Trying to help a deeply upset teenager — perhaps one undone by a social slight or flipping out about an upcoming test — is among the most common and stressful challenges in all of parenting. Amid all that stress, it’s easy for well-meaning adults to make missteps.
More often than not, we jump in with earnest questions or suggestions: “Any chance you did something that hurt your friend’s feelings?” or “Would it help if I quizzed you on what you’ve studied so far?” But, despite our best intentions, these efforts often seem to only agitate our teenagers further.
Even though I’ve got years of training and experience as a clinical psychologist, for a long time I more or less muddled my way through the adolescent meltdowns that inevitably arose at my practice. Lately, however, I’ve managed to improve my approach, and I owe it all to a fateful trip to Texas.
I was chatting with the counseling team at a Dallas girls’ school a few years ago when the conversation turned to how we each handle students who become unglued during the school day.
“That,” said one of the counselors in a Texas twang, “is when I get out a glitter jar.” As I tried to conceal my immediate skepticism, she went off to retrieve one. While we waited for her to return, I sat there thinking that whatever she was bringing back, I hated it already.
First, as a parent with a neatness hang-up and kids who love art projects, I have come to loathe glitter. Second, if there was any psychology behind this, it seemed bound to be a little, well, poppy.
The counselor returned holding a clear jam jar. Its lid was glued on and it was filled with water plus a layer of sparkling purple glitter sitting at the bottom. “When a girl falls apart in my office, I do this,” she said, while shaking the jar fiercely, like an airport snow globe. Together we beheld the dazzling glitter storm that resulted. Then she placed the jar down on the table between us and continued, “After that I say to her, ‘Honey, this is your brain right now. So first … let’s settle your glitter.’”
Mesmerized, I watched the swirling glitter slowly fall to the bottom of the jar. Finally getting over myself, I was ready to acknowledge the brilliance behind this homemade device.
Sitting right there was an elegant model of the neurology of the distressed teenager. Early in adolescence, the brain gets remodeled to become more powerful and efficient, with this upgrade retracing the order of the original in utero development. The primitive regions, which are just above the back of the neck and house the emotion centers, are upgraded first — starting as early as age 10. The more sophisticated regions, located behind the forehead and giving us our ability to reason and maintain perspective, are redone last and may not reach full maturity until age 25.
While this process is underway, young people are put in a rather delicate position. Though they tend to be highly rational when calm, if they become upset, their new, high-octane emotional structures can overpower their yet-to-be upgraded reasoning capacities, crashing the entire system until it has a chance to reset.
I have enthusiastically recommended glitter jars to several parents and colleagues knowing that some teenagers will instantly benefit from having a concrete model of emotional distress. That said, I have come to appreciate that a glitter jar’s main utility is in the instructions it provides to those who are caring for the overwrought: Be patient and communicate your confidence that emotions almost always rise, swirl and settle all by themselves.
Not long after I returned from Texas, I ran into a visibly upset sophomore in the lunchroom of the school where I consult each week. She looked stricken, and her eyes were red from crying.
Urgently she asked, “Are you free?”
“Yes,” I replied, turning her toward my office.
Once there, she buried her hands in her face and broke into heaving sobs. Soon, she slowed her breathing and looked at me, even as tears continued to stream down her face. In the past, I would have taken that opening to quiz her about what had gone wrong. In retrospect, I now see this as the verbal equivalent of further shaking the mental glitter jar. Instead, I asked if she wanted a glass of water, or some time alone to let her painful feelings die down. She declined both offers, so we just sat there quietly.
Not a minute had passed before she relaxed completely. Then she volunteered that she had done poorly on a test that morning and had fallen down a rabbit hole of worries about what a bad grade might mean for her future. Now, with her glitter nearly settled and her mind more clear, she regained perspective on the situation. Within moments she decided that the low grade probably wasn’t such a big deal, and if it was, she’d figure out how to make up for it in other ways.
This is not to say that letting glitter settle is the solution to all teenage problems. But I have found it to be a better first response than any other. Every time I stop myself from trying to figure out what made a teenager upset, and focus instead on her right to just be upset, I find that doing so either solves the problem or helps clear the path to dealing with it.
It’s critical to recognize that when we react to psychological distress as though it’s a fire that needs to be put out, we frighten our teenagers and usually make matters worse. Reacting instead with the understanding that emotions usually have their own life cycle — coming as waves that surge and fall — sends adolescents the reassuring message that they aren’t broken; in fact, they’re self-correcting.
So, when you next encounter a young person in full meltdown, take a deep breath and think to yourself (Dallas accent optional), “First … let’s settle your glitter.”
As of Monday, the United States has new federal physical-activity guidelines. The new guidelines, which represent a scientific consensus about how much and what types of physical activities we should complete for good health, bear a strong resemblance to the existing, 10-year-old governmental recommendations. But they also feature some important updates and expansions, including the first-ever federal activity parameters for 3-year-olds, as well as a few surprising omissions.
And they offer a subtle, admonitory reminder that a substantial majority of us are not moving nearly as much as we should.
The idea that the government might suggest how much we need to exercise is relatively new. The first federal exercise recommendations were released in 2008, after several years of scientific background study.
During that time, an advisory board of researchers, most of them from academia, scoured the available scientific literature for clues about the relationships between physical activity and health and how much and what types of exercise seemed best able to lengthen people’s life spans and reduce their risks for disease.
Using that information, they assembled and presented a scientific report to the Department of Health and Human Services, which used it as the basis for the original 2008 guidelines.
Most of us probably know what those guidelines suggested.
In essence, they called for adults who are not disabled to complete at least 150 minutes a week of moderate-intensity exercise, such as brisk walking or other activities that raise people’s heart rates and breathing to the point that they can talk to a companion but cannot, should they be so inclined, sing.
The guidelines also noted that 75 minutes of vigorous exercise, such as jogging, would be equally effective but that the exercise, whatever its intensity, should take place in nonstop bouts of at least 10 minutes at a time and preferably every day.
Adults were urged, too, to do some type of strength training twice a week, while children older than 6 and teenagers were told to exercise moderately for at least 60 minutes a day.
That was 10 years ago. Since then, exercise scientists have published a mountain’s worth of new research about the health effects of physical activity — and of sitting — and of how much time we really need to spend in motion.
So two years ago, the Department of Health and Human Services convened a new panel of scientific advisers to sift through this research and provide updated exercise recommendations.
To the surprise of some scientists and other observers, these guidelines, which were published on Monday in JAMA, are broadly the same as the previous set.
Again, they call for adults to complete at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous activity every week, along with strength training twice a week.
They also suggest balance training for older people and, for the first time, urge kids between the ages of 3 and 5 to be active for at least three hours a day, an acknowledgment that even small children run the risk of being too sedentary these days.
The most substantive change in the new recommendations involves how long each bout of exercise should be. The new guidelines say they do not need to last for 10 minutes.
