Medication nonadherence—when patients don’t take their medications as prescribed—is unfortunately fairly common, especially among patients with chronic disease. When this is the case, it is important for physicians and other health professionals to understand why patients don’t take their medications. This will help teams identify and improve patients’ adherence to their medications.
A path to lasting lifestyle change
Give your patients the advice they need to set and achieve sustainable health goals. Explore AMA’s resources to help patients create healthy habits.
If you don’t have a true picture of a patient’s medication-taking behavior, you may needlessly escalate their treatment, resulting in potential harm to the patient, unnecessary work for the practice and increased costs overall.
Most nonadherence is intentional with patients making a rational decision not to take their medicine based on their knowledge, experience and beliefs. These are the top eight reasons for intentional nonadherence.
Patients may be frightened of potential side effects. They may have also experienced previous side effects with the same or similar medicine. Additionally, patients report not taking their medication because they may have witnessed side effects experienced by a friend or family member who was taking the same or similar medication. From seeing those side effects experienced by someone else, it may have led them to believe the medication caused those problems.
A major barrier to adherence is often the cost of the medicine prescribed to the patient. The high cost may lead to patients not filling their medications in the first place. They may even ration what they do fill in order to extend their supply.
To overcome this, check that the drug you’re prescribing is on the patient’s insurance formulary. Selecting and prescribing a medication known to be on a discount list can decrease the cost regardless of insurance.
Nonadherence can also happen when a patient does not understand the need for the medicine, the nature of side effects or the time it takes to see results. This is especially true for patients with chronic illness—taking a medication every day to reduce the risk of something bad happening can be confusing.
When a patient has several different medicines prescribed with higher dosing frequency, the chances that they are nonadherent increase. Physicians can try to simplify a patient’s dosing schedule by adjusting medicines so they can be taken at the same time of day. Choosing long-acting drugs can also help if the dosing burden is too complex. Additionally, if possible, consolidate medicines by using combination products.
As stated above, nonadherence might occur when there is a lack of symptoms. Patients who don’t feel any different when they start or stop their medicine might see no reason to take it. Additionally, once a patient’s condition is controlled, they may think the problem has resolved and may discontinue using the medication. It is important to inform your patient that they may need to take the medicine for a long time.
There has been news coverage of marketing efforts by pharmaceutical companies influencing physician prescribing patterns. This ongoing mistrust can cause patients to be suspicious of their doctor’s motives for prescribing certain medications.
If a patient is concerned about becoming dependent on a medicine, it can also lead to nonadherence. One way to overcome this is to improve patient-physician communication. Inadequate communication can account for 55% of medication nonadherence, making it important to understand the patient’s rationale for nonadherence, according to an AMA STEPS Forward™ module on medication adherence.
Patients who are depressed are less likely to take their medications as prescribed. Physicians and other health professionals may be able to uncover this by sharing issues and asking if the patient can relate to it. To reduce embarrassment, express that many patients experience similar challenges.
Learn more through the AMA’s STEPS Forward open-access modules which offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
The CME module, “Medication Adherence,” is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit.
This module is part of the AMA Ed Hub, an online platform with top-quality CME and education that supports the professional development needs of physicians and other health professionals. With topics relevant to you, it also offers an easy, streamlined way to find, take, track and report educational activities.
Holding on to negative events increases your stress level and generally lowers your enjoyment of life. It results in feeling resentful, angry, and upset. It’s important that you learn to adapt, correct your errors, and grow from negative events. A key component to being able to do this is to be able to forgive yourself for any mistakes or wrongdoings you may have done.
What is Self-Forgiveness Vs. Self-Compassion?
It is easy to mistake self-forgiveness with self-compassion. Self-compassion is different but similar to self-forgiveness. The three hallmarks of self-compassion are:
Kindness to yourself. Life is not perfect, so why would people be? When the going gets tough and things do not go to plan, people who practice self-compassion remember this. They acknowledge the inevitability of imperfection and are caring and loving to themselves.
Shared humanity. Everyone experiences setbacks in life. Everyone will feel difficult emotions or have to problem solve as unexpected situations arise. Giving yourself compassion means not thinking that you are the only person in the world who experiences these things.
Clarity and mindfulness. Having negative emotions can make people feel uncomfortable. Commonly, they will either exaggerate or downplay these emotions. Being able to clearly sit with these emotions and see them for what they are is a sign of self-compassion.
Self-compassion is different than self-forgiveness in that self-forgiveness is a way of reconciling the way you see yourself after you experience guilt, shame, and disappointment. These feelings happen when you do something that makes you question the image you have of yourself. Therefore, it is a facet of self-compassion.
Strategies for Self-Forgiveness
You may at times do something that challenges your own self-perception. And it can be hard to reconcile with yourself when you do something that negatively affects you or others. Here are some tips for how to internally practice self-forgiveness:
Think back. Think back to a time in your life when you felt safe and cared about someone. Remember who that is — it could be a friend, relative, teacher, mentor, spiritual figure, or a pet. Visualize the feeling of being around them and being protected. Let yourself feel safe. Then, together with your protector, list all of your positive qualities.
Remember the event. Next, acknowledge the facts surrounding what you need to forgive yourself for. Remember back to the specific event and how it made you feel. Notice what is hard to face. Make a list of what happened and sort it all into three different categories: moral faults, unskillfulness, and everything else. Moral faults call for guilt or remorse, and unskillfulness requires correction like committing to never doing a certain act again.
Don’t avoid guilt. Not feeling great about doing something bad is healthy and natural. If we wipe away the bad feelings of doing bad, what are we left with? However, there is a difference between shame and guilt. Shame comes with defensive feelings like denial, avoidance, and violence. It is not helpful to tell yourself that you are a bad person at your core and feel guilty. By doing so, you may not think that you can change. Feeling guilt over your actions, however, can help you not repeat them.
Take responsibility. You cannot forgive yourself if you don’t own up to what you did both to yourself and to the person you have wronged. Let them know that you take accountability for what you did and let yourself know this too. Learn to fully accept that you did whatever you did.
