Your Budding Daughter: Some Practical Suggestions for Parents

What? Already?
Puberty in Girls, Step By Step
The Stages of Development
'Is This Normal?' When to See Your Physician
Helping Your Daughter to Be Well-Informed
Sex Education
Menstruation, tampons and pads
In Closing

What? Already?

Puberty! It started happening to my 10-year-old daughter this spring. She needed new sandals - women's size 7 sandals! She got those little bumps under her nipples that we doctors call 'breast buds'. Next, I was 'excused' from joining her in the dressing room when we shopped for her clothes, and the bathroom door was locked when she showered. The pants I hemmed up in June were too short by October, despite only being washed once. And she admits to 'maybe' having a few hairs 'down there'.

As a loving mom and adolescent medicine specialist, these are heady times for me. I am proud of my daughter and thrilled to see her embark on this road toward womanhood. I know that she is progressing normally. But still, I think, 'Hold on, she's only in fifth grade!'

My daughter is perfectly normal. Puberty, often first recognized at the onset of breast development, usually begins about the time a girl turns 10. There is a wide range of 'normal' starting times, and the onset time varies in different ethnic groups. For instance, it may occur between the ages of 8 and 14 in white girls, and may begin as early as 7 years of age in African American girls.

Puberty in Girls, Step by Step

Puberty is outwardly manifested by two main sets of changes:

  • Rapid increases in height and weight, referred to as the height and weight spurts

  • Development of breasts, and pubic and axillary (underarm) hair

Tracking the changes during puberty

These changes, and the other physical changes of puberty, occur in a predictable sequence. We use sexual maturity rating (SMR) scales to track a youngster's progression through puberty. Knowing the timing of these changes, related to each other and related to the sexual maturity ratings, is very helpful. After all, most of us like to know what to expect. For example, when my daughter developed breast buds, I was able to tell her that she'd start finding little hairs near her labia majora (outer lips of the vagina) within six months or so. And she knows that she is likely to have her first menstrual period about 2 years after her breasts first started developing. This means she'll be a little over 12 years of age, close to the national average of 12 years and 4 months.

The height spurt

Ultimately, 20-25% of a girl's adult height is acquired in puberty. The height spurt usually begins just before or after breast budding develops. Over a period of about 4 years, girls grow close to a foot taller than they were at the beginning of the height spurt. The bones that grow first are those furthest from the center of the body. This is why my daughter's shoe size shot up before the rest of her body began growing faster. The earlier growth in the arms and legs accounts for the awkwardness and 'gangly' appearance of many teenagers. Their center of gravity is shifting, and they haven't gotten used to those long arms and legs. The growth in the spinal column alone accounts for 20% of the height increase. This is why it is important to check for scoliosis (sideways curvature of the back) before puberty begins. A slight curve can turn into a much larger one during all that growth.

The weight spurt

A girl's height spurt is followed about 6 months later by her weight spurt. This is, of course, when she can never get enough to eat. Fully 50% of ideal adult body weight is gained in puberty. In girls, the proportion of body weight in fat increases from about 16% to nearly 27%. Lean body mass, especially muscle and bones, also increase substantially. It's the growth and maturation of bones, in particular, which makes calcium intake so important.

Getting enough calcium

Most of you know of the importance of good calcium intake for all women, especially growing teenagers, pregnant women, and nursing mothers. Milk and other dairy products are the least expensive, most convenient sources. Nonfat milk has just as much calcium as whole milk. If your daughter doesn't like milk, try doctoring it up with chocolate powder or syrup (this is the only way I can get my daughter to drink it). Calcium is also available as a nutritional supplement in tablet form, but many teenagers find the tablets too large to swallow comfortably. Your daughter may like the fruit or chocolate-flavored calcium-supplement chews available in drugstores now.

The Stages of Development

The table below summarizes the events at each stage of development. The average (mean) age listed here can vary widely; about 2 years either side of these listed ages will usually be considered normal.

Sexual Maturity Rating Average Age (Years) Features What Happens
1 8 2/3 Growth, breasts and pubic hair Height spurt begins. Body fat at 15.7%. Breasts are prepubertal; no glandular tissue. No pubic hair.
2 11 1/4 Breasts The areola (pigmented area around the nipple) enlarges and becomes darker. It raises to become a mound with a small amount of breast tissue underneath. This is called a 'bud'.
2 11 3/4 Pubic hair and growth A few long, downy, slightly darkened hairs appear along the labia majora. At the end of this stage, the body fat has increased to 18.9%.
3 11 2/3 Growth Peak height velocity (maximum growth rate) is reached. Body fat is now 21.6%.
3 12 Breasts Development of breast tissue past the edge of the areola.
3 12 1/3 Pubic hair Moderate amount of more curly, pigmented, and coarser hair on the mons pubis (the raised, fatty area above the labia majora). Hair begins to spread more laterally. Menarche (first menstrual period) occurs in 20% of girls during this pubic hair stage
4 12 3/4 Pubic hair Hair is close to adult pubic hair in curliness and coarseness. Area of pubis covered is smaller than adults, and there are no hairs on the middle surfaces of the thighs. Menarche occurs in 50% of girls.
4 13 Breasts Continued development of breast tissue; in side view, areola and nipple protrude.
4 13 Growth End of growth spurt. Body fat reaches mature proportion: 26.7%. After menstruation begins, girls grow at most 4-5", usually less.
5 14 1/2 Pubic hair and Body fat Adult. It is normal for some long pigmented hairs to grow on the inner thighs. Body fat remains at 26.7%.
5 15 1/4 Breasts Adult breasts.