Any physical activity, no matter how brief, including walking up stairs or from the car to the office, provides health benefits, according to the new guidelines, and counts toward exercise goals.
Using these parameters, “it will be much easier” for people to accumulate the desired 150 weekly minutes of moderate activity, says Adm. Brett Giroir, the assistant secretary for health at H.H.S., who oversaw the development of the formal guidelines.
This idea is captured in a new H.H.S. website cheerfully titled “Move Your Way” that summarizes the latest guidelines.
But despite this expansiveness, the 2018 recommendations do not cover some types or aspects of exercise, including high-intensity interval training. Although these brief, intense workouts are popular and widely studied, the guidelines’ writers felt that more research was needed about their safety and effects.
For the same reason, the guidelines do not set a target for how much — or little — time people should spend sitting or how many steps they should take each day, instead reiterating that the best goal is 150 minutes a week of activity.
Helpfully, the new guidelines do include some practical proposals for increasing exercise, including having health care workers ask people about their exercise habits during every appointment and employers promote physical activity at work.
But such efforts are voluntary, of course, and may be unable to overcome the greatest challenge facing the implementation of the new guidelines, which is us.
Despite 10 years of hearing that we should be moving more, few of us are.
Only about 20 percent of American adults meet the existing recommendations, and a third never work out at all, statistics show.
But Admiral Giroir says he believes that the new guidelines can and should inspire large numbers of people to get moving.
“They are so simple,” he says. “You can walk, dance, mow your lawn, park your car a little farther away. It all counts and could really make an impact on people’s health.”
In a survey of 2,089 English schoolgirls ages 11 to 18, nearly three-quarters listed at least one breast-related concern regarding exercise and sports. They thought their breasts were too big or too small, too bouncy or bound too tightly in an ill-fitting bra. Beginning with feeling mortified about undressing in the locker room, they were also self-consciously reluctant to exercise and move with abandon.
Experts on adolescent health praised the study for identifying and quantifying an intuitive thought.
“We make assumptions about what we think we know, so it’s important to be able to say that as cup size increases, physical activity decreases for a lot of girls,” Dr. Sharonda Alston Taylor, an assistant professor of pediatrics at Baylor College of Medicine in Texas, who focuses on adolescent obesity.
The challenge is what to do about it.
After reading the study, some pediatricians and adolescent health specialists said they needed to do a better job informing girls about breast health and development. Almost 90 percent of the girls in the study said they wanted to know more about breasts in general, and nearly half wanted to know about sports bras and breasts specifically with respect to physical activity.
Joanna Scurr, the lead author of the study and a professor of biomechanics at the University of Portsmouth in England, said the breast itself had little internal support, so when a girl’s body moved, the breast moved independently, and the movement increased with breast size. In up to 72 percent of exercising women, she said, that movement was a cause of breast pain or discomfort.
Yet while sports and physical education programs frequently recommend protective gear for boys, like cups, athletic supporters and compression shorts, comparable lists for young women rarely include a mandatory or even recommended sports bra.
Only 10 percent of the girls surveyed said they always wore a sports bra during sports and exercise. More than half had never worn one.
Dr. Taylor said that lack of education about bra fitting and sizing was commonplace in her practice.
“The mom will say, ‘I don’t know what size she is,’ and the patient will say, ‘I just grab my sister’s or my mother’s bras to wear.’”
Using data from this study and others, the researchers from sports and exercise health departments at three British universities are trying to design school-based educational programs.
When researchers asked the girls how they would prefer to receive breast information — via a website, an app, a leaflet or a private session with a nurse — the overwhelming majority replied that they wanted a girls-only session with a female teacher.
At what age? “Most of them said 11,” Dr. Scurr said.
Andria Castillo, now 17 and a junior at Mather High School in Chicago, says she remembers that when she was around that age, she was painfully self-conscious about her breast size; she thought she was developing more slowly than everyone else.
“I felt boys and girls were making fun of me,” she said. “Even though no one called me out, I felt they were, behind my back. I was taking taekwondo, and I would look in the big mirror and try to find ways to cover myself up and hide. I asked my dad if I could stop going.”
She had a friend who had been active in sports. But in the sixth grade, the girl’s breasts developed rapidly. “She eventually stopped going to gym altogether,” Ms. Castillo said. “Instead, she just went to a classroom and did her homework.”
In time, Ms. Castillo turned her attitude around; she is now on her school’s varsity water polo and swim teams. She credits not only her mother, but also a Chicago-based project, Girls in the Game, which has body-positive, confidence-building programs, including single-sex athletics.
Some experts in female adolescent obesity and fitness suggested that young girls would be more comfortable in single-sex gym classes. But others said that option had its disadvantages, too.
Kimberly Burdette, a doctoral candidate in psychology at Loyola University Chicago who looks at the psychological factors that promote well-being and healthy weight in girls, says such separation might be helpful at a time when adolescent girls had a heightened awareness that others were looking at their bodies.
“It’s hard to be in the zone, focusing on athletic movement, on what your body can do, if you’re thinking about what others think your body looks like,” she said. “I like programming that is for girls only, where a girl can try a sport, regardless of her ability, without the male gaze.”
But Elizabeth A. Daniels, an assistant professor of developmental psychology at the University of Colorado, Colorado Springs, disagreed. “I’m not sure the concern or embarrassment is always just about boys,” she said, noting that girls can make derisive comments about one another. “So do we change the structure of the gym class or address respectful behavior?”
Here are results of research regarding the importance of children having connections with trusted adults. Sacred Heart’s advisory program and efforts to “build community as a Christian value” help enormously in these areas. This article serves as an important reminder of the positive benefits of a strong partnership between home and school.
At times, it might seem like teens want nothing to do with adults. But research from Independent School Health Check (ISHC) shows that the opposite is true. In 2007, we created ISHC, a computer-based survey, to more accurately gauge the experience of adolescents in independent schools. The ISHC assesses students’ perceptions, feelings, and behaviors regarding their schools, families, and friends as well as the risk and protective factors that affect their health and well-being. The survey assesses school attitudes and motivation, school pressure, parental supervision, social and emotional connections to adults and peers, substance use, sexuality, sleep, and diet.
Over the past 11 years, the ISHC has collected data from 80,816 middle and high school students in 102 independent schools; most schools have conducted the survey multiple times. Schools that conduct surveys typically use the data to develop and fine-tune health and wellness programs, to identify areas that need attention, as well as areas of particular strength.
One area of inquiry for the ISHC is a student’s relationship with adults. The survey asks students to rate “the adult(s) who is primarily responsible for caring for [them] on a daily basis” on behaviors such as “expresses interest in my life,” “expects me to ask if I can go out,” and “supports my efforts in sports, music, or other activities.” The survey also asks students to rate their perceptions of teachers including statements such as “teachers at my school pay attention to my personal needs, not just academic performance,” and “my teachers treat me with respect.”
