Category: Mental Illness

30 Free Autism Resources: Support Across the Lifespan

Whether you are autistic, exploring a possible diagnosis, supporting an autistic family member, or looking for services, knowing where to start can feel overwhelming. ASD resources aren’t only for young children—support may be helpful throughout adolescence and adulthood as needs, goals, and circumstances change.

autism
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Understanding Autism & Diagnosis

Explore trusted resources to better understand autism, diagnosis, advocacy, and available support for autism spectrum disorder (ASD).

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1. Autism Help and Information | Autism Speaks You can find the information that you need by searching by topic or life stage. There is also the ability to apply filters such as the level of support needs (some support, moderate amount of support, intensive support) of the person with ASD.

2. Autism Materials and Resources | Autism Spectrum Disorder (ASD) | CDC This page includes materials and resources about autism spectrum disorder (ASD). These materials have been developed through CDC activities and are based on key findings from the latest ASD research.

3. Autism Society of America | Creating connections for the Autism community to live fully Since 1965, the Autism Society of America, and our affiliate network, connects people to the resources they need through education, advocacy, resources, and community programming.

4. Autistic Self Advocacy Network The Autistic Self Advocacy Network seeks to advance the principles of the disability rights movement with regard to ASD. ASAN believes that the goal of autism advocacy should be a world in which autistic people enjoy equal access, rights, and opportunities.

Resources for Parents & Families

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5. 100 Day Kit School Age Children This 100 Day Kit was created to help you make the best possible use of the next 100 days in the life of your child. It contains information and advice collected from trusted and respected experts on ASD and from parents like you.

6. Autism diagnosis | Autism Speaks Whether you’re looking for information about the diagnostic criteria for ASD, navigating the process of getting an autism diagnosis for your child, or exploring the steps involved in getting a diagnosis as an adult, you’ve come to the right place.

7. Autism Navigator Autism Navigator® is a web-based instructional program developed by the Florida State University Autism Institute to increase the capacity of primary care, early intervention, and other service providers, as well as families, to better serve young children with or at risk for ASD.

8. Center for Parent Information and Resources All the materials found on the CPIR Hub have been created and archived for Parent Centers around the country to help them provide support and services to the families they serve.

9. Child Mind Institute | Transforming Children’s Lives The Child Mind Institute is dedicated to transforming the lives of children and families experiencing mental health and learning disorders through excellence in science, education, and care.

10. Families | Organization for Autism Research The diagnosis of ASD is a life-changing event. Through informed action and the use of treatments and interventions that match your autistic child’s development, you can enhance your child’s quality of life.

11. Family Voices All children, youth, and families, especially those with special health care needs and disabilities, experience their best health and quality of life.

12. Organization for Autism Research | Helping Families Today The Organization for Autism Research (OAR) is dedicated to improving the lives of autistic individuals, their families, and supporters by funding practical research and providing valuable resources.

13. Sesame Workshop-Autism Sesame Workshop is a global nonprofit organization with a mission to help children everywhere grow smarter, stronger, and kinder.

14. Vanderbilt TRIAD Nashville | Services for Families of Children with Autism TRIAD offers a variety of programs and services for families of autistic people.

Resources for Autistic Adults

These resources offer practical information, tools, and support to help autistic adults navigate healthcare, relationships, independence, self-advocacy, and everyday life.

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15. AASPIRE Healthcare Toolkit | Organization for Autism Research The AASPIRE Healthcare Toolkit is a comprehensive resource designed to improve healthcare experiences for autistic adults.

16. Adult Autism Health Resources Helping adults to navigate the health care system as well as communicate and advocate for high-quality care in collaboration with their clinical providers.

17. Adults on the Spectrum — American Autism Association The American Autism Association encourages healthy lifestyles, fosters independence and inclusion, and promotes personal empowerment to better the quality of life for people with ASD.

18. Autism Grown Up Autism Grown Up, Inc. is a non-profit organization that is entirely online. We create and provide resources for autistic people and all members of an autistic person’s support network, including family members, teachers, clinicians, therapists, professionals, peers, employers, and other important stakeholders.

19. Autism Resources for Adults (PDF) A comprehensive resource guide for autistic adults covering diagnosis, mental health, relationships, education, employment, benefits, housing, independent living, and community support.

