How Can I Manage Social Anxiety? Three Tips From a Mount Sinai Psychologist

Aug 18, 2025 | Psychiatry, Your Health

Avoiding other people from time to time is normal. But if you isolate yourself out of fear of embarrassment or rejection, you may have social anxiety disorder.

Charissa Chamorro, PhD

In this Q&A, Charissa Chamorro, PhD, a Mount Sinai clinical psychologist, explains how to know if you might have social anxiety disorder and what you can do to be more confident around others.

“Treatment isn’t about getting rid of anxiety—it’s about learning you can feel anxious and still engage meaningfully. The more you approach instead of avoiding, the more confidence you build,” says Dr. Chamorro, Assistant Clinical Professor, Psychiatry, Icahn School of Medicine at Mount Sinai.

What is the difference between being shy and having social anxiety disorder?

Social anxiety disorder is a diagnosable mental health condition. Shyness is considered a personality trait that can be shaped by temperament and experiences. While shyness usually involves mild discomfort in social settings, social anxiety involves a persistent, intense fear of being judged, embarrassed, or rejected.

Unlike shyness, social anxiety interferes with your life. If you avoid situations you actually want to be part of or cancel plans because of discomfort, you may have social anxiety disorder.

What causes social anxiety disorder?

The causes are thought to be a combination of biological and environmental factors, but not necessarily due to bullying or poor parenting. Some people are more prone to anxiety, and experiences like negative social feedback can reinforce that.

What are signs I might have social anxiety disorder?

  • Avoiding social interactions: Not just avoiding parties, but isolating yourself at work or having a hard time starting conversations with co-workers.
  • Going blank in conversations: You may blame yourself—thinking, “Why can’t I think of something to say?”—but this can be part of your body’s fight, flight, or freeze response to anxiety.
  • Over-apologizing and deferring to others instead of stating your own preferences: People with social anxiety often seek social approval.
  • Rumination: Replaying past conversations, focusing on something you think went wrong, or feeling that you were really embarrassing. Thinking about social interactions is normal, but if it causes distress and is hard to control, you may have social anxiety.
  • Perfectionism: Feeling that you have to know the perfect thing to say before you can speak.
  • Hiding behind your phone in public: Not for work or enjoyment, but to avoid engaging with others.

How can I become more confident in social situations?

Here are three tips you might find useful:

  • Remind yourself that everyone feels awkward sometimes. That normalizes the experience and helps you feel less alone.
  • Vocalize your feelings. For example, if you’re giving a speech, you might say, “I’m feeling nervous because I really want this to go well.” Naming it can disarm others and help you feel more confident.
  • Reframing your thoughts can build confidence. Instead of telling yourself, “I’m so awkward,” tell yourself, “A part of me feels anxious, and that’s okay. I’m going to do my best.” Coaching yourself with more balanced, supportive thoughts can make a difference.

How can a mental health professional help me with social anxiety?

Social anxiety is highly treatable, and cognitive behavioral therapy (CBT) is the gold standard. CBT helps you identify thoughts contributing to anxiety and use cognitive restructuring to examine them.

How does a therapist use cognitive behavioral therapy to treat social anxiety?

I would ask you to recall positive social experiences to challenge self-critical thoughts, like “I can never connect with people.” Cognitive behavioral therapists work on helping you create more balanced thoughts—for example, “Sometimes I feel awkward, but I’ve also connected with others before.”

Therapists also assign gradual behavioral exposures—small tasks like ordering coffee and making eye contact with the cashier, then building up to things like attending a party. The goal is to break the cycle of avoidance and create opportunities to approach social situations.

Are there medications that treat social anxiety?

CBT is often very effective, but if symptoms remain or access is limited, medication may be a helpful additional support. Depending on how severe your anxiety is—especially if generalized anxiety is also present—we may refer you to a psychiatrist to discuss medication options.

What happens if I continue to avoid social situations?

Avoidance makes anxiety stronger. When you avoid a social situation, anxiety goes down short-term, but you don’t get the chance to learn that you can manage it.

Treatment isn’t about getting rid of anxiety—it’s about learning you can feel anxious and still engage meaningfully. The more you approach instead of avoiding, the more confidence you build.

Schedule an appointment with a Mount Sinai mental health professional

How Can I Create Healthier Phone Habits? Three Tips From a Mount Sinai Psychologist

Updated on Aug 13, 2025 | Psychiatry, Your Health

Phones have become a necessary part of life, but if you find yourself mindlessly scrolling or constantly reaching for your phone out of boredom, you may have a phone addiction.

