Part 2: Think You Can Ace This DSM-5-TR Quiz? Let’s See.
Think you’re ready for a deeper challenge? This DSM-5-TR (Part 2) quiz takes it up a notch, pushing you to apply diagnostic knowledge with sharper distinctions and more advanced clinical nuance. You’ll test your ability to spot subtle differences, identify key specifiers, and recognize patterns that trip people up on the NCE—and in real-world assessments. Stay focused, trust your training, and use this as a chance to strengthen the areas that matter most. Let’s dive in.
Think you’ve got a solid handle on diagnostic criteria and clinical distinctions? This DSM-5-TR (Part 1) quiz will put your knowledge to the test. You’ll review core features, duration requirements, and differentiating symptoms across a variety of disorders—just like you’ll see on the NCE and in real clinical practice. Take your time, trust what you know, and notice where you might want a little more review. Let’s get started.
Once you’re finished with Part 1, move on to Part 2. If you’re studying for the NCE, you may also want to consider taking the free NCE 2025-2026 Practice Exam.
Ketamine therapy is a medically supervised treatment that uses low doses of ketamine to reduce symptoms of treatment-resistant depression, anxiety, PTSD, and chronic pain. It works by influencing glutamate signaling and promoting neuroplasticity, helping the brain form new, more adaptive pathways.
Jump to a Section:
What Is Ketamine?
Let’s start with the facts. Ketamine is “a dissociative anesthetic that has some hallucinogenic effects” (Drug Enforcement Administration, 2020). Originally developed as an anesthetic, ketamine is commonly used in veterinary medicine for short-term sedation and pain relief during surgery and procedures.
Currently, ketamine is the only FDA-approved psychoactive drug available to mental health providers and their patients. It has been shown to improve symptoms of depression in individuals with treatment-resistant depression as well as rapidly reduce suicidal ideations in suicidal patients (Grunebaum et al., 2018). Ketamine may also be a promising treatment for alcohol use disorder (AUD). Individuals with AUD were able to abstain for longer with ketamine-assisted psychotherapy.
How Ketamine Works in the Brain
Ketamine affects the brain differently than traditional antidepressants. Most standard medications for depression work on the serotonin system and can take several weeks to produce noticeable changes.
Ketamine acts primarily on the glutamate system, the brain’s main excitatory neurotransmitter, by blocking NMDA receptors and increasing the release of BDNF (Brain-Derived Neurotrophic Factor).
This process promotes neuroplasticity, which is the brain’s ability to form new neural connections. In simpler terms, ketamine temporarily shifts the brain out of rigid, depressive thought patterns and opens a window where learning, emotional processing, and therapeutic change may happen more effectively. It’s not just numbing symptoms—it’s helping the brain reconnect, adapt, and respond in new ways.
What Results Should I Realistically Expect?
Ketamine therapy does not work the same way for everyone. Some people experience noticeable relief within the first few sessions, while others notice more gradual changes in mood, perspective, or emotional flexibility. The effects are often strongest when therapy and lifestyle support are included. Most people will need a series of sessions followed by occasional maintenance treatment. The goal is not to “erase” depression or anxiety overnight — it’s to create space for healing and change.
Risks & Side Effects
While ketamine therapy can be effective, it is not without risks. Common short-term side effects include dizziness, nausea, elevated blood pressure, blurred vision, fatigue, and dissociation (a temporary sense of disconnection from one’s thoughts, surroundings, or body). These effects typically resolve within one to two hours after a session.
Less commonly, ketamine can cause emotional overstimulation, anxiety during the experience, or headache afterward. Ketamine is not recommended for individuals with uncontrolled hypertension, a history of psychosis, or certain types of bipolar disorder, as it may worsen symptoms.
Anxiety disorders that have not responded to standard treatments
Who Should Avoid Ketamine Therapy
Ketamine therapy may not be appropriate for individuals with:
Bipolar I disorder (due to risk of inducing mania)
Active or untreated psychosis
Uncontrolled high blood pressure or cardiovascular instability
Current misuse of dissociative or stimulant substances
Pregnancy or breastfeeding, unless cleared by a physician
Screening should always be thorough and individualized.
Because ketamine has misuse potential, it should only be used under medical supervision with structured follow-up and integration support. Screening, careful dosing, and monitoring are essential to ensure the therapy is both safe and effective.
Finding a Ketamine Therapy Provider
Choosing a ketamine therapy provider should involve more than locating the nearest clinic. Look for a program that offers medical supervision, clear screening procedures, and a treatment plan tailored to your history and needs. Reputable clinics will conduct a comprehensive assessment before beginning treatment, monitor your physical and psychological response during sessions, and provide integration support afterward to help you process insights and maintain progress.
Method
How It’s Given
Where It Happens
Cost
Pros
Cons
IV Infusion
Slow, controlled drip
Clinic only
High
Most research support
Expensive; requires time on-site
IM Injection
Single injection
Clinic
Moderate
Fast onset; predictable
Less adjustable dose mid-session
Spravato (Esketamine)
Nasal spray
Clinic + monitoring
High (but may be covered)
FDA-approved; insurance may help
Must meet specific criteria
Lozenge/Troche
Dissolves under tongue
Clinic or at-home protocols
Lower
Flexible + accessible
Greater variation in absorption
Ask who will be present during the dosing session, how emergencies are handled, and whether psychotherapy is included as part of the program—not just ketamine infusions alone. Be cautious of providers who market ketamine as a “miracle cure” or minimize the need for follow-up care. A trustworthy ketamine program should prioritize safety, transparency, and continuity of care, not just symptom relief.
Ketamine therapy is available in outpatient clinics and specialty mental health centers across the United States. If you’re searching locally, try “ketamine therapy near me” or ask your mental health provider for referrals.
Reflection Prompt: If you are considering ketamine therapy, what are the main symptoms or patterns you are hoping to shift? Writing your intentions down can support clarity in your treatment decisions.
Cost & Insurance Coverage
Ketamine therapy varies in cost depending on the type of treatment and setting. IV infusions typically range from $350–$900 per session, while Spravato (esketamine nasal spray) may be covered by insurance when used for treatment-resistant depression. Oral lozenges and at-home protocols are often more affordable but should still be supervised by a trained provider. It’s important to ask providers about pricing, financial policies, and whether they assist with insurance pre-authorization.
What to Expect During Treatment
Assessment: Your provider reviews medical and mental health history.
Preparation: You may set intentions or talk through emotions beforehand.
Administration: Ketamine is given via IV, IM injection, nasal spray (Spravato), or oral lozenge.