20. Autism Spectrum Disorder in Teenagers and Adults | Autism Spectrum Disorder (ASD) | CDC People with ASD face challenges during the transition from childhood to adolescence and adulthood. Research suggests fewer young people with ASD have the same opportunities as their peers without ASD.

21. Autistic Adults Welcome Pack (PDF) This booklet will be helpful for you if
you have just found out you are autistic (through diagnosis and/or self
identification).

22. Engaging Activities for Autistic Adults: A Comprehensive Guide Meaningful activities for autistic adults aren’t a luxury, they’re a proven lever for mental health, social connection, and daily functioning. The right activities reduce anxiety, provide sensory regulation, build genuine friendships, and create the kind of purposeful structure that turns an overwhelming week into a manageable, even enjoyable one.

23. Roadmap to Self-Empowerment for Autistic Adults | Autism Speaks In this Roadmap, you will find questions to ask yourself to help establish the supports you need in your everyday life across a variety of settings and roles.

Screening for ASD

ASDscreening tools can help identify signs and characteristics that may be associated with autism and indicate when a more comprehensive evaluation may be helpful. These screenings are not diagnostic, but they can be a useful first step for individuals and families who have questions or concerns. The following free screening tools are available for different age groups.

24. Birth to 5: Watch Me Thrive! (PDF)

25. CAT-Q Free Test | Camouflaging Autistic Traits Questionnaire

26. CDC’s Developmental Milestones | Learn the Signs. Act Early. | CDC

27. Empathy Quotient Assessment | Fast & Free Results

28. Free Autism Test Take a quick and accurate test. This test is called AQ-50 and known to be reliable screening tool.

29. Free Online Autism Test — Quick Screening Tool | Autism Test Online Four different screening tools. Take a research-based screening used by healthcare professionals. Completely private, takes just a few minutes, and helps you understand yourself better.

30. Ritvo Autism & Asperger Diagnostic Scale (RAADS-14) – Psychology Tools (Interactive tool)

Bonus Resources for Clinicians

Adapting Psychological Therapies for Autism – Therapist Experience, Skills and Confidence – PMC This article explores how therapists adapt cognitive behavioral therapy (CBT) for autistic clients, including the use of clearer language, greater structure, visual supports, and individualized approaches.

Autism and Therapy | Neurodivergent Insights Autism acceptance in therapy means recognizing that autistic people have unique strengths and challenges and tailoring therapy to be more autistic friendly. It means understanding that the goal of therapy is not to “cure” autistic people but to support us in achieving our goals and living fulfilling lives.

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What’s Your DSM-5-TR IQ (Part 2)?

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.

For Part 1, see What’s Your DSM-5-TR IQ?

QUIZ START

What’s Your DSM-5-TR IQ?

Part 1: How Strong Is Your DSM-5-TR Mastery?

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.

QUIZ START

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.

High-Functioning Depression: The Quiet Art of Falling Apart

High-Functioning Depression: It Doesn’t Mean You’re Okay

Stop calling it “being strong.”

Most people don’t break down. They shut down.

They keep working. Keep caretaking. Keep smiling in photos.


They say, “It’s fine, I’m just tired,” because the alternative is having to explain a pain they can barely understand themselves.

The world praises them for being “resilient.”

But it’s not resilience.

It’s the art of falling apart quietly.
Numbness dressed up as strength.

High-functioning.

Name the Phenomenon

We’ll call it:

Functional Freeze.

Your body did not fail you. It protected you.


When the world asked you to keep going, your nervous system made sure you could.

We don’t talk enough about functional freeze

There’s a version of you that performs your life without actually feeling your life.

  • You get things done.
  • You meet your obligations.
  • You seem okay.

But inside?

It’s quiet. Too quiet.

Flat. Heavy. Far away.

This isn’t laziness.
It isn’t weakness.
It isn’t “not trying hard enough.”

This is your nervous system turning the volume down to protect you because everything was too loud to feel at once. It’s high-functioning depression.

When feelings are too overwhelming to process in real-time, your body turns them down so you can keep going.

Not broken.
Adapted.

You learned to survive by disappearing from yourself

Maybe you grew up in a home where your feelings were “too much.”
Maybe you were the caretaker.
The reliable one.
The one who held it all together.