Try to repair the damage. It may be hard for you to truly forgive yourself if you feel you haven’t done what you need to do to make amends. Perhaps this means offering financial aid, repairing the property, or simply saying sorry to someone.
Have empathy for more than yourself. It has been found that people have trouble with self-forgiveness when they also have empathy with the other party involved. It’s normal for people to struggle with this tension. However, without having empathy for both yourself and the other person, this self-forgiveness can be empty and not mean much.
These tips are difficult to incorporate, but so is having true self-forgiveness. It will most likely be a long journey that will have valleys and peaks. You may never fully release the negative feelings you have. Self-forgiveness doesn’t need to be a self-indulgent thing but rather a clear appraisal of your capacity for doing bad and good.
I had the privilege of interviewing Mr.Acey back in 2013 and It was an honor back then especially not knowing how long of a list of achievementshe really had. I received the most heat for NOT asking him about his awards but I felt like if you knew of him then you know of his awards and if you didn’t… GOGGLE! But since I didn’t back then let me fix my mistake and update those that didn’t or does not know of him.
Mr. Acey is an international spoken word artist who has received accolades from Amiri Baraka, Stevie Wonder, Berry Gordy, and Essence Magazine Editor Emeritus – Susan Taylor. His poetry has been featured in film and television.
Acey has won spoken word awards in the US, the UK and Germany, and his work has been associated with Sundance Film Festival prizes.Taalam was honored to be a guest of Congresswoman Maxine Waters for the Congressional Black Caucus’ 2007 & 2008 “Young Gifted and Black” panels. He has recited work and given workshops in several countries such as Mexico, Germany, Jamaica, Holland, Austria and approximately one hundred schools of higher education; including the esteemed Graduate School of Education at UC Berkeley, where he delivered a lecture on contemporary Spoken Word.
Taalam Acey has recorded seventeen CDs and authored seven books. Additionally, films that include his work have garnered an Audience Award (2002) and a Special Jury Prize (2006) at the Sundance Film Festival. He was featured in an acclaimed Radio-One London slam poetry documentary and Marc Smith, the founder of slam poetry, used Acey’s work in his definitive book. Taalam was selected as a special guest opening act for R&B legend Thelma Houston and luminaries for which Acey has had an audience with and received accolades from include Max Roach, June Jordan and Berry Gordy. Taalam currently resides in the Atlanta suburbs. You can see Taalam Acey as he travels doing shows across the states. Please check his website to find an event close to you. You won’t be disappointed.
You look at the clock and it’s 11:11. You think of a friend and they call. You’re considering changing jobs and just like that, the perfect one is posted. These are all signs your intuition is on point — and you should consider listening to it.
Intuition is often described as a gut feeling — when you feel like you just know something — which can seem a bit nebulous. So if you want a better way to understand it, start by considering it as a culmination of all the experiences, relationships, and interactions you’ve had thus far in life, says certified business and life coach Dr. Sonja Stribling. “Intuition is based on your own personal awareness of a particular situation,” she tells Bustle. It’s why you might feel pulled in a certain direction.
There is, however, often something more magical going on. According to certified life coach Terri Kozlowski, intuition is also an unconscious awareness or wisdom that can’t always be explained, which is why you might “know” something even if you haven’t lived it before. “The gut instinct is the physical response your body has to something, which can be positive or negative,” she tells Bustle. “It’s trying to tell you to notice something that isn’t on the physical level.”
However you define it, you can get better at trusting your gut. Stribling suggests taking time to check in with yourself on a regular basis, just to gauge how you feel. You can also practice listening to your inner voice as you make decisions. “The more you act on your insights, the more you build your intuition and courage muscle,” says certified breathwork coach and hypnotherapist Francesca Sipma. The more often you listen to the signs listed below, the clearer your intuition will be.
You’re Somehow Always Right
You Have Vivid Dreams
If you have a big decision to make or are processing a worry or concern, don’t be surprised if you start having weirdly vivid dreams. This is your subconscious testing out different solutions to help you land on the best possible outcome.
“Once you make your decision and stand firm in it based on your initial thoughts, you will find that you are able to sleep with a clear mind and heart,” Stribling says. “Pay attention to your dreams — they are trying to speak to you.”
You Have Nagging Thoughts
Take note if your mind keeps replaying the same situation over and over again or if you can’t seem to shake a concern. “Nagging thoughts or feelings that you can’t get rid of are signs that your gut is trying to speak to you,” Stribling says. “They show that there is something that may require deeper thought.”
It could be related to any area of your life, whether it’s work, relationships, family, moving to a new city, or starting a new job. If you can’t stop thinking about it, allow yourself space to stop and reflect. “Give yourself time to internalize what you’re trying to figure out,” says Stribling. You just might be able to “hear” the right answer.
You Often Stare Into Space
Do you find yourself daydreaming a lot? “Deep thought can also be a sign that you are highly in touch with your intuition,” Stribling says. “The more you think and analyze, the more you are able to tap into deeper subconscious thought, allowing you to pick every aspect of your decision-making that others may not think of.”
You Pick Up On Everyone’s Energy
If you notice that someone’s energy feels off or you don’t trust their intentions, listen to that gut reaction. According to life coach Lauren Paton, this is a common trait among people with strong intuition.
“You’re able to very quickly assess if someone has the right energy,” she tells Bustle. “If you can make quick assessments both good and bad based on what you feel from someone — and they turn out to be right — that’s your intuition calling.”
You Seem To Know Things Before They Happen
Sometimes your intuition can make you feel almost like a psychic. “Ever feel like you know what someone is going to say, or that you just intrinsically know what a problem is before anyone else gets there?” Paton asks. “This is the beautiful combination of your experiences, your understanding of people, and your openness to noticing what might be going on.” The next time you pick up on the feeling, go with it and see what happens.