Experience: You will be awake but may feel relaxed, introspective, or detached from your surroundings.
Monitoring: A trained clinician remains present and monitors vital signs.
Integration: After the session, therapy or reflection helps apply insights to daily life.
If you’re considering ketamine therapy, it’s normal to have questions. Understanding what to expect can help you decide whether this approach feels right for you. The following FAQ offers clear, straightforward information about the treatment process, safety, benefits, and practical details. Use it as a starting point — and bring any additional questions to your provider so you can make an informed, confident decision.
Support for Reflecting and Applying Insights After Ketamine Sessions
After each session, consider:
Note emotional shifts: Write down changes in mood, self-talk, or emotional patterns within 24 hours.
Capture insights or themes: Record any images, metaphors, or realizations that felt meaningful during the session.
Schedule an integration therapy session: Ideally within 48–72 hours to deepen the work while the brain is in a flexible state.
Practice grounding exercises: Gentle breathwork, slow stretching, or sensory awareness to support nervous system regulation.
Return to daily responsibilities gradually: Avoid jumping immediately into high-stress environments.
Observe patterns over time: Notice how mood, sleep, concentration, and energy shift across multiple sessions.
Be patient with the process: Change often occurs gradually, with cumulative sessions.
Summary
Ketamine therapy is an emerging treatment option for individuals who have not experienced enough relief from traditional approaches to depression, anxiety, PTSD, or chronic pain. By influencing the brain’s glutamate system and supporting neuroplasticity, ketamine can help reduce symptoms and create an opportunity for meaningful therapeutic change. However, it is not a stand-alone solution or a quick fix.
The most effective outcomes occur when ketamine is provided in a medically supervised setting and paired with integration therapy to support new patterns of thinking and coping.
If you’re considering ketamine therapy, take time to research providers, ask questions, and choose a program that prioritizes safety, transparency, and whole-person care.
Disclaimer: This article is for educational purposes only and is not a substitute for medical or mental health treatment. Always consult with a licensed healthcare provider before beginning ketamine therapy or changing your treatment plan.
Glossary of Key Terms
Neuroplasticity: The brain’s ability to form new neural pathways and reorganize existing ones. Increased neuroplasticity can support emotional and cognitive change during treatment.
Glutamate: The primary excitatory neurotransmitter in the brain. Ketamine acts on glutamate signaling, which plays a central role in mood, learning, and memory.
NMDA Receptor: A receptor involved in neural communication. Ketamine temporarily blocks this receptor, which can lead to rapid changes in mood and perception.
Dissociation: A temporary sense of detachment from thoughts, emotions, or surroundings. This is a common and expected part of ketamine’s therapeutic effect and usually fades shortly after treatment.
Integration Therapy: The therapeutic process of reflecting on and applying insights gained during a ketamine session. Integration helps translate the experience into lasting emotional and behavioral change.
References
Grabski, M., McAndrew, A., Lawn, W., Marsh, B., Raymen, L., Stevens, T., Hardy, L., Warren, F., Bloomfield, M., Borissova, A., Maschauer, E., Broomby, R., Price, R., Coathup, R., Gilhooly, D., Palmer, E., Gordon-Williams, R., Hill, R., Harris, J.,Mollaahmetoglu, O. M., Curran, H.V., Brandner, B., Lingford-Hughes, A., Morgan. C. J. A. Adjunctive ketamine with relapse prevention–based psychological therapy in the treatment of alcohol use isorder. American Journal of Psychiatry, 2022; DOI: 10.1176/appi.ajp.2021.21030277
Grunebaum, M. F., Galfalvy, H. C., Choo, T.-H., Keilp, J. G., Moitra, V. K., Parris, M. S., Marver, J. E., Burke, A. K., Milak, M. S., Sublette, M. E., Oquendo, M. A., & Mann, J. J. (2018). Ketamine for rapid reduction of suicidal thoughts in major depression: A midazolam-controlled randomized clinical trial. American Journal of Psychiatry, 175(4), 327–335. https://doi.org/10.1176/appi.ajp.2017.17060647
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., … Wolfson, P. (2019). Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198. https://doi.org/10.1080/02791072.2019.1587556
Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., … Ladha, K. S. (2022). Ketamine assisted psychotherapy: A systematic narrative review of the literature. Journal of Pain Research,15, 1691–1706. https://doi.org/10.2147/JPR.S360733
Cassie Jewell, LPC, LSATP is a licensed clinical therapist and behavioral health clinician specializing in depression, anxiety, trauma recovery, and harm reduction. She has experience supporting individuals with treatment-resistant mental health conditions and approaches care through a trauma-informed, client-centered lens. Cassie is also a stroke survivor and mental health advocate who writes about recovery, resilience, and evidence-based approaches to healing. She created Mind Remake Project to provide accessible, practical mental health resources for individuals and clinicians.
Depression is heavy. It slows you down, fogs your thinking, drains your energy, and makes even simple tasks feel overwhelming. If you’re struggling, it doesn’t mean you’re weak or “not trying hard enough.” It means your mind and body are under strain—and they need care, not criticism. This guide walks through practical, realistic ways to support yourself or someone you love through depression. No toxic positivity, no “just go for a walk” nonsense. Just clear strategies, gentle structure, and small steps that actually help you move forward and help depression, even on the days when you don’t feel like you can.
What Does Depression Feel Like? (Why Do I Feel This Way?)
Depression isn’t just “feeling sad”—it’s a whole-body experience that can affect emotions, thoughts, and physical energy. People often describe a heavy, persistent sense of emptiness or hopelessness, like they’re moving through life on autopilot or watching the world from behind glass. It can disrupt sleep, appetite, concentration, and motivation, making even simple tasks feel exhausting or pointless. Many individuals isolate themselves, lose interest in things they once enjoyed, and struggle with self-criticism or guilt.
These symptoms can look different across people and age group—for example, adolescents may show irritability or academic decline, while adults may primarily experience physical symptoms like fatigue or chronic pain. Depression can also be chronic or come in episodes, sometimes returning throughout life. Ultimately, depression affects how a person feels, thinks, and functions day to day, making it much more than just a bad mood.
Take a free depression screening assessment from Mental Health America here.
What Causes Depression?
Depression doesn’t have one single cause. Instead, it develops from a mix of biological, psychological, and environmental factors. Chronic stress, major life changes, trauma, or ongoing conflict can overwhelm the brain and body, increasing vulnerability to depression. Research also shows that the immune system, endocrine system, and even vascular health play a role. When these systems become dysregulated over time—especially under stress—the brain’s ability to manage mood and emotional resilience can weaken. In some people, this leads to changes in motivation, energy, sleep, and mood that evolve into major depressive disorder.