Or maybe life has just been relentless for too long.

When there is no space to fall apart, your system chooses shut down over collapse.

You didn’t choose numbness.
Numbness chose you—to keep you alive.

Read that again.

And here’s the hardest part

People who are “high-functioning” almost never get help.

Because:

  • No one realizes they’re struggling
  • They’re so good at performing “fine” that even they start to believe it
  • They feel guilty asking for support because “other people have it worse”

And so they stay silent.

Invisible.

Hurting in plain sight.

You don’t have to stay in shutdown

And we’re not jumping to “fix” anything.

We start small. Gentle. Slow.

Try this today (yes, just this):

For 10 seconds, pause and ask your body:

“What am I feeling physically right now?”

Not emotionally.
Not why.
Not how to change it.

Just notice:

  • Tight jaw?
  • Heavy chest?
  • Numb?
  • Shoulders up near your ears?

If you can notice it,
you’re already coming back to yourself.

That’s the work.
Tiny reconnections.
Without forcing anything to open before it’s ready.

You deserve support that doesn’t require you to collapse first

Somatic Grounding

Before you click away, unclench your jaw.
Drop your shoulders.
Exhale slowly.


Notice the space that makes.


You’re still here.
Your body is still on your side.

Your system just let go—just a little.
That’s not weakness. It’s returning.
Pretending you’re fine isn’t required to move toward feeling fine.

You don’t have to fall apart to deserve support.


Everything You Need to Know About Ketamine Therapy

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.

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.

Who May Benefit From Ketamine Therapy

People who have:

  • Treatment-resistant depression
  • Severe or recurrent depressive episodes
  • Suicidal thoughts needing rapid intervention
  • PTSD or trauma-related symptoms
  • Chronic pain conditions (e.g., CRPS, fibromyalgia)
  • 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.

MethodHow It’s GivenWhere It HappensCostProsCons
IV InfusionSlow, controlled dripClinic onlyHighMost research supportExpensive; requires time on-site
IM InjectionSingle injectionClinicModerateFast onset; predictableLess adjustable dose mid-session
Spravato (Esketamine)Nasal sprayClinic + monitoringHigh (but may be covered)FDA-approved; insurance may helpMust meet specific criteria
Lozenge/TrocheDissolves under tongueClinic or at-home protocolsLowerFlexible + accessibleGreater 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.

Ketamine Therapy FAQDownload

Ketamine Therapy Progress Tracker Worksheet

ketamine_progress_trackerDownload

This worksheet includes:

  • Daily tracking for mood, sleep, and energy
  • Space to log emotional shifts and insights
  • A format that supports integration and therapeutic reflection

Clinician version:

ketamine_progress_tracker_clinicianDownload

Integration Checklist

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

Drug Enforcement Administration. (2020, June). Ketamine: Drug fact sheet. U.S. Department of Justice. https://www.dea.gov/sites/default/files/2020-06/Ketamine-2020_1.pdf

Cassie Jewell

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.

How to Help Depression

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)

Introducing a Free Prolonged Grief Disorder Mini-Course

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.

PART 1:

PART 2:

PGD HANDOUTDownload

Assessments

Brief Grief Questionnaire

Grief-Related Avoidance Questionnaire

Inventory of Complicated Grief

PG-13 Assessment

…

EDUCATIONAL SHORT FILM FOR CLIENTS:

For more grief resources visit Grief & Loss: A Comprehensive Resource Guide.

200 Free Online (& PDF) Screening & Assessment Tools for Adults

This is an updated version of the post 500 Free Online Assessment & Screening Tools – mind remake project, which has been archived due to broken links.