'Is This Normal?' When to See Your Physician

Parents often have concerns about whether their daughter is starting puberty too early or too late, or whether she is progressing normally. Occasionally they may also notice a physical feature which seems 'different' and want to check it out. Hopefully, the information provided above will be useful in charting your daughter's progress. But whenever you are uncertain, it is best to seek out medical advice. Every girl is different.

Some 'differences' that should lead you to the doctor

There are a few things that should definitely lead you to the pediatrician (or adolescent medicine specialist, if there is one in your area). They are:

  • No breast development by age 13.

  • No menstrual period by between the ages of 13 ½ to 14.

  • In a girl who is at Sexual Maturity Rating 3 or higher, cyclic abdominal pain (pain similar to period cramps) every 3 to 5 weeks, but no menstrual periods. This is rare.

  • Development of pubic hair but no breast development within 6 to 9 months.

Breast development is a very individual thing. There are, however, a number of potential 'dilemmas' to be aware of in this process. They are:

  • Asymmetry (one breast much larger than the other): This may be minimal, or it may be visible even when your daughter is dressed. Some girls with asymmetric breast size are embarrassed to wear a swimsuit, regardless of the extent of asymmetry. In severe cases, plastic surgery is the ultimate answer. This can be performed in teenagers after puberty and after the breasts are fully grown.

  • Very large breasts: Very large breasts can be a source of constant embarrassment and self-consciousness from puberty onwards. They can also cause medical difficulties, namely back problems. Plastic surgery is 'medically indicated' and may well be covered by a health plan, particularly if you and your surgeon are persistent.

  • 'Too small' breasts: Breasts that are 'too small' may also cause embarrassment. Small breasts do not cause medical problems; they do not affect a woman's ability to nurse a baby. With that said, I live in southern California, where breast augmentation seems to be 'de rigeur' for anyone who wants it. Regardless of where you live, I suggest trying some of the ideas in the 'tips' section below before delving into the intense debate about breast augmention surgery. Remember also that teenagers are famously self-conscious about their appearance. Once your daughter is older, she will hopefully have developed more self-confidence. She will then be in a better position to make an educated decision about breast augmentation.

  • Inverted nipple(s): An inverted nipple means just that: the nipple is pointed inwards, rather than outwards. Looking at the breast from the side, you do not see the tip of the nipple protruding. This condition occurs occasionally. It can interfere with breast-feeding. If you notice it, bring it to your doctor's attention. A new non-surgical treatment has recently become available.

  • Tuberous breast disorder: This is a fairly uncommon disorder that often goes unrecognized until a new mother has difficulty breast-feeding. In this condition, growth at the base of the breast (where it attaches to the chest wall) is restricted by a band of tissue. Breast tissue, therefore, grows outwardly while the base remains narrow. This results in a breast shaped like a tuber (for example, a potato). Tuberous breast disorder is surgically correctable.

Helping Your Daughter to Be Well-Informed

Hopefully, your daughter is already well-informed about puberty and the menstrual cycle. It is also important at this time that she be well-informed about sexual intercourse and sexuality.

Sex Education

I recommend that you and your spouse/partner talk with your daughter about when you think it is acceptable to have sexual intercourse. Please be sure that she is well equipped to decline or refuse sexual intercourse - and that she knows that anyone, including a friend or a date, who forces her to have sex, is committing a crime.

She should know that pregnancy and sexually transmitted diseases are the common consequences of teenage sexual activity. And, despite your own recommendations, she needs to know about contraception - including emergency contraception. Emergency contraception refers to the 'morning after pill', and it is much less unpleasant and much easier to obtain nowadays.

Menstruation, tampons, and pads

  • I suggest that girls make themselves familiar with their bodies by using a hand-held mirror to look at their genitals, early in puberty if possible. Having a drawing on hand is helpful in identifying the different parts of their anatomy. I believe that this helps girls to become more comfortable with their developing bodies. And when the discussion comes to tampons, as it almost inevitably does, they have a better sense of what is involved.

  • Within a year of the time your daughter begins breast development, purchase several different packages of sanitary supplies for your daughter and invite her to check them out. I consider this part of 'de-mystifying' menstrual periods. (And, one of her visiting friends might need something).

  • Every girl should maintain a menstrual calendar to keep track of her periods. I suggest she keep a small calendar and pen right with her sanitary supplies. It is most helpful for physicans reviewing the calendar if the first day of flow is marked, say, with a circle and the last day with an 'X'.