You Experience Synchronicities
Do you notice weird coincidences or patterns, especially when you’re wondering what to do next in life? “Something as simple as trying to determine what habits to implement for better health and [suddenly] seeing several articles and news stories about plant-based diets can be a clue to the direction you are to go,” says Kozlowski.
You can also use these synchronicities to confirm you’re on the right path after you make a decision. “When you experience synchronicities, it shows that you are following your internal guidance system,” intuition expert Micara Link tells Bustle. “Synchronicities are the proof that you’re on the right track and that you’re in alignment with your highest good.”
The Clock Is Always At 11:11
Consider how it feels when you look at the clock and notice it’s 11:11 or 4:44 — or whatever other number feels important — as it can be very reaffirming. “When you catch the clock at a certain time, and you feel that perhaps a message is attached […] then that ‘knowing’ is something inside yourself that you intuitively understand,” Jill Sylvester, LMHC, a licensed mental health counselor and wellness coach, tells Bustle.
Your Body Is Relaxed
When your intuition is guiding you in the right direction, you’ll notice that your body seems to relax, particularly around your chest and stomach. You’ll go from a tight or sinking feeling, Kozlowski says, to one that feels warm and peaceful. “This is a positive physical sign from your intuitive self,” she explains.
You Feel Purposeful
You’ll also notice that you feel purposeful, whether you’re marching out the door to a job interview, date, vacation, etc. — you won’t catch yourself wavering or second-guessing. “Your intuition is the voice of your most authentic self — when you listen to this voice and follow its guidance, you automatically align with the deeper meaning of your life: your purpose,” Link says. Think of the saying, “When you know you know.”
You Find The Good In People
If you’re a highly intuitive person, don’t be surprised if it feels like you get along with everyone and anyone. “Intuitive people are sensitive to other people’s feelings and tend to read between the lines,” holistic wellness coach Daisy Mack tells Bustle. “They really tap into soul connections, seeing past the facades to what really matters to the other person and consequently striking up bonds and breaking down barriers.”
Remember, though, that your intuition can also hint when something’s off. As Sylvester says, “Your intuition is strong when you might experience a negative or positive emotion in the presence of someone or something that may not be healthy for you.” This little voice can truly save you from getting mixed up with the wrong people, so listen to it.
Answers Feel Like Lightbulbs
According to licensed therapist Amanda Stemen, MS, LCSW, your intuition can feel like a lightbulb going off in a way that brings instant peace. “It lightens the load and you feel yourself exhale,” she tells Bustle. “You sit in the awareness for a moment, smiling at the clarity is just paved. Suddenly any other answer seems ridiculous.”
You’re Always At The Right Place At The Right Time
Your intuition is on point if it seems like you’re constantly in the right place at the right time, to the point where it feels like you’re in sync with the universe. “What’s actually happening is you’re following that inner voice before the conscious mind can get in there and stir up any doubt,” Mack says.
It also proves you’re following your heart rather than your head. “This can be a frustrating trait to logical friends as there seems to be no obvious reason for your decisions,” Mack says, “but it’s important for an intuitive person to follow their ‘gut.’”
You’re In Tune With Your Body
You may also have an easier time listening to your body. “A sign of a deep connection with your intuition is how acutely aware you are of what’s happening in your body,” confidence coach Lisa Philyaw, MS, tells Bustle. You know when you’re reaching the point of burnout and take time to recharge, you zero in on the signs you’re about to get sick and lay low. Whatever it is, it’s good that you listen to these cues.
You Think Of Someone & They Text You
How funny is it when you think of someone and then they text out of the blue, or you randomly see them at a coffee shop? “This suggests that your intuition sensed that these events were about to happen,” licensed psychotherapist Joyce Marter, LCPC tells Bustle. So why not see what the reason might be? Text them back, say hi, and ask what they’ve been up to. Who knows? You might end up coming back into each other’s lives for a really cool reason.
You Have Reservations When Nobody Else Does
Try to listen to your sneaking suspicion that something is off or wrong. For example: “In business dealings or perhaps when making a financial investment, if you have reservations, even though the deal sounds great, this may be your intuition advising you that the opportunity is too good to be true,” Marter says. It may often feel like you’re the odd man out — the one saying, “Hey, wait a second…” — but that’s a good thing!
You’ve Always Been Safe
The one thing you should probably never doubt is the gut feeling that you aren’t safe. Think about all the times you walk around at night, go into parking garages, or travel alone. Does your gut steer you away from shadowy corners? Does your inner voice scream out to turn around?
“If you notice the goosebumps you get or the hairs on the back of your neck when something is off or you feel scared, this is a good indicator that you have good intuition,” Erin Dierickx, LMFT, a licensed marriage and family therapist associate, tells Bustle. “When you are able to sense your body and what you are experiencing in a situation, this means you can gauge if a situation is safe or not. This is helpful not only for reading the room but also for maintaining your safety.”
Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Frontiers in psychiatry, 9, 44. https://doi.org/10.3389/fpsyt.2018.00044
Spending time alone doesn’t have to mean you’re lonely. Alone time can be an opportunity to get to know yourself better, improve your mental health, and do things you enjoy.
“Humans are social beings, hardwired to be connected to others. At the same time, it’s important to learn how to tolerate and even appreciate alone time in extended periods,” says Heather Z. Lyons, PhD, a psychologist, and owner of Baltimore Therapy Group in Baltimore, Maryland.
Whether it’s voluntary or necessary, here are 10 ways to be happier alone:
1. Develop a relationship with yourself
Being alone gives you the chance to nurture your relationship with yourself. However, it’s not always easy to do this.
“Alone time might be difficult for people for different reasons,” says Lyons. “Use the discomfort as an opportunity to learn about yourself. Reflect on what comes up for you when you are alone,”
For example, you can do this by thinking or journaling about your values, likes, dislikes, and current emotions.
In a large 2020 study conducted in the United Kingdom, participants completed a survey every two years about their overall mental well-being and volunteering habits from 1996 to 2014. Those who volunteered at least once a month reported better mental health than those who volunteered infrequently or never.