“Addiction isn’t just about substances—it can also be behavioral,” says Naomi Dambreville, PhD, a licensed clinical child and adult psychologist at The Mount Sinai Hospital. “Phone addiction is compulsive and excessive phone use, feeling out of control, or distressed when away from your phone. If you feel withdrawal when not online or fear missing content, you may have a problem.”

Naomi Dambreville, PhD

In this Q&A, Dr. Dambreville, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, explains how to know if you might have an unhealthy relationship with your phone, and tips for using it in healthier ways.

What are some signs that I spend too much time on my phone or social media?
We live in a digital society and rely on phones for many everyday activities. It can be hard to realize phone use is a problem because it’s so convenient, but signs include:

  • Everything revolves around your phone. You shop, socialize, get news, and do almost everything through your phone—and rarely engage in real-life alternatives.
  • You have an automatic relationship with your phone. Every notification prompts an instant reaction, you check every direct message, constantly scroll, or have FOMO (fear of missing out)—especially if being offline makes you feel sad or out of the loop.
  • Trouble focusing. If you’re multitasking—watching TV and scrolling, talking to someone but still on your phone—or always reaching for your phone at work or in class.
  • Low tolerance for boredom. Your instinct is to grab your phone the moment you have nothing to do. Scrolling becomes a default time filler with no real purpose.
  • Physical symptoms—headaches, fatigue, sleep disruption, eye strain, and “digital thumb” (thumb, hand, or wrist pain from holding your phone for long periods).
  • Phone-related conflicts. Your phone causes conflicts in your relationships because your loved ones feel ignored.

How can I use my phone in healthier ways?

Here are three ways to create healthier phone habits:

  • Train your social media algorithms: Block unwanted content, use filters, and control what you see. Choose not to view certain images or videos.
  • Create rules around phone use. No phones at dinner, during conversations, or bedtime. For families, agree on time limits, app access, and talk about uncomfortable content.
  • Use the phone for connection, but notice when it causes discomfort. Align phone use with your values and make space for real-world experiences.

How does phone addiction, including doom scrolling, affect mental health?
Doom scrolling refers to consuming large amounts of news, often bad—for example, catastrophic storms, conflicts, or negative political content. We grab our phones to search for updates and end up exposed to real-time traumatic or distressing information.

This behavior becomes mindless. You might scroll to stay informed but end up feeling worse. Bad moods lead to more scrolling, which worsens the mood further. It affects attention, mood, self-esteem, and can trigger irritability, anxiety, or anger.

Do “digital detoxes” reduce phone addiction? How?
A digital detox helps reduce or stop phone use. It’s about breaking the cycle of compulsive use. Detoxing gives your mind and body a break and allows space to build new habits. Here’s how:

  • Start by building awareness. Notice what you use your phone for—shopping, paying bills, etc. Try doing some of those activities in real life. Spend an hour off your phone, and see how it feels.
  • Notice withdrawal reactions—thinking about your phone, missing notifications, or feeling uncomfortable without it. Use app limits and be intentional: “I’m checking my bank app” vs. “I ended up scrolling Instagram.”
  • Replace phone time with real-life activities—reading a book, joining a club, socializing in person, or trying a new hobby.

How can a mental health professional help?
People often seek help for anxiety, low self-esteem, or conflict—and phone use may be a factor. Therapists can help with behavior changes, digital detox plans, and social skills. They can also address phone-related issues like gambling, shopping, and excessive social media use, helping reduce dependency and improve well-being.

Schedule an appointment with a Mount Sinai mental health professional

Stories Behind the Science: Dennis S. Charney, MD, and Psychiatry

Updated on Jun 25, 2025 | Featured, Psychiatry, Research, School

Stories Behind the Science: Dennis S. Charney, MD, and Psychiatry

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, created a legacy by serving as Dean for 18 years—one of the longest tenures of any medical school dean in the United States. His research career has been just as illustrious over the decades.

Rooted in psychiatry, pharmacology, and neurobiology, Dr. Charney’s research has resulted in treatment breakthroughs for depression, enhanced medical and scientific understanding, and led to two U.S. Food and Drug Administration (FDA)-approved therapies. He has published more than 800 articles, which have been cited more than 198,000 times, according to Google Scholar, and was elected to the prestigious National Academy of Medicine in 2000.