Over the years, we have been impressed by the high level of engagement that so many parents maintain, and by the extent to which so many students feel that their teachers support their personal needs as well as their academic needs.
Not all parents are supportive, however, nor do all students find encouraging adults in schools—perhaps because they were already wary about trusting an adult. Nevertheless, when we track what happens to adolescents without a reliable adult to talk to and depend on, we find that these are young people at greater risk. Conversely, when adolescents have an adult to talk with, there is benefit to both the student and to the school.
The ISHC asks several questions about students’ interactions with the adults in their lives. More than three-quarters say they “have an adult to talk to on a regular basis about what is going on in [their] life.” About 84 percent agree that “if faced with a really important question or serious problem, [they] would talk to an adult.” Mothers are the adults who students talk to the most (81.9 percent), followed by fathers (62.8 percent). Teachers (26 percent), counselors (24.6 percent), and coaches (15.4 percent) are also adults students turn to.
In high-stakes behavior, the absence of adult support is alarming. For those adolescents who think their parents are not interested or supportive, the likelihood of suicidal thoughts triples. Students who think their teachers are not attentive to their needs are twice as likely to report self-harm or suicidal thoughts. These students are also more likely to break school rules and have a much lower sense of belonging.
How Schools Can Help
What can schools do to encourage students to have attachments to adults in the community? They can build on the already effective outreach of the adults in the school community by supporting adviser programs. Offer advisers training, support, and accountability to guide them so they are able to productively engage with students and their parents. Schools can enhance their programs by offering training in communication strategies, scheduling regular adviser times, and expecting that advisers maintain contact with their advisees and their parents/guardians.
Building a working connection with families is another important strategy for enhancing students’ perception that adults are available to them. In addition to the standard parent meetings and activities that schools offer, it is important to encourage parents/guardians to reach out to their child’s adviser with any questions or concerns about their child, their family, or the school program. An effective adviser program can function as a safety net for all students when they experience academic, social, or personal problems in school and at home. ▪
As the weather turns warmer and the days are longer, many parents are looking forward to spending more quality time with the family. A great place to start is by taking your kids outdoors — a lot. As the parent of a 6-year old and a 10-month-old, I think a lot about how our family can provide experiences that help them reach their potential. As the head of the National Wildlife Federation, I am also focused on where children spend their time, and how it impacts their lives.
Here is a sobering statistic: The average American child spends five to eight hours a day in front of a digital screen, often at the expense of unstructured play in nature. The good news is departing from this trend is easier than you think, and quality outside time can fit into even the busiest of schedules. It is worth the effort; the benefits go beyond a little time spent in the fresh air.
Over the past few decades, children’s relationship with the great outdoors and nature has changed dramatically. Since the 1990s researchers have noticed a shift in how children spend their free time. The days of the free-range childhood, where kids spend hours outside playing in local parks, building forts, fording streams and climbing trees, have been mostly replaced by video games, television watching and organized activities such as sports and clubs. We have traded green time for screen time — and it has had an impact on kids’ well-being and development. Our approach to raising children has changed as well, as parents who allowed kids to play largely unsupervised from dawn to the dinner bell have yielded to “helicopter parents” who are afraid to allow their children to roam free, because of perceived safety concerns.
So if childhood has changed, why is it still important for kids to spend time in nature? Here are a few of the benefits:
Better school performance. Time spent in nature and increased fitness improve cognitive function.
More creativity. Outdoor play uses and nurtures the imagination.
Much higher levels of fitness. Kids are more active when they are outdoors.
More friends. Children who organize their own games and participate in unstructured group activities are less solitary and learn to interact with their peers.
Less depression and hyperactivity. Time in nature is soothing, improves mood and reduces stress. It can also increase kids’ attention span, because things move at a slower pace than they do on the screen.
Stronger bones. Exposure to natural light helps prevent vitamin D deficiency, making outdoorsy children less vulnerable to bone problems, cardiovascular disease, diabetes and other health issues.
Better sleep. Exposure to natural light, and lots of physical activity, help reset a child’s natural sleep rhythms.
A longer life span and healthier adult life. Active kids are more likely to grow into active adults.
And the best part, all of these benefits — especially those related to health and well-being — also apply to the adults spending more time with their children outdoors.
Kids who play more outdoors have fuller and more wholesome lives. Often, when they go outdoors they transform. I love watching my older daughter’s smile grow as her senses awake to the sight of birds and butterflies, the smell of flowers and trees and the sounds of water rushing or leaves rustling. Importantly, she gets a vital break from her intense indoor, too often digitized and highly regimented lifestyle.
Here are the NWF’s top tips for helping children and families reap the benefits of spending time outdoors.
Explore wildlife with Ranger Rick — From colorful birds to playful squirrels, wildlife holds a special fascination for children of all ages. Taking time to learn about and explore local wildlife with the children in your life is a great way to get kids engaged with the natural world and spending time outside. The National Wildlife Federation’s outdoor ambassador Ranger Rick and his friends provide countless ideas for family outdoor adventures at rangerrick.com.
Commit to a green hour — Whenever possible, set aside an hour of nature play time for kids each day. The American Academy of Pediatrics and the Centers for Disease Control agree an hour of free play and moderate activity daily is a prescription for lasting health. Increasing a child’s time in nature and the outdoors does not have to be a heavy burden for parents and caregivers; a quick stop at a local park on the way home from school, fishing in a local stream, or an impromptu picnic outside all count. More information is available at: nwf.org/greenhour.
Garden for wildlife in your backyard — Every family, whether they have a windowsill in an apartment or a yard, can take small actions that make a big impact for children and wildlife. Planting native plants and providing wildlife with food, water, shelter and places to raise their young can transform any space into a bustling wildlife destination and help kids cultivate a love of nature: nwf.org/Garden-for-Wildlife.
At a time when parenting can seem fraught with complexities, one of the best things we can do for ourselves and our children is simply opening the door and stepping outside.
Collin O’Mara is the president and CEO of the National Wildlife Federation and a father of two. Find him on Twitter @Collin_OMara.
Professor of Psychology, San Diego State University
Around 2012, something started going wrong in the lives of teens.
In just the five years between 2010 and 2015, the number of U.S. teens who felt useless and joyless – classic symptoms of depression – surged 33 percent in large national surveys. Teen suicide attempts increased 23 percent. Even more troubling, the number of 13- to 18-year-olds who committed suicide jumped 31 percent.
In a new paper published in Clinical Psychological Science, my colleagues and I found that the increases in depression, suicide attempts and suicide appeared among teens from every background – more privileged and less privileged, across all races and ethnicities and in every region of the country. All told, our analysis found that the generation of teens I call “iGen” – those born after 1995 – is much more likely to experience mental health issues than their millennial predecessors.