You can also do this without leaving home. “You can volunteer to tutor students via video, or donate to a food bank,” says Tina B. Tessina, PhD, LMFT, a psychotherapist in Long Beach, California.
3. Learn something new
Take the initiative to absorb and learn new information or practice a skill while alone. “This might include engaging in activities that require executive functioning skills like focus such as reading or creating,” says Lyons.
“Consider doing something different than usual: this is a great time to try something new or take a class via video,” says Tessina.
Being active can go a long way towards happiness. “Partaking in a daily, mindful walk, or engaging in some form of physical activity could alleviate anxiety,” says Leela R. Magavi, MD, a psychiatrist and regional medical director at Community Psychiatry in Newport Beach, California.
In a large 2018 study, researchers found that people who worked out regularly experienced 43.2% fewer days of poor mental health in the previous month than those who were inactive.
5. Spend time in nature
A large 2019 study found people who spent at least two hours in nature over a week were much more likely to report greater well-being and health than those who spent no time outside.
Whether the time spent outside was in small increments or big chunks did not affect the results, and benefits peaked at 200 to 300 minutes a week outdoors. Go on a long walk, read in a park, or just sit outside.
6. Practice gratitude
It’s all too easy to get caught up focusing on what you don’t have.
“I recommend my patients to list things they are thankful for physically, emotionally, and spiritually every morning and evening, especially when lonely during the holidays,” says Magavi. “Furthermore, creating gratitude lists and reading these out loud in front of the mirror could help target multiple sensory centers in the brain to maximize the benefits of this activity.”
7. Take a break from social media
While social media may seem like a chance to connect with others, it can actually cause stronger feelings of loneliness.
A large 2019 study of students aged 18 to 30 years old found an association between social media use and a sense of isolation. For every 10% increase in negative experiences on social media, users reported a 13% average increase in feelings of isolation.
8. Take yourself on a date
While doing something you like may seem obvious, you rarely have the opportunity to do precisely what you want.
“Most people have never had a sustained period of time to think only about their preferences. Create space during your alone time to ask yourself, ‘What do I really want to be doing?,'” says Jeni Woodfin, LMFT, a therapist at J. Woodfin Counseling in San Jose, California.
Take yourself to see a movie or peruse a new museum exhibit. Or, if you want to stay in, cook yourself your favorite meal.
Meditating not only improves mindfulness, but a 2010 review found the practice can increase the amount of gray matter in the brain. This part of the brain is responsible for perspective-taking and emotional regulation.
While the idea of meditating may sound intimidating, the actual practice is accessible to anyone. You can try meditating solo or with the help of apps or Youtube videos.
10. Foster or adopt a pet
Yes, technically, this would give you a companion, but a pet can’t talk back, so it counts.
“Having an animal at home with you creates a relationship that can bring joy, laughter, and unexpected challenges that will keep you on your toes,” says Woodfin. “Animals give us a reason to get out of bed. If you’re struggling to find the motivation to keep moving, having a pet that needs to go for a walk is a win-win situation.”
When to see a professional
Over time, if feelings of anxiety and depression persist or develop, professional care may be necessary. According to Woodfin, a few signs you may need to seek professional help include:
Disregarding your appearance or not changing your clothes for multiple days
Consistently declining invites to engage with others
Regularly spending all day in bed or on the couch
Overindulging in alcohol, marijuana, or other drugs as a way to numb or stimulate yourself
“The warning signs of increased isolation, increased drug and/or alcohol use, and a decrease in the care and keeping of your body are serious enough that a call to a mental health professional would be helpful,” says Woodfin
Spending time alone doesn’t have to be a lonely experience. Instead, it can be a time of happiness. Engaging in activities such as nature walks, journaling, and meditation can help you enjoy your time and better understand yourself.
However, if you think you may be experiencing anxiety or depression, it’s always best to seek help from a mental health professional.
Sarah Fielding is a freelance writer covering a range of topics with a focus on mental health and women’s issues. She is also the co-founder of Empire Coven, a space for highlighting trailblazing women across New York.
Respect means that you recognize that your partner is a whole person, and not just a way to get something that you want. It means that you know your partner has different experiences and opinions from you, and that’s ok.
It’s easy to say that you have respect for someone, but acting with respect can be a bit trickier. That’s why this Teen Dating Violence Awareness Month, I want to talk about how you can show respect in your relationship. After all, just because you don’t physically harm your partner or call them names, does NOT mean that you are treating your partner with respect.
Here are six ways that you can show your partner respect. What would you add?
1. Demonstrate trust.
Trust is essential in any relationship, even non-romantic ones. But it means a lot more than believing that your partner won’t cheat on you, and feeling trust isn’t nearly as powerful as showing that you trust your partner with your actions.
You can demonstrate trust by not texting or calling your partner constantly. Instead, text or call them once. Leave a message saying that you’re thinking of them, and that you hope to hear from them soon. This shows that you trust them to reach out to you when they can, and that you know your partner appreciates your efforts.
This should go without saying, but don’t go through your partner’s phone or personal things without permission. If you have a weird feeling that they’re trying to hide something from you, talk to them about it. There’s no need to stir up drama if there’s nothing going on!
2. Be mindful of how you communicate.
Communication is one of the most important parts of a relationship, and one of the hardest. That’s because being open and honest with your partner means being open and honest with yourself.
Don’t expect your partner to be a mind reader. If you’re upset, it’s important to talk openly about what’s bothering you. Don’t be accusatory. Use “I” statements, like “I feel really ignored and unimportant when you cancel our plans at the last minute,” or “I feel annoyed when you keep asking me to hang out when you know I need to study. I really appreciate it when others respect my time.” Your emotions are always valid—don’t feel bad for feeling what you feel.
Everyone disagrees sometimes, and that’s totally ok. When you do, don’t disappear or shut down communication. At a minimum, tell your partner that you’re upset and need some time to cool down and process your thoughts before you talk. This way they don’t feel like you’re disappearing on them, or ignoring their feelings. Validate your partner’s feelings by saying things like, “I understand why you feel that way,” or “I hear what you’re saying.”
