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Mental health

Social anxiety – what it is and how to overcome it

By Mandana Ahmadi, founder and CEO of Alena



Mandana Ahmadi, founder and CEO of Alena
Have you ever experienced the flutter of butterflies in your stomach when approaching a conversation with someone? Have you found yourself debating whether to attend a party where everyone is unfamiliar? Have you ever felt profound regret over something you said, causing sleepless nights?

These are all telltale signs of social anxiety, a common yet often overlooked condition that quietly exerts control over our lives.

Left unaddressed, social anxiety can lead to significant comorbidities such as depression, substance abuse, and eating disorders. However, the good news is that social anxiety is highly treatable.

Social anxiety itself is not inherently negative; it serves as an essential function in creating effective societies where individuals care for one another and understand their place in the larger community. However, when social anxiety becomes impaired—whether excessive or lacking—it hinders our ability to tap into the resources that society offers.

This struggle often underlies the development of comorbidities: we feel down and spiral into depression when we can’t advance in our careers despite our potential and skills, we turn to drinking or comfort eating to soothe our anxiety, and the accumulated sleep debt harms our overall health.

By addressing the root cause, which can sometimes be social anxiety, we can reverse these negative patterns.

Social anxiety is influenced by various cognitive functions, which, when impaired, intensify social anxiety or drive it to suboptimal levels. Four major drivers include the rumination function, avoidance behaviour, accurate perception of others’ opinions, and attentional focus during social interactions.

Here at Alena this is our area of expertise, and the Alena app can help measure the health of these cognitive functions and provide scores, followed by cognitive behavioural therapies that target these specific areas. While there is no instant remedy for social anxiety, there are steps you can take.

The first step towards overcoming social anxiety is to recognise that it is a common and normal experience. Many people struggle with social anxiety, but it often remains misunderstood.

By acknowledging it, you are already on the path to overcoming it. Understand that your anxious feelings are more a product of how your brain processes information rather than an accurate reflection of how others perceive you.

When anxiety strikes, there is a tendency to want to escape, hide, or distract ourselves from the discomfort. Instead, allow yourself to experience those feelings and focus on calming your body through slow breathing techniques commonly used in meditation.

By slowing down, you can help your body break free from the fight-or-flight response. Shift your attention away from your inner thoughts and redirect it towards the external world. This can be done by immersing yourself in the sounds around you or paying close attention to the visual details in your surroundings.

You will notice a sense of relief as your attention releases from the internal spiral, leading to a lighter and less tense state.

Next, try to imagine yourself in the shoes of someone you love who is going through a similar situation. Consider how you would talk to them and evaluate the seriousness of the situation if it involved them.

By adopting an external perspective, you distance yourself from your own anxious thoughts and gain a more objective view of reality. This helps to ground you in the present moment.

Lastly, the most effective way to overcome social anxiety is through exposure to small social events and gradually increasing your comfort zone.

Often, you will realise that nothing catastrophic happens, challenging the belief that social situations are as major and terrifying as they may seem. By incrementally expanding your social experiences, you will build confidence and realize that you can handle them.

Remember, you are not alone, and overcoming social anxiety takes time and effort. With the right support, strategies, and a gradual approach, you can regain control of your life and thrive in social situations. 


Mandana Ahmadi is the founder and CEO of Alena. Mandana is dedicated to tackling the world’s mental health crisis, starting first with social anxiety. She has worked with the International Brain Laboratory, and achieved her PhD in computational neuroscience from UCL Gatsby. 

Mental health

Eight steps for coping with a chronic illness diagnosis

By Dr Becky Spelman, psychologist and founder at Private Therapy Clinic



A chronic illness diagnosis can disrupt every aspect of someone’s life.

Emotionally, a diagnosis may cause fear, anxiety, sadness, and frustration. Physically, it can lead to changes in a person’s daily routine, limitations in activities and the need for ongoing medical assistance.

Socially, it may result in isolation, as the person may feel misunderstood or unable to take part in certain activities. Financially, the cost of treatments and medications can add additional stress to individuals and families.

Increasingly, younger women are being diagnosed with long-term conditions, such as chronic fatigue syndrome, endometriosis and autoimmune diseases, which occur far more in women than men.

Coping with the psychological effects of a chronic illness, however, is just as important as managing the physical symptoms. Here, we explore some healthy ways that may help.

Knowledge is power

Take some time to research your condition, its symptoms and treatment options. You can ask your medical provider to provide you with the relevant information and head to reputable websites such as the NHS website. Understanding your chronic illness can help you to alleviate anxiety and gain a sense of control

Be kind to yourself

It is essential to show yourself kindness and compassion when you’re living with a chronic illness. Know that it is okay to have bad days and that you are doing your best. Make time for self-care activities, rest when you can and be patient with yourself as you adjust to your new reality.

Surround yourself with support

You don’t have to go through this alone. Call on trusted friends, families or a therapist who can provide you with emotional support at this time. Tell them about the diagnosis and any worries you have, it can be therapeutic to express your emotions to others.

Make time for self-care

Self-care, such as exercise or mindfulness, can help you to cope with a chronic illness by promoting emotional wellbeing, reducing stress and providing a sense of control and empowerment.

Try journaling 

Journaling is a great way to acknowledge and process the emotions surrounding your diagnosis. It can help to prevent them from becoming overwhelming and impacting your mental health.

Manage your expectations

You may have to alter your goals and manage your expectations after being diagnosed with a chronic illness, and these should align with your capabilities and limitations.

Accept that some tasks may take longer to complete, and celebrate every achievement along the way. This will help you to stay motivated as you navigate life after a diagnosis.

Seek therapy 

Therapy can be immensely beneficial for someone coping with a chronic illness diagnosis. A therapist can provide a supportive and non-judgmental space for you to process your emotions, fears and anxieties related to the condition.