  • What about tampons? There are pluses and minuses. Sports involvement may be limited or impossible for girls who are having their period but not using tampons. Other girls are fastidious and do not want to risk a bloodstain on their clothes. Still others are uncomfortable about touching their genitals or fearful that using tampons may be painful. Here is what I recommend to my teenage patients:

    • Talk about tampon use with your mother. Some mothers are concerned that using tampons means that a girl will no longer be a virgin. Actually, the opening in the hymen (membrane that partially covers the opening of the vagina) is usually large enough for a mini-sized tampon by the time of a girl's first period. Other mothers are rightfully concerned about the risk of toxic shock syndrome. This has become a rarity since the materials used to make tampons were changed some years ago. I believe that tampons are safe for all women, provided that they are changed at least every 4 hours during the daytime and do not leave the tampon in place for more than 8 hours at night. Some women prefer to use tampons during the daytime only.

    • If staining, and not sports participation, is the primary concern, then an investment in black panties might be all that is needed.

    • Try different brands and types of pads and/or tampons to see what works best for you. 'Super' pads can feel (and look) like a diaper on a diminutive teenager. On the other hand, a 'mini' tampon may not absorb enough flow to last more than a few hours, and this can be a problem at school. I suggest a combination of a mini-tampon and a pad for maximal protection.

    • If your daughter wants to try tampons, I recommend trying teen-sized tampons (marketed as such). I think that a slim plastic applicator is easier for a girl to use than tampons without an applicator or with a cardboard applicator. Also, a bit of lubricating jelly or Vaseline placed on the tip of the applicator may make the insertion easier at first.



  • When to wear a bra? I think that whenever your daughter requests one, it's time. Developing breasts are quite tender, and even the logo on a sports T-shirt may cause discomfort. Fortunately, those smooth cotton 'sports' bras are available everywhere.

  • If your daughter is concerned about breast asymmetry, consider purchasing a padded bra and removing the padding from one side. In more marked cases, you might wish to order a set of the bra inserts advertised in newspapers and women's magazines. Again, use the insert in one side only. If this is inadequate, I recommend that my patients who are too young for surgery, or who can't arrange payment, seek out assistance at a shop specializing in breast prostheses (artificial breasts). Although generally used by women who have had a mastectomy (removal of a breast), a prosthesis can also be helpful for severe breast asymmetry.

  • Given the emphasis on 'normalcy' and on breasts in our society, I think it is reasonable for her to wear a padded or lined bra if she wishes. Most commonly, only older girls (SMR 4 or 5) have this concern. As mentioned earlier, this is a temporary concern for many adolescents.

  • If your daughter has very large breasts, it is important that she wear a bra designed especially to provide extra support, often by use of a criss-cross design in the back. If possible, it should be purchased at a department store that has specially trained undergarment fitters.

Getting more information

If you need help or more information on any of these topics, there are some great web sites operated by SIECUS (the Sexuality Information and Education Council of the United States) and Planned Parenthood. SIECUS has a special 'For Parents' section. Planned Parenthood has a special section for teens, and there is also a special website for adolescents called 'Go Ask Alice' from Columbia University. For the most up-to-date information about emergency contraception, check the Emergency Contraception website at Princeton University.

If you haven't already done so, purchase or borrow books about puberty, sexuality, and teen issues for your daughter. SIECUS provides an excellent bibliography of resources for parents, children, and adolescents. Here are a few of my personal favorites. You'll find more information about them in the SIECUS bibliography.

It's Perfectly Normal: Changing Bodies, Sex and Sexual Health, by Robie H. Harris

My Body, My Self, by Lynda Madaras and Area Madaras

What's Happening to My Body? For Girls, by Lynda Madaras

What's Happening to Me?, by Peter Mayle

The Period Book: Everything You Don't Want to Ask (But Need to Know), by Karen Gravelle and Jennifer Gravelle (When it comes to periods, this is the most practical book; it's fun, too.)

In Closing

This article has focused mostly on normal and non-gynecological aspects of puberty. While my suggestions and recommendations are far from complete and definitely not inclusive, I hope that the information provided above have given you some information on what physical changes to expect during your daughter's puberty.

APA Reference
Staff, H. (2027, December 27). Your Budding Daughter: Some Practical Suggestions for Parents, HealthyPlace. Retrieved on 2022, August 16 from

Last Updated: March 26, 2022

Being Overweight Affects Your Sex Drive

Being overweight hampers your sex life

Add a bad time in bed to the list of ways excess weight can impede your life satisfaction. In a survey of more than 1,000 obese and normal-weight men and women, more than half of obese people reported problems with sexual enjoyment, sex drive or sexual performance or avoided sex altogether, compared with only 5 percent of their normal-weight counterparts. It's unknown whether the problems are physical or psychological. However, losing weight makes obese women feel more confident, says Martin Binks, Ph.D., co-lead researcher and director of behavioral health at Duke Diet & Fitness Center in Durham, N.C. And that's true for women who are merely overweight too: After dropping 10 or 20 pounds, women told Binks "they feel younger sexually."

APA Reference
Staff, H. (2025, December 21). Being Overweight Affects Your Sex Drive, HealthyPlace. Retrieved on 2022, August 16 from

Last Updated: March 26, 2022

Lots of Food. No Sex. Time for Rehab

I'M AN ADDICT. My drug of choice isn't heroin, crystal meth, or crack cocaine, but it's just as destructive and impossible to kick cold turkey. I'm strung out on food.