Communication goes beyond words, though. You can tell your partner that you care by wearing the cologne they like, sharing a playlist with them, or bringing them flowers.
3. Be reliable and accountable.
A huge part of a relationship is trust, but how can you trust someone if they’re constantly canceling plans or, even worse, lying?
When you make plans, follow through. Don’t say yes to a dinner you’re not sure you’ll be able to go to. Instead, be accountable. Keep a calendar and check it when you and your partner are making plans. Don’t say you’ll call and then don’t. Instead, set a reminder on your phone. Being dependable respects your partner’s time and emotional energy. After all, it can be stressful to have your plans change constantly.
Of course there will be times when you have no choice but to cancel—there’s a family emergency, you’re sick, you forgot about a big test that you have to study for. You shouldn’t feel guilty (or be made to feel guilty!) about these circumstances. But it can help a lot if you show you’re aware of the effect that those actions (whether they’re within your control or not) have on your partner. Apologize, offer to reschedule, and make sure you check in with them when you’re free.
4. Encourage time apart.
When you’re in a new relationship, you may be so excited that you want to spend all your time with your partner. That’s totally normal. But it can be easy to ignore the other important relationships in your life, like with your family and friends. No single person—no matter how awesome they are—can take care of all your social and emotional needs. And everyone needs a break from their significant other every once in a while. Spending time alone or with other people means that both of you can continue to grow as individuals. You can both bring new ideas and activities to your relationship, keeping it exciting and engaging. It also gives you both a chance to talk about your relationship with your friends and family. Who doesn’t want to brag a bit about their new love?
5. Appreciate your differences.
Don’t criticize your partner for their ideas or interests. You can disagree with someone and still respect their opinion. Part of what makes relationships awesome is the differences! Your partner can help you see the world from a new perspective, even if you don’t ultimately change your mind. You can show your partner you appreciate them by going to their baseball game or art show, even if you would never set foot in a baseball stadium or art gallery otherwise.
Accept your partner’s boundaries, even when they’re different from yours. If your partner doesn’t want to kiss in public, or have sex, or lie to their parents, don’t pressure them. This is coercive, and potentially abusive.
6. Get to know yourself.
In a relationship, you’re not just getting to know another person. You’re getting to know yourself better. Being in a relationship can help you figure out what you want and need from the people you’re close with. What are you willing to compromise on? Which qualities complement your own? What are your core values that you can’t compromise on? Maybe you don’t care that your partner isn’t into R&B music the way you are, but you can’t stand that they’re mean to your cat. Get to know yourself as an individual and as a partner. Knowing yourself helps you communicate better, and your partner will definitely appreciate that.
Knowing your personal boundaries makes it a lot easier to know when those boundaries have been crossed, and when you should end a relationship.
Showing respect may sound complicated, but it’s really not.
It all comes down to listening to your partner, and being kind to them. If your partner wants to know where you are all the time, frequently accuses you of lying or cheating, puts you down, calls you names, or is in any way physically aggressive, you may be in an abusive relationship. Abusive relationships are based on power and control, rather than respect. They take a serious toll on millions of people’s lives each year, and one in three teenagers in the United States has experienced dating abuse. Consider seeing a therapist. They can help you work through what’s going on, and figure out the next steps that are best for you.
Tiffanie Brown, LCSWis a clinical social worker at Mount Sinai Adolescent Health Center. She has been working with marginalized and underserved adolescents for 6 years. Ms. Brown has received intensive training in Dialectical Behavior Therapy (DBT) and specializes in work with individuals who are emotionally dysregulated and engage in self-harm and high risk behaviors. Ms. Brown provides ongoing individual, group, and family therapy to the adolescent population, using a combination of cognitive behavioral therapy and psychodynamic approach.
The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 12,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.
A version of this post was originally published in February, 2017.
This recipe has the sauce mixed right in with the beef so, there is really no specific process for making it separate. However, if you want to make the sauce and store separately, you can.
Simply saute down the onions and garlic, then mix in all ingredients except the ground meat. Stir over medium heat for 3-4 minutes and then set aside to cool and pour into a jar to store. This recipe for the sauce is good for 4-5 days in the refrigerator.
How to Make Sloppy Joes from Scratch
Heat the oil in a large skillet and cook the ground beef until no longer pink, then remove, drain, and set aside.
Into the same skillet, add in the onion and cook for 2-3 minutes or until they are softened.
Stir in the garlic and continue cooking for another minute.
Pour in the ground beef and stir then add in the tomato paste. Mix this together well.
Now, add in the ketchup.
Add the brown sugar, mustard, paprika, Worcestershire sauce, salt, and black pepper.
Stir this together until mixed well.
Add in the water, and cook down for another 2-3 minutes.
Chicken Fried Rice
2 tablespoon + 1 teaspoon sesame oil
1 pound ground chicken
1 teaspoon salt
4 cups cooked rice
1 teaspoon black pepper
½ teaspoon ginger
2 tablespoons minced garlic
2 cups frozen peas and carrots
⅓ cup soy sauce
How to Make Chicken Fried Rice
In a large skillet or wok, heat the 1 tablespoon sesame oil over medium heat.
To the skillet, add the ground chicken, salt, black pepper, and ground ginger. Cook, 4 to 5 minutes, stirring regularly until the chicken is cooked through. Remove the chicken and set it aside.
To the skillet, add an additional 1 teaspoon sesame oil, then add the frozen peas and carrots along with the minced garlic and stir, continuously for 2 minutes.
Move the vegetables to the side of the pan, then add another tablespoon of sesame oil and the eggs to the skillet.
Cook the eggs, stirring regularly until scrambled.
Stir the vegetables and eggs together, then add the chicken back to the skillet and stir to combine.
Add in the rice and soy sauce and stir well.
Reduce the heat to low, and cook, stirring regularly, for an additional 2 to 3 minutes until the rice is heated through.