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
  • Interactive=No PDF, might require email or account signup, self-scoring unless indicated otherwise
a woman interviewing a man
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ADHD

ADHD Test: Adult ADHD Screening Quiz Interactive with scoring information

Adult ADHD Self-Report Scale (ASRS-v1.1) Interactive with scoring information

Structured Adult ADHD Self-Test (SAAST, Version 2011.1) Interactive with scoring information

Wender Utah Rating Scale – 25 item version (WURS-25) – NovoPsych PDF for download, scoring instructions available

Anger & Aggression

Clinical Anger Scale PDF

Buss and Perry Aggression Questionnaire (BPAQ) – NovoPsych PDF for download, scoring instructions included

Antisocial Personality Disorder

The Psychopathy Checklist Printable form

Triarchic Psychopathy Measure (TriPM) PDF for download, scoring instructions available

Anxiety

Adult Separation Anxiety Questionnaire (ASA-27) PDF for download, scoring instructions available, Source: NovoPsych

Anxiety Tests – Free Online Anxiety Quizzes | Interactive assessments (Source: Anxiety Centre)

APA_DSM5_Severity-Measure-For-Specific-Phobia-Adult.pdf PDF

Appearance Anxiety Inventory (AAI) – NovoPsych PDF for download, scoring instructions available

Brief Fear of Negative Evaluation Scale (BFNE) – Addiction Research Center – UW–Madison PDF for download, scoring instructions available

Fear of Physician Scale Printable form

Hamilton Anxiety Rating Scale (HAM-A) PDF

Interactive Anxiousness Scale (IAS) PDF

 Intolerance of Uncertainty Scale (IUS) PDF for download, scoring instructions available

Liebowitz Social Anxiety Scale Interactive, self-scoring, Source: The National Social Anxiety Center (NSAC) 

Panic Disorder Severity Scale – Self Report Form PDF

Penn State Worry Questionnaire (PSWQ) PDF

Personal Report of Public Speaking Anxiety (PRPSA) Printable form with scoring instructions

Short Health Anxiety Inventory (SHAI) – NovoPsych PDF for download, scoring instructions available

Shyness Scale (SS) Printable form with scoring instructions

Temperament and Character Inventory (TCI) PDF for download, scoring instructions available

Attachment & Relationships

Adult Attachment Interview (AAI) PDF

Attachment Style Questionnaire PDF

Attachment Style Questionnaire – Short Form (ASQ-SF) – NovoPsych PDF for download, scoring instructions included

Attachment Styles and Close Relationships

Couples Satisfaction Index PDF

Codependency-Questionnaire.pdf PDF with scoring instructions

DA Tools PDF for download, scoring instructions available

Friel Co-Dependency Assessment Inventory PDF, scoring information here

Ideal Partner and Ideal Relationship Scales Word doc for download

Kansas Marital Satisfaction Scale PDF

LOVE ATTITUDES SCALE PDF

MAQ (a measure of adult attachment qualities) Printable form

Marital Forgiveness Scale (Dispositional) Printable form

Passionate Love Scale PDF

Perceived Relationship Quality Components Inventory (PRQC) Word Doc for download

Relationship Attachment Style Test Interactive, self-scoring (fee for full report results, snapshot results free)

Relationships Questionnaire PDF

Relationship Power Inventory (RPI) Word doc for download

Spann-Fischer Codependency Scale PDF

Bipolar & Mania

Goldberg Bipolar Spectrum Screening Questionnaire Interactive with scoring information, Source: Counselling Resource

Goldberg Mania Questionnaire Interactive with scoring information, Source: Counselling Resource

Manic State Rating Scale PDF

Mood Disorder Questionnaire (MDQ) – NovoPsych PDF for download, scoring instructions available

Tri-Axial Bipolar Spectrum (TABS, Version 2011.1) Questionnaire Interactive with scoring information, Source: Counselling Resource

Young Mania Rating Scale PDF

Borderline Personality Disorder

Borderline Personality Questionnaire (BPQ) – NovoPsych PDF for download, scoring instructions included

Emotion Regulation Inventory (ERI) PDF for download, scoring instructions available, Source: NovoPsych

Borderline Symptom List (BSL-23) – NovoPsych PDF for download, scoring instructions available

McLean Screening Instrument for BPD (MSI-BPD) – NovoPsych PDF for download, scoring instructions available

Burnout

Burnout Assessment Tool (BAT) Test manual with assessment

Oldenburg Burnout Inventory (OLBI) – NovoPsych PDF for download, scoring instructions available

Communication

Richmond Humor Assessment Instrument Printable form with scoring instructions

Self-Perceived Communication Competence Scale (SPCC) Printable form with scoring instructions 