I'm 35 years old, stand 5'10" tall, and weigh 300 pounds. I am obese. Over the years, I've tried every diet to hit The New York Times best-seller list, yo-yoing all over the scale, from a rotund 315 pounds down to a burly 245, and rebounding back to a plump 300. Nothing seems to work, and inevitably the jones to graze always gets the best of me.

Every evening, I eat myself into a coma, then crash in front of the TV or down enough Jack Daniels and ginger ale to dull my senses. My edibles-as-drugs problem is compounded by the fact that I live in New York City, home of the world's best food fixes--thick, juicy steaks at Smith & Wollensky's, the world's greatest pizza at John's, dry-rub baby-back ribs at Virgil's BBQ, and the tastiest ethnic restaurants. But, let's face it, even if I lived in a gastronomic backwater, I'd still do the same thing.

This is what it's like being a walking fat body: I have to shop at big-and-tall stores, paying top dollar because nothing in the pages of this or any magazine fits me off the rack. I need a seat-belt extender on airplanes. And I have a hard time stuffing myself into the cheap seats at Knicks games.

Even more disturbing: My weight is harshing my sex life. Performance isn't the issue--it's just getting in the game. Usually hesitant to approach women, I often rely on friends to make the opening move. I shrug it off to shyness, but I know the real reason: I'm afraid to have relationships with women because I don't find myself attractive, so why, I figure, should they?

I'm not looking for your pity. Fuck that. I'm comfortable in my skin. While the looks and sneers sting, they usually come from superficial assholes I wouldn't want to know anyway. But the health implications do terrify me: limited mobility, diabetes, liver damage, gout (from which I already suffer), heart disease, and stroke. All point to an early grave.

Then came the assignment: Spend two weeks at the Duke University Diet & Fitness Center (DFC) in Durham, N.C., and write about it for Men's Fitness. I felt like I had just won the lottery.

Orientation: May 9

Established in 1969, the DFC is one of the country's oldest weight-management centers. From the outside, this one-story brick building looks like my old grammar school. But inside, it's more like a clinic, with its large gym, 25-meter pool, and many doctors' offices. Its program teaches health and wellness through diet, exercise, and behavior modification--voluntary rehab for the weight-challenged.

Looking around orientation, I size up my hefty comrades. They, too, seem to think, "What the hell did I get myself into?" When the time comes for introductions, this might as well be A.A. "Hi, my name is Chuck, and I'm obese."

I was sure the other attendees would wallow in self-pity: "I ate myself into a blob because life dealt me crappy cards." Boo-fucking-hoo. But in reality, I get a positive vibe from my fellow food fiends. Most are fired up for the coming battle and unafraid to share experiences. I admire that.

Day One: May 10

Enrolling in the DFC is like earning a master's degree in healthy living. The most repeated lesson: The keys to fitness are time management and organization. But to me, the idea of planning out meals and exercise is non-spontaneous and unappealing--I've always flown by the seat of my extra-large pants. This will be the hardest adjustment.

Medical, nutritional, physical, and psychological evaluations begin today. I'm poked and prodded by anyone in a lab coat. The goal of this interrogation, explains DFC director Dr. Howard Eisenson, is to produce a clinical profile to ensure I'm healthy enough to go through the program. It's humiliating--I can't go more than seven minutes on the treadmill during my stress test. My lab results show no abnormalities, but I still feel like a big whale.

Day Two: May 11

Today we focus on good nutrition. You need a comprehensive understanding of what healthy comestibles are and how they affect your body. Indeed, as Funkadelic once put it, "Free your mind and your ass will follow."

During my physical assessment, I realize exercise doesn't have to be monotonous and shouldn't be painful. The slogan "No pain, no gain" is bull-shit. "If you're hurt," cautions Gerald Endress, DFC's fitness manager, "you won't get off the couch. Your success in this program and in life depends on getting out and doing some physical activity."

As the day ends, one thing is clear: Losing weight and getting healthy will be a long process. I didn't wake up one morning with this huge gut. It took years of lethargy to eat and drink myself into this shape. I simply let my consumption spiral out of control in college--and never stopped.

Day Three: May 12

This morning, I attend a meditation class to learn how to "communicate" with my body and make peace with my inner-hunger demon. Sounds ludicrous, but I am actually able to converse with my pained parts--specifically, my sore back muscles, pounding head, and grumbling stomach--simply by concentrating and asking each what it wants. By recognizing there is a problem, my body feels better. This type of touchy-feely crap normally doesn't fly with me. This experience, however, is enlightening. (It still freaks me out, though.)

Next up, I meet with nutrition manager Elisabetta Politi, who corroborates my worst fear: I eat too much shit. Who would've thought fast food, Chinese delivery, and pizza aren't good for you? "Proper eating is all common sense" she says. "Stay away from heavy fats, count calories, eat less processed sugar, limit your sodium intake, and you'll be fine."

Uh, easy for her to say. In my world, eating isn't just a means of sustenance--it's a social event. Food should be enjoyed, even celebrated. "You can still eat out in restaurants with friends," she assures me. "Just choose the right things off the menu and manage your portions. You'll learn."