Genetics and personal history also matter. Some individuals are simply more biologically sensitive to the effects of stress, while others may develop depression after repeated depressive episodes throughout their lives. Social factors—like isolation, relationship difficulties, discrimination, or lack of support—can increase risk as well. Depression can present differently in different groups; for example, adolescents may show behavioral or academic problems, and men may mask symptoms with anger or withdrawal due to social expectations. Because of these overlapping influences, depression is best understood as a complex condition shaped by both internal vulnerabilities and external stressors—not a personal failure or weakness.
Does Depression Go Away on Its Own?
Sometimes, yes — but not usually. It’s true that for some people, depressive symptoms fade when a stressful situation improves or life steadies out. But for many others, depression doesn’t just resolve with time. It tends to stick, linger in the background, or come back in cycles. And the longer depression goes unaddressed, the more it can dig in, draining energy, motivation, confidence, and connection. It isn’t simply “feeling sad” or having a bad week—it’s a shift in brain and body functioning that can affect sleep, appetite, thinking, and how you experience the world.
The biggest misconception is that you just need to push through, “stay positive,” or wait it out. That’s not how depression works. It’s a real medical and psychological condition, and like any health condition, it deserves support and treatment. The good news? Depression is highly treatable, and there are multiple pathways to feeling better—therapy, medication, mindfulness-based approaches, lifestyle interventions, social support, and sometimes a combination. Recovery isn’t instant, and it isn’t one-size-fits-all, but people do get better. You don’t have to carry this alone, and you don’t have to accept depression as a permanent state. Reaching out for support is not a sign of weakness — it’s a sign that you’re ready for something different.
How Is Depression Treated?
Depression is treatable, and often the most effective approach combines therapy with medication rather than relying on one alone. Antidepressant medications can help regulate mood, energy, sleep, and concentration, while psychotherapy supports coping skills, emotional processing, behavior change, and building healthier patterns over time. Treatments like mindfulness-based cognitive therapy have also shown benefits, particularly for individuals with chronic or treatment-resistant depression, by reducing rumination and improving quality of life. Because depression can recur, some people may need ongoing maintenance treatment, while others recover fully and gradually taper supports. There is no one-size-fits-all path—treatment is most effective when tailored to the person’s needs, experiences, and history.
Common Therapy Approaches for Treating Depression
Cognitive Behavioral Therapy (CBT): Helps identify and challenge negative thought patterns and replace them with more balanced, realistic perspectives.
Mindfulness-Based Cognitive Therapy (MBCT): Combines mindfulness practices with CBT techniques to reduce rumination and prevent relapse, especially in chronic or recurring depression. Depression
Dialectical Behavior Therapy (DBT): Teaches emotional regulation, distress tolerance, and interpersonal effectiveness — especially helpful when depression comes with intense emotions or self-criticism.
Acceptance and Commitment Therapy (ACT): Focuses on accepting difficult emotions, clarifying personal values, and taking meaningful action even when depressed.
Interpersonal Therapy (IPT): Addresses relationship stressors, role transitions, grief, and communication patterns that may contribute to depression.
Psychodynamic Therapy: Explores root causes, unresolved emotional conflicts, and past experiences that influence current mood and behavior.
Common Medications Used to Treat Depression
SSRIs (Selective Serotonin Reuptake Inhibitors): Often the first-line treatment because they tend to have fewer side effects. Examples:Sertraline (Zoloft), Fluoxetine (Prozac), Escitalopram (Lexapro), Citalopram (Celexa), Paroxetine (Paxil).
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Useful when depression includes physical symptoms like fatigue or chronic pain. Examples:Venlafaxine (Effexor), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq).
Atypical Antidepressants: Work differently in the brain and can be helpful when SSRIs/SNRIs aren’t a good fit. Examples:Bupropion (Wellbutrin) — often increases energy and has low sexual side effects; Mirtazapine (Remeron) — can support sleep and appetite.
Tricyclic Antidepressants (TCAs): Older medications that can be very effective, often used when newer meds haven’t worked. Examples:Amitriptyline, Nortriptyline, Imipramine.
MAOIs (Monoamine Oxidase Inhibitors): Effective but used less commonly due to dietary restrictions and interactions. Examples:Phenelzine (Nardil), Tranylcypromine (Parnate).
Options When You Can’t Afford Therapy or Medication
Not everyone has insurance, and even with coverage, mental health care can be expensive. That doesn’t mean you’re out of options. There are ways to get support while you work toward longer-term treatment.
Community Mental Health Centers: Most counties have public clinics that offer therapy and psychiatric services on a sliding scale (you pay what you can). Some offer free short-term counseling.
Training Clinics & Universities: Counseling and psychology graduate programs often run clinics where you can see supervised therapists-in-training for low or no cost. The therapy is usually high-quality because every session is reviewed and supported by licensed clinicians.
Support Groups (Free or Low-Cost): Groups like NAMI, Depression and Bipolar Support Alliance (DBSA), and local peer-run wellness centers offer free support groups led by trained volunteers or peers who understand what depression feels like. These are not therapy — but they are connection, validation, and structure.
Telehealth + Sliding Scale Platforms: Some therapy platforms let you request low-cost rates (for example, Open Path Collective—usually $40–$70/session). Others offer discounted community rates if you ask.
Primary Care Physicians: If therapy isn’t accessible, a PCP can sometimes start basic mental health treatment, including medication management, at much lower cost than psychiatric specialty care.
Crisis Services: If things feel overwhelming or unsafe, crisis lines and text lines are free and available 24/7. They do more than just “talk you down” — they help you plan your next steps and get support safely:
988 Suicide & Crisis Lifeline (US)
Text HOME to 741-741
988lifeline.org for chat
Structure & Daily Supports: This part is not a cure, but it helps keep your footing:
Keeping a consistent sleep/wake routine
Eating at least one real meal a day
Getting outside for even 5 minutes of sunlight
Staying in gentle contact with at least one supportive person
These are not “fixes.” They’re supports — scaffolding while you climb out of something heavy and exhausting. The goal is to not go through depression alone, even when traditional treatment feels out of reach.
Self-Help Workbooks
The Cognitive Behavioral Workbook for Depression: A Step-by-Step Program
28-Day CBT Workbook for Adults: A Straightforward Guide to Start Rewiring Your Brain in 15 Minutes a Day—With Proven Cognitive Behavioral Therapy Techniques For Anxiety, Depression, & Self-Esteem
Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety (Retrain Your Brain with CBT)
Understanding Prolonged Grief Disorder in Clinical Practice
Grief is a universal human experience. Most of us, at some point, will lose someone we love—and the emotional pain that follows is not something to “fix,” pathologize, or rush. But there are times when grief doesn’t soften. It doesn’t shift. It doesn’t make room for life again. Instead, it remains intense, consuming, and disruptive long after the loss.