To read more about Dr. Charney’s career timeline, click here

One of his biggest research milestones was discovering that ketamine can be used as a fast-acting antidepressant, offering a useful alternative for patients who do not respond well to conventional therapies. However, pursuing that discovery was not easy amid societal stigma at the time.

“We were looked at like we were pursuing a PCP study or something,” said Dr. Charney, referring to the recreational street drug. “But we knew we had something big on our hands. We were on the verge of discovering something that could change the lives of patients, and we were very motivated. We weren’t scared, and we went about doing it the right way.”

In addition to discovering the antidepressive effects of ketamine, Dr. Charney is known for his work on the science of resilience, and for his role in the first FDA-approved digital therapeutic for depression.

Read more below about the decades of Dr. Charney’s research efforts, and what it was like being at the frontier.

The Beginnings:
A Focus on Bringing
Bench to Bedside

A young Dr. Charney (right) with mentor and collaborator George Heninger, MD (left), photo taken in 1996.

In the early 1980s, working at the Yale School of Medicine in conjunction with the Connecticut Mental Health Center, Dr. Charney was focused on understanding the pathophysiology of serious forms of depression, along with panic and anxiety disorders and obsessive-compulsive disorder.

“We wanted to develop better treatments for these conditions,” said Dr. Charney.

At the time, the neurotransmitters serotonin and norepinephrine were known to be involved in some psychiatric conditions, and Dr. Charney and his team members were developing methods of examining those relationships closely.

“It’s fair to say we developed, at that time, more sophisticated ways of studying those neurotransmitters,” he said, adding, “although they’re probably not considered sophisticated today.”

Those efforts led to the study of yohimbine, an alkaloid of the bark of the yohimbe tree, which revealed that excessive norepinephrine function was involved in panic disorder and PTSD (Arch Gen Psychiatry, 1984, now JAMA Psychiatry).

“That study was a great example of a combination of going from the lab to studying patients,” he said.

While a number of serotonin and norepinephrine reuptake inhibitors were emerging at the time, Dr. Charney’s findings were showing that targeting these neurotransmitters alone were insufficient to move the needle on treating depression.

“However, I felt that just looking at serotonin and norepinephrine couldn’t tell us the whole story about depression,” said Dr. Charney.

Finding Alternatives: Ketamine and the Glutamate System

Starting in the late 1980s, the treatment of major depression moved toward using selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, there was still a notable proportion of patients for whom these drugs were not effective enough.

“In patients who were not doing better, we tried to augment the serotonin system,” said Dr. Charney. “It didn’t work.”

“With all the studies we’ve been doing in depression, we thought monoamines told only part of the story in depression,” he noted, referring to the class of neurotransmitters that includes dopamine, serotonin, and norepinephrine. “So we thought maybe there is another system that was, in part, regulated by the monoamines, but would be more fundamentally involved in depression.”

In the early 1990s, Dr. Charney and his collaborator at Yale, John H. Krystal, MD, began looking for a pathway affected by monoamine neurotransmitters, and through a logical progression of studies, focused on the glutamate system and, soon, on ketamine—an anesthetic with known effects on the glutamate system. This work yielded some of Dr. Charney’s top-cited papers (Arch Gen Psych, 1994).

In the mid-1990s, Drs. Charney and Krystal did a series of studies on ketamine, first on healthy volunteers and then a small trial on seven patients with major depressive disorder (MDD). The results were shocking.

“The patients got better in a few hours,” recalled Dr. Charney. “I was like, ‘Are you kidding me?’ As an investigator watching it, it was like a miracle.”

Dennis S. Charney, MD (right) with John H. Krystal, MD (left), being awarded the Colvin Prize at the Brain and Behavior Research Foundation Gala, November 2019.

Drs. Charney and Krystal published their findings (Biological Psychiatry, 2000), but faced skepticism from both the scientific and general communities. The study was dismissed as not being replicable, and additionally for the fact that the researchers were working with a compound that was stigmatized for its recreational use.

When Dr. Charney went to the National Institute of Mental Health (NIMH) in 2000, he sought to repeat history. “Nobody believed it, nobody was trying to replicate it, so we’re going to have to do it ourselves at NIMH,” he said. “In the second study, we replicated it dead on.”