Behavior modification, then, is the gateway to shedding pounds. Of course, when I was young, my parents practically taught me the opposite--that leaving food on my plate was a waste of money. Or they'd say, "Clean your plate: Kids are going hungry all over the world." This was clearly a mistake of good intentions, but it's not their fault I have self-control issues. They were looking out for my best interests. Now I'm an adult. I have to learn to leave more food on my plate.

Day Four: May 13

Let's talk alternative exercise--yoga, for instance. I thought that was a chicks-ercise. But after road-testing these simple stretching movements and correct breathing and relaxation techniques, I'm invigorated, my focus and mental acuity enhanced. Also in my new routine are water aerobics, a daily one-hour walk, and, three times a week, a half-mile swim and weight workout. This healthy-living "crap" might just work.

Later, my group gathers to interpret our lab results. Mine are not good. Suddenly, my newfound enthusiasm takes one to the gut--I have quantitative evidence that I'm on the road to an early grave.

My glucose is high. (I'm, like, one candy bar away from diabetes.) My cholesterol's good/bad ratio is bad/bad. (It's 6.2--it should be under 5.0.) And my triglycerides (fat stored in the bloodstream) are double the norm. Plus, I display four of the five indicators for increased risk of heart disease. (My father, while not overweight, died of a heart attack at age 59.)

Graded on a curve, my results aren't so horrible: A couple of people in the group learn they have serious medical conditions needing immediate attention. Others' cholesterol levels are as high as the population of Hong Kong. Still, this doesn't comfort me. After all, I'm on what is derisively called a "fat farm." And I'm not vying for the DFC's coveted Most Weight Lost prize. I'm fighting my own demons.

Day Five: May 14

What a turnaround--I'm on top of the world this morning! I've lost nearly eight pounds.

Portion control helped get me to this point. They're not starving me, just giving me smaller amounts of healthier foods. Instead of eating lots of starchy fillers--potatoes, rice, etc.--my plate is filled with fresh vegetables, salad, and fruits. Food preparation is also key: limiting oil, mayonnaise, and fatty condiments, and grilling or steaming foods, not frying.

The result: I feel better, I have more stamina, and I'm thinking more clearly--after just five days!

I'm also really digging Pilates. The stretching and strength-enhancing movements have loosened my limbs, improved my flexibility, and tightened my stomach muscles. (It's even better in a coed class: Some of the positions are very sexually suggestive.)

Though I'm enjoying my time in this sheltered environment, I wonder how I'm going to translate my experiences here to the real world. That's where today's Planning Your Restaurant Experience class comes in handy. It teaches us how to order off the menu by asking the waiter about ingredients and preparation. And we're reminded about portion control, a difficult hurdle for me because I've always enjoyed the supersize, more-for-my-money mentality.


Day Eight: May 17

Eating healthier starts with buying healthier foods. This afternoon, nutritionist Monette Williams takes me and another patient, Warren, on a tour of a Kroger's supermarket. Instead of grabbing items off the shelves impulsively (as I would at home), we stroll the aisles and carefully read nutrition labels. The foods Warren and I normally buy are loaded with sodium, processed sugars, and wasted calories. Now we're empowered, knowing which foods to reject and which to embrace.

Last Day: May 22

I'm a convert. Two weeks ago, I would never have predicted such a change in lifestyle and attitude. Now I know that pessimism is what killed my other healthy-living attempts.

Still, going home is a little scary. I'm worried about falling back into gluttony. But I've resolved to join a gym, mapped out my exercise regimen, and worked out some menus. I've lost 12.5 pounds and more than halved my triglycerides to normal. Last Thursday, I was ready to buy burial insurance--now I'm looking into mountain bikes.

One Month Later

The real world isn't as scary as I predicted. I'm still losing weight (I'm down 24 pounds), and I exercise daily. Every morning I stretch, then walk an hour. I lift twice a week, play racquetball, and do yoga and Pilates. And I can't imagine powering down Ben & Jerry's Cookie Dough on the couch.

The DFC taught me we all need to get off our fat asses, exercise, and eat healthier foods. More important, I learned I have an amazing support system. My family and friends are here for me, and I can call them anytime.

I'm still hardly slim--I strive to be 200 pounds by May. At that point, I'll be a changed man. Well, a thinner, more fit one, anyway.



According to Harvard research, Body Mass Index (BMI) measurements may incorrectly classify some men as being over-weight when they are, in fact, in very good shape. Why? Muscle weighs more than fat, so a 250-pound weightlifter and a similar-sized office drone can often have the same BMI. That's why--if you're trying to get fit--it's better to focus on your waist circumference, rather than your actual poundage. You can mark progress with a tape measure, or simply grab a pair of jeans you can't fit into anymore and try them on once a week. Even if your weight and BMI aren't changing with your workout, the jeans should gradually start to fit you better--a sure sign your program is working.


It's not just your imagination that having a wife weighs you down. Most married men are thinner pre-vow than post--as those wedding pictures (and cruel friends) are sure to point out. One theory suggests that not being on the lookout for a partner allows you to get comfortable (i.e., fat). On the flip side, marital problems also lead to stress-eating and the inevitable weight gain that follows. But before you swear yourself to the single life or call that divorce attorney, there is one more twist to the equation. You may be thinner when you're single, but studies show that married guys live significantly longer than bachelors. The choice is yours, cowboy.