This isn’t “just grief.” It’s not weakness. It’s not resistance. It’s not a failure to cope.
It may be Prolonged Grief Disorder (PGD)—a clinical condition recognized in the DSM-5-TR, characterized by sustained longing, identity disruption, and functional impairment that doesn’t resolve with time alone.
As clinicians, we need to know how to distinguish adaptive grief from clinically significant prolonged grief, without rushing to diagnose, minimize, or invalidate. That requires clarity, competence, and respect for cultural and individual mourning practices.
To support that work, I’ve created a 10-module clinical training on Prolonged Grief Disorder designed for counselors, social workers, psychologists, bereavement specialists, and anyone providing grief-informed care. The training is evidence-based, clinically practical, and grounded in trauma-informed, person-centered practice.
You’ll learn how to:
Recognize the clinical presentation of PGD
Differentiate PGD from depression and PTSD
Conduct appropriate assessment and screening
Understand risk patterns and diagnostic nuance
Apply core treatment approaches supported by research
The aim is simple: No pathologizing grief. No guessing in diagnosis. No forcing closure. Just clear, competent, compassionate clinical care.
Grief doesn’t follow rules, and prolonged grief disorder is more than “taking too long to move on.” This training cuts through the confusion.
We’ll break down the core symptoms, explore what makes grief become prolonged, and walk step-by-step through how Prolonged Grief Treatment approaches healing. If you work with clients who feel stuck, overwhelmed, or disconnected after a loss, this training gives you practical tools you can start using right away.
Disclaimer: I worked hard to include only tools that are reliable and validated, but please don’t use these tools as diagnostic measures. They’re provided here for educational purposes only. If a questionnaire is copyrighted, please comply with copyright regulations.
PDF=Direct link to PDF
PDF for download=Link to webpage (or website) with PDF link
What does it mean to truly thrive? Flourishing goes beyond just getting by—it’s about rewiring your brain for growth, resilience, and fulfillment. Discover how positive psychology and neuroplasticity can help you build a thriving life.
Neuroplasticity & Recovery: The brain has the ability to rewire itself—at any age or health status—meaning growth and change are always possible.
Flourishing & Positive Psychology: Martin Seligman’s PERMA model defines wellbeing through Positive Emotion, Engagement, Relationships, Meaning, and Achievement.
Your Brain on Flourishing: Research shows flourishing changes the brain, enhancing life satisfaction, self-esteem, and motivation.
Practical Steps to Flourish:
Gratitude practice
Daily reflection
Identify & use strengths
Final Takeaway:Healing, growth, and thriving are possible—and they start today, not someday in the future
After having a stroke at 42 as a relatively healthy adult with minimal risk factors and spending three weeks in the hospital and then inpatient physical rehab, I’m not taking life for granted. And I’m not going to wait until I retire to do all the things I’ve been wanting to do. Tomorrow isn’t promised. And I want to spend the rest of my life not just existing but flourishing.
The stroke was a profound shock to me and everyone in my life; I maintain a healthy weight, I don’t smoke, and I have no family history of stroke. (I’m even plant-based!) It came out of nowhere.
Fortunately, the damage was minimal: I experience some balance issues and short-term memory impairment, but fundamentally, I’m still the person I was before. I know that some stroke survivors undergo significant personality changes, depending on which part of the brain is most affected. This post has become deeply personal, leading me to research the brain’s capacity to rewire itself—a phenomenon known as neuroplasticity. Through this, I’m learning how to potentially repair neural pathways or create new ones as I recover.
Research indicates that even individuals with mental illness and substance use, including those with chronic or reoccurring disorders, can fully recover and reach high levels of wellbeing (e.g., flourishing) (Keyes et al., 2022).
Neuroplasticity & Flourishing
“Neuroplasticity can be viewed as a general umbrella term that refers to the brain’s ability to modify, change, and adapt both structure and function throughout life and in response to experience” (Voss, et al., 2017)
Reseeardh indicates that neuroplasticity is possible in brains young and old, as well as brains healthy and diseased (Voss, et al., 2017). So there’s hope for everyone, no matter your age or your physical/mental health.
Understanding the brain’s ability to rewire itself naturally leads to the question: What does it mean to truly thrive? This is where the concept of flourishing comes in.
Flourishing & Positive Psychology
Maslow originally coined the term positive psychology in the 1950s, and the movement gained momentum as psychologists sought alternatives to outdated treatment modalities. Around the same time, humanistic psychology emerged, with Maslow arguing that psychology’s focus on disorder and dysfunction overlooked human potential.
Martin Seligman, a co-founder of positive psychology, became a leading figure in the movement during the 1990s (Nash, 2015). His work centered on authentic happiness, which he defined as a fulfillment achieved not by pursuing momentary pleasures but by making intentional choices that bring meaning to life. According to Seligman (2011), authentic happiness consists of three key elements: positive emotion, engagement (flow)—using one’s highest strengths and talents to meet the world—and meaning—”belonging to and serving something greater than oneself” (p. 11, p. 17).
As Seligman worked to conceptualize wellbeing, he determined that it was comprised of fourth element: accomplishment as in “accomplishment for the sake of accomplishment” (p. 19). As he further developed the construct of wellbeing, he observed that wellbeing has five measurable elements, and introduced the concept of PERMA:
Positive emotion
Engagement
Relationships
Meaning
Acheivement
He observed that “No one element defines wellbeing but each contributes to it” (Seligman, 2017, p.24). Eventually, Seligman concluded that the goal of positive psychology within wellbeing theory is “to measure and to build human flourishing” (Seligman, 2011, p. 29) He suggested several practical exercises for flourishing:
Practice gratitude by expressing it in an intentional and thoughtful way.
Focus on the positive. “Every night for the next week, set aside 10 minutes before you go to sleep. Write down three things that went well today and why they went well” (Seligman, 2011, p. 33). Be sure to stick with it for the entire week.
Identify and use your signature strengths. Start by discovering your signature strengths by taking the free VIA Strengths of Character Survey here: Questionnaire Center | Authentic Happiness. (The assessment is interactive and self-scoring. Registration required.) Examine your top five strengths and determine whether each is a signature strength. Once you’ve determined your signature strengths, carve out a time in your weekly schedule to exercise one or more of these strengths in a new way and then reflect on it through writing. Seligman suggested answering the following questions: “How did you feel before, during, and after engaging in the activity? Was the activity challenging? Easy? Did you lose your sense of self-consciousness? Do you plan to repeat the exercise?” (Seligman, 2011, pp. 39-40).