At the end of his stint at NIMH in 2004, Dr. Charney brought his findings with him to the Mount Sinai School of Medicine (now the Icahn School of Medicine), where he began his career as Dean of Research.

Dr. Charney is a named co-inventor on patents filed by Mount Sinai relating to the use of ketamine for the treatment of treatment-resistant depression and suicidal ideation. Mount Sinai licensed those patents to Janssen Pharmaceuticals, Inc. for the development of SPRAVATO (esketamine) by Janssen, which received FDA approval in 2019. Its approval makes it the first antidepressant of its kind to target N-methyl-D-aspartate (NMDA) receptors—introducing the first new class of antidepressant drugs since the 1950s.

A Prescription for Resilience

In the 1990s, Dr. Charney turned his focus to studying trauma and PTSD, in collaboration with Steven M. Southwick, MD. That journey led to some of Dr. Charney’s most impactful work on understanding resilience.

“My buddy, Steve Southwick, was really involved in that work,” said Dr. Charney of his colleague, who passed away in 2022. “He’s on a lot of my papers, and he became my closest friend.” The ties between the two researchers dated back to before the 1980s.

Drs. Charney and Southwick tackled understanding PTSD from all angles—psychological, biological, social, pharmacological. Then, they had an idea to take their findings a step further to help patients.

“Back then, we thought, ‘If we studied people who were resilient—people who had been traumatized but didn’t develop PTSD—perhaps we could learn something from it, and apply those lessons to help patients with PTSD,” said Dr. Charney. “That’s how I ended up studying resilience for over 30 years.”

Dr. Charney’s paper on resilience (Am. J. Psychiatry, 2004) became one of his most cited works after his publications on ketamine in depression. He and Dr. Southwick then published a book called “Resilience: The Science of Mastering Life’s Greatest Challenges” (Cambridge University Press, 2012).

The book, now in its third edition, is rooted in the hundreds of interviews Drs. Charney and Southwick did with people who faced challenges in their lives—including prisoners of war and survivors of sexual and physical abuse. It includes a “prescription” for being resilient—10 steps that people can take to overcome life challenges.

From left to right, Dennis S. Charney, MD; Steven M. Southwick, MD; and John H. Krystal, MD.

“Not just for others—our research on resilience was also a personal journey,” said Dr. Charney. In 2016, Dr. Charney survived being shot, and he credits the lessons on resilience for overcoming that ordeal.

Those resilient factors also helped Dr. Charney navigate the stresses of the COVID-19 pandemic, and he established the Center for Stress, Resilience and Personal Growth in 2020 to extend that support to Mount Sinai staff.

Through Boldness,
a New Therapy Emerges

 

In 2024, the FDA approved a new class of treatments: digital therapeutics. In that class was REJOYN, a prescription smartphone app by Click Therapeutics and Otsuka Precision Health for major depressive disorder. That novel treatment had its beginnings through Dr. Charney’s research.

“This goes back to when we were interviewing prisoners of war who were subject to solitary confinement in Vietnam,” said Dr. Charney. “Some of them said that when they were in solitary, all they could do was think.”

A Life Magazine cover from 1967, featuring a prisoner of war from the Vietnam War, whom Drs. Charney and Southwick had interviewed as part of their research on resilience. That body of work eventually led to the development of Rejoyn, a digital app for treating depression.

Over time, some of those individuals reported developing cognitive capacities they never had before, such as being able to do complex multiplication with just their mind. “To me, that suggested evidence of neuroplasticity, where you can change the chemistry and circuits in your brain through repeated tasks,” said Dr. Charney.

With that inspiration, Dr. Charney pondered whether neuroplasticity could be tapped to “correct” the brain circuitry of patients with depression and improve their symptoms.

“We knew something about the circuits of depression that involved the prefrontal cortex and subcortical regions, like the amygdala. What if we developed a task that involved both of those regions?” he said.

Brian Iacoviello, PhD, Assistant Professor of Psychiatry at the Icahn School of Medicine, and Dr. Charney developed the Emotional Faces Memory Task and ran two randomized controlled studies. The findings (npj Digital Medicine, 2018) showed that patients who did the task repeatedly had improvements in their depression symptoms.

Drs. Charney and Iacoviello are co-inventors of patents filed by Mount Sinai for the Emotional Faces Memory Task intervention for the treatment of depression and related psychiatric disorders. Mount Sinai licensed the patents to Click Therapeutics, Inc. and Otsuka Precision Health for the development of REJOYN, a digital treatment for depression. REJOYN received FDA clearance in 2024, as the first prescription adjunctive treatment for adults with MDD.