What happened so that so many more teens, in such a short period of time, would feel depressed, attempt suicide and commit suicide? After scouring several large surveys of teens for clues, I found that all of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.
All signs point to the screen
Because the years between 2010 to 2015 were a period of steady economic growth and falling unemployment, it’s unlikely that economic malaise was a factor. Income inequality was (and still is) an issue, but it didn’t suddenly appear in the early 2010s: This gap between the rich and poor had been widening for decades. We found that the time teens spent on homework barely budged between 2010 and 2015, effectively ruling out academic pressure as a cause.
However, according to the Pew Research Center, smartphone ownership crossed the 50 percent threshold in late 2012 – right when teen depression and suicide began to increase. By 2015, 73 percent of teens had access to a smartphone.
Not only did smartphone use and depression increase in tandem, but time spent online was linked to mental health issues across two different data sets. We found that teens who spent five or more hours a day online were 71 percent more likely than those who spent less than an hour a day to have at least one suicide risk factor (depression, thinking about suicide, making a suicide plan or attempting suicide). Overall, suicide risk factors rose significantly after two or more hours a day of time online.
Of course, it’s possible that instead of time online causing depression, depression causes more time online. But three other studies show that is unlikely (at least, when viewed through social media use).
Two followed people over time, with bothstudies finding that spending more time on social media led to unhappiness, while unhappiness did not lead to more social media use. A third randomly assigned participants to give up Facebook for a week versus continuing their usual use. Those who avoided Facebook reported feeling less depressed at the end of the week.
The argument that depression might cause people to spend more time online doesn’t also explain why depression increased so suddenly after 2012. Under that scenario, more teens became depressed for an unknown reason and then started buying smartphones, which doesn’t seem too logical.
What’s lost when we’re plugged in
Even if online time doesn’t directly harm mental health, it could still adversely affect it in indirect ways, especially if time online crowds out time for other activities.
For example, while conducting research for my book on iGen, I found that teens now spend much less time interacting with their friends in person. Interacting with people face to face is one of the deepest wellsprings of human happiness; without it, our moods start to suffer and depression often follows. Feeling socially isolated is also one of the major risk factors for suicide. We found that teens who spent more time than average online and less time than average with friends in person were the most likely to be depressed. Since 2012, that’s what has occurred en masse: Teens have spent less time on activities known to benefit mental health (in-person social interaction) and more time on activities that may harm it (time online).
Depression and suicide have many causes: Genetic predisposition, family environments, bullying and trauma can all play a role. Some teens would experience mental health problems no matter what era they lived in.
But some vulnerable teens who would otherwise not have had mental health issues may have slipped into depression due to too much screen time, not enough face-to-face social interaction, inadequate sleep or a combination of all three.
It might be argued that it’s too soon to recommend less screen time, given that the research isn’t completely definitive. However, the downside to limiting screen time – say, to two hours a day or less – is minimal. In contrast, the downside to doing nothing – given the possible consequences of depression and suicide – seems, to me, quite high.
It’s not too early to think about limiting screen time; let’s hope it’s not too late.
A man vaped during lunch time in central London.CreditTolga Akmen/Agence France-Presse — Getty Images
WASHINGTON — A national panel of public health experts concluded in a report released on Tuesday that vaping with e-cigarettes that contain nicotine can be addictive and that teenagers who use the devices may be put at higher risk of switching to traditional smoking.
Whether teenage use of e-cigarettes may lead to conventional smoking has been intensely debated in the United States and elsewhere. While the industry argues that vaping is not a steppingstone to conventional cigarettes or addiction, some antismoking advocates contend that young people become hooked on nicotine, and are enticed to cancer-causing tobacco-based cigarettes over time.
The new report by the National Academies of Sciences, Engineering and Medicine is the most comprehensive analysis of existing research on e-cigarettes. It concluded the devices are safer than traditional smoking products and that they do help smokers quit, citing conclusive proof that switching can reduce smokers’ exposure to deadly tar, numerous dangerous chemicals and other carcinogens.
But it stopped short of declaring e-cigarettes are safe, noting that there are no long-term scientific studies of the devices’ addictive potential or their effects on the heart, lungs or on reproduction.
The panel found evidence among studies it reviewed that vaping may prompt teenagers or young adults to try regular cigarettes, putting them at higher risk for addiction, but that any significant linkage between e-cigarettes and long-term smoking has not been established. It said it was unable to determine whether young people were just trying cigarettes or becoming habitual smokers.
“When it got down to answering the questions about what the impacts on health are, there is still a lot to be learned,” said David Eaton, of the University of Washington, who led the committee that reviewed existing research and issued the report. “E-cigarettes cannot be simply categorized as either beneficial or harmful.”
The report was commissioned in 2016, after the F.D.A. gained the authority to regulate tobacco products that had previously been outside its jurisdiction, such as e-cigarettes, cigars and other goods.
Mitch Zeller, head of the agency’s tobacco division, said the committee was assigned to assess the existing science, and to point out where research gaps suggest more study was needed. The report will aid the agency in its review of applications for lower-risk tobacco products and the potential harm or benefits those pose to individuals and the public.
On Wednesday, an F.D.A. advisory panel will review an application from Philip Morris International for iQOS, an electronic device that unlike e-cigarettes, contains tobacco in a stick that the company says heats it but does not burn it. It releases nicotine vapor the company says is less hazardous than smoke. If approved, it would be the first company allowed by the government to claim its product is less harmful than cigarettes.
Also this week, on Friday, the agency’s new nicotine steering committee will hold a public hearing on over-the-counter therapeutic products, among them gums, patches and lozenges, designed to help smokers quit.
Cessation was one area where the committee’s report did give the booming e-cigarette industry some good news. It pointed out the benefits for smokers of tobacco-based cigarettes who are trying to quit. and. But people who continue to smoke cigarettes, alternating with e-cigarettes, do not gain the same health benefits, the committee said. That’s especially important given that most adults who vape also still smoke or use other tobacco products.
While there is no evidence at this time that e-cigarettes or their components cause cancer, the committee recommended more long-term research. Some e-cigarettes do contain chemicals and metals whose long-term effects — including on pregnancy — also require additional research, the committee said.
Smoking rates among adults and teenagers have declined significantly over the last few decades. In 2015, the last year for which the Centers for Disease Control and Prevention has statistics, about 37 million Americans, 15 percent of adults aged 18 and older, smoked cigarettes. The number has declined from nearly 21 percent of every 100 adults in 2005; and 42 percent in 1965.
With that decline, the e-cigarette industry has emerged as a potential substitute and Big Tobacco has been among the device developers enjoying new profits from the tobacco alternatives. Bonnie Herzog, a well-known Wells Fargo tobacco analyst, predicted the industry will grow about 15 percent to $5.1 billion in retail sales in the United States, in 2018. Of that, she noted that $1.6 billion will be spent on the pre-filled cartridges sold mostly by the big tobacco companies, and $3.5 billion on open vapor systems; the liquid refill products, most of which are sold at vape shops.