Taste and add additional salt and black pepper if needed before serving
What does it mean to you to “fail better?” Better than someone else? Fail/fare a little better each time you try? Maybe it means to fail spectacularly! Go big or go home! Or how about failing but getting better along the way—getting better through failure—and learning something from the experience? I believe that is the key: to allow failure to be a springboard from which we succeed and grow.
How we handle failure is more important than how we handle success. We are all going to experience failure at some point in our lives, and our attitude about that failure is what determines whether we bounce back or fall hard.
1. Decide you want to bounce back. The power of intention is amazing, and the simple, conscious decision or desire to bounce back will make it far easier for you to do so. When you decide you want to do something and spend a little time visualizing, parts of your subconscious, intuition and conscious mind all start working together towards that goal—it’s the power of positive thinking at work. Even if you have no idea how you will do it, why not start by telling yourself that you’d like to bounce back from this failure? How you speak to yourself is so important.
2. When you fail at something, it isn’t about you. Well, in a way it is, but it isn’t about your core personality, humanity or your soul. It’s much harder to bounce back when you take failure to heart too much and make it about your value as a person. Your importance to those who love you does not change when you fail; your potential to make a difference in the lives of those around you does not change. If anything, your potential increases with every failure experience you have, since the most painful events in life often give us the most valuable experiences and dramatic growth. Experiencing failure makes us more compassionate, and that also increases our capacity to make a difference in the world.
How can you make sure you don’t take failure too personally? Remind yourself—literally, tell yourself—that deep down, you are still you. The failure was just a thing that happened, like a hundred other things that have happened to you. Maybe you did some things that didn’t work out, but if you compared notes with every ridiculously successful person out there, you’d find they all have similar stories to tell. Since you survived, you can still thrive!
3. Still breathing? Keep at it. Often when we are rushed or stressed, or have been through a trauma, we breathe shallowly and unevenly, which hampers our thinking and increases our anxiety. Stop from time to time and check your body to see how deeply you are breathing, and take a deep breath to reduce your stress levels and reset your brain waves. Some practices like yoga focus on breathing, but even without the exercise element, simply taking deeper, conscious breaths will improve your clarity and help you to learn important lessons from the failure.
4. Reframe and start from where you are. In the autumn of 1972, an unusually early frost hit the vineyards of Peachland, British Columbia, Canada. It was devastating: grapes still clinging to their vines froze into little globes of ice. The year’s grape harvest would have been a complete failure, except that the vineyard’s owner, Walter Hainle, decided to make wine anyway. He knew of a tradition in Germany of making sweet dessert wines from frozen grapes, and although he originally planned on keeping the wine for personal use, he decided to sell it six years later. The wine was one-of-a-kind, which means it commanded a premium price. Thus, a lucrative, ridiculously successful new wine market was born— ice wine. It worked with the Canadian climate rather than against it, and it would have never been discovered if it hadn’t been for what seemed like a failure at the time.
The ability to reframe a life event is directly related to our ability to bounce back. Practice on small, easy things, and decide that you won’t:
Instead, try to see the situation from another perspective—the essence of reframing—and see what you might be able to learn from it all.
So, when you fail, begin from exactly where you are, look for opportunities, take a deep breath and get back in the game, knowing that you are learning valuable lessons along the way, having great new experiences and living life to the fullest! Vive la failure!
Timothy Ferriss, author of The 4-Hour Workweek said this about achieving success in life:
If you are suffering from insomnia, there are many steps you can take to change behaviors and lifestyle to help you get to sleep. Here are some tips for beating insomnia.
Wake up at the same time each day. It is tempting to sleep late on weekends, especially if you have had poor sleep during the week. However, if you suffer from insomnia you should get up at the same time every day in order to train your body to wake at a consistent time.
Eliminate alcohol and stimulants like nicotine and caffeine. The effects of caffeine can last for several hours, perhaps up to 24 hours, so the chances of it affecting sleep are significant. Caffeine may not only cause difficulty initiating sleep, but may also cause frequent awakenings. Alcohol may have a sedative effect for the first few hours following consumption, but it can then lead to frequent arousals and a non-restful night’s sleep. If you are on medications that act as stimulants, such as decongestants or asthma inhalers, ask your doctor when they should best be taken to help minimize any effect on sleep.
Limit naps. While napping seems like a proper way to catch up on missed sleep, it is not always so. It is important to establish and maintain a regular sleep pattern and train oneself to associate sleep with cues like darkness and a consistent bedtime. Napping can affect the quality of nighttime sleep.
Exercise regularly. Regular exercise can improve sleep quality and duration. However, exercising immediately before bedtime can have a stimulant effect on the body and should be avoided. Try to finish exercising at least three hours before you plan to retire for the night.
Limit activities in bed. The bed is for sleeping and having sex and that’s it. If you suffer from insomnia, do not balance the checkbook, study, or make phone calls, for example, while in bed or even in the bedroom, and avoid watching television or listening to the radio. All these activities can increase alertness and make it difficult to fall asleep.
Do not eat or drink right before going to bed. Eating a late dinner or snacking before going to bed can activate the digestive system and keep you up. If you suffer from gastroesophageal reflux (GERD) or heartburn, it is even more important to avoid eating and drinking right before bed since this can make your symptoms worse. In addition, drinking a lot of fluids prior to bed can overwhelm the bladder, requiring frequent visits to the bathroom that disturb your sleep.
Make your sleeping environment comfortable. Temperature, lighting, and noise should be controlled to make the bedroom conducive to falling (and staying) asleep. Your bed should feel comfortable and if you have a pet that sleeps in the room with you, consider having the pet sleep somewhere else if it tends to make noise in the night.
Get all your worrying over with before you go to bed. If you find you lay in bed thinking about tomorrow, consider setting aside a period of time — perhaps after dinner — to review the day and to make plans for the next day. The goal is to avoid doing these things while trying to fall asleep. It is also useful to make a list of, say, work-related tasks for the next day before leaving work. That, at least, eliminates one set of concerns.