“Like with ketamine for depression, I see going for a digital approach for depression as a story about being bold,” said Dr. Charney. “Each time, it was a realization that our current understanding isn’t enough, and it’s worth it to take a different approach.”

With more than 50 patents, and a slew of scientific achievements, what’s next for Dr. Charney? “Resilience will continue to inspire me after I step down as Dean,” he said.

Dr. Charney steps down as Dean from the Icahn School of Medicine on Monday, June 30, and Eric J. Nestler, MD, PhD, has been appointed Interim Dean.

“I’m going to need to figure out how to be inspired next. I’m going to continue my research in depression and resilience,” said Dr. Charney. One option that’s underway is working on the fourth edition of his book on resilience. But there might be other bold options out there too.

“I have two therapies on the market,” said Dr. Charney. “My goal is to discover a third. I’m not sure if anyone in psychiatry has ever done that.”

Five Ways to Help Reduce Everyday Stress

Updated on Apr 28, 2025 | Mental Health, Psychiatry, Your Health

Some stress is part of everyone’s life. But there are times when the daily demands of the job or school, the complications of home life, the pressure of living in the New York metropolitan area, and the state of the world can combine to leave you feeling physically and emotionally overwhelmed. As you face these stressful experiences, you may notice your sleep is disrupted or certain muscles in your body are more tense or find you are lacking energy or a sense of enthusiasm or confidence.

You know you need to do something. But what?

In this Q&A, Jacqueline Hargrove, PhD, a licensed clinical psychologist and Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, says you can start by  separating “stressors,” those things like multiple work deadlines, numerous familial responsibilities, or upsetting news events, from stress, which is your body’s understandable response to these stressors. Once you do that, she offers five tips on how to improve your mindset and increase your flexibility so you can begin to improve how you manage stress and get unstuck from cycles of chronic stress even while the stressors of life persist.

Get physical

The best way to deal with the stress is to do things that are physical. That helps break down those stress-related hormones that increase our heart rate and our breathing and get us ready for action—so that they don’t linger in the body. This can be a whole host of different things. Anything that literally just gets your heart rate going, or breathing deeply is fair game. Physical activity helps your body reach a calmer state. A lot of folks may not like going to the gym or going for a run. So, you can take a brisk walk through your closest park, or dance to a few of your favorite songs. Or just focus on deep breathing or breathing exercises.

Alternatively, you can connect with other people and soak up some physical affection. If you’ve ever come home from work and been greeted warmly by your partner, your child, or even a pet, you know how that can be comforting and stress reducing.  Even laughing and crying can be helpful, as many may know from having a good cry or experiencing a deep belly laugh. Afterwards, you feel better, because it’s a physical process that actually helps us release some of that stress and tension that can stay stuck in our bodies.

Figure out what you can control and what you can’t

A lot of the stressors we face today are out of our control. With this in mind, it’s important to understand whether a stressor you are facing is something you have some control over, and can problem solve, or not. If there is something, even a small thing, that you can do and is in your control that will help reduce or eliminate the stressor then absolutely do it.  However, if it’s something that’s more chronic or something that you don’t necessarily have control over, try to see what meaning you can gain from the experience, or try to ensure that you aren’t dealing with the challenge alone.  Many aspects of our day-to-day lives, such as work responsibilities or managing the care of a child or family member, can come with stress. But often it is the positive meaning we can associate with the purpose of our jobs or the people we love that can help us mitigate the stress associated with them. However, let’s say you are dealing with a stressor that is truly unpleasant and feels unbearable. Sometimes just shifting our expectations, or temporarily accepting the way things are in the moment, can actually reduce stress. This is because we are no longer fighting with what we are expecting of other people or with our desires for things to be a certain way that we really can’t control. This isn’t to say you should give up on getting your needs met or figuring out ways to address the stressor—certainly not. However, shifting our expectations or learning to accept the ways things are in the moment can get us out of a tug of war with the issue, can preserve our energy, and can actually give us space to face the issue with more clarity and creative problem-solving down the road.