The vaping industry, as well as traditional tobacco companies, are also gearing up for a lengthy fight with the F.D.A. over the campaign by the agency’s commissioner, Dr. Scott Gottlieb, to slash levels of nicotine in traditional cigarettes to nonaddictive or minimally addictive levels.
Dr. Gottlieb is expected to issue an initial proposal, calling for public comment on lower nicotine levels, in the near future.
The new report reflects the complexity of the issues surrounding e-cigarettes and the balancing act tobacco regulators face over the pros and cons of the many alternatives to conventional cigarettes. The notion of e-cigarettes as a gateway to conventional cigarettes for youths has been a sticking point.
Adam Leventhal, a professor of preventive medicine at the University of Southern California, and an author of the report, said his group did an exhaustive literature search, reviewing all studies on youths and e-cigarette use from around the world. Of those, they found 10 studies that they deemed strong enough to address the question. But these studies did not show that using e-cigarettes caused teens to move on to tobacco, only that the use of e-cigarettes was associated with later smoking of at least one traditional cigarette. The report noted that more than 11 percent of all high school students had used e-cigarettes within the past month, a total of nearly 1.7 million youths.
“The evidence was substantial that this association was consistent across a number of research methodologies, age ranges, locations, and research groups in and outside the U.S.,” Mr. Leventhal said.
More intriguing was the report’s finding of moderate evidence that youths who use e-cigarettes before trying tobacco, are more likely to become more frequent and intense smokers.
Critics have long contended that the flavored liquids for the devices are luring adolescents to the habit, at a time when nicotine is especially hazardous for their brain development. Three of the top-selling flavors at e-liquid.com, a large online retailer, include “Unicorn Milk” (strawberries and cream), “TNT” (strawberry, apple and peach) and “I Love Donuts” (blueberries and pastry).
The authors of the new report cite conclusive evidence that vaping can be addictive, and that exposure to nicotine from e-cigarettes is highly variable, depends on the characteristics of the device, as well as how it is used. They also cited conclusive proof that in addition to nicotine, most e-cigarettes also contain and emit numerous potentially toxic substances.
In terms of second hand vapor, the committee said there was conclusive evidence that e-cigarette use increases airborne concentrations of particulate matter and nicotine indoors.
The report concluded that much of the current research on e-cigarettes is lacking by scientific standards and that many important areas have not yet been studied. Dr. Eaton, in an interview, said that the authors did not distinguish between industry-funded, and independent research.
Many of the existing studies were also flawed, either in methodology or because of industry-financed bias. In addition, the levels of nicotine and other chemicals, including metals, vary in e-cigarettes from brand to brand, which has complicated some research findings.
Mr. Zeller praised the report and stressed its strong findings that youths who start on e-cigarettes are more likely to become heavier users of tobacco.
“And for kids who initiate on e-cigarettes, there’s a great chance of intensive use of cigarettes. As the regulator, we’ve got to factor all that in,” Mr. Zeller said.
In July, the F.D.A. delayed the deadline at least four years for e-cigarette companies to submit applications for currently marketed products to demonstrate that their public health benefit warrants agency approval. The agency did not delay other aspects of its tobacco control work, including requirements for mandatory age and photo-ID checks to prevent illegal sales to minors and the banning of free samples.
Public health advocates who objected to the July delay, said this report gave them further concern.
“What the report demonstrates is that despite the popularity of e-cigarettes, little is known about their overall health effects, and there is wide variability from product to product,” said Matthew L. Myers, President of Campaign for Tobacco-Free Kids. “That makes the case even stronger for F.D.A. regulation. This report makes very real the concern that e-cigarettes may well increase the use of combustive tobacco products.’’
The vaping industry was cautiously optimistic about the influence of the report. Gregory Conley, president of the American Vaping Association, a nonprofit that advocates for vapor products, said it was good news. He said the findings were consistent with those reached by the Royal College of Physicians and other institutions in Britain that have issued reports indicating e-cigarettes are less dangerous than traditional smoking and help with cessation.
“The committee’s findings also fall in line with F.D.A. Director Scott Gottlieb’s nicotine strategy, a key element of which involves adult smokers switching to lower risk products,” he said. “In the wake of this report, it is more apparent than ever that true leadership is needed in public health to ensure that adult smokers have access to truthful information about the benefits of switching to smoke-free products.”
So often when we take a closer look at a particular concern, inevitably we conclude that the biggest influencer at play is the smartphone. Whether it’s to assign blame, dispense praise or explain any range of human behaviors, so frequently this ubiquitous device finds its way into the center of the discussion.
And given the wide range of services the device can perform – web access, photography, voice communications, and more – that’s understandable.
Distracted driving? Yes. We examine the role that texting plays when we’re behind the wheel.
Teenage anxiety? Bullying? Self-worth? Yes, yes and yes. The talk becomes how social media interaction – and access to it on a tiny machine that nearly every kid in America carries everywhere – affects the psyche and human development of teenagers. The list of issues goes on and on.
In fact, this dynamic has become so prevalent that when we even suspect the smartphone as being a major source of a particular problem, we’re now almost inclined to react the opposite way. We’re starting to reject the knee-jerk reaction that the phone is always the cause of the problem, since, surely, not every problem can be traced back to the device, right?
Yet, sometimes, the smartphone may actually be responsible.
That’s the conclusion drawn by researchers at San Diego State University studying sleep-deprived American teenagers. After conducting a meta-analysis surveying more than 360,000 subjects, they concluded that decreasing sleep time comes at the expense of increasing screen time.
“Teens’ sleep began to shorten just as the majority started using smartphones,” states Jean Twenge, Professor of Psychology at SDSU. “It’s a very suspicious pattern.”
As we wrote earlier this year, the National Sleep Foundation recommends teenagers get between 8 and 10 hours of sleep nightly. Contrast that to the findings by researchers, who say that beginning in 2009 when smartphone use became widespread, there was a 17 percent increase of students reporting sleeping 7 hours or less per night, which sleep experts term as insufficient.
The research team used data from two “long-running, nationally representative, government-funded surveys,” one called Monitoring the Future, and another called the Youth Risk Behavior Surveillance System and determined that “about 40% of adolescents in 2015 slept less than 7 hours a night, which is 58% more than in 1991 and 17% more than in 2009.”
Meanwhile, those who spent 5 hours daily on their devices had a 50 percent greater chance of not getting the adequate amount of sleep that other teenagers got who were online for just an hour.
“Portable media devices are of special importance for insufficient sleep as they not only directly displace or delay sleep time by increasing arousal that interferes with sleep,” the authors wrote in their paper titled, “Decreases in self-reported sleep duration among U.S. adolescents 2009-2015 and links to new media screen time,” published in the journal Sleep Medicine, “but are also easily carried into the bedroom and used in bed before sleep while emitting light that can affect sleep-wake rhythms.”