APA Reference
Staff, H. (2025, December 16). Lots of Food. No Sex. Time for Rehab, HealthyPlace. Retrieved on 2022, August 16 from

Last Updated: March 26, 2022

When Anxiety Affects Your Feelings of Self-Worth

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Over the years, I have been able to cope with my anxiety much more effectively than I did when I was younger; however, there are still plenty of times when my anxiety has affected my self-worth.

What does this look like for me? Recently, I have been fortunate enough to have been granted opportunities that I feel very blessed to have and am very grateful for. However, even with that sense of gratitude, I also sometimes don't feel I am worthy of them. As a matter of fact, I will purposely identify reasons that I think I am not worthy.

Why Anxiety Makes You Feel Like You Aren't Worthy

I've learned that sometimes questioning your self-worth might be related to things that have happened in the past, to high expectations you've set for yourself and then weren't able to reach, or just simply due to constant questioning of choices that you've made.  I've also learned that even though logically, I know it is not reasonable to try to convince myself that I am a failure of any sort and that I actually do deserve good things in life, my anxious brain sometimes speaks to me in a different way.

It ruminates and perseverates on mistakes that I've made and "what-ifs" and second-guessing actions that I've taken. And this starts to get in the way of the self-confidence I try to build for myself.

As is usually characteristic of anxiety, I'll often find myself living in the past or convincing myself that I'll make a poor choice in the future. I neglect to focus on the present and the things I do have control over. So once I've focused on those mistakes that I've made, I've then convinced myself that those mistakes define my self-worth.

How to Increase Your Feelings of Self-Worth When You're Anxious

One thing I've learned from processing this with my therapist is that I have a tendency to focus on how I feel about a situation more than the facts, which can sometimes lead me to rumination about those feelings. Since they are often anxious feelings, this then leads me to elevated anxiety. So I've learned that it is important for me to focus on the facts of a situation rather than my worries, fears, and other negative thoughts.

A key strategy for this is using mindfulness. I've found that mindfulness meditation is effective in helping me practice this. Reciting self-affirmations for myself every day has also been helpful for me to counteract negative self-talk. Reframing negative self-talk has also been important. This takes practice; however, I've found that the more I do practice doing this, the more I have been able to use this technique over the years.

Lastly, I think it is important to have a strong emotional support system that can help not only validate your feelings but help to remind you that you are deserving of the wonderful things in life. Are there strategies you use to help boost your feelings of self-worth? Share them in the comments below.

Why Trusting Therapists Is Difficult with BPD

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People who have borderline personality disorder (BPD) have a reputation for being difficult to treat in therapy. As someone who has BPD, I can attest to this: I can be very defensive, and I have a habit of trying to do the therapist's job by diagnosing myself and telling them what I think I need. I also don't stick with any therapist for long and have been known to bail with almost no warning.

It's not that I'm trying to be difficult; it's that I find therapy so difficult, and my behaviour reflects this. Many of the symptoms of BPD come in direct conflict with being able to connect with a therapist. I struggle with impulsivity, sensitivity, and unstable perceptions of myself and others, and these challenges make it incredibly difficult to stick with therapy over the long term. In my life, there are very few long-term relationships.

The Challenge of Being Vulnerable During Therapy

My biggest challenge in relationships is my inability to fully trust anyone. This is especially true with people in authority, and I perceive therapists as authority figures. I immediately put my defences up. If I can't lower those defences, I can't be open about my feelings and concerns. The result is going through the motions of therapy with minimal genuine investment in the process.

It's not that I don't recognize that I'm mentally unwell. I know I am, and I desperately wish I didn't suffer so much emotionally. Trust, however, isn't something that can be forced. To sit down with a stranger in an office and be honest about deeply personal things is no small feat. It doesn't take much for me to get overwhelmed and shut down.

It's scary to be emotionally vulnerable. I'm always worried about being judged and rejected. The irony, of course, is that this is the very thing I do myself: I'm quick to judge and reject other people, especially therapists. It's a defence mechanism.

Doubting How Much Therapists Can Help Me

Another reason that I struggle to stick with therapy is related to the fact that I've been told many times that BPD is for life. The impression I have is that my mental illness is less about what's happened to me and more about who I am as a person. If I'm cursed to live with this illness forever, I wonder what meaningful difference a therapist can make. Arguably, I may never know if I don't give a therapist a chance for longer than a few sessions. I also won't know the meaningful difference sticking with other people in my life could make unless I commit more to them.

I see many vicious cycles at play in all of my relationships: avoiding conflict, stifling feelings of discomfort, trying to be what I think the other person wants me to be, taking things too personally, and ultimately walking away when being in the relationship feels unbearable.

I'm good at acting like I'm more confident and comfortable than I am in therapy sessions. However, you can't act when you're trying to be open and vulnerable. Finding the courage to take off my armour and put those defences aside is both necessary and terrifying.

The Search for the Right Therapist Is Worth It

It's helpful to remind myself that just because I've struggled to find a therapist I was able to be truly vulnerable with in the past doesn't mean it'll never happen. Even if my BPD diagnosis means I can be difficult to treat, if I have the genuine desire to get better for the sake of myself and the people who care about me, perhaps I can find the courage to endure discomfort in therapy and learn to extend trust in good faith.