They can also offer coping strategies, tools and techniques and diagnose any underlying mental health concerns that may arise, such as depression or anxiety and provide further guidance.

Stay positive 

A positive mindset, including focusing on gratitude, can also help to enhance your overall mental health and quality of life.

The diagnosis of a chronic illness can profoundly impact a person’s life. Regularly utilising strategies to navigate the emotional journey of living with a chronic illness can significantly improve a person’s life.

Dr Becky Spelman is a psychologist and founder of Private Therapy Clinic. 

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Mental health

Women on the pill less likely to report depression, study shows

A new study has shown the prevalence of major depression amongst pill users was significantly lower



Women taking the oral contraceptive pill are less likely to report depression, researchers have found.

The research, which analysed data from 6,239 US women aged 18-55 years old, found that the prevalence of major depression amongst users of the oral contraceptive pill (OCP) was significantly lower, at 4.6 per cent, compared to former OCP users (11.4 per cent).

The study,  published in the Journal of Affective Disorders, was led by researchers at Anglia Ruskin University (ARU), alongside experts from the Dana-Farber Cancer Institute in Boston and University of California, Davis.

The researchers have suggested two possible explanations for their findings, which are contrary to a commonly held belief that OCP can cause depression.

One is that taking the pill can remove concerns about unwanted pregnancy, therefore helping to improve the mental health of OCP users.

It is also possible the results could be influenced by “survivor bias”, where women who experience signs of depression while using OCP stop taking it, moving them into the category of former users.

Contraception is a crucial component of preventive health care,” said lead author, Dr Julia Gawronska, postdoctoral research fellow at Anglia Ruskin University.

“Most women tolerate taking the oral contraceptive pill without experiencing depressive symptoms but there is a subset of women that may experience adverse mood side effects and even develop depression, and the reasons are not entirely clear.

“Unlike some previous studies, we found that women currently taking the oral contraceptive pill were much less likely to report clinically relevant depression compared to women who previously took the pill.”

She added: “Taking the pill could provide positive mental health benefits for some women, simply by removing their concerns about becoming pregnant. The ‘survivor effect’ could also play a part, with women who experience symptoms of depression more likely to discontinue taking it, placing them into the group of former users.

“However, stopping taking the pill without a suitable alternative increases the risk of unintended pregnancy.

“It is important that women are fully supported, provided with full information, and offered alternative forms of contraception if necessary.”

The cross-sectional study used data collected by the Center for Disease Control and Prevention in the US.

In both users and former users, researchers found that widowed, divorced or separated women, obese women or those with a history of cancer were more likely to report depression.

In former users, depression was more commonly reported in Black or Hispanic women, smokers and those with lower levels of education or experiencing poverty.

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Maternal depressive symptoms could start in early pregnancy, study finds

Maternal depression can negatively affect a child’s nutrition, physical health, cognitive functions and socioemotional development



Maternal depressive symptoms could begin from early pregnancy and last up to two years after childbirth, a large-scale international study has shown.

While health professionals often emphasise the postpartum stage after childbirth as a high-risk period for the onset of depression, this latest research has found that maternal depressive symptoms can appear from early pregnancy.

The study, led by researchers from A*STAR’s Translational Neuroscience Programme of the Singapore Institute for Clinical Sciences (SICS) in Singapore, involved seven prospective observational cohorts across the UK, Canada and Singapore.

The researchers analysed the maternal depressive symptom trajectories of 11,563 pregnant women, spanning multiple decades in the largest such analysis to date. Each cohort included depressive symptoms measured at multiple perinatal time points and analysed independently.

The data was based on prospective maternal self-reports of depressive symptoms, eliminating the potential bias collected from retrospective reports.

The study showed three distinct clusters of mothers with stable low, mild, and high symptom levels over the perinatal period – the period from the beginning of pregnancy up to two years post-birth. The trajectories of depressive symptoms were present for all mothers.

This was true even in the case of those who met clinical cut-offs for probable depression indicating that more serious instances of depression in women begin prior to the birth of the child.

“Several recent studies, including one conducted locally suggest that maternal depressive symptoms may begin before conception, which is why interventions, guidelines for care, and public health policies aimed at alleviating maternal depressive symptoms should target as early as preconception, at least during pregnancy, in addition to the postnatal period, for more effective outcomes,” explained Dr Michelle Kee, research scientist at A*STAR’s SICS and first author of the paper.

Professor Michael Meaney, the director of the translational neuroscience programme at SICS, said: “The medical media continues to refer to maternal depression as ‘postnatal depression’, implying that the onset of symptoms occurs following the birth of the child.

“This extensive analysis shows that the onset of symptoms is in the prenatal period and remains largely stable thereafter. This is true for women in the community as well as for those experiencing more severe symptom levels.”

He added: “The results of this study point to the early antenatal period as a crucial time point for the identification of stable trajectories of maternal depressive symptoms and emphasises the critical importance of prenatal intervention.”

Associate Professor Helen Chen, senior consultant, department of psychological medicine at the KK Women’s and Children’s Hospital, said: “This study provides strong evidence across populations that it is crucial to address depression during pregnancy so that mothers are well and ready to receive their babies, rather than to wait until the postnatal period, for postnatal depression has traditionally been the focus.

“Given what we know about the impact of perinatal depression on child development and health outcomes, the paper will help to inform healthcare systems to direct resources upstream to the antenatal period.

“This will benefit our mothers and their children, and population health of future generations.”

Previous findings from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) project showed that prenatal maternal mental health plays a significant role in the brain development and health of babies.

Research found that maternal depressive symptoms can negatively affect a child’s nutrition, physical health, cognitive functions, socioemotional development and academic achievement, in some cases increasing the risk of ADHD and depression.

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