Here’s an article about one school’s efforts to limit student stress. Stress and anxiety continue to be issues of concern for us at Sacred Heart as we have hard working and accomplished students who take their work extremely seriously. We have made much progress in this area over the years through our concentration on wellness; we’ve hired a full-time school psychologist, have instituted meditation and breathing exercises, have limited the amount of homework, have created many opportunities for the girls to receive exercise and no longer publicly share our high honor’s list in grades 5-7. Are there additional areas that you think we should be concentrating on?
Crying jags over B’s and test scores are common at Lexington High School. To lift spirits, students decorated rocks that they gave to friends.CreditGretchen Ertl for The New York Times
Small rocks from the beaches of eastern Massachusetts began appearing at Lexington High School last fall. They were painted in pastels and inscribed with pithy advice: Be happy.… Mistakes are O.K.… Don’t worry, it will be over soon. They had appeared almost by magic, boosting spirits and spreading calm at a public high school known for its sleep-deprived student body.
Crying jags over test scores are common here. Students say getting B’s can be deeply dispiriting, dashing college dreams and profoundly disappointing parents.
The rocks, it turns out, were the work of a small group of students worried about rising anxiety and depression among their peers. They had transformed a storage area into a relaxation center with comfy chairs, an orange/peach lava lamp and a coffee table brimming with donated art supplies and lots and lots of rocks — to be painted and given to favorite teachers and friends. They called it the Rock Room.
“At first it was just us,” said Gili Grunfeld, a senior who helped with the effort. “Then everyone was coming in.”
So many rocks were piling up, they had to be stored in a display case near one of the cafeterias. The maxims seemed to call out to students as they headed to their classes in conceptual physics, computer programming, astronomy and Advanced Placement Music Theory.
And they became a visual reminder of a larger, communitywide initiative: to tackle the joy-killing, suicide-inducing performance anxiety so prevalent in turbocharged suburbs like Lexington. In recent years, the problem has spiked to tragic proportions in Colorado Springs, Palo Alto, Calif., and nearby Newton, Mass., where stress has been blamed for the loss of multiple young lives. In January, a senior at Lexington High School, who had just transferred from a local private school, took her own life.
Residents in this tight-knit hamlet, with its high level of civic engagement, are hoping to stem the tide. Mary Czajkowski, the district superintendent, was hired in 2015 with the mandate of “tackling the issue head on.”
Elementary school students now learn breathing exercises and study how the brain works and how tension affects it. New rules in the high school limit homework. To decrease competition, there are no class rankings and no valedictorians and salutatorians. In town, there are regular workshops on teen anxiety and college forums designed to convince parents that their children can succeed without the Ivy Leagues. Last October, more than 300 people crammed into the town hall for a screening of “Beyond Measure,” a sequel to Vicki Abeles’s documentary on youth angst, “Race to Nowhere.”
“We want to be a model,” said Jessie Steigerwald, a longtime school board member.
But it has not been easy.
Claire Sheth, a mother of four who had invited Ms. Abeles to town, describes Lexington students as “tired to the core.” Students say depression is so prevalent that it affects friendships, turning teenagers into crisis counselors. “A lot of kids are trying to manage adult anxiety,” said the principal, Laura Lasa.
The problem is not anecdotal. In a 2015 national health survey, 95 percent of Lexington High School students reported being heavily stressed over their classes and 15 percent said they had considered killing themselves in the last year. Thinking about it most often were Asian and Asian-American students — 17 percent of them, as is the case nationally.
The town’s growing Asian community has not been timid acknowledging the problem. Through college forums and chat rooms, a group of parents and leaders of the local Chinese-American and Indian-American associations have been working to lower the competitive bar and realign parental thinking. Others are pushing back. They don’t want the workload reduced — they moved here for the high-rigor schools. At association meetings, where the tension is most pronounced, discussions about academic competition in the district have brought some to tears.
Indeed, reversing the culture is complicated in a town that prides itself on sending dozens of students to the Ivy Leagues: 10 went to Harvard last year and seven to the Massachusetts Institute of Technology. Young people are lauded at school board meetings and online for having published academic papers or performed at Lincoln Center. Last year, the varsity team placed second in the 2016 History Bowl nationals and fourth in the National Science Bowl. The robotics team has qualified for the FIRST Championship, an international technology and engineering competition, for five of the last six years.
After school recently at the public library, which was packed with students poring over textbooks, calculus work sheets, lab reports and term papers, a sophomore looked up from her world history textbook and said, “You see all these people? They want the same thing — that’s really overwhelming.” What they want: Entry into a top colleges when acceptance rates are at an all-time low.
Lexington looks and feels like a lot of other affluent suburbs: serene, stately, with a whiff of muted money. Minivans and aging Volvos are packed with violins and well-worn soccer gear. There are meticulously restored Colonials and Tudor revivals. Walk along the red brick sidewalks of Massachusetts Avenue, which cuts through the center of town, and Lexington’s Brahmin past is evident: a statue on the Battle Green of a musket-toting Captain John Parker, who led the fight against the British in 1775.
In evidence as well are signs of the burgeoning biotech industry, and the changing face of America’s elite.
Since 2000, the Asian population has ballooned from 11 percent to an estimated 22 percent of Lexington’s 32,000 or so residents, surpassing Newton (at about 13 percent) and Cambridge (15 percent). Today, more than a third of Lexington’s students are Asian or Asian-American. The demographic mirrors the migration of Asian families to suburbs across the country.
In the Crafty Yankee or the Asian bakery across the street, you are likely to bump into electrical engineers from Seoul, physicists from Beijing and biochemists from Boston. They teach at Harvard (10 miles away) and run labs at M.I.T. (11 miles). They hold top positions in the pharmaceutical companies that dot the Boston-area tech corridor. More than half of the adults in Lexington have graduate degrees. And many want their children to achieve the same.
In many ways, students in Lexington are the byproduct of the self-segregation that Enrico Moretti writes about in his book “The New Geography of Jobs,” which addresses the way well-educated, tech-minded adults cluster in brain hubs. For their children, that means ending up in schools in which everyone is super bright and hypercompetitive. It’s hard to feel special.
Best-selling authors and child psychologists have long urged parents to divest themselves from their child’s every accomplishment, thereby sending the message that mental health matters more than awards. In Lexington, the attack is more comprehensive, involving schools, neighborhoods, churches and synagogues. It is riffing off research that shows that resilience and happiness, reinforced by the entire community, can be just as contagious as stress and depression.
“You need to bring along everybody,” said Ms. Abeles, whose campaign has taken her to towns with similar communitywide efforts, including Elkins Park, Penn., San Ramon and Burbank, Calif., and New Rochelle, N.Y.