The suffering I endure hiding from myself and others can't be worse than the discomfort of being vulnerable with someone who is qualified to help people like me. I need to believe that deeper healing is possible. In the end, learning to trust myself -- my strength, my resilience, my courage -- is the key to trusting anyone else, be they a parent, a friend or a therapist.

8 Ways That I Reduce Anxiety as a Writer

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Recently, I wrote and submitted a sample article for an upcoming magazine. That was a big step for me, as rejection has always been a big fear of mine. While I was relieved to have submitted the story, I am anxious to know whether it will be accepted. Thankfully, these eight methods have been helping me to reduce my anxiety as a writer.

8 of My Anxiety Reduction Techniques as a Writer

  1. I write articles for other publications. Exposure therapy is important in that it forces me to get outside of my comfort zone. I use this technique by submitting stories to multiple online publications. This sounds like it would add to my anxiety, but it has the opposite effect. As I submit more stories, I increase my chances of getting something published.
  2. I take writing courses to improve my skills. Since my anxiety is triggered by the fear of rejection, it makes sense to improve my skills. Learning more about different types of writing broadens my knowledge and experience. Currently, I am taking a writing course on LinkedIn Learning. The website includes certifications that I can add to my LinkedIn profile.
  3. I confide in other writers for advice. A vital part of mental health is having a supportive community to confide in when times are hard. I participate in online writing groups because the other members share my passion and struggles. They can relate to the fear of story rejection and criticism. Writers with more experience than me provide me with encouragement, tips, and success stories. They inspire me to keep writing and submitting my work.
  4. I make plans with friends. Even though I love to write, it can be emotionally exhausting at times. Also, it requires a lot of time by myself. When I am anxious, being alone is difficult. It often leads to rumination. So by making plans with friends, I have other things to think about and look forward to. Currently, my plans involve shopping, dining out, watching movies, taking walks, and playing games.
  5. I watch funny shows and movies on Netflix. It is not always possible to hang out with friends. So when I am alone, it helps to watch comedies. Laughter relieves my stress, and it gives me something positive to think about. The more time I spend laughing, the less time I have to be anxious. Also, a lot of my writing is inspired by shows and movies.
  6. I work out while listening to music. I love to exercise on the elliptical at the gym. It works out my entire body, and it is not as hard on my joints as the treadmill. For the elliptical to fully relieve my anxiety, I need to listen to music that energizes me. The repetitive movement and the loud bass distract me from negative thoughts.
  7. I read blogs and books for pleasure. Sometimes I just need an escape. Fiction stories and memoirs allow me to imagine what it would be like in a made-up situation or someone else's life. Reading also exposes me to different writing styles, which helps me improve my content.
  8. I talk with my therapist about my anxiety. My therapist helps me by pointing out my thought distortions so that I can look at my situations from a healthy perspective. He also asks me what coping skills I have been using, and he reminds me to keep taking care of myself. It is helpful to have a safe place where I can talk about my struggles and gain insight to overcome them.

Setting and Respecting My Boundaries

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Setting and then respecting healthy boundaries for myself has always been difficult. Saying "no" just isn't in my wheelhouse. I struggle with the fact that I need to be perfect and please everyone.

Self-Care Includes Both Setting and Respecting the Boundaries I Set

My battle with panic and anxiety this past year forced me to face the fact that I can't please everyone all the time while still respecting my need for self-care. While I'm getting better at setting boundaries, when it comes to certain circumstances—looking after my grandkids specifically—I have a really hard time respecting those boundaries to my own detriment.

My Perspective Has Changed After Dealing With Verbal Abuse

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Getting older can bring many challenges and heartaches, including the death of family and loved ones. Unfortunately, the last few years of my life have included losing several family members and some great friends. Each time I say goodbye to someone else, my perspective focuses more on my life choices. 

Learning How To Heal

It is natural to look back and reflect on your life and how you spend your time when you lose someone you love to illness or accident. However, I have realized that because of my recovery from verbal abuse, my journey has aided me in seeking out the life I want. This goal includes surrounding myself with supportive and loving people rather than condescending or abusive. 

The first time I lost a friend at a young age to an accident, I spent several years in anguish, replaying scenarios that I should have done or things I should have said. Thankfully, my therapists helped me heal and process her death in a healthy method that allowed me to move forward. 

Reflecting After Verbal Abuse 

Unfortunately, as I grow older, I cannot escape the possibility of losing more family and friends through the years. However, my perspective has changed each time I attend a memorial service to honor those we loved and lost. Of course, I still cry and get upset during these sad times, but there are differences. 

After some time for proper grieving, I can look past the loss and celebrate the relationship of the person who is no longer here. I remember the fun events and good times with them and smile because I was fortunate enough to have that person in my life. 

Making Changes 

My recovery from verbal abuse has given me the strength and tools to make deliberate changes in my life that will result in more positive relationships. I no longer allow individuals to talk disrespectfully to me or engage in verbally abusive conversations. 

I mindfully choose the people I surround myself with in my personal and work relationships that support a better environment for my family and me. I have slowly learned what it means to put myself first so that I am better emotionally, mentally, and physically each day, enabling me to be a better person to my spouse and my children. 