Reduce stress. There are a number of relaxation therapies and stress reduction methods you may want to try to relax the mind and the body before going to bed. Examples include progressive muscle relaxation (perhaps with audio tapes), deep breathing techniques, imagery, meditation, and biofeedback.
Consider participating in cognitive therapy. Cognitive therapy helps some people with insomnia identify and correct inappropriate thoughts and beliefs that may contribute to insomnia. In addition, cognitive therapy can give you the proper information about sleep norms, age-related sleep changes, and help set reasonable sleep goals, among other things.
The only thing worse than getting really bad news is having to give it to someone you love. Sometimes you have no choice to but to step up and have a tough conversation. Before you say anything, you know your words can hurt and change their life in some way.
Reassuring someone who’s just heard devastating news can be difficult, especially if you’re the one who told them. But if you prepare for your conversation, you can make the task more bearable for you and create a safe space for them. Look through these tips to help you anticipate your loved one’s needs as you break bad news to them.
Post-planning tip: If you are the executor for a deceased loved one, it’s tough to handle both the emotional and technical aspects of their unfinished business without a way to organize your process. We have a post-loss checklist that will help you ensure that your loved one’s family, estate, and other affairs are taken care of.
Steps for Breaking Bad News to a Loved One
Before saying anything to your loved one, take a few moments to plan your approach. While you can’t take away your loved one’s pain or shock, you can give it a softer place to land. Even if you don’t have much time, consider the following steps to make the task easier for both of you.
As the saying goes, put the oxygen mask on yourself before assisting anyone else. Try to avoid breaking bad news when you’re upset, if possible. Address your emotional reaction before talking to your loved one, even if you only get a few minutes to yourself. Allow the first wave of emotions to move through you until you can think more clearly. You may also help your loved one by identifying your feelings, so pay attention to how you react.
Acknowledge that this is a hard thing to do, both to yourself and your loved one. Nobody likes sharing bad news. It’s usually a surprise to the other person and it can also be difficult to soften the blow. Cut yourself some slack for struggling with your side of the process. Do your best and understand it will be hard for both of you.
2. Consider your setting
Your loved one may react in unexpected ways when you deliver the news. Choose a setting that offers a calm space and few distractions. You may want to consider inviting another support person to be there with you. Here are some suggestions:
Choose a place that won’t be too noisy or busy. You want your loved one to hear you clearly.
Pick a place that offers some privacy, quiet, and space to move around. A room with a door is ideal, even better if it’s one they could stay in for a while if they need to be alone.
When dealing with a strong emotional reaction, a small room can make people feel trapped. Some people pace or feel like standing up when they get upset.
Be aware of your positioning in the room. Place yourself away from the door so your loved one could easily leave the room if they want to.
3. Stay calm
Your calm and reassuring presence won’t change how bad the news is for your loved one. But it can help them get through the initial rush of emotion. Set the expectation that you are steady and calm, that they can count on you to help them through the moment. By avoiding raising your voice, you can help change the tone of the conversation and keep it calm. Move to a quieter location if background noise is an issue.
Also, be aware of your body language. Make sure your posture and body language are as relaxed as possible. Sit down or try to stay in the same position as much as you can. Avoid pacing or moving around, especially if the space is small. Your extra movement may be agitating to your loved one.
4. Don’t wait long and do it in person if you can
Don’t wait to deliver your news. Waiting will only prolong your stress and won’t make the news any better. Take some time to prepare for the conversation and choose the quickest and best way to deliver the message.
Bad news is delivered best in person. If meeting up with your loved one won’t delay you much, your physical presence can mean the world to them. You can offer a comforting touch and show your sincerity in non-verbal ways.
When speaking in person isn’t possible, these options can help you deliver the news promptly. Each choice has pros and cons to consider, so choose the method that makes the most sense for them.
Pro – Allows you to give the news promptly if you can’t be there in person.
Con – Not everyone has access or is comfortable using video technology.
Pro – Everyone has access to phones. Some may prefer this to keep their reaction more private.
Con – Leaves out some non-verbal communication.
Typed text (instant messaging, texting, email)
Pro – Can be quicker for some people, easier if in a noisy situation. Better than waiting a long time.
Con – The message might not get to the person right away. Limited ability to have a conversation. Impersonal, little emotional context, and no physical presence.
5. Be truthful and direct
Tell your news in as few words as possible to get to the point. You may need to share some other information, but don’t string it along. Get to the critical news right away and share the background story if they are asking for it or if they are ready for it.
Another tip is to avoid sugar-coating your message or giving false hope. Doing so could create another disappointment down the road. If it’s possible to change the situation, keep your comments brief and factual.
6. Prepare your message
Being prepared helps you deliver your news with less chance of becoming emotional yourself. But be aware of sounding like a robot. Keep sincerity in mind and make an effort to talk naturally, like yourself. Your presence is what will reassure them, so be your normal self as much as you can.
Practice what you’ll say a few times. If your emotion wells up when you speak, rehearsing your message can keep you moving through the words. Your body memory will kick in and get you through the toughest parts.
7. Speak at the appropriate level for the person
As you prepare your message, consider the person you’re telling. Your goal is to deliver news in a way your loved one can easily understand. Make your message simple and clear no matter who you’re speaking to. Mature adults will appreciate an honest and respectful approach.
If you’re talking to a child or person with limited mental capacity, take extra care with your word choice. Here are some options to consider:
Use concrete words you know they will understand.
Avoid using vague terms, especially when talking about death.
If the bad news is about something that can’t be changed, be clear about this. Avoid giving false hope or mixed messages.
Be respectful, even with a simplified message.
Explain your emotions to help them feel safe sharing theirs.
9. Understand your loved one’s state of mind first
Knowing your loved one’s state of mind can help you with your approach. If they’ve had a rough day, acknowledge that first and be understanding. Pay attention to that first so they know you care.
Don’t sugarcoat or skirt the truth about the bad news, even if your loved one is struggling. Instead, consider how well they are coping at the moment and give the news in smaller bites, if needed.