Peter Levine, associate dean for research at the Jonathan M. Tisch College of Civic Life at Tufts, says that communities that bond to promote pro-social behavior can be powerful inoculators for young people.
“Family problems are often community problems,” he said. “They need community solutions.”
No one is more aware of this than Ms. Lasa, who grew up here, earned degrees from nearby Springfield College and Lesley University, and then returned to the district — watching all the while as the population morphed from relatively laid back to Type A. She often wakes to emotional emails from parents delivered to her inbox after midnight. Most, she says, are about their children’s academic standing, and the tone is often disappointment.
Last fall, as 557 bright-eyed freshmen gathered in cushioned folding chairs in the auditorium for orientation, she gave a speech that over the last few years has come to focus more and more on stress reduction. She begged the students to make mistakes. “Do not believe that you must acquire straight A’s to be a successful student,” she said. “If you and/or your parents are caught up in society’s picture of success, let us help you change the focus.”
Students are now required to meet with counselors when choosing courses to talk about their academic loads. The practice is largely seen as a way of keeping students from overscheduling to beef up their college transcripts.
“We are trying to change a culture that is deeply rooted here,” Ms. Lasa told me in a sunny Boston accent as she barreled through the school. She was showing off the 45-minute free period she instituted this year, allowing — or in some cases, forcing — students to take time to unwind. Some were playing basketball in the gym. Others were talking with teachers. A few hung out in classrooms, chatting with friends. An awful lot, though, were getting a head start on homework.
Ms. Lasa says she is trying to “balance all the messages” they are getting about success and happiness. The one she wants to most impart is: “Slow down.”
The paradox of Lexington High School is that while indicators of anxiety abound, so too does an obsession with happiness. A large banner from the town’s newly formed suicide prevention group, a chapter of the national organization Sources of Strength, greets students as they enter the sprawling red brick building, proclaiming: “Be a Part of Happiness.” There are close to 50 students in the group. Below the banner are remnants of their project to spread positivity. Students were asked to write down their sources of strength, which were then posted beneath the banner and on Facebook. Some named their pets or friends. One wrote: “My mom.” Another: “Trip to Israel!” A girl with green hair: “Chicken curry.”
One morning in February, students in “Positive Psychology: The Pursuit of Happiness,” a popular elective, were following up on a discussion about the psychologist Barbara Fredrickson’s “broaden and build” theory, which posits that negative emotions like anxiety and fear prompt survival-oriented behaviors, while positive emotions expand awareness, spurring new ideas, creativity and eventually building skills.
“Today, we are going to look at pretty simple ways to make it more likely that you experience positive emotions on a day-to-day basis,” Matthew Gardner told his “Happiness” students as they pulled out notebooks and pencil cases. The class discussed the benefits of exercise and eating foods that release feel-good hormones. The students also learned that smiling and being smiled at releases dopamine, which has an uplifting impact.
Mr. Gardner offered an alternative to smiling: “Our brains are not so perfect that, sometimes, if you hold a pen or pencil like this” — he held a pencil between his teeth — “you activate some of the same face muscles. You might get a little bit of a dopamine effect, too.”
Several students held pencils between their teeth to test the theory.
At one point, the class practiced laughter yoga, raising their arms slowly as they breathed in, then lowering them as they breathed out, and bursting into peels of laughter. Afterward, the students recorded changes in their pulse rate to demonstrate research from the HeartMath Institute that shows heart rates slow down and smooth out after bouts of good feeling.
“It’s not just that your heart rate goes down and you become very calm,” Mr. Gardner explained. “It’s that the shape of your heart rate is smooth and more controlled. Frustration is more jagged.”
Their homework assignment: Do laughter yoga or “smile at five people you wouldn’t normally smile at.”
The effects of smiling are also taught in the A.P. Psychology class that Gili Grunfeld is taking, and it has informed her thoughts on stress. On a winter afternoon, she and several classmates were uncoiling in the Rock Room, making friendship bracelets and sketching in fat coloring books. A Post-it that read “Unplug” was taped to the wall clock. The students were bemoaning how so many of their peers develop “tunnel vision,” in Gili’s words, about schoolwork and extracurricular activities, sacrificing sleep and time with friends.
“They isolate for academics,” she said glumly.
Soon the students had changed topics, and were discussing the ice that had caked the school parking lot that morning and how to balance on it. The subtext, once again, was well-being: How much can friends support each other if both feel overwhelmed?
“Are we more likely to fall or are we more steady if we hold onto each other?” asked Jocelyn Geller, a junior.
“I feel like if you have a friend with you, you feel safer,” said Millie Landis, a sophomore, pulling Jocelyn up and wobbling on the floor with her to demonstrate. “But you could pull each other down.”
The district has increased the number of counselors and social workers, including those working in the district’s elementary schools, and expanded the training they receive in identifying and supporting at-risk students.
Cynthia Tang, whose parents emigrated from Taiwan, has been a counselor at Lexington High for 12 years. Warm and well-liked, she organizes workshops addressing the pressure on Asian students to succeed, borrowing insights from the childhood discord she experienced with her own parents as well as research on biculturalism. Studies show that the less assimilated parents are to American culture, the more stressed the children.
Adding to the pressure, she says, are cultural differences in how parents, raised abroad, and their offspring, raised in the United States, are expected to process setbacks and strife: American educators routinely encourage students to share their feelings; not so in Asia.
“I really see a lot of this being bicultural conflict,” Ms. Tang said. “When you have one side of the family holding one set of values and the other embracing a new set of values, that inherently creates a lot of misunderstanding and a lot of tension.”
Ms. Tang says that the disconnect is compounded by a lack of knowledge about the various routes to success available in the United States. Last year, she was brought in by the vice president of the local Chinese-American Association, Hua Wang, to help plan the college forum, a three-hour event on Father’s Day. Dr. Wang, an engineering professor at Boston University, wanted to shift the focus away from a guide on applying to top colleges.
Despite resistance from the organizers, he and Ms. Tang prevailed. At the forum, she presented a slide show celebrating the academic trajectories of respected Chinese-Americans: the fashion designer Vera Wang went to Sarah Lawrence College; Andrew Cherng, the founder of the fast-food chain Panda Express, went to Baker University in Kansas; the best-selling author Amy Tan, San José State University. Parents were surprised. But, Ms. Tang said, “I think a lot of parents felt like: ‘What do I do with that information?’”
This year, organizers will delve deeper into the differences between the Chinese and American systems, and are planning to add another new element: a panel discussion on combating stress. Dr. Wang said they want to showcase families who have adopted a more “holistic view” of education. Selected parents of graduating seniors will be asked to talk about how they encouraged their children to get enough sleep, comforted them when they came home with B’s and discouraged them from skipping ahead in math to be eligible for higher level classes earlier.
