childhood when youngsters push toward new accomplishments

two personality traits correlate with very different health behaviors are:

conscientiousness (striving for competence and achievement, self-discipline, orderliness, reliability, deliberativeness) and extraversion (being active, talkative, assertive, social, stimulation-seeking)

what happens when we sleep

divided into two major types: an active state, characterized by rapid eye movement (REM) and called REM sleep (or dream sleep), and a quiet state, referred to as non-REM or NREM sleep, that consists of four stages: In Stage 1, a twilight zone between full wakefulness and sleep, the brain produces small, irregular, rapid electrical waves. The muscles of the body relax, and breathing is smooth and even. In Stage 2, brain waves are larger and punctuated with occasional sudden bursts of electrical activity. The eyes are no longer responsive to light. Bodily functions slow still more. Stages 3 and 4 constitute the most profound state of unconsciousness. The brain produces slower, larger waves, and this is sometimes referred to as "delta" or slow-wave sleep (Figure 2.3) After about an hour in the four stages of non-REM sleep, sleepers enter the time of vivid dreaming called REM sleep, when brain waves resemble those of waking more than those of quiet sleep. The large muscles of the torso, arms, and legs are paralyzed and cannot move— possibly to prevent sleepers from acting out their dreams. The fingers and toes may twitch; breathing is quick and shallow; blood flow through the brain speeds up; men may have partial or full erections.

People with high EQ are more likely to

enjoy good mental and physical health and are more productive at work and happier at home. **They're also less prone to stress, depression, and anxiety, and they bounce back more quickly from serious illnesses.

individuals low in self-compassion

extremely critical of themselves, believe they are unique in their imperfection, and obsessively fixate on their mistakes. After a traumatic life event, self-compassion may help individuals recognize the need to care for themselves, reach out for social support, engage in less self-blame and self-criticism, and look back on the time as an emotionally difficult event rather than an experience that defines or changes them Therapists have developed specific cognitive treatments that can increase the attributes of compassion for self and others and alleviate feelings of anxiety and depression.

In nationwide surveys, Americans who feel in control of their lives report

greater psychological well-being than those who do not, as well as extraordinarily positive feelings of happiness.

hedonic habituation

happiness doesnot last, it fades

psychological well-being cannot be

measured

gender differences in mood management

men- try to distract themselves (alcohol or drugs) women- talk to someone or ruminate on why they feel bad

psychological health includes

mental, emotional, social, and spiritual dimensions

One way to boost self-control is with a short bout of

moderate exercise

high conscientiousness

organized, careful, disciplined-- wearing seatbelt

Maslow's Hierarchy of Needs

physiological, safety, love/belonging, esteem, self-actualization

One of the most useful techniques for bolstering self-esteem and achieving your goals is developing the habit of

positive thinking and talking -- fight off negative thoughts

emotional health

refers to feelings and moods, both of which are discussed later in this chapter

To attain the highest level of psychological health, you must first

satisfy your needs for safety and security, love and affection, and self-esteem.

One of the most effective positive activities

small acts of kindness

breathing disorders

snoring can be a sign of a serious problem and increases the likelihood of health problems and of accidents. Caused by the vibration in tissues in the mouth and throat as a sleeper tries to suck air into the lungs, snoring can be so loud that it disrupts a bed partner or others in the same house. In young people, the cause is most likely to be enlarged tonsils or adenoids. In adults, extreme snoring may be a symptom of sleep apnea, which may itself be harmful to health. Heavy snorers and people with sleep apnea may be more likely to develop memory and thinking problems at younger ages than their better-rested peers. Translated from the Greek words meaning "no" and "breath," apnea is exactly that: the absence of breathing for a brief period. People with sleep apnea may briefly stop breathing dozens or even hundreds of times during the night. As they struggle for breath, they may gasp for air, snore extremely loudly, or thrash about. Although apnea, which can lead to high blood pressure, stroke, and cardiovascular disease, may affect as many as 10 million Americans, most are unaware of the problem. More physical activity and fewer hours sitting can lead to improvements. Effective treatments include weight loss (if obesity is contributing to the problem), a nasal mask that provides continuous positive airway pressure (CPAP) to ensure a steady flow of air into the lungs, and, in severe cases, surgery to enlarge the upper airway. Treatment can reduce snoring, improve quality of sleep, and boost performance at work or school.

high extraversion

sociable, fun-loving, affectionate more likely to put health at risk

Positive psychology

the scientific study of ordinary human strengths and virtues

Conscientiousness

striving for competence and achievement, self-discipline, orderliness, reliability, deliberativeness

Abraham Maslow believed

that human needs are the motivating factors in personality development. First, we must satisfy basic physiological needs, such as those for food, shelter, and sleep. Only then can we pursue fulfillment of our higher needs—for safety and security, love and affection, and self-esteem.

culture

the set of shared attitudes, values, goals, and practices of a group that are internalized by an individual within the group. In our diverse society, many cultural influences affect Americans' sense of who they are, where they came from, and what they believe. Cultural rituals help bring people together, strengthen their bonds, reinforce the values and beliefs they share, and provide a sense of belonging, meaning, and purpose.

Maslow Pyramid

to attain the highest level of psychological health, you must first satisfy your needs for safety and security, love and affection, and self-esteem

autonomous individual

true to themselves weigh pros and cons draw upon internal resources may seek opinions of others, but don't allow their actions to be dictated by others

positive psychiatry

which promotes positive psychosocial development in those with or at high risk of mental or physical illness

low self esteem is more common in people

who have been abused as children and in those with psychiatric disorders, including depression, anxiety, alcoholism, and drug dependence.