10. Share the news sitting down
Start the conversation by sitting down, and suggest that your loved one do the same. Be sure seating is available even if they don’t sit down right away. Your loved one may feel unsteady or faint if they’re shocked by what you say.
Sitting down also puts you and your loved one on the same level. This can be more comfortable for both of you, allowing for better eye contact and physical contact.
11. Let your loved one react
No matter how calmly you deliver the news, your loved one may get emotional in some way. You aren’t trying to keep them from getting upset. You are giving your loved one the safest and most comfortable setting to hear the news.
Your loved one could become numb and seem dazed, or they may cry and become angry. Mixed emotions are normal and can be difficult to express. Be a good listener and try not to interrupt them or cut them off.
You may also catch some heat as the bearer of bad news. Understand that your loved one may react poorly and direct their emotion toward you, even if you are just the messenger. Don’t take their first reaction to heart if they lash out at you. Bad news takes adjustment and emotions can take a long time to unfold. Get through the initial reaction and handle the details later.
12. Offer support
Once you’ve delivered the news, offer your loved one support as they cope. Depending on the situation, you may start helping them cope right away. And if they want space, respect that and reach out again later. Here are a few ways you can support your loved one as they deal with the news.
If it works, spend time together right after sharing the news.
Offer practical help like running errands, cooking meals, or household tasks.
If the bad news means they need to make major changes in their life like moving or looking for a job, offer to help them with these tasks.
If the news affects you as well, share how you are coping or adjusting.
Reach out regularly and offer a listening ear.
Breaking Bad News Examples
When you have bad news to share, finding the right words can be tough. You may be emotional yourself, or you may anticipate the other person’s reaction. Here are a few examples and word choices for breaking bad news.
“I’m afraid I need to share some bad news with you.”
“I have something to tell you, and I wish it were better news.”
Give the other person a heads-up that you have to share something uncomfortable. This allows them to center in and prepare to listen to you. It may feel awkward, but it sets the tone for what’s to come.
“I have cancer.”
“I’ve lost my job.”
“Your uncle John was in an accident this morning, and it doesn’t look good.”
Say the meat of your news in the fewest words possible and in plain language. You can add details and context after they’ve absorbed the essential parts. Whatever you need to say, be sure it doesn’t have jargon or a big lead-up story. Once a person knows there’s a bad ending, anxiety and tension can build up until they learn the worst part.
“I can see this is hard for you.”
“You’ve been quiet. Anything you want to share or ask?”
“Do you want to hear full details now, or just the key points?”
Give the other person some time to absorb the shock. It’s OK to comment on their emotions without sounding like you know exactly what they’re going through. Check in with them before moving on with the story. They may not be in a mental space to hear more details for a few moments.
“So in a nutshell, I had a heart attack and I’ll need surgery to repair the damage. The doctors think I can recover, but it will take some time.”
Recap your news briefly after you’ve explained everything. Emotion can interfere with a person’s ability to comprehend and think clearly. So make sure the other person can walk away understanding the main points of your news.
You could also consider asking them to repeat what you said back to you. This may be more critical when the bad news is about them and requires action on their part. They’ll need to be able to recall the foundation of the bad news and what it means for them.
Frequently Asked Questions: Breaking Bad News
When you have important but upsetting information to share, you may worry about stumbling out of the gate when you start talking. It’s understandable, but there are ways to make it easier on yourself. Take these tips to heart when deciding how to deliver the news.
When’s the best time to break bad news?
There’s no perfect time to break bad news, but some circumstances make it easier to process. Here are a few tips and suggestions to start with.
If the time and situation allow, pull your loved one aside when they aren’t in the middle of something.
Try to avoid sharing the news when they are likely to be tired, like first thing in the morning or just before bed.
Leave enough time for you to be there while they absorb the shock.
One research study suggests that the ideal time to deliver bad news is when a person is already feeling stressed. Why? Because they are already somewhat primed to expect negativity. With that mindset, they can better accept and adapt to more bad circumstances. It sounds counterintuitive, but it may mean that the ideal situation may not have a huge impact.
What should you avoid saying when delivering bad news?
“I know exactly how you feel.”
Saying this may sound kind and empathetic. You may even have some idea or experience with this situation. But in reality, everyone’s emotional reaction in a given moment is unique.
“It’s going to be OK.”
Unless you actually know it’s OK, don’t say this. Otherwise, saying it will be OK can sound like you’re glossing over their shock or emotional struggle.
“It could be worse.”
“At least it’s not XYZ.”
Minimizing the impact of your bad news may sound like the kind thing to do, but it actually stamps down the validity of the other person’s reaction. Allow their reaction to be genuine and authentic, whatever it is.
What should you avoid doing when delivering bad news?
Delivering bad news can be stressful. Do your best to cope with your own discomfort so it doesn’t interfere with your ability to be supportive.
Pacing and not speaking clearly or slowly enough
Find some ways to burn off any nervous energy. Otherwise, the anxiety may unintentionally create a few problems:
Adding more stress to an already difficult situation
Making your voice difficult to hear and understand
Causing you to speak faster and with less clarity
Leaving as soon as you share your news
You may be dreading the moment you drop your news on the other person. Disappearing right away may feel like the easiest way to avoid feeling bad, but it can leave the other person hanging. Come prepared for some discomfort so you can be there for the other person when they first react.
Acting cold or impersonal
Your way of coping may be to remain more stoic with your feelings, and that’s OK. But recognize that the other person may be experiencing shock or an unexpected surge of emotion. Acknowledge their experience and show compassion as they react.
Breaking Bad News to a Loved One
Bad news is never easy to hear. With some preparation and care, the task of breaking bad news can be less overwhelming for you. You’ll be there for your loved one, no matter how much it hurts. Help them know they aren’t alone in their pain.
Holeywell, Ryan. “Let’s Talk.” Texas Medical Center, November 1, 2017, tmc.edu.
Mooneyham, GenaLynne C., MD “Helping your children deal with bad news.” Duke University School of Medicine, August 7, 2018