Seligman observed that the exercises were effective even in depressed individuals.
To measure your current level of flourishing, take the short assessment below.
Citation: Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.
Description: The Flourishing Scale is a brief 8-item summary measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological wellbeing score.
Instructions:Below are 8 statements with which you either agree or disagree. Using the 1-7 scale below, indicate your agreement with each item by indicating that response for each statement.
1= Strongly disagree—————————–7=Strongly agree
I lead a purposeful and meaningful life.
My social relationships are supportive and rewarding.
. I am engaged and interested in my daily activities.
actively contribute to the happiness and well-being of others.
I am competent and capable in the activities tf
I am optimistic about my future.
People respect me.
Total your score. The possible range of scores is from 8 (lowest possible) to 56 (highest possible). A high score represents having many psychological resources and strengths.
Click on the link below to download a PDF version of the scale:
Advancements in brain imaging technology have demonstrated that talk therapy induces measurable physical changes in the brain, including alterations in both neural activity and structural connectivity (American Psychiatric Association, 2020). Research further suggests that flourishing in life is associated with brain changes such as increased activity in specific regions and enhanced connectivity between hemispheres (Goldbeck et al., 2019).
Expanding on this, Waugh (2022) found that brain areas linked to life satisfaction, self-esteem, relationship satisfaction, and goal progress exhibit differences in structure and neural functioning in individuals who experience higher levels of flourishing. Additionally, positive emotions activate key regions of the prefrontal cortex and limbic system, which enhance cognition, behavior, and motivation. This neural activation fosters better decision-making and supports healthier lifestyle choices, ultimately contributing to improved physical wellbeing (Kandel, 2013).
This journey has taught me that flourishing isn’t about waiting for the perfect conditions—it’s about making intentional choices today. The brain is adaptable, healing is possible, and wellbeing is within reach. Neuroplasticity shows that our brains can rewire and grow, no matter our circumstances. Positive psychology teaches that thriving isn’t about chasing fleeting pleasure, but about cultivating meaning, engagement, and accomplishment. Science confirms that our thoughts, actions, and experiences can reshape the brain, reinforcing wellbeing. I’m not waiting until retirement to do the things I’ve always wanted to do—because tomorrow isn’t promised, but flourishing starts now.
Resources for Flourishing
Action for Happiness Daily actions, community-based well-being initiatives, and science-backed happiness resources
Goldbeck, F., Haipt, A., Rosenbaum, D., Rohe, T., Fallgatter, A. J., Hautzinger, M., & Ehlis, A.-C. (2019). The positive brain – Resting state functional connectivity in highly vital and flourishing individuals. Frontiers in Human Neuroscience, 12, Article 540. https://doi.org/10.3389/fnhum.2018.00540
Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.
Kandel, E. R. (2013). The new science of mind and the future of knowledge. In S. H. Koslow & M. F. Huerta (Eds.), Neuroscience in the 21st century (pp. 3–20). Academic Press. https://doi.org/10.1016/B978-0-12-407236-7.00001-2
Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.
Voss, P., Thomas, M. E., Cisneros-Franco, J. M., & de Villers-Sidani, É. (2017). Dynamic brains and the changing rules of neuroplasticity: Implications for learning and recovery. Frontiers in Psychology, 8, 1657. https://doi.org/10.3389/fpsyg.2017.01657
augh, C. (2022). An affective neuroscience perspective on psychological flourishing: How the brain believes that things are going well. In I. Ivtzan (Ed.), The psychology of flourishing (pp. 33–47). Springer. https://doi.org/10.1007/978-3-031-09786-7_3
All about social anxiety, including triggers, symptoms, risk factors, and treatments, plus 7 strategies for coping with “in-the-moment” social anxiety.
In this post, I’ll define and describe social anxiety, list its triggers and risk factors, and discuss treatment options as well as coping strategies for overcoming social anxiety disorder.
Alternatively, you can watch the YouTube version below:
Anxiety’s Adventures in Social-land
With social anxiety, every social interaction is an adventure of sorts; you’re in “flight-or-fight” mode, prepped to face the danger that lies ahead… which is telling the waiter what you’ll have for dinner. Once again, your sneaky brain has tricked your body into preparing for a battle when you only need to answer the question, “Would you like fries with that?”
This article is written from both a professional and personal point of view, as I was extremely shy as a child and struggled with social anxiety in adolescence and as a young adult.
What Is Social Anxiety?
People with social anxiety disorder (SAD) experience a persistent fear of social situations in which they fear they’ll be scrutinized and humiliated. This fear leads to avoidance, impacting their ability to make friends, go to school, get a job, and be successful at work.
Examples of anxiety-provoking triggers include:
Walking into an unfamiliar place such as a gas station or store
Using a public bathroom when someone else is there
Being asked to self-introduce in front of a group
Entering a room full of people
Eating in public
Having to ask for directions or help
Speaking with an authority figure
Giving a presentation
Going on a date
Using public transportation
Being the center of attention
It convinces you that every situation will have a terrible outcome. It convinces you that everyone sees you in the worst light.
A distinguishing characteristic of social anxiety is that the anxiety response is disproportionate to the trigger or event. For example, while it’s normal to feel somewhat anxious before making a speech or meeting your significant other’s parents for the first time, it’s not normal to experience intense fear or distress.
The following are signs of social anxiety:
Blushing
Sweating
Stuttering
Rapid heartrate
Avoiding eating and/or drinking in public
Avoiding using public restrooms
Limiting eye contact
Submissiveness
Speaking in a soft or slow voice
Rigid body posture
Self-medicating with alcohol or other substances (e.g., drinking before a party to alleviate anxiety symptoms)
Diverting attention to others
Coming off as arrogant or aloof
Being highly controlling of the conversation
Hoarseness or vocal changes when speaking
Feeling restless or irritable
Fidgeting
Presenting with extreme poise
Increased empathy
Social anxiety is often misunderstood and underrecognized. SAD is different from simply preferring to avoid social events. People with social anxiety may enjoy social gatherings where they feel comfortable and safe, such as with close friends or family members. However, they may avoid other enjoyable social events due to their anxiety.
Social anxiety disorder can feel like being under a spotlight. The spotlight is uncomfortable and the person with SAD may go to great lengths to avoid it and not “get caught.” A person with social anxiety feels embarrassed about being embarrassed.