This would not be the only time that Dr. Wang has engaged in this kind of dialogue. Using the Mandarin words “danding,” which means to keep calm and steady, and “ruizhi,” which means wise and farsighted, he has initiated conversations on WeChat, an online chat room popular among Chinese parents. Recently, he told them: “Calmness and wisdom from the parents are the Asian child’s greatest blessings.”
But the message was not well received by everyone. Among the posted responses: “If your child gets a C, how do you get to a point of calm? You think we should be satisfied because at least he didn’t get a D?” And: “But my heart still whispers: Am I not just letting my child lose at the starting line?”
One parent, Melanie Lin, found herself, too, in a heated conversation on WeChat after early-admissions decisions arrived last school year. She urged the other parents to stop bragging on the site about acceptance letters to top-tier schools: “If it’s only those students who are attending the big-name schools that are being congratulated, then the idea being passed on is that only those students are successful, and attending a big-name school is the only way to become the pride of your parents.”
Dr. Lin, who works at a pharmaceutical company, emigrated in the 1990s from Beijing to get a Ph.D. in biochemistry from Arizona State University. She says her rebuttal annoyed even close friends, whose online responses accused her of trying to deny parents and their children their moments in the spotlight.
Recounting the conversation with me brought Dr. Lin to tears. “There is just so much pressure,” she said. For her, the struggles are not theoretical. On the home front, she too can be just as obsessed as her peers, she says.
Her daughter, Emily, would agree. During junior year, she dreaded car rides and family dinners — any time, really, that she was alone with her parents — because conversations routinely veered back to college. Now a senior, Emily has eight A.P. and 13 honors classes under her belt. She is also a violinist, choral singer, competitive swimmer and class vice president.
For a chunk of her high school career, Emily was one of those who “isolated for academics,” working into the early morning hours on homework and waking up, sometimes before dawn, after only five or so hours of sleep. She skipped birthday parties and lunch to squeeze in more studying. “I was never doing anything for pure fun,” she said. “I put my head down and I was always running somewhere with some purpose.”
But as a member of a youth board for a teen counseling center in town, she realized that her study habits were unhealthy. To get support for herself and others, she helped launch the town’s Sources of Strength chapter. She has assisted in planning student outreach events and spoke up at a town meeting about “the dog-eat-dog” competition that still persists at the high school.
Homework remains heavy, students say, particularly in high-level classes. Class rankings may be gone but students have a pretty good sense of where they stand. And while there has been talk of a later start time to the day so students can get more sleep, the idea is on hold.
In December, when early decisions came in, Emily found out she was deferred to the regular admissions pool by Yale, her top choice. Parents on WeChat were more sensitive this time around, but accepted seniors still bragged on Facebook.
Since then, Emily has been admitted to nine universities; rejected by three, including Yale; and waitllisted by Harvard and the University of Chicago. She is deciding between Columbia and Duke.
Through it all, she has wondered if it’s worth it.
“I lost out on a lot of high school,” she had told me as she waited for college decisions. What she hopes is that students who come after her find some balance before their time at Lexington is up.
Take a deep breath, expanding your belly. Pause. Exhale slowly to the count of five. Repeat four times.
Congratulations. You’ve just calmed your nervous system.
Controlled breathing, like what you just practiced, has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. Buddha advocated breath-meditation as a way to reach enlightenment.
Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.
“Breathing is massively practical,” says Belisa Vranich, a psychologist and author of the book “Breathe,” to be published in December. “It’s meditation for people who can’t meditate.”
How controlled breathing may promote healing remains a source of scientific study. One theory is that controlled breathing can change the response of the body’s autonomic nervous system, which controls unconscious processes such as heart rate and digestion as well as the body’s stress response, says Dr. Richard Brown, an associate clinical professor of psychiatry at Columbia University and co-author of “The Healing Power of the Breath.”
Consciously changing the way you breathe appears to send a signal to the brain to adjust the parasympathetic branch of the nervous system, which can slow heart rate and digestion and promote feelings of calm as well as the sympathetic system, which controls the release of stress hormones like cortisol.
Many maladies, such as anxiety and depression, are aggravated or triggered by stress. “I have seen patients transformed by adopting regular breathing practices,” says Dr. Brown, who has a private practice in Manhattan and teaches breathing workshops around the world.
When you take slow, steady breaths, your brain gets the message that all is well and activates the parasympathetic response, said Dr. Brown. When you take shallow rapid breaths or hold your breath, the sympathetic response is activated. “If you breathe correctly, your mind will calm down,” said Dr. Patricia Gerbarg, assistant clinical professor of psychiatry at New York Medical College and Dr. Brown’s co-author
Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University, recently completed a small study in which she measured the effect of daily yoga and breathing on people with diagnoses of major depressive disorder.
After 12 weeks of daily yoga and coherent breathing, the subjects’ depressive symptoms significantly decreased and their levels of gamma-aminobutyric acid, a brain chemical that has calming and anti-anxiety effects, had increased. The research was presented in May at the International Congress on Integrative Medicine and Health in Las Vegas. While the study was small and lacked a control group, Dr. Streeter and her colleagues are planning a randomized controlled trial to further test the intervention.
“The findings were exciting,” she said. “They show that a behavioral intervention can have effects of similar magnitude as an antidepressant.”
Controlled breathing may also affect the immune system. Researchers at the Medical University of South Carolina divided a group of 20 healthy adults into two groups. One group was instructed to do two sets of 10-minute breathing exercises, while the other group was told to read a text of their choice for 20 minutes. The subjects’ saliva was tested at various intervals during the exercise. The researchers found that the breathing exercise group’s saliva had significantly lower levels of three cytokines that are associated with inflammation and stress. The findings were published in the journal BMC Complementary and Alternative Medicine in August.
Here are three basic breathing exercises to try on your own.
If you have the time to learn only one technique, this is the one to try. In coherent breathing, the goal is to breathe at a rate of five breaths per minute, which generally translates into inhaling and exhaling to the count of six. If you have never practiced breathing exercises before, you may have to work up to this practice slowly, starting with inhaling and exhaling to the count of three and working your way up to six.
1. Sitting upright or lying down, place your hands on your belly.
2. Slowly breathe in, expanding your belly, to the count of five.
4. Slowly breathe out to the count of six.
5. Work your way up to practicing this pattern for 10 to 20 minutes a day.
When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.
1. Sit up straight on the floor or the edge of a chair.
2. Place your hands on your belly.
3. As you inhale, lean forward and expand your belly.
4. As you exhale, squeeze the breath out and curl forward while leaning backward; exhale until you’re completely empty of breath.
5. Repeat 20 times.
Energizing HA Breath
When the midafternoon slump hits, stand up and do some quick breathwork to wake up your mind and body.
1. Stand up tall, elbows bent, palms facing up.
2. As you inhale, draw your elbows back behind you, palms continuing to face up.
3. Then exhale quickly, thrusting your palms forward and turning them downward, while saying “Ha” out loud.