Take stock of your environment and surroundings. It’s not necessarily all on you

Try to contextualize your stress. What I mean by that is, sometimes we can think we have a personal failing because we’re so stressed out. But if we just take a minute to step back, we realize there’s so much going on in our lives and it makes sense we feel stressed. Dealing with economic uncertainty or facing continually upsetting national and global news events is stressful. Being a caregiver to a child or family member can be an added level of stress that other people do not have to manage. Navigating your life as a person of color, an immigrant, a member of the LGBTQ community or a person living in an under-resourced neighborhood has its own stress due to discrimination or systemic barriers that disproportionately affect these communities. There are so many ways in which our identities and the roles we have can contribute to the stress that we experience. In this way, it can help to acknowledge how our identities and the environment we are in play a role in the day-to-day stress we experience. This can help us not be so self-critical and can also help us identify ways to manage that stress and find empowering ways to deal with the stressors.

Redefine productivity

In the United States, there is a common narrative that centers around always needing to be productive, and that is a culture that is ripe for stress. Productivity can simply mean intentionally working toward a meaningful goal. So, let’s say your goal is mental health and well-being, then rest can be a really productive thing that you’re doing in line with that goal. Making time for yourself can therefore be productive. Also, capitalize on idle time. This can include choosing to not do anything during those five minutes in between meetings. Or if you take public transit during your commute, maybe intentionally getting off one stop earlier and extending your walk home. Finding time when you don’t need to be engaging with your day-to-day stressors can be really important.

Learn to say no

Learn to say no to things and learn to set boundaries. A lot of our stress can come from sometimes feeling like we have to say yes, or put more and more on our plates, when it actually isn’t in our best interest to do so. If you’re saying yes to things, and you have the ability to say no, you can ask yourself: Is this benefitting me? Does engaging in this activity help me feel energized and excited? Or does it end up making me feel depleted and resentful? Take time to listen to your body, set some boundaries, and find ways to reclaim some of your time and energy.

Overall, it’s important to remember that stress, not chronic stress, is a part of life. However, we can learn ways to process the stress so it doesn’t build up in our bodies and develop effective ways to deal with life’s stressors that can help us feel more empowered and resilient.

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How to Deal With Stress and Anxiety During Challenging Times

Updated on Nov 7, 2024 | Psychiatry, Your Health

Life can get messy, and it’s natural to feel stressed out and anxious. Thankfully, there are many things you can do to alleviate those unsettling feelings.

“You might feel a sense of anxiety, dread, uncertainty, disillusionment, or a little bit of fear—all of those things make sense in times of stress, and all of those feelings are within the range of normal emotions,” says Jonathan DePierro, PhD, Associate Director of the Center for Stress, Resilience, and Personal Growth at Mount Sinai, which provides services that support the resilience and mental health of health care workers, first responders, and the general public.

Actions that help you feel better do not have to be big undertakings—you can begin with something as simple as a breathing exercise, says Dr. DePierro, who is also Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai.

For those who might feel overwhelmed when the going gets tough, Dr. DePierro shares some pointers on getting past those hurdles and being resilient.

First things first: Have self-compassion

Sometimes people kick themselves or blame themselves for having certain reactions, but those reactions make sense, and it is OK to be in those states.

“For example, today I am not feeling my best, and I may not feel my best tomorrow. I may not even feel my best next week,” says Dr. DePierro, “but cutting yourself a break and not expecting the best out of yourself or out of the people around you during trying times is a good way to start.”

It is important to take time to acknowledge and engage your feelings. Avoiding them isn’t going to make you feel better, he adds.

Jonathan Depierro, PhD, Associate Director of the Center for Stress, Resilience and Personal Growth, and Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai.

Don’t avoid doing things

Sometimes, when people get really stressed, they stop doing the things that make them feel less stressed because they don’t have the energy and don’t feel like it anymore, says Dr. DePierro.

“That is not great, because it cuts off that source of stress relief,” he notes. If you have routines to destress, like yoga, exercise, spiritual practices, hobbies, or hanging out with friends, it is even more important to do those things when you’re feeling demotivated.

“If you catch yourself not wanting to do them, do them anyway,” he says.

Not all relief has to involve big gestures—some can be quick and accessible, such as breathing exercises. A simple thing to try is “box breathing,” which involves taking a deep breath for four seconds, holding it in for four seconds, exhaling for four seconds, and then pausing for another four.

“The idea is that this can function as a reset button to our fight-or-flight response,” says Dr. DePierro. “This reminds your body that in this moment, you are safe. You might not know what will happen in the next week or 10 years from now, but right at this moment, you can remind yourself through changing your physiology that you are safe.”