SocioCommunicative Style Scale (SCS) Printable form with scoring instructions 

Talkaholic Scale Printable form with scoring instructions

Tolerance for Disagreement Scale (TFD) Printable form with scoring instructions

Willingness To Communicate (WTC) Printable form with scoring instructions

Willingness to Listen Measure Printable form with scoring instructions

Compassion & Self-Compassion

Compassion Motivation and Action Scales – Compassion (CMAS-other) – NovoPsych

The Compassion Scale (CS) PDF

Self-Compassion Scale (SCS) PDF, includes scoring instructions

Self-Compassion Scale-Short Form (SCS-SF), PDF, includes scoring instructions

Self-Compassion Test Interactive, self-scoring version

Coping Strategies & Maladaptive Coping

Brief Resilient Coping Scale PDF

Brief Experiential Avoidance Questionnaire (BEAQ) – NovoPsych PDF for download, scoring instructions available

COPE Inventory (Full version) Includes scoring information, Interactive, self-scoring version

Maladaptive Schema Scale (MSS) – NovoPsych PDF for download, scoring instructions available

The Proactive Coping Inventory PDF

Young Schema Aligned (MSS-YSQ) – NovoPsych PDF for download, scoring instructions available

Depression

Beck Depression Inventory (BDI) | PDF with scoring instructions (Author: Aaron T. Beck)

Behavioral Activation for Depression Scale | PDF with scoring instructions

The British Columbia Cognitive Complaints Inventory (BC-CCI) PDF

Center for Epidemiologic Studies Depression Scale (CES-D), NIMH PDF

Depression Screening – My HealtheVet – My HealtheVet Interactive, self-scoring

Geriatric Depression Scale (GDS-15) – NovoPsych PDF for download, scoring instructions available

Goldberg Depression Questionnaire Interactive with scoring information, Source: Counselling Resource

Hamilton Depression Rating Scale (HDRS) PDF

Inventory of Depressive Symptomatology (Self-Report) (IDS-SR) PDF

Male Depression Risk Scale (MDRS-22) – NovoPsych PDF for download, scoring instructions available

Dissociation & Depersonalization

Cambridge Depersonalization Scale PDF

Multidimensional Inventory of Dissociation – 60-item version (MID-60) – NovoPsych PDF for download, scoring instructions available

Eating Disorders & Body Image

Binge-Eating Scale (BES) – NovoPsych PDF for download, scoring instructions available

BODY-IMAGE IDEALS QUESTIONNAIRE (with Manual)

Body Image Qurstionnaire-BIQ Manual-4

Clinical Impairment Assessment Questionnaire (CIA) – NovoPsych PDF for download, scoring instructions available

Eating Attitudes Test-26 (EAT-26) – NovoPsych PDF for download, scoring instructions available

Eating Disorder Examination © (EDE) (Edition 17.0D) PDF for download, scoring instructions available

Eating Disorder-15 (ED-15) – NovoPsych PDF for download, scoring instructions available

Eating Disorder Diagnostic Scale (EDDS) Interactive, self-scoring

Eating Pathology Symptoms Inventory (EPSI) Printable form

Eating Questionnaire PDF

Image Fixation Questionnaire Printable form with scoring instructions

The Sick, Control, One, Fat, Food (SCOFF) Questionnaire Interactive, self-scoring

Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) PDF for download, scoring instructions available

Emotional Intelligence

Brief Emotional Intelligence Scale (BEIS-10) PDF for download, scoring instructions included, Source: NovoPsych

Mindfulness

Acceptance & Action Questionnaire-II PDF

Automatic Thoughts Questionnaire (ATQ) Printable form

Cognitive and Affective Mindfulness Scale- Revised (CAMS-R) PDF

Five Facet Mindfulness Questionnaire (FFMQ-15) – NovoPsych PDF for download, scoring instructions available

Freiburg Mindfulness Inventory PDF

Kentucky Inventory of Mindfulness Skills PDF

Mindful Attention Awareness Scale (MAAS) PDF for download, scoring instructions included

Philadelphia Mindfulness Scale (PHLMS) Printable form

Toronto Mindfulness Scale Printable form

Motivation

Intrinsic Motivation Inventory PDF for download, scoring instructions included

Work Extrinsic and Intrinsic Motivation Scale (WEIMS) PDF for download, scoring instructions included