Nobody realizes that some people expend tremendous energy merely to be normal.
Albert Camus
Additionally, people with SAD may not seem anxious, even to those who know them well. This is because they have learned to hide their anxiety or disguise it as something else, such as disinterest or aloofness. They may become withdrawn or overcompensate for their anxiety by being overly talkative and dominating the conversation. They may seem the opposite of anxious, completely poised or arrogant even, having trained themselves to not appear anxious.
Who Is at Risk for Developing Social Anxiety?
In the United States, social anxiety disorder affects approximately 7% of the population, with higher rates in women and younger adults. Rates of SAD decrease with age.
The typical onset of social anxiety disorder is in childhood between the ages of 11 and 13. It often starts as shyness but can also develop in response to a significant humiliating event, such as being bullied or having an accident in public. Although less common, SAD can develop in adulthood, usually in response to stress or a major life change.
There are a number of risk factors that contribute to the development of SAD including:
Genetics: People with a family history of SAD or other anxiety disorders are more likely to develop the condition themselves.
Environmental factors: Parents who act anxious or nervous are modeling this for their children.
Personality: Children who tend to be nervous or shy in new situations as well as children who fear rejection or punishment are more likely to develop social anxiety. A tendency to experience negative emotions, poor self-concept, and introversion are also associated with SAD.
Perfectionism: There is an association between perfectionism and SAD. Some people with SAD attempt to hide their symptoms by presenting as perfectly as they can.
How Is Social Anxiety Treated?
Treatment interventions for social anxiety disorder include medication and psychotherapy.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line pharmacological treatments for SAD. Another type of medication, beta-blockers (e.g., propranolol), can be prescribed to treat the physical symptoms of anxiety. They work by blocking adrenaline, which reduces a person’s heartrate and helps with tremors.
Cognitive behavioral therapy (CBT) and exposure therapy are effective therapeutic approaches for managing SAD, especially when combined with medication.
Complementary treatment interventions include exercise and mindfulness-based interventions.
In-the-Moment Coping Strategies for Social Anxiety Disorder
If you have social anxiety, there are a number of in-the-moment coping strategies that can help you manage your anxiety. Here are a few examples:
Self-talk: Talk to yourself in a positive and reassuring way. Tell yourself that whatever you’re facing can’t hurt you. (And you won’t die from embarrassment.) You can also try repeating a mantra to yourself, such as “This is nothing I can’t handle” or “I’ve been through worse and survived” to get yourself through the situation.
Remind yourself that everyone makes mistakes: When you feel embarrassed about something you said or did, remember that everyone makes mistakes or experiences social awkwardness from time to time. And don’t forget how quickly people forget. Hours or even minutes from now they’re not going to be thinking about you, so don’t dwell on it or let it ruin your day.
Learn to laugh at yourself: Laughing at yourself can help you to take yourself less seriously and to see the humor in the situation. This can help to reduce your anxiety by making you feel more relaxed.
Talk about it: Although it may seem counterproductive, some people find it helpful to purposely bring attention to their symptoms and/or condition. This takes the power away from your anxiety. For example, before a presentation lead with, “Bear with me, public speaking makes me anxious” or if you’re worried about blushing say, “I’m little anxious right now so I might blush.” You’ll find that most people are sympathetic.
Play the “so what” game: This is a helpful strategy for challenging your negative and/or distorted thoughts. When you’re feeling anxious, ask yourself, “So what?” What’s the worst that could happen? Once you’ve identified the worst-case scenario, you’ll realize that it’s not as bad as you thought it was.
“Dim” the spotlight: This is an avoidance strategy, not a long-term solution, but it can help you survive when you’re overwhelmed. Try to find ways to make yourself less noticeable. This could mean standing behind a podium, sitting instead of standing, or (literally) dimming the lights. You may actually build confidence this way to the point where you no longer need to make yourself less noticeable.
Bring a buddy: Sometimes it can be helpful to have someone with you for moral support. If you’re going to be in a social situation where you’re feeling anxious, have a friend or family member tag along. This can help you to feel more confident and less alone.
There is no one-size-fits-all approach, so experiment until you find what helps you the most.
To conclude, social anxiety disorder can be debilitating, but there are effective treatments for SAD as well as coping strategies for managing symptoms. You may have SAD, but that doesn’t mean you are SAD.
Be kind to yourself. Have self-compassion. Forgive yourself for mistakes and forgive your brain for betraying your body. You have social anxiety. So what? With time and effort, you can remake yourself and overcome.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Evans, R., Chiu, K., Clark, D. M., Waite, P., & Leigh, E. (2021). Safety behaviours in social anxiety: An examination across adolescence. Behaviour Research and Therapy, 144, 103931. https://doi.org/10.1016/j.brat.2021.103931
Gilboa-Schechtman, E., & Shachar-Lavie, I. (2013). More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety. Frontiers in Human Neuroscience, 7, 904. https://doi.org/10.3389/fnhum.2013.00904
Li, J., Cai, Z., Li, X., Du, R., Shi, Z., Hua, Q., Zhang, M., Zhu, C., Zhang, L., & Zhan, X. (2021). Mindfulness-based therapy versus cognitive behavioral therapy for people with anxiety symptoms: A systematic review and meta-analysis of random controlled trials. Annals of Palliative Medicine, 10(7), 7596–7612. https://doi.org/10.21037/apm-21-1212
National Collaborating Centre for Mental Health (UK). Social Anxiety Disorder: Recognition, Assessment and Treatment. Leicester (UK): British Psychological Society (UK); 2013. (NICE Clinical Guidelines, No. 159.) 6, INTERVENTIONS FOR ADULTS. https://www.ncbi.nlm.nih.gov/books/NBK327654/
Pelissolo, A., Abou Kassm, S., & Delhay, L. (2019). Therapeutic strategies for social anxiety disorder: Where are we now? Expert Rev Neurother, 19(12), 1179-1189. doi: 10.1080/14737175.2019.1666713
Pittelkow, M. M., Aan Het Rot, M., Seidel, L. J., Feyel, N., & Roest, A. M. (2021). Social Anxiety and Empathy: A Systematic Review and Meta-analysis. Journal of Anxiety Disorders, 78, 102357. https://doi.org/10.1016/j.janxdis.2021.102357
Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as treatment for anxiety: Systematic review and analysis. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9
This is the first in a series called “Mental Illness in Music,” in which I will explore human emotion and mental disorders through song lyrics. In this piece, I reveal “the saddest song of all time,” a lyrical representation of sadness, heartbreak, and depression.