Helping your friends helps yourself

Putting calendar reminders or alarms to do joyful things can be helpful, but so is telling a friend about your action plan.

“You might tell a friend, ‘Hey, I’m going to get on the bike at 2 pm, can I call you while I’m on the bike? Or can we do it together, either next to each other or virtually?’ and that can be really meaningful,” says Dr. DePierro. If both individuals are struggling, having each other for accountability helps pick both of you up.

You can start that by checking in on your friends, especially if you feel they might be going through similar stressors.

“It could be an unhappy face or waving hand emoji, and that initiates a conversation,” says Dr. DePierro. “It doesn’t have to be something elaborate.”

It requires a little bit of bravery and vulnerability to tell somebody you trust that you are suffering and not doing well, but if you do, they can try to understand what’s going on with you and support you, he adds.

Checking in on your friends is good for your friends, but it’s also good for you. Acting altruistically and offering support activates the positive emotion centers of our brain, notes Dr. DePierro. Sometimes, when people go through difficult times, they lose their sense of meaning and purpose, but it’s really important to recommit to one’s core values, and to align daily actions, even in very tiny ways, to those core values.

Use tools to place limits

It is very easy to “doomscroll” and be caught in a loop of negative news through social media and the internet.

There aren’t a lot of guardrails on some of these platforms, and strong emotions, misinformation, and conflicting information can come through unfiltered and unmoderated. “These can trigger a fight-or-flight response, enough to make the heart race and incite feelings of nausea or being tense,” says Dr. DePierro. These are not helpful states to be in, especially right before bed.

If you have to check the news or social media, don’t do it right before sleeping, and especially not while in bed, he points out. These can impact your quality of sleep.

Setting screen time limits can help too—just as a parent might set them for kids, adults can benefit from them, and nowadays there are built-in tools and applications that can help.

Part of why doomscrolling is bad is that the act is without intention and becomes a negative feedback loop, where the bad thing reinforces the bad. “It’s easy to keep scrolling and only see nothing good,” says Dr. DePierro. “In those instances, I might suggest a ‘palate cleanser’ instead on those platforms. Is there something you can watch that makes you feel good? Videos of puppies, perhaps? Or something inspiring.”

Being intentional about finding content that gives a sense of joy helps break the cycle of doomscrolling. Flagging, bookmarking, and favoriting those uplifting pieces of content so you can always return to them is helpful. “Think of it as a virtual shoebox of things that make you feel good, which you can use,” he adds.

Learn when to seek professional help

If the feelings of unease and anxiety persist for weeks or even months, or especially if they disrupt your daily life, it might be time to seek professional help. This could include a primary care provider or a therapist.

It’s important to note that a singular feeling, while distressing, does not necessarily indicate a psychiatric disorder. “Just feeling sad alone does not make a depressive episode, or having a bad memory does not make post-traumatic stress disorder,” says Dr. DePierro. It usually has to be a cluster of symptoms occurring over weeks to months for it to be considered a mental health disorder, and this is where professional help can make that determination, he says.

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Computational Psychiatry Postdoctoral Fellow Earns NIH Director’s Early Independence Award

Updated on Oct 28, 2024 | Featured, Psychiatry, Research

Cognitive scientist, computational neuroscientist, well-being researcher—it’s hard to choose only one label to describe Shawn Rhoads, PhD, who recently completed a postdoctoral research fellowship at the Center for Computational Psychiatry at the Mount Sinai Health System. But one title that sticks is recipient of the 2024 National Institute of Health (NIH) Director’s Early Independence Award. The prestigious award, part of the NIH’s High-Risk, High-Reward Research program, supports creative early-career scientists in launching independent research careers.

The award will support Dr. Rhoads as he launches his own lab at Mount Sinai, where he is transitioning to a faculty position as Assistant Professor of Psychiatry, Icahn School of Medicine at Mount Sinai. His research uses modern tools including neuroimaging and computational modeling to approach a modern—and growing—problem. “We’re in the midst of a loneliness epidemic,” Dr. Rhoads explains.

In 2023, the United States Surgeon General released a health advisory on social isolation, citing recent research that found half of U.S. adults report loneliness. Such social disconnection has been linked to a host of negative outcomes, including a greater risk of heart disease, dementia, depression, and early death.