Obsessive-compulsive & Hoarding

Clutter Image Rating PDF

Hoarding Rating Scale PDF

Obsessional Compulsive Inventory – Revised (OCI-R) – NovoPsych

Saving Inventory – Revised PDF

Personality Tests

DISC Personality Test Interactive, self-scoring

International Personality Item Pool – NEO – 120 item version (IPIP-NEO-120) – NovoPsych PDF for download, scoring instructions available

NovoPsych Five Factor Personality Scale – 30 item version (NFFPS-30) – NovoPsych PDF for download, scoring instructions available

Personality Inventory for DSM-5 – Short Form (PID-5-SF) – NovoPsych PDF for download, scoring instructions available

Positive Psychology & Life Satisfaction

Brief Resilience Scale (BRS) PDF

Comprehensive Inventory of Thriving (CIT) and Brief Inventory of Thriving (BIT)

Connor-Davidson Resilience Scale (CD-RISC 25) Must submit request to obtain scale

Empathy Quotient (EQ-40) – NovoPsych PDF for download, scoring information available

Flourishing Scale PDF for download

Grit Scale Interactive, self-scoring

Personal Wellbeing Index – Adult – 5 (PWI-A) – NovoPsych PDF for download, scoring instructions available

Quality of Life Enjoyment and Satisfaction Questionnaire PDF for download, scoring instructions available

Recovery Assessment Scale PDF

Rosenberg Self-Esteem Scale (RSE) PDF

Satisfaction with Life Scale (SWLS) PDF for download, scoring instructions separate PDF

Scale of Positive and Negative Experience (SPANE)

Toronto Empathy Questionnaire, Interactive, self-scoring

VIA Character Strengths Survey Interactive, sell-scoring

Wellbeing Assessment Interactive, self-scoring

Self-Determination

Who Five Well Being Index (WHO-5)​ Interactive, self-scoring

Perceived Choice and Awareness of Self Scale (PCASS) (PDF for download, scoring instructions included)

Perceived Competence Scales (PCS) (PDF for download, scoring instructions included)

Self-Regulation Questionnaires (SRQ) (PDFs for download, scoring instructions included)

Substance Use & Behavioral Addictions

AlcoholScreening.org (Interactive, self-scoring)

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) PDF for download, Source: WHO

Alcohol Use Disorders Identification Test (AUDIT) Interactive, self-scoring, (Click here for a PDF version from UMKC SBIRT)

Alcohol Use Self-check Interactive, self-scoring, Source: FOUNDRY

Addiction Test – Mental Health America Interactive, self-scoring

CAGE-Substance-Screening-Tool PDF

Drinking Behavior Questionnaire PDF. Scoring instructions here

Drinking Motives Questionnaire-Revised (DMQR) PDF for download, scoring instructions available

Drug Abuse Screening Test, DAST-10

Leeds Dependence Questionnaire (LDQ) – NovoPsych PDF for download, scoring instructions available

Michigan Alcohol Screening Test (MAST), Revised | Interactive with scoring information, Source: Counselling source

Problem Gambling Self-Assessment – National Council on Problem Gambling

Processes of Change Questionnaire (for Alcohol Use) PDF

Processes of Change Questionnaire (for Drug Use) PDF

Problem Gambling Severity Index (PGSI) – NovoPsych

Sexual Addiction Test Interactive, self-scoring, Source: PsychCentral

Yale Food Addiction Scale PDF

Trauma & Stress

Adverse Childhood Experiences Questionnaire (ACE-Q) – NovoPsych PDF for download, scoring instructions available

Chronic Stress PDF for download, scoring instructions available, Source: PhenX

The Civilian Mississippi Scale PDF

Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) Must submit request to obtain scale, free training for clinicians

General Distress Screener PDF for download, scoring instructions available, Source: PhenX

International Trauma Questionnaire (ITQ) – NovoPsych PDF for download, scoring instructions available

Kessler Psychological Distress Scale PLUS (K10+) – NovoPsych PDF for download, scoring instructions available

Life Events Checklist for DSM-5 (LEC-5) – NovoPsych PDF for download, scoring instructions available

Mississippi Scale for Combat-related PTSD PDF, Scoring information here

Modified PTSD Symptom Scale (MPSS-SR) Must submit request to obtain scale

Perceived Stress Scale (PSS-10) – NovoPsych PDF for download, scoring instructions available

PTSD Symptom Scale – Interview for DSM-5 Must submit request to obtain scale

Trauma History Questionnaire PDF

Structured Interview for PTSD (SI-PTSD) Must submit request to obtain scale

Websites with Free Assessments

Browse through multiple assessments to find the one that suits your needs. Please ensure compliance with copyright regulations.