And although I mourn the loss of loved ones that are no longer here each day, I actively seek out meaningful and healthy relationships in my current days. Because I never know when someone's days will end, I aim to enjoy a more positive life while I am here rather than experiencing a world of verbal abuse and harm. 

So, if you want a sign to make a change in your life for the better, this is it. Phone your friend for a coffee, talk with your grandmother as often as possible, and make an effort to have a friendly chat with the person at the bus stop. Each positive change you can make in your daily life will make a difference. 

Challenging My (False) Self-Injury Beliefs Helped Me Heal

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Misinformation doesn't just trick other people into believing stigmas surrounding self-harm—those of us struggling with it may fall prey to false self-injury beliefs, too.

False Self-Injury Beliefs Held Me Back

It's so much easier to see when someone else is clinging to a false belief than to catch ourselves in the act. I used to hold all sorts of beliefs about self-injury—beliefs that ultimately kept me trapped in a vicious cycle. These beliefs included things like:

  • "I hurt myself because I am weak"
  • "I hurt myself because I am broken"
  • "I deserve to be punished like this"
  • "There is something wrong with me as a person"
  • "This is the only way I can cope with what I'm feeling"
  • "It's okay because at least I'm not hurting anyone else"
  • "If I tell anyone, they'll think less of me, they won't understand"
  • "Wanting someone to notice my scars means I'm just doing this for attention"
  • "Going through this on my own is braver than asking for help"

It's hard to say where I picked these thoughts up—through media, other people, the internet, or somewhere else entirely—because I didn't even realize I'd absorbed them.

That's the tricky thing about the lies we tell ourselves as self-harmers. We think we came up with them all on our own. Worse, we believe them.

I used to use these lies like weapons against myself; they pushed me toward self-harm, rather than self-care. I used them as bricks to put up a wall between myself and the world, between my current reality and the possibility of recovery. They blinded me to the truth, which was simply this: I did not deserve what I was going through. I deserved to heal.

And so do you.

Refuting Your False Self-Injury Beliefs Can Help You Heal

The good news is that, like any negative thought pattern, you can challenge your own false beliefs about self-injury. In fact, doing so is a vital step in the recovery process.

The more I practiced challenging the lies I told myself about my self-harm, the better I got at stopping them in their tracks—before they wormed their way into my subconscious and took root there. This helped me develop a more balanced and realistic view of my situation and, most importantly, my own ability to change it.

The first step in healing, after all, is believing that you can. If you don't believe it yet, fake it until you do. Negative thought patterns get ingrained in our brains by repetition—luckily, the same goes for positive thought patterns. 

If you're having trouble practicing on your own—and don't worry if you do, this can be tough at first—please consider reaching out for extra support. A mental health professional, such as a therapist or counselor, can help you identify techniques that will make this process easier for you, and help you make steady progress at your own pace.

Depression Has Stolen My Sense of Humor

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Of late, life has become pretty humorless. I don't find anything funny; on the contrary, I cringe at jokes that get laughs out of most people. If others' jokes have this effect, it's a given that I cannot see the funny side of things myself. And to think I used to be a mischievous twentysomething! Well, my grim outlook is more a result of depression than a side effect of growing up. 

Depression Makes Life Humorless and Colorless

When I say that depression makes life colorless, I mean that it prevents one from appreciating the good things in life. According to research conducted by OSU1, this is why "it isn't helpful to tell people with symptoms of depression or anxiety to simply be more grateful for the good things they have." In my case, depression makes me someone hard to amuse. And that is a shame because laughter has many health benefits, and I've found that it helps me forget all my worries and problems. When I'm laughing, my mind, body, and soul are at peace, albeit temporarily. Wan smiles and polite laughs don't do anything for me; only genuine laughter enables me to achieve this state. Unfortunately, it's been a while since I've had a good laugh. 

Humor Is an Effective Coping Mechanism for Depression

Many of us have heard of the adage 'laughter is the best medicine', and it seems we believe it. It's probably why according to research in the Journal of Psychiatric Research2, "adults with depression symptoms used more humor and sarcasm as a potential coping strategy during the Covid-19 pandemic. Humor use was greater in those with psychiatric disorders, perhaps due to self-preservation mechanisms during times of distress." What this suggests is that humor helps one to cope with depression. As long as one is not being self-deprecating, I think humor is highly effective in the war on depression. Not everyone has it, but as a quick Google search will reveal, there are many ways to improve your sense of humor. 

Laughter Will Reenter My Life 

I was born with a weird sense of humor, and depression cannot steal it from me forever. This isn't the first time it has disappeared, and I know it will come back to me. It always does; sometimes, it returns in full force, other times it is barely alive. But I know it will be a part of me again. All I can do till then is wait.



  1. Grabmeier, J. G. (2020, March 9). Gratitude interventions don’t help with depression, anxiety: Being grateful has benefits, but not for these issues. ScienceDaily.

  2. Rothermich, K. R., Ogunlana, A. O., & Jaworska, N. J. (2021, May 24). Change in humor and sarcasm use based on anxiety and depression symptom severity during the COVID-19 pandemic. Journal of Psychiatric Research.