Dr. Rhoads’s research aims to understand the cognitive and neural processes that drive social decision-making—work that could lead to interventions that boost social connection and improve well-being.

A New Way to Study Loneliness  

As an undergrad at the University of Southern California, Dr. Rhoads double majored in psychology and physics. “I was interested in physics as a potential research path, but it was missing that human element,” he says. Fortunately, he found the perfect marriage of his interests and talents in cognitive science and computational modeling. He went on to earn a PhD in the Laboratory on Social and Affective Neuroscience at Georgetown University.

In 2022, he joined Mount Sinai as a postdoctoral fellow in the lab of Xiaosi Gu, PhD, Director of the Center for Computational Psychiatry at the Mount Sinai Health System, and Associate Professor of Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai. It was a perfect fit. “Mount Sinai is one of the only places in the country with an integrated center using computational methods to better understand mental health,” he says.

Working with Dr. Gu, Dr. Rhoads set about designing a project to learn more about loneliness. One response to feeling lonely is to experience a craving or desire for social interaction. “We often think of craving as a negative thing, as in addiction,” he says. “But in this case, craving can be positive if it motivates us to go out into the world to seek connection.”

Some of Dr. Gu’s previous work explored craving in substance use disorders. Now, she and Dr. Rhoads are applying a similar framework to understand how social craving arises, and what happens when that process goes awry. Their model suggests that social craving changes in response to social cues, such as seeing a group of people having fun together. Such social cravings, they predict, are also influenced by expectations and experiences. What happens, for instance, if someone goes to a party expecting a fulfilling social interaction, but doesn’t end up connecting with anyone?

With support from the NIH award, he will use functional brain imaging to understand what happens in people’s brains when they experience social cravings and engage in social interactions. Ultimately, Dr. Rhoads hopes to determine whether those patterns of neural activity can predict negative mental health outcomes such as depression or anxiety.

Seeing Social Decision Making in Real Time

In another line of research, Dr. Rhoads is looking into the brain to see social decision-making in action. In collaboration with researchers, including Ignacio Saez, PhD, Associate Professor of Neuroscience, Neurosurgery, and Neurology, Icahn Mount Sinai, and leader of the invasive electrophysiology core at the Nash Family Center for Advanced Circuit Therapeutics at Mount Sinai, he is working with patients hospitalized while receiving 24/7 intracranial direct brain monitoring as part of their epilepsy treatment.

Dr. Rhoads designed a “gamified” cognitive task for two patients to play together. Each player can earn points working independently, but they have a better chance of high scores if they team up to work with one another. “In order to play together, you need to engage in higher-order social cognitive processes,” he says. For instance, the players have to think multiple steps into the future—not only about their own actions, but also about what they think their partner might do. “The player’s choices are contingent upon their beliefs about what the other person’s strategy is. If I go right, for example, I might assume you’ll go left,” he says.

This ability to consider another person’s mental state is known as theory of mind. By taking direct brain recordings while patients play the game, Dr. Rhoads and his colleagues can apply computational models to make predictions about the players’ beliefs and actions, and see how those predictions play out in the form of brain activity. By collecting brain recordings from two individuals as they interact, the researchers can see social learning and social decision-making in real time. “This is a dynamic system, with changing information as the two players adapt and make choices,” he says.

The ability to imagine another person’s thoughts and perspectives can be helpful, such as when two people are collaborating. But it can also go awry. A person with social anxiety, for example, might ruminate on what they think another person is thinking about them. A person with psychosis might have paranoia about other people being out to get them. “The idea is that we can adapt this model to examine when these cognitive processes can be maladaptive,” Dr. Rhoads says.

A Bright Future for Computational Psychiatry

Though Dr. Rhoads is launching his independent research career, he’s not interested in going it alone. He is eager to collaborate across disciplines, bringing together diverse tools and perspectives to answer questions with implications for individuals and for society.

Meanwhile, he hopes to make computational research accessible to more people. He’s co-director of the Summer Program in Computational Psychiatry Education (SPICE), a research program for high school and college students offered by the Center for Computational Psychiatry. He’s also helping to organize a computational psychiatry workshop for trainees of all levels.

“Computational psychiatry can seem like a daunting field to get into. But we need a diverse and well-represented future of researchers,” he says. “Making these tools more accessible will help us answer some big questions about social behavior and well-being.”

Learn more about the Center for Computational Psychiatry

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