Aisel | Validated Mental Health Screening Tools – Free Online Scale Library 🆕

Depression Assessment Instruments APA

Questionnaire Center | Authentic Happiness

Self-Report Measures – Addiction Research Center – UW–Madison

Counselling Resource Psychological Self-Tests and Quizzes

Psychiatry.org – DSM-5-TR Online Assessment Measures

Resources | The Fetzer Institute

RESEARCH MEASURES Dr. James C. McCroskey

All tools | Best Practices in Psychology Portal – McGill University

Assessments – NovoPsych

 Open-Source Psychometrics Project

PhenX Toolkit: Resources

PSYCHOLOGICAL SCALES

Mental Health Tests and Quizzes PsychCentral

Welleing Measures | The Human Flourishing Program

Metrics & Methods: Questionnaires – selfdeterminationtheory.org

Scales Overview – Ed Diener, Subjective WellBeing

Clinician Tools – SBIRT for Substance Abuse

Substance Use Assessments | Taking the Escalator

TTM Measures – HABITS Lab – UMBC

Measurement Resources – MedConsults – College of Medicine – University of Florida

Scales/Measures | Social Interaction Lab University of Minnesota

Screening & Brief Intervention Tools – University of Victoria

Tovani Health | Free Online Mental Health Screenings: PHQ-9, GAD-7, and more Short, interactive, self-scoring mental health screens 🆕

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How Your Brain Changes When You’re Thriving (Includes PDF Flourishing Scale)

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.

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Key Points

  • 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:

  1. Practice gratitude by expressing it in an intentional and thoughtful way.
  2. 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.
  3. 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).
photo of women hugging each other
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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

  1. I lead a purposeful and meaningful life.
  2. My social relationships are supportive and rewarding.
  3. . I am engaged and interested in my daily activities.
  4. actively contribute to the happiness and well-being of others.
  5. I am competent and capable in the activities tf
  6. I am optimistic about my future.
  7. 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:

The Flourishing Scale

Flourishing & Your Brain

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).

flourishing
Photo by Ron Lach on Pexels.com

Summary

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

Authentic Happiness | Authentic Happiness

Black Dog Institute | Better Mental Health | Science. Compassion. Action.

Greater Good: The Science of a Meaningful Life

Mind & Life Institute Focused on wellbeing and the mind-brain connection

PositivePsychology.com – Helping You Help Others Articles, research studies, worksheets, and practical tools related to positive psychology

Positive Psychology Center A leading research center on flourishing, resilience, and wellbeing science, founded by Dr. Seligman

Positive Psychology Institute

Self-Compassion by Kristin Neff: Join the Community Now Assesses how self-kindness and mindfulness contribute to flourishing

The Science of Well-Being | Coursera Free course from Yale on wellbeing

On Amazon: Diener, E., & Biswas-Diener, R. (2011). Happiness: Unlocking the mysteries of psychological wealth. Wiley-Blackwell.

On Amazon: Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.

On Amazon: Ryan, R. M., & Deci, E. L. (2018). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Press

VIA Character Strengths Survey & Character Reports

References

American Psychiatric Association. (2020, January 6). Brain imaging shows the impacts of psychotherapy. https://www.psychiatry.org/news-room/apa-blogs/brain-imaging-shows-the-impacts-of-psychotherapy

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

Nash, J. (2015, February 12). The 5 founding fathers and a history of positive psychology. PositivePsychology.com. https://positivepsychology.com/founding-fathers/

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

Overcoming Social Anxiety

All about social anxiety, including triggers, symptoms, risk factors, and treatments, plus 7 strategies for coping with “in-the-moment” social anxiety.

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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.

Kelly Jean (Blogger)

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

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