Throughout history, humans have used music to portray emotions. The tempo, rhythm, melody, and harmony of a musical piece can all be used to create a certain emotional mood. However, this post focuses on lyrics, which can evoke powerful emotional responses. Lyrics can stir up strong emotions, form a bond between strangers, transport us to a different place, or they can trigger personal memories or associations.
The “saddest song of all time” is a compilation of lyrics from different songs, spanning the decades from 1950 to 2000. I removed slang and edited the lyrics to be in first-person tense, so that the song would be a personal reflection on pain, rather than a description of the pain of others. The result is a haunting and emotionally raw composition that captures the pain of heartbreak, loss, and loneliness, i.e., the saddest song of all time.
Trigger warning: This post contains references to suicide and may be triggering for some people. If you are feeling suicidal or thinking about harming yourself, please reach out for help. You can call the National Suicide Prevention Lifeline at 988. You can find additional resources for suicide prevention and recovery here on this site. You are not alone.
Mental Illness in Music Series (Part 1): The Saddest Song of All Time
Hello, darkness, my old friend I’ve come to talk with you again
I have nothing here to sell you Just some things that I will tell you Some things I know will chill you to the bone
I can still feel the breeze that rustles through the trees And misty memories of days gone by But we could never see tomorrow… No one told us about the sorrow
The grass in the valley is starting to die And out in the darkness the whippoorwills cry
I can’t spell away this hurt That’s dripping down my cheek
My pouring tears Are running wild
All I hear is the sound of rain falling on the ground I sit and watch as tears go by
It’s plain to see The sun won’t shine today But [I’m not] in the mood For sunshine anyway
Now the clouds have covered o’er And the wind is blowing cold I don’t need anybody Because I learned to be alone.
…
I can’t remember anything Can’t tell if this is true or dream Deep down inside I feel the scream This terrible silence stops me
Words like violence Break the silence Come crashing in… Painful to me Pierce right through me
I’m not half the man I used to be There’s a shadow hanging over me Oh, yesterday came suddenly
You remember the faces, the places, the names You know it’s never over, it’s relentless as the rain
In the town of broken dreams The streets are filled with regret
I’ve only sad stories to tell this town My dreams have withered and died
Now those memories come back to haunt me They haunt me like a curse Is a dream a lie if it [doesn’t] come true Or is it something worse?
I fall to pieces Time only adds to the flame
And goodnight to the street sweepers The night watchmen flame keepers
That hollow place where martyrs weep And angels play with sin.
…
So, you think you can tell Heaven from Hell Blue skies from pain?
I don’t build up illusion till it makes me sick [I’m not] afraid of confusion, no matter how thick
Why does the sun go on shining? Why does the sea rush to shore?
And the sunlight shining through the crack in the window pane Numbs my brain, oh Lord
Life is but a memory Happened long ago Theatre full of sadness For a long forgotten show
Time has a way of taking time Loneliness is not only felt by fools Alone, I call to ease the pain,
“Hello emptiness, I feel like I could die”
Emptiness Is a place you’re in With nothing to lose But no more to win
Emptiness is filling me to the point of agony Growing darkness taking dawn I was me, but now he’s gone
No, I can’t forget tomorrow When I think of all my sorrow
I look inside myself and see my heart is black I see my red door, I must have it painted black
Accidentally like a martyr The hurt gets worse and the heart gets harder.
…
[I’ve] used up all [my] coupons except the one… Written on [my] wrist Along with several thousand dreams
I’m sinking in the quicksand of my thought And I [don’t have] the power anymore
I’m so hard to handle I’m selfish and I’m sad
I’m beat, I’m torn Shattered and tossed and worn
I could live a little better with the myths and the lies When the darkness broke in I just broke down and cried
I wear this crown of shit Upon my liar’s chair Full of broken thoughts I cannot repair
No one knows what it’s like To be hated To be fated to telling only lies
And there’s a taste in my mouth As desperation takes hold
Above me a bird slowly crawls across the sky Why is there nothing now to do but die?
I tried and failed and I’m tired and weary Everything I ever [did] was wrong And I feel like going home
I was shivering inside… I was swallowing my pain
I said, Mother I’m frightened The thunder and the lightning I’ll never come through this alone
Oh Mother, I can feel the soil falling over my head
Ice frozen six feet deep How long does it take?
Now in darkness, world stops turning.
The Saddest Song of All Time Song List
The Sound of Silence - Simon & Garfunkel (1964) | Songwriter(s): Paul Simon
Hello, darkness, my old friend
I've come to talk with you again
The Grand Tour - George Jones (1975) | Songwriter(s): Norro Wilson, Carmol Taylor, & George Richey
I have nothing here to sell you
Just some things that I will tell you
Some things I know will chill you to the bone
How Can You Mend a Broken Heart - Al Green (1972) | Songwriter(s): Barry & Robin Gibb
I can still feel the breeze that rustles through the trees
And misty memories of days gone by
But we could never see tomorrow…
No one told us about the sorrow
Alone and Forsaken - Hank Williams (1952) | Songwriter(s): Hank Williams
The grass in the valley is starting to die
And out in the darkness the whippoorwills cry
D.I.V.O.R.C.E. - Tammy Wynette (1968) | Songwriter(s): Bobby Braddock & Curly Putman
I can't spell away this hurt
That's dripping down my cheek
Drown in My Own Tears - Ray Charles (1957) | Songwriter(s): Henry Glover
My pouring tears
Are running wild
As Tears Go By - The Rolling Stones (1965) | Songwriter(s): Mick Jagger, Keith Richards, & Andrew Loog Oldham
All I hear is the sound of rain falling on the ground
I sit and watch as tears go by
Kathleen - Townes Van Zandt (1969) | Songwriter(s): Townes Van Zandt
It's plain to see
The sun won't shine today
But [I’m not] in the mood
For sunshine anyway
Anywhere I Lay My Head - Tom Waits (1985) | Songwriter(s): Tom Waits
Now the clouds have covered o'er
And the wind is blowing cold
I don't need anybody
Because I learned to be alone.
One - Metallica (1988) | Songwriter(s): James Hetfield & Lars Ulrich
I can't remember anything
Can't tell if this is true or dream
Deep down inside I feel the scream
This terrible silence stops me
Enjoy the Silence - Depeche Mode (1990) | Songwriter(s): Martin Gore
Words like violence
Break the silence
Come crashing in...
Painful to me
Pierce right through me
Yesterday - The Beatles (1965) | Songwriter(s): John Lennon & Paul McCartney
I'm not half the man I used to be
There's a shadow hanging over me
Oh, yesterday came suddenly
Adam Raised a Cain - Bruce Springsteen (1986) | Songwriter(s): Bruce Springsteen
You remember the faces, the places, the names
You know it's never over, it's relentless as the rain
Lonesome Town - Ricky Nelson (1959) | Songwriter(s): Baker Knight
In the town of broken dreams
The streets are filled with regret
Withered and Died - Richard & Linda Thompson (1974) | Songwriter(s): Richard Thompson
I've only sad stories to tell this town
My dreams have withered and died
The River - Bruce Springsteen (1980) | Songwriter(s): Bruce Springsteen
Now those memories come back to haunt me
They haunt me like a curse
Is a dream a lie if it [doesn’t] come true
Or is it something worse?
I Fall to Pieces - Patsy Cline (1961) | Songwriter(s): Hank Cochran & Harlan Howard
I fall to pieces
Time only adds to the flame
Tom Traubert’s Blues - Tom Waits (1976) | Songwriter(s): Tom Waits
And goodnight to the street sweepers
The night watchmen flame keepers
Dirge - Bob Dylan (1974) | Songwriter(s): Bob Dylan
That hollow place where martyrs weep
And angels play with sin.
Wish You Were Here - Pink Floyd (1975) | Songwriter(s): David Gilmour & Roger Waters
So, you think you can tell Heaven from Hell
Blue skies from pain?
Most of the Time - Bob Dylan (1989) | Songwriter(s): Bob Dylan
I don’t build up illusion till it makes me sick
[I’m not] afraid of confusion no matter how thick
The End of the World - Skeeter Davis (1962) | Songwriter(s): Arthur Kent & Sylvia Dee
Why does the sun go on shining?
Why does the sea rush to shore?
T.B. Sheets - Van Morrison (1967) | Songwriter(s): Van Morrison
And the sunlight shining through the crack in the window pane
Numbs my brain, oh Lord
Fruit Tree - Nick Drake (1969) | Songwriter(s): Nick Drake
Life is but a memory Happened long ago
Theatre full of sadness
For a long forgotten show
In My Darkest Hour - Megadeath (1988) | Songwriter(s): Dave Mustaine & David Ellefson
Time has a way of taking time
Loneliness is not only felt by fools
Alone, I call to ease the pain,
Bye-Bye Love - The Everly Brothers (1958) | Songwriter(s): Felice & Boudleaux Bryant
“Hello emptiness, I feel like I could die”
The Sun Ain’t Gonna Shine Anymore - The Walker Brothers (1966) | Songwriter(s): Bob Crewe & Bob Gaudio
Emptiness
Is a place you're in
With nothing to lose
But no more to win
Fade to Black - Metallica (1984) | Songwriter(s): Cliff Burton, James Hetfield, Lars Ulrich, & Kirk Hammett
Emptiness is filling me to the point of agony
Growing darkness taking dawn
I was me, but now he's gone
Without You - Harry Nilsson (1971) | Songwriter(s): Pete Ham & Tom Evans
No, I can't forget tomorrow
When I think of all my sorrow
Paint It Black - The Rolling Stones (1966) | Songwriter(s): Mick Jagger & Keith Richards
I look inside myself and see my heart is black
I see my red door, I must have it painted black
Accidentally Like a Martyr - Warren Zevon (1978) | Songwriter(s): Warren Zevon
Accidentally like a martyr
The hurt gets worse and the heart gets harder.
Dress Rehearsal Rag - Leonard Cohen (1971) | Songwriter(s): Leonard Cohen
[I’ve] used up all [my] coupons except the one…
Written on [my] wrist
Along with several thousand dreams
Quicksand - David Bowie (1971) | Songwriter(s): David Bowie
I'm sinking in the quicksand of my thought
And I [don’t have] the power anymore
River - Joni Mitchell (1971) | Songwriter(s): Joni Mitchell
I'm so hard to handle
I'm selfish and I'm sad
Trouble - Cat Stevens (1970) | Songwriter(s): Cat Stevens
I'm beat, I'm torn
Shattered and tossed and worn
She’s Lost Control - Joy Division (1979) | Songwriter(s): Bernard Sumner, Peter Hook, Stephen Morris, & Ian Curtis
I could live a little better with the myths and the lies
When the darkness broke in
I just broke down and cried
Hurt - Nine Inch Nails (1994) | Songwriter(s): Trent Reznor
I wear this crown of shit
Upon my liar's chair
Full of broken thoughts
I cannot repair
Behind Blue Eyes - The Who (1971) | Songwriter(s): Pete Townshend
No one knows what it's like
To be hated
To be fated to telling only lies
Love Will Tear Us Apart - Joy Division (1980) | Songwriter(s): Ian Curtis, Peter Hook, Stephen Morris, & Bernard Sumner
And there's a taste in my mouth
As desperation takes hold
The Shortest Story - Harry Chapin (1976) | Songwriter(s): Harry Chapin
Above me a bird slowly crawls across the sky
Why is there nothing now to do but die?
I Feel Like Going Home - Charlie Rich (1960) | Songwriter(s): Charlie Rich
I tried and failed and I'm tired and weary
Everything I ever [did] was wrong
And I feel like going home
Jealous Guy - John Lennon (1971) | Songwriter(s): John Lennon
I was shivering inside…
I was swallowing my pain
Night Comes On - Leonard Cohen (1984) | Songwriter(s): Leonard Cohen
I said, Mother I'm frightened
The thunder and the lightning
I'll never come through this alone I Know It’s Over - The Smiths (1986) | Songwriter(s): Morrissey & Johnny Marr
Oh Mother, I can feel the soil falling over my head
Borrowed Tune - Neil Young (1975) | Songwriter(s): Neil Young
Ice frozen six feet deep
How long does it take?
War Pigs - Black Sabbath (1970) | Songwriter(s): Tony Iommi, Ozzy Osbourne, Geezer Butler, & Bill Ward
Now in darkness, world stops turning.
Do you have a lyric that you think would be perfect for the series Mental Illness in Music? If so, please submit your lyric using the Contact form by October 1, 2023.
References
Gabrielsson, A., & Juslin, P. N. (2003). Emotions in music. In P. N. Juslin & J. A. Sloboda (Eds.), Handbook of music and emotion: Theory, research, applications (pp. 59-92). Oxford University Press.
Juslin, P. N., & Laukka, L. (2003). Expression and communication of emotions in music. In P. N. Juslin & J. A. Sloboda (Eds.), Handbook of music and emotion: Theory, research, applications (pp. 73-104). Oxford University Press.
Krumhansl, C. L. (2002). Music and emotion: Theory and research. Annual Review of Psychology, 53(1